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Hurricanes MGuide

The impact of the 2005 Atlantic hurricane season and the resulting death, injury, destruction, and population displacement were unprecedented in U.S. history. During 2005, 15 tropical storms became hurricanes. For the first time, four major hurricanes made landfall in the United States; three of those reached Category 5 intensity.

The worst effects were felt from Hurricanes Katrina and Rita. On August 29, Hurricane Katrina struck the U.S. Gulf Coast, causing severe damage from a two-story storm surge, powerful winds, and heavy rains. Approximately 80% of New Orleans was flooded after the surge from the Gulf of Mexico forced breaks in a levee, releasing water from Lake Pontchartrain into the city. Katrina became the deadliest U.S. hurricane since 1928 and likely the costliest natural disaster on record in the United States.

On September 24, response and recovery activities in the wake of Katrina were interrupted when Hurricane Rita struck the Gulf Coast. Rita rendered more homes uninhabitable and thousands more seeking shelter elsewhere. More than 200,000 persons were displaced by the hurricanes and dispersed to evacuee shelters in 18 states. The economic and health consequences of Hurricanes Katrina and Rita extended far beyond the Gulf region and ultimately affected states and communities throughout the United States.

CDC, along with other disaster-relief agencies, provided emergency services after Hurricanes Katrina and Rita and dispatched teams to conduct surveillance of illness and injury and rapid assessments of the needs among residents and shelter evacuees. MMWR devoted two special issues (January 20, 2006 and March 10, 2006) to the public health response by CDC and others. Reports from those issues and other issues of MMWR regarding public health responses to hurricanes in 2005 and in earlier years are offered at the following links to provide emergency responders and health-care providers with an updated hurricane resource.


Summary of Notifiable Diseases — United States, 2005 3/30/2008
The Summary of Notifiable Diseases — United States, 2005 contains the official statistics, in tabular and graphic form, for the reported occurrence of nationally notifiable infectious diseases in the United States for 2005. These statistics are collected and compiled from reports sent by state health departments to the National Notifiable Diseases Surveillance System (NNDSS), which is operated by CDC in collaboration with the Council of State and Territorial Epidemiologists (CSTE).
Morbidity Surveillance After Hurricane Katrina --- Arkansas, Louisiana, Mississippi, and Texas, September 2005 7/07/2006
After Hurricane Katrina made landfall on the U.S. Gulf Coast in August 2005, public health responders worked to identify and prevent hurricane-related morbidity and mortality among affected populations. This report summarizes the challenges of conducting national surveillance after Hurricane Katrina.
Mold Prevention Strategies and Possible Health Effects in the Aftermath of Hurricanes and Major Floods 6/09/2006
This report provides information on how to limit exposure to mold and how to identify and prevent mold-related health effects after major floods and hurricanes. Information is provided regarding assessing exposure, clean-up and prevention, personal protective equipment, health effects, and public health strategies and recommendations. The recommendations assume that, in the aftermath of hurricanes or major floods, buildings wet for >48 hours will generally support visible and extensive mold growth and should be remediated, and excessive exposure to mold-contaminated materials can cause adverse health effects in susceptible persons regardless of the type of mold or the extent of contamination. To prevent exposure that could result in adverse health effects from disturbed mold, persons should 1) avoid areas where mold contamination is obvious; 2) use environmental controls; 3) use personal protective equipment; and 4) keep hands, skin, and clothing clean and free from mold-contaminated dust.
Health Hazard Evaluation of Police Officers and Firefighters After Hurricane Katrina --- New Orleans, Louisiana, October 17--28 and November 30--December 5, 2005 4/28/2006
Summarizes the results of a health hazard evaluation of local police officers and firefighters after Hurricane Katrina. The evaluation determined that upper respiratory and skin rash symptoms were the most common physical symptoms reported and lacerations and sprains were the most common injuries. In addition, approximately one third of the respondents reported either depressive symptoms or symptoms of posttraumatic stress disorder, or both. These results underscore the need to incorporate the safety and health of emergency responders into existing disaster preparedness plans and to provide periodic responder training and education in tasks unique to disaster situations. Clinical follow-up of the physical and psychological health of emergency responders should be conducted to better understand, monitor, and treat their health conditions.
Rapid Needs Assessment of Two Rural Communities After Hurricane Wilma --- Hendry County, Florida, November 1--2, 2005 4/21/2006
Describes a rapid needs assessment of communities most affected by Hurricane Wilma. The assessment determined that approximately one third of households also had been affected by at least one other hurricane that preceded Wilma during 2004 and 2005. More than half of the households surveyed lived in homes that were damaged but still habitable, and 10% of households in one subdivision reported their homes as uninhabitable; approximately 73% of households had not received information about how to remain safe during clean-up activities. Results of the assessment were immediately provided to local and state authorities for allocation of resources to help these communities recover from the hurricane.
Tuberculosis Control Activities After Hurricane Katrina --- New Orleans, Louisiana, 2005 3/31/2006
Updates previous information and summarizes tuberculosis (TB) cases reported as of December 31, 2005, among persons undergoing TB treatment in the New Orleans area when Hurricane Katrina made landfall and among persons who were evacuated and subsequently received a diagnosis of TB in other parts of the country. By October 13, 2005, all 130 TB patients from the New Orleans area had been located and, if still indicated, had resumed TB treatment. As a result of heightened public health surveillance among Hurricane Katrina evacuees, six other New Orleans evacuees began treatment (i.e., two persons with known TB and four with previously undiagnosed TB) after arriving in other states. The success of these post-disaster TB control measures affirms the utility of alternative data sources during health-related emergencies and the importance of maintaining a strong TB control component in the public health sector.
Public Health Response to Hurricanes Katrina and Rita — United States, 2005 3/10/2006
On August 29, 2005, Hurricane Katrina struck the Gulf Coast, the eye making landfall at Plaquemines Parish, Louisiana. The events that followed made Katrina the deadliest hurricane since 1928 and likely the costliest natural disaster on record in the United States. The disaster was compounded when Hurricane Rita made landfall 26 days later near the Texas-Louisiana border, forcing cessation of hurricane response activities in New Orleans and evacuation of coastal regions of Louisiana and Texas. The first issue, published January 20, 2006, focused on public health activities in Louisiana. This second issue focuses on activities in other states directly or indirectly affected by the two hurricanes.
Surveillance for Illness and Injury After Hurricane Katrina --- Three Counties, Mississippi, September 5--October 11, 2005 3/10/2006
In Mississippi, the storm surge from Hurricane Katrina was an estimated 27 feet high at the Hancock County Emergency Operations Center and extended inland for 6–12 miles. The devastation was greatest in the coastal counties of Hancock, Harrison, and Jackson, where public infrastructure was severely disrupted. Multiple hospitals, health clinics, and public health facilities were either destroyed or nonfunctioning immediately after the hurricane. The Mississippi Department of Health (MDH) asked CDC to help conduct active surveillance at hospital emergency departments, federal Disaster Medical Assistance Team operation sites, and outpatient health-care facilities in Hancock, Harrison, and Jackson counties. On September 4, a team of 17 CDC staff members was deployed to Mississippi to work with MDH and an Epi Strike Team from the Florida Department of Health to provide surveillance for injury and illness. This report describes those activities and their findings
Illness Surveillance and Rapid Needs Assessment Among Hurricane Katrina Evacuees --- Colorado, September 1--23, 2005 3/10/2006
After Hurricane Katrina struck the Gulf Coast, 200,000 evacuees were sent to shelters in 18 states, including Colorado, which had 3,600 evacuees registered at the former Lowry Air Force Base, with an average of 400 in residence per day. In all, an estimated 6,000 evacuees were living throughout Colorado in the weeks after Hurricane Katrina. As a result of this influx, the Colorado Department of Public Health and Environment Tri-County Health Department established surveillance systems to provide early detection of outbreaks and determine the scope of medical conditions of evacuees. A rapid needs assessment also was conducted to assess acute medical and other needs of evacuees. Results indicated that many evacuees had chronic conditions and approximately half planned to remain in the area. The most common acute symptoms were related to altitude sickness, requiring education of incoming Gulf Coast evacuees regarding the effects of the mile-high altitude in Denver.
Rapid Community Needs Assessment After Hurricane Katrina --- Hancock County, Mississippi, September 14--15, 2005 3/10/2006
On August 29, 2005, Hurricane Katrina moved northeast from Louisiana and made its second landfall over Hancock County, Mississippi. Katrina ravaged the Mississippi coast, leaving thousands of residents without shelter, food, water, utilities, and access to health care. To obtain information about the effects of the hurricane on residents in Hancock County, the Mississippi Department of Health asked CDC to conduct a rapid community needs assessment in what was presumed to be the state’s most severely affected county. The objectives of the assessment were to 1) identify the public health needs of the community and 2) estimate the effect of the hurricane on households to assist response and recovery activities. This report describes the results of that assessment, which indicated that more than one third of the homes had been destroyed, many in the area lacked critical household services and remained dependent on relief agencies, and some were in need of health services such as medical care and prescription refills.
Mortality Associated with Hurricane Katrina --- Florida and Alabama, August--October 2005 3/10/2006
On August 25, 2005, Hurricane Katrina made landfall between Hallandale Beach and Aventura, Florida, as a Category 1 hurricane, with sustained winds of 80 mph. Storm effects, primarily rain, flooding, and high winds, were substantial; certain areas reported nearly 12 inches of rainfall. After crossing southern Florida and entering the Gulf of Mexico, the hurricane strengthened and made landfall on August 29 as a Category 3 hurricane in southeastern Louisiana. Katrina was one of the strongest hurricanes to strike the United States during the past 100 years and was likely the nation’s costliest natural disaster to date. This report summarizes findings and recommendations from a review of mortality records of Florida’s Medical Examiners Commission (FMEC) and the Alabama Department of Forensic Science (ADFS). CDC was invited by Florida Department of Health (FDOH) and Alabama Department of Public Health (ADPH) to assess the mortality related to Hurricane Katrina. The mortality review was to provide county-based information that would be used to 1) define the impact of the hurricane, 2) describe the etiology of deaths, and 3) identify strategies to prevent or reduce future hurricane-related mortality. Information from the characterization of these deaths will be used to reduce hurricane-related mortality through early community awareness of hurricane-related risk, prevention measures, and effective communication of a coordinated hurricane response plan.
Carbon Monoxide Poisonings After Two Major Hurricanes --- Alabama and Texas, 2005 3/10/2006
Hurricanes Katrina and Rita struck the U.S. Gulf Coast on August 29, 2005, and September 24, 2005, respectively, causing widespread damage and leaving approximately 4 million households without electrical power. Multiple carbon monoxide (CO) poisonings were reported in coastal states after these hurricanes. The Alabama Department of Public Health and the Texas Department of State Health Services asked CDC to help investigate the extent and causes of these hurricane-related CO poisonings. The investigation identified 27 CO poisoning incidents resulting in 78 nonfatal poisonings and 10 deaths in hurricane-affected counties in Alabama and Texas, nearly all of which were caused by gasoline-powered generators. To prevent future CO poisonings during power outages, CDC continues to recommend that generators be placed far from homes, away from window air conditioners, and that CO detectors be used by all households operating gasoline-powered appliances, with batteries replaced yearly.
Rapid Assessment of Health Needs and Resettlement Plans Among Hurricane Katrina Evacuees --- San Antonio, Texas, September 2005 3/10/2006
On September 3, 2005, approximately 12,700 evacuees from regions affected by Hurricane Katrina arrived in San Antonio, Texas and were housed in four primary evacuation centers. To assess evacuee needs for clinical care, public health services, and housing assistance, the San Antonio Metropolitan Health District requested CDC assistance to conduct a needs assessment of heads of households in the evacuation centers. This report summarizes the findings of the assessment, which identified substantial numbers of evacuees with chronic health conditions, physical or mental disabilities, and needs for counseling and housing assistance.
Public Health Response to Hurricanes Katrina and Rita --- Louisiana, 2005 1/20/2006
On August 29, 2005, Hurricane Katrina struck the Gulf Coast near the Louisiana-Mississippi border as a category 3 hurricane. The effect of earlier category 5 wind speeds on Gulf waters and the massive size of the storm created devastating storm-surge conditions for coastal Mississippi, Louisiana, and Alabama and caused damage as far east as the Florida panhandle. Storm-induced breeches in the New Orleans levee system resulted in catastrophic flooding of approximately 80% of that city. Hurricane Katrina was the deadliest hurricane to strike the United States since 1928. Preliminary mortality reports indicated approximately 1,000 Katrina-related deaths in Louisiana, 200 in Mississippi, and 20 in Florida, Alabama, and Georgia. MMWR is highlighting the public health response to Hurricanes Katrina and Rita with two special issues. This issue focuses on public health activities in Louisiana 1--2 months after Hurricane Katrina, during which time local authorities reopened portions of New Orleans and the pre-disaster population began to return.
Two Cases of Toxigenic Vibrio cholerae O1 Infection After Hurricanes Katrina and Rita --- Louisiana, October 2005 1/20/2006
Louisiana was struck by Hurricane Katrina on August 29, 2005, and by Hurricane Rita on September 24, 2005. The two hurricanes caused unprecedented damage from wind and storm surge and levee breaks resulted in disastrous flooding. With the flooding, an immediate public health concern was the potential for outbreaks of infectious diseases, including cholera. This report describes the investigation by the Louisiana Office of Public Health and CDC into two cases of toxigenic V. cholerae O1 infection attributed to consumption of undercooked or contaminated seafood. Although noncholeragenic Vibrio illnesses were reported in 22 residents of Louisiana and Mississippi after Hurricane Katrina, no epidemic of cholera was identified, and no evidence exists of increased risk to Gulf Coast residents.
Surveillance in Hurricane Evacuation Centers --- Louisiana, September--October 2005 1/20/2006
Before the arrival of Katrina, New Orleans and surrounding parishes were under a mandatory evacuation order. Because of this order and subsequent flooding, approximately 400,000 residents became displaced. The Louisiana Department of Health and Hospitals recognized the need for communicable disease surveillance in evacuation centers. On September 8, 2005, statewide daily syndromic surveillance for communicable diseases was begun. In addition to collecting and analyzing data on communicable disease syndromes, data were collected on chronic medical conditions, injuries, and mental health conditions. This report summarizes the development and implementation of this surveillance system.
Injury and Illness Surveillance in Hospitals and Acute-Care Facilities After Hurricanes Katrina and Rita --- New Orleans Area, Louisiana, September 25--October 15, 2005 1/20/2006
In response to Hurricane Katrina, CDC and the Louisiana Department of Health and Hospitals implemented active surveillance on September 9, 2005, to monitor for injuries and illnesses at functioning hospitals and other acute-care facilities in the greater New Orleans area. On September 20, the system was interrupted because of mandatory evacuation for Hurricane Rita. Surveillance was reestablished on September 24, and repopulation of Orleans Parish began on September 30. This report updates a previous report on injuries and illness surveillance during September 8--25, 2005, describing events during the days after Hurricane Rita, when repopulation began. Results indicated that 17,446 visits occurred at participating facilities during this period. The proportion of relief workers with acute respiratory illnesses and unintentional injuries was higher compared with residents, but the proportion of falls and motor-vehicle crashes among relief workers was lower.
Assessment of Health-Related Needs After Hurricanes Katrina and Rita --- Orleans and Jefferson Parishes, New Orleans Area, Louisiana, October 17--22, 2005 1/20/2006
Seven weeks after Hurricane Katrina struck the New Orleans area, causing levees to break and large sections of the city to flood, local authorities had reopened most of Jefferson Parish and much of Orleans Parish to residents. To identify health-related needs among returning parish residents, state and local public health and mental health agencies and CDC conducted an assessment. This report describes the results of that assessment, which determined that 20.2% of housing units still lacked water, and 24.5% had no electricity. In addition, 49.8% of adults had levels of emotional distress that indicated a potential need for mental health services. As a result of these findings, the Louisiana Office of Mental Health established a crisis-counseling program to provide interventions and support to hurricane survivors.
Health Concerns Associated with Mold in Water-Damaged Homes After Hurricanes Katrina and Rita --- New Orleans Area, Louisiana, October 2005 1/20/2006
After Hurricanes Katrina and Rita made landfall, large sections of New Orleans and three surrounding parishes were flooded for weeks, leading to extensive mold growth in residences. As residents reoccupied the city, local health-care providers and public health authorities were concerned about the potential for respiratory health effects from exposure to water-damaged homes. On October 6, 2005, CDC was invited by the Louisiana Department of Health and Hospitals to assist in documenting potential exposures. This report summarizes the results of that investigation, which determined that 46% of inspected homes had visible mold growth and that residents and remediation workers did not consistently use appropriate respiratory protection.
Norovirus Outbreak Among Evacuees from Hurricane Katrina --- Houston, Texas, September 2005 10/14/2005
Surveillance for Illness and Injury After Hurricane Katrina --- New Orleans, Louisiana, September 8--25, 2005 10/14/2005
Carbon Monoxide Poisoning After Hurricane Katrina --- Alabama, Louisiana, and Mississippi, August--September 2005 10/07/2005
Infectious Disease and Dermatologic Conditions in Evacuees and Rescue Workers After Hurricane Katrina --- Multiple States, August--September, 2005 9/30/2005
Vibrio Illnesses After Hurricane Katrina --- Multiple States, August--September 2005 9/23/2005
Hurricane Katrina Response and Guidance for Health-Care Providers, Relief Workers, and Shelter Operators 9/09/2005
Epidemiologic Assessment of the Impact of Four Hurricanes---Florida, 2004 7/22/2005
Carbon Monoxide Poisoning from Hurricane-Associated Use of Portable Generators---Florida, 2004  7/22/2005
Preliminary Medical Examiner Reports of Mortality Associated with Hurricane Charley --- Florida, 2004 9/17/2004
Brief Report: Acute Illness from Dry Ice Exposure During Hurricane Ivan --- Alabama, 2004 12/24/2004
Rapid Assessment of the Needs and Health Status of Older Adults After Hurricane Charley — Charlotte, DeSoto, and Hardee Counties, Florida, August 27–31, 2004 9/17/2004
Rapid Community Health and Needs Assessments After Hurricanes Isabel and Charley --- North Carolina, 2003—2004 9/17/2004
Tropical Storm Allison Rapid Needs Assessment --- Houston, Texas, June 2001 5/03/2002
Morbidity and Mortality Associated with Hurricane Floyd --- North Carolina, September--October 1999 5/05/2000
Needs Assessment Following Hurricane Georges -- Dominican Republic, 1998 2/12/1999
Deaths Associated with Hurricanes Marilyn and Opal -- United States, September-October 1995 1/19/1996
Surveillance for Injuries and Illnesses and Rapid Health-Needs Assessment Following Hurricanes Marilyn and Opal, September-October 1995 2/2/1996
Comprehensive Assessment of Health Needs 2 Months After Hurricane Andrew -- Dade County, Florida, 1992 6/11/1993
Emergency Mosquito Control Associated with Hurricane Andrew -- Florida and Louisiana, 1992 4/09/1993
Injuries and Illnesses Related to Hurricane Andrew -- Louisiana, 1992 4/09/1993
Rapid Health Needs Assessment Following Hurricane Andrew -- Florida and Louisiana, 1992 9/18/1992
Epidemiologic Notes and Reports Surveillance of Shelters after Hurricane Hugo -- Puerto Rico 1/26/1990

CDC Guidance for Shelter Operators, Health-Care Providers, and Relief Workers

To help medical and relief workers respond safely and effectively in the aftermath of Hurricane Katrina, CDC has compiled a set of resource guides. These guides include information on such topics as infectious diseases, sanitation and hygiene, wound care, management of acute diarrhea, interim immunization recommendations for relief workers and displaced persons, vaccine storage, electrical safety, injury prevention, and disaster mental health resources. MMWR will continue to provide additional guidance on this site as the emergency response to Hurricane Katrina progresses.




Safer, Healthier People

Morbidity and Mortality Weekly Report
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