Plague, fever, and deadly illness have, er, plagued humankind since the beginning of recorded history. From the Biblical plagues to the 1918 influenza outbreak, from the Black Death to Bird Flu, humans have had to deal with some pretty nasty microorganisms eating us alive. In 1918, up to 100 million people died due to the flu (dubbed the "Spanish Flu" because wartime press wouldn't cover the outbreak anywhere but in Spain). The H1N1 virus that caused the Spanish Flu originated as an avian disease which mutated and became infectious to humans.  The Black Death, conventionally thought to have been bubonic plague caused by the fleas from rats (Yersinia pestis), has recently been the subject of some controversy regarding its microbiology, but what is known is that it killed somewhere between a third to two-thirds of Europe's population within a few short years. Smallpox, a disease currently considered wiped out by modern medicine, is the most likely culprit for the deaths of over eighty million Native North and South Americans after the arrival of Columbus and the beginning of European exploration of the New World.

Not for nothing are scientists and politicians scrambling madly right now to find ways to combat Avian Flu (H5N1) before human-to-human transmissions begin to spread. The word "pandemic" is very close to "pandemonium" and right now, both mean death on such a scale that humans have never seen. Plus, there's always the zombies. Very contagious, zombies. So it would pay to have a few tips in mind for surviving a potential medical disaster.

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If a pandemic is headed your way, you should actually be glad. It hasn't reached you yet. This is a much better situation to be in than surrounded by the undead who've got an urge to pass it along. If you can, isolate yourself and your household. Stock up on non-perishables, as recommended in our last article, and if possible, secure your water supply. This will be problematic depending on where you live. Those of you on well water are going to be in a much better position than those of us using the municipal pipes, especially in the worst case scenario. Fortunately, water filtration kits are easy to come by, hiking supply stores carry drop-in purification tablets, bottled water is all the rage these days, large sediment can be filtered out by coffee filters, and when it comes to plumbing, the toilet doesn't care if the water is contaminated by zombie germs anyway.

If you can't isolate yourself (work, school, that pesky having-a-life problem) then take steps to protect yourself. Don't share drinks. Wash your hands frequently, especially right before you eat. When you're in a public place touching common surfaces, take a moment and use some hand sanitizer every so often. Get out of the habit of touching your face. Don't touch dead animals if you can help it, and use gloves if you can't. You don't have to seal yourself in a bubble but you can minimize your contact with germs, especially when you know something nasty is on the way.

In the best case scenario, the pandemic will be identified quickly and contained, the infected patients will be taken to hospitals and quarantined, and life as you know it will continue to go on more or less the same. In the world of the zombie plague, this is unlikely to be the case, what with the health workers all becoming undead and hungry, so you might be called on to treat your otherwise medically-urgent problems at home.

Every house, plague-contained or not, should have basic first aid and medical supplies. If you don't, think of this as the perfect time to get yourself to the nearest camping store and pick one up. Maybe one for the car too, since if you're driving hellbound on the freeway, dodging the undead, you really don't want to have to nip back home to get your kit to reattach your own slightly-nibbled foot. Your first aid supplies should contain (but are no means limited to): bandages of various sizes, including joint bandages; gauze with tape; scissors to cut the tape and/or cut off clothing over a wound; non-latex gloves; antiseptic wipes, cream and/or sanitizer; tweezers; instant cold packs; a thermal blanket; a card with emergency numbers, physician contact and health insurance information; a fever-reducing medicine appropriate for each age group in your household (ibuprofen is standard); pain relievers as can be tolerated by household members; backup scrips and supplies for any daily needed medication (such as insulin); topical anesthetic for mouth pain, preferably one that can double in an emergency; allergy creams and/or pills for after-exposure treatments; stomach medicine that can treat diarrhea and vomiting. You probably have some of these things on hand already. Be sure to check expiration dates regularly and dispose of old meds carefully.

Learn basic first aid. Learn how to bandage a cut, how to properly ice a contusion (first clue: don't put ice directly on it --- use the cold packs), how to identify when skilled intervention is required. Classes should be available locally; I had mine at the fire station. Your job may offer first aid training; take the day and avail yourself. If the grid is up, you can always consult the Internet (someplace reliable like WebMD). If it's not, you'll have to rely on your own know-how. (Though to be fair, if the grid is down and we don't have Internet access anymore, most of fandom will have already declared it the end of the world and gone off to sit catatonic in the corner waiting for a page to load that never will again.)

You'll need to find out what the initial symptoms are of the pandemic in your area in order to figure out if yourself or a loved one is infected. For example, do you feel a sudden, strong urge to feast on the flesh and/or brains of your fellow humans? Have you been bitten recently by a rather grey-faced passerby? Then you are probably going to become a zombie and walk the world in your shambling undead quest for cannibalistic nummies. You should sequester yourself from your friends and family as rapidly as possible, or at least make sure they're well-marinated in your favorite sauce. If a loved one has begun a quest to gnaw on flesh (Vampirism counts! Don't let the fancy clothes and cool accents fool you!) then you probably have an undead infestation on your hands. Other pandemics will have their own initial symptoms, and you should follow the news to see what to look out for, as well as suggestions for initial treatment. Bird flu, for example, is unlike vampirism in that the old cross-and-garlic trick is unlikely to be effective.

Again, if the medical personnel in your area are already toast, you're going to have to rely on your own abilities in order for you and yours to survive. First question: what's the mortality rate for the pandemic? If someone in your household is infected, is your best bet to nurse her/him through, just keep her/him comfortable, or quarantine her/him from everyone as soon as possible? Your goal is survival, and while taking care of a sick loved one is a noble cause, if it means the deaths of everyone else in your home, you've got a hard decision to make, and probably not a lot of time to make it. When it comes to the undead, go for the removal of the head. It is the kindest and most effective route, generally speaking, and will prevent recurrence or transmission of the disease. Smallpox victims and other more typical plague sufferers will require a different approach.

Influenza is a killer even today due to dehydration, shock, and secondary infections, especially in the very young or the immuno-compromised. Make sure among your supplies that you keep on hand copious amounts of liquids with electrolytes (Gatorade, Pedialyte, etc) in order to replace lost fluids and electrolytes from patients with diarrhea and nausea. Keep simple foods such as rice, bread, applesauce and (when available) bananas to maintain nutrition for patients who have trouble keeping other foods down. Your tins of Spam will have to wait until the patient can digest them; in the case of zombies, Spam may do as a human substitute should you decide to wait out the course of the infection.

Be ready, willing and able to relocate should the quarantine come and not catch you in its net, or if rioting mobs of zombies are heading for your house. Have a "jump bag" ready. A good resource for what should go into your jump bag can be found here. (If you're not willing to go whole-hog with a jump kit, consider packing an overnight bag and keeping it in the closet in case of an unexpected trip.) Jump bags are important if you have to land somewhere for a long time, say a six-month quarantine of your hometown. Copies of important documents will help to ease the transition between locations, and a change of clothes is always nice; one does not want to smell like the zombies while fleeing them. When readying jump supplies, don't forget your pets. A copy of Fluffy's rabies shot records and a small pack of nibbles for the trip will help your faithful companion stay with you along the way. (Your tropical fish are probably out of luck. Sorry.) The thing to remember about relocation is that your house or apartment is not nearly as important as your life. It won't do you any good to drop dead in your own house of Bird Flu if you could have lived by walking ten miles north.

Keep an eye on the news. Much of it will be sensational, like the SARS outbreak, or the recent hand foot and mouth disease (EV71) coverage from China. Bird flu is the big worry, with its 70-90% mortality rate among humans, though again, human to human transmission is still in the very early stages. Watch for death tolls. Watch for disease to come out of areas of catastrophe, such as the cyclone or earthquake, and consider making a small donation to the relief workers helping to minimize that risk. Keep an eye on your local cemeteries: flooded, they bring disease; disturbed, they bring undead. Get acquainted with your neighbors and find out if the group of you can survive a quarantine together. Sign up for that first aid course and restock your first aid kit. Pack your overnight bag. Sharpen your ax.

*sneeze*

Oh, and don't forget the tissues!