Hurricane Season Public Health Preparedness, Response, and Recovery Guidance for Health Care Providers, Response and Recovery Workers, and Affected Communities — CDC, 2017

On September 13, 2017, this report was posted online as an MMWR Early Release.

CDC 2017 Hurricane Incident Management System Team¹ (View author affiliations)

CDC and the Agency for Toxic Substances and Disease Registry (ATSDR) have guidance and technical materials available in both English and Spanish to help communities prepare for hurricanes and floods (Table 1). To help protect the health and safety of the public, responders, and clean-up workers during response and recovery operations from hurricanes and floods, CDC and ATSDR have developed public health guidance and other resources; many are available in both English and Spanish (Table 2).

Hurricane Harvey made landfall on the Texas coast on August 25, 2017, as a Category 4 storm. In southeast Texas, record rainfall caused extensive flooding and damage to public infrastructure and communities, and displaced thousands of persons. As of September 12, 2017, the media have reported >80 storm-related deaths attributed to Hurricane Harvey (medical examiner confirmation is pending for some deaths). Most of these deaths likely were caused by drowning in flood waters within the first few days after impact (e.g., drowning at home or in vehicles).

On September 7, 2017, a Category 5 hurricane, Irma, reached the Lesser Antilles, including the U.S. territories of Puerto Rico and the Virgin Islands. Hurricane Irma then continued its path across the Greater Antilles and made landfall in south Florida on September 10, 2017. Irma’s hurricane-force winds and related storm surges caused substantial damage in the Caribbean and Florida.

Many areas in Texas, Louisiana, Florida, Georgia, and the U.S. territories affected by these storms are still experiencing disruptions in essential services, including electricity, potable water, food, and communications. Numerous health care and public health systems sustained damage. Environmental health impacts from the hurricanes included effects on industries, chemical plants, and hazardous waste sites. Many displaced persons remain in shelters or other temporary housing.

As part of the overall U.S. Department of Health and Human Services response and recovery operations, CDC and ATSDR are supporting public health and medical care functions for affected communities and persons displaced by the hurricanes. As of September 12, 2017, CDC and ATSDR had sent pharmacy and federal medical station supplies to Texas, Louisiana, and Florida. CDC and ATSDR have also activated and deployed members of the U.S. Public Health Service Commissioned Corps and other personnel to provide technical support for critical public health functions. Field operations and the CDC and ATSDR Emergency Operations Center are supporting mortality and morbidity surveillance; public health messaging and risk communication; water, sanitation, safety, and facility assessments; community rapid needs assessments; mold abatement; industrial and residential contaminant exposure prevention; and vector control.

There are potential public health and safety concerns after hurricane impact. Many injuries and illnesses from hurricanes and floods occur during the response and recovery phases. Common hazards include vehicle- and nonvehicle-related drowning, carbon monoxide poisoning (e.g., from any gasoline-powered engine, including generators and clean-up equipment), electrocution, falls, lacerations, and exposure to mold and industrial and household chemicals (1–8). In addition, exacerbation of existing chronic conditions and development of acute mental health symptoms are frequent reasons for seeking health care services following a disaster (9–11). Guidance and other resources to assist in addressing many of these hazards and risk are available (Table 2).

CDC and ATSDR also offer a disaster response clinical consultation service to assist health care providers, public health professionals, and emergency response partners. This service can be accessed by emailing CDC IMS Clinical Inquiries at eocevent168@cdc.gov.

For additional assistance, health care providers, public health professionals, and members of the public can also use CDC and ATSDR’s information service, CDC-INFO. Live agents provide up-to-date science-based health information. CDC-INFO can be reached Monday through Friday from 8:00 a.m. to 8:00 p.m. Eastern Time at 1–800-CDC-INFO (1–800–232–4636) or by submitting a web-based form (https://wwwn.cdc.gov/dcs/ContactUs/Form). Services are available in English and Spanish.

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Corresponding author: CDC Joint Information Center Administrator, eocjicad@cdc.gov.

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¹Emergency Operations Center, CDC.

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References

1. Brandt M, Brown C, Burkhart J, et al. Mold prevention strategies and possible health effects in the aftermath of hurricanes and major floods. MMWR Recomm Rep 2006;55(No. RR–8). PubMed
2. CDC. Deaths associated with Hurricane Sandy—October–November 2012. MMWR Morb Mortal Wkly Rep 2013;62:393–7. PubMed
3. Johanning E, Auger P, Morey PR, Yang CS, Olmsted E. Review of health hazards and prevention measures for response and recovery workers and volunteers after natural disasters, flooding, and water damage: mold and dampness. Environ Health Prev Med 2014;19:93–9. CrossRef PubMed
4. Kim S, Kulkarni PA, Rajan M, et al. Hurricane Sandy (New Jersey): mortality rates in the following month and quarter. Am J Public Health 2017;107:1304–7. CrossRef PubMed
5. Marshall EG, Lu SE, Shi Z, Swerdel J, Borjan M, Lumia ME. Work-related unintentional injuries associated with Hurricane Sandy in New Jersey. Disaster Med Public Health Prep 2016;10:394–404. CrossRef PubMed
6. Ragan P, Schulte J, Nelson SJ, Jones KT. Mortality surveillance: 2004 to 2005 Florida hurricane-related deaths. Am J Forensic Med Pathol 2008;29:148–53. CrossRef PubMed
7. Sengul H, Santella N, Steinberg LJ, Cruz AM. Analysis of hazardous material releases due to natural hazards in the United States. Disasters 2012;36:723–43. CrossRef PubMed
8. Wang A, Issa A, Bayleyegn T, et al. ; Hurricane Matthew Incident Management System Team, CDC Emergency Operations Center. Notes from the field: mortality associated with Hurricane Matthew—United States, October 2016. MMWR Morb Mortal Wkly Rep 2017;66:145–6. CrossRef PubMed
9. Bell SA, Abir M, Choi H, Cooke C, Iwashyna T. All-cause hospital admissions among older adults after a natural disaster. Ann Emerg Med . Epub August 5, 2017. PubMed
10. Noe RS, Schnall AH, Wolkin AF, et al. Disaster-related injuries and illnesses treated by American Red Cross disaster health services during Hurricanes Gustav and Ike. South Med J 2013;106:102–8. CrossRef PubMed
11. Schwartz RM, Gillezeau CN, Liu B, Lieberman-Cribbin W, Taioli E. Longitudinal impact of Hurricane Sandy exposure on mental health symptoms. Int J Environ Res Public Health 2017;14:957. CrossRef PubMed

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TABLE 1. English and Spanish community guidance for preparing for hurricanes and floods — CDC, 2017

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TABLE 2. English and Spanish guidance for response and recovery from hurricanes and floods, by primary target audience — CDC, 2017

* Information on this webpage is available in 11 different languages.
^† Currently not available in Spanish.
^§ This fact sheet is available in six additional languages, available at https://www.cdc.gov/co/factsheets.htm.

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