Skip directly to search Skip directly to A to Z list Skip directly to page options Skip directly to site content

Notes from the Field: Mortality Associated with Hurricane Matthew — United States, October 2016

Please note: An erratum has been published for this report. To view the erratum, please click here.

Alice Wang, PhD1,2; Anindita Issa, MD1,2; Tesfaye Bayleyegn, MD2; Rebecca S. Noe, MPH2; Christine Mullarkey3; Julie Casani, MD3; Craig L. Nelson, MD4; Aaron Fleischauer, PhD3,5; Kimberly D. Clement, MPH3; Janet J. Hamilton, MPH6; Christopher Harrison, MPH7; Laura Edison, DVM5,7; Kathrin Hobron, MPH8; Katie M. Kurkjian, DVM5,8; Ekta Choudhary, PhD2; Amy Wolkin, DrPH2; Hurricane Matthew Incident Management System Team, CDC Emergency Operations Center (View author affiliations)

View suggested citation

After 3 days as a Category 3 and 4 hurricane in Haiti and Bahamas, Hurricane Matthew moved along the coast of the southeastern United States during October 6−8, 2016 (1). Early on October 8, the storm made landfall southeast of McClellanville, South Carolina, as a Category 1 hurricane with sustained winds of approximately 75 mph, leading to massive coastal and inland flooding, particularly in North Carolina and South Carolina (2). Florida, Georgia, North Carolina, South Carolina, and Virginia made major disaster declarations; approximately 2 million persons were under evacuation orders in Florida, Georgia, North Carolina, and South Carolina (3). In response to the hurricane, CDC activated the Emergency Operations Center Incident Management System, tracked online media reports of Hurricane Matthew–associated deaths, and contacted states for confirmation of deaths. This report summarizes state-confirmed Hurricane Matthew–associated deaths that occurred during October 1−October 21 in Florida, Georgia, North Carolina, and South Carolina.

Forty-three hurricane-associated deaths were reported in four states; the median decedent age was 58 years (range = 9–92 years) (Table). Drowning was the most common cause of death, accounting for 23 (54%) deaths. Among all deaths, 26 (60%) occurred in North Carolina; 18 (69%) of these were drowning deaths associated with a motor vehicle. Twelve deaths occurred in Florida, including five that resulted from injuries during prestorm preparation or poststorm cleanup (e.g., a fall from a ladder or roof). A child’s death in Florida resulted from carbon monoxide poisoning related to indoor generator use.

Despite public health warnings to avoid flood waters, among all 23 hurricane-related drownings, 18 deaths (78%) occurred in motor vehicles (e.g., vehicle driven into standing water, vehicle swept away by water, or person found in car). As little as 6 inches of water might result in loss of control of a vehicle, and 2 feet of water can carry most cars away (4). An evaluation of public health messages to drivers about avoiding flood waters might inform future prevention measures. Evaluation of the public’s reception and response to those messages, as well as an assessment of ascertainment of child deaths in disaster settings, might inform future prevention measures. Mortality surveillance after disasters plays a critical role in evaluating the causes, manners, and circumstances of deaths, and data can be used to guide prevention messages during the response and recovery period and to prevent deaths during future public health emergencies (5).



Brett Lycett, Florida Department of Law Enforcement; Renée Funk; Miguel Cruz; Josephine Malilay; Hurricane Matthew Incident Management System Team, CDC Emergency Operations Center; Lorrie Backer, Division of Environmental Hazards and Health Effects, National Center for Environmental Health, CDC.


Corresponding author: Alice Wang,, 770-488-3411.


1Epidemic Intelligence Service, CDC; 2Division of Environmental Hazards and Health Effects, National Center for Environmental Health, CDC; 3North Carolina Department of Health and Human Services; 4North Carolina Office of the Chief Medical Examiner; 5Career Epidemiology Field Officer Program, CDC; 6Florida Department of Health; 7Georgia Department of Public Health; 8Virginia Department of Health.



  1. National Oceanic and Atmospheric Administration. Hurricane Matthew. Discussion number 26. Washington DC: US Department of Commerce, National Oceanic and Atmospheric Administration, National Hurricane Center; 2016.
  2. The Weather Channel. Hurricane Matthew recap: destruction from the Caribbean to the United States. Atlanta, GA: The Weather Company; 2016.
  3. Federal Emergency Management Agency. Hurricane Matthew. Washington DC: US Department of Homeland Security, Federal Emergency Management Agency; 2016.
  4. CDC. Driving through water after a disaster. Atlanta, GA: US Department of Health and Human Services, CDC; 2012.
  5. CDC. Preliminary medical examiner reports of mortality associated with Hurricane Charley—Florida, 2004. MMWR Morb Mortal Wkly Rep 2004;53:835–7. PubMed


Return to your place in the textTABLE. Characteristics of reported deaths related to Hurricane Matthew for all deaths including drowning — North Carolina, Florida, Georgia, and Virginia, October 2016
CharacteristicNorth Carolina (n = 26) No. (%)*Florida (n = 12) No. (%)Georgia (n = 3) No. (%)Virginia (n = 2) No. (%)Total (n = 43) No. (%)
Male18 (69)9 (75)3 (100)2 (100)32 (74)
Female8 (31)3 (25)0011 (26)
Age group (yrs)
≤1701 (8)001 (2)
18–6414 (54)5 (42)2 (67)2 (100)23 (54
≥6511 (42)6 (50)1 (33)018 (42)
Unknown1 (4)0001 (2)
Cause of death
Drowning22 (85)001 (50)23 (54)
Trauma2 (8)8 (67)3 (100)1 (50)14 (33)
Exacerbation of condition1 (4)1 (8)002 (5)
Electrocution02 (17)002 (5)
CO poisoning01 (8)001 (2)
Fire1 (4)0001 (2)
Directly related mechanism of death§
Vehicle drowning18 (69)00018 (42)
Non-vehicle drowning4 (15)0005 (12)
Tree-related trauma1 (4)2 (17)2 (67)05 (12)
Indirectly related mechanism of death§
Vehicle crash injury1 (4)1 (8)1 (33)1 (50)4 (9)
Preparation/repair injury05 (42)005 (12)
Electrocution02 (17)002 (5)
Medical exacerbation1 (4)1 (8)002 (5)
CO poisoning01 (8)001 (2)
Fire1 (4)0001 (2)

Abbreviation: CO = carbon monoxide.
* Percentages might not sum to 100% because of rounding.
Exacerbation of a person’s preexisting medical condition because of storm-related power failure.
§ A direct death is defined as a death caused by environmental forces of the hurricane and direct consequences of these forces, whereas an indirect death is caused by unsafe or unhealthy conditions as a result of loss/disruption of usual services, personal loss, or lifestyle disruption.


Suggested citation for this article: Wang A, Issa A, Bayleyegn T, et al. Notes from the Field. Mortality Associated with Hurricane Matthew — United States, October 2016. MMWR Morb Mortal Wkly Rep 2017;66:145–146. DOI:

Use of trade names and commercial sources is for identification only and does not imply endorsement by the U.S. Department of Health and Human Services.
References to non-CDC sites on the Internet are provided as a service to MMWR readers and do not constitute or imply endorsement of these organizations or their programs by CDC or the U.S. Department of Health and Human Services. CDC is not responsible for the content of pages found at these sites. URL addresses listed in MMWR were current as of the date of publication.

All HTML versions of MMWR articles are generated from final proofs through an automated process. This conversion might result in character translation or format errors in the HTML version. Users are referred to the electronic PDF version ( and/or the original MMWR paper copy for printable versions of official text, figures, and tables.

Questions or messages regarding errors in formatting should be addressed to