Prehospital and Disaster Medicine

Special Report

Evaluation of Active Mortality Surveillance System Data for Monitoring Hurricane-Related Deaths—Texas, 2008

Ekta Choudharya1 c1, David F. Zanea2, Crystal Beasleya3, Russell Jonesa4, Araceli Reya5, Rebecca S. Noea1, Colleen Martina1, Amy F. Wolkina1 and Tesfaye M. Bayleyegna1

a1 Division of Environmental Hazards and Health Effects, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia USA

a2 Community Preparedness Section, Texas Department of State Health Services, Austin, Texas USA

a3 Clinical Management, Pharmaceutical Product Development, Austin, Texas USA (formerly affiliated with the Environmental Epidemiology and Disease Registries Section, Texas Department of State Health Services, Austin, Texas USA)

a4 Community Preparedness Section, Texas Department of State Health Services, Health Service Region 7, Temple, Texas USA

a5 Office of Public Health Preparedness and Response, Centers for Disease Control and Prevention, Career Epidemiology Field Officer assigned to Texas Department of State Health Services, Austin, Texas USA

Abstract

Introduction The Texas Department of State Health Services (DSHS) implemented an active mortality surveillance system to enumerate and characterize hurricane-related deaths during Hurricane Ike in 2008. This surveillance system used established guidelines and case definitions to categorize deaths as directly, indirectly, and possibly related to Hurricane Ike.

Objective The objective of this study was to evaluate Texas DSHS' active mortality surveillance system using US Centers for Disease Control and Prevention's (CDC) surveillance system evaluation guidelines.

Methods Using CDC's Updated Guidelines for Surveillance System Evaluation, the active mortality surveillance system of the Texas DSHS was evaluated. Data from the active mortality surveillance system were compared with Texas vital statistics data for the same time period to estimate the completeness of reported disaster-related deaths.

Results From September 8 through October 13, 2008, medical examiners (MEs) and Justices of the Peace (JPs) in 44 affected counties reported deaths daily by using a one-page, standardized mortality form. The active mortality surveillance system identified 74 hurricane-related deaths, whereas a review of vital statistics data revealed only four deaths that were hurricane-related. The average time of reporting a death by active mortality surveillance and vital statistics was 14 days and 16 days, respectively.

Conclusions Texas's active mortality surveillance system successfully identified hurricane-related deaths. Evaluation of the active mortality surveillance system suggested that it is necessary to collect detailed and representative mortality data during a hurricane because vital statistics do not capture sufficient information to identify whether deaths are hurricane-related. The results from this evaluation will help improve active mortality surveillance during hurricanes which, in turn, will enhance preparedness and response plans and identify public health interventions to reduce future hurricane-related mortality rates.

Choudhary E, Zane DF, Beasley C, Jones R, Rey A, Noe RS, Martin C, Wolkin AF, Bayleyegn TM. Evaluation of active mortality surveillance system data for monitoring hurricane-related deaths, Texas, 2008. Prehosp Disaster Med. 2012;27(4):1-6.

(Received June 28 2011)

(Accepted July 12 2011)

(Revised September 20 2011)

(Online publication July 17 2012)

Correspondence:

c1 Correspondence: Ekta Choudhary, PhD, MPH Division of Environmental Hazards and Health Effects National Center for Environmental Health Centers for Disease Control and Prevention 4770 Buford Highway, NE MS F-57 Chamblee, GA 30341 USA E-mail echoudhary@cdc.gov