Community Preparedness Section (MC 1926), Texas Department of State Health Services, PO Box 149347, Austin, TX 78714-9347, USA.
Disaster Med Public Health Prep. 2011 Mar;5(1):23-8. doi: 10.1001/dmp.2011.8.
On September 13, 2008, Hurricane Ike, a category 2 storm with maximum sustained winds of 110 mph, made landfall near Galveston, Texas. Ike produced a damaging, destructive, and deadly storm surge across the upper Texas and southwestern Louisiana coasts. Thirty-four Texas counties were declared disaster areas by the Federal Emergency Management Agency; 15 counties were under mandatory evacuation orders. To describe causes of death associated with this hurricane and identify prevention strategies during the response and recovery phases, the Texas Department of State Health Services (DSHS) monitored mortality data in 44 counties throughout the state. This report summarizes Ike-related deaths reported by Texas medical examiners, justices of the peace (coroners), forensic centers, public health officials, and hospitals.
Based on the Centers for Disease Control and Prevention (CDC) disaster-related mortality surveillance form, DSHS developed a state-specific 1-page form and collected (optimally daily) data on demographic, date and place of death, and cause and circumstance of deaths. A case was defined as any death that was directly or indirectly related to Ike among evacuees, residents, nonresidents, or rescue personnel in the declared disaster counties, counties along the Texas Gulf coast or counties known to have evacuation shelters occurring September 8, 2008, through October 13, 2008. Analyzed data were shared with the state emergency operation center and the CDC on a daily basis.
The surveillance identified 74 deaths in Texas as directly (10 [14%]), indirectly (49 [66%]), or possibly (15 [20%]) related to Ike. The majority of deaths (n=57) were reported by medical examiners. Deaths occurred in 16 counties of the 44 counties covered by the surveillance. The majority of deaths occurred in Harris and Galveston (28 [38%] and 17 [23%]), respectively. The deceased ranged in age from younger than 1 year to 85 years, with an average age of 46 years (median 50 years); 70% were male. Of the 74 deaths, 47 (64%) resulted from injuries, 23 (31%) from illnesses, and 4 (5%) were undetermined. Among the injuries, carbon monoxide poisoning (13 [18%]) and drowning (8 [11%]) were the leading causes of injury-related deaths. Cardiovascular failure (12 [16%]) was the leading cause of illness-related deaths.
Defining the relation of death to hurricane using an active mortality surveillance system is possible. The active mortality surveillance form used in Ike provided valuable daily information to DSHS, state emergency management officials, and the CDC regarding the characteristics of deaths in the state. Most of the Ike-related deaths were caused by injury (direct and indirectly related) such as carbon monoxide poisonings and drowning and may have been preventable by educating the public.
2008 年 9 月 13 日，二级风暴“艾克”（Ike）以每小时 110 英里的最高持续风速登陆德克萨斯州加尔维斯顿附近。“艾克”在得克萨斯州北部和德克萨斯州西南部路易斯安那州沿海地区引发了破坏性、毁灭性和致命的风暴潮。34 个德克萨斯州的县被联邦紧急事务管理局宣布为灾区；15 个县下达了强制疏散令。为了描述与这场飓风有关的死亡原因，并在应对和恢复阶段确定预防策略，德克萨斯州卫生服务部（DSHS）在全州 44 个县监测了死亡率数据。本报告总结了德克萨斯州法医、治安法官（验尸官）、法医中心、公共卫生官员和医院报告的与“艾克”有关的死亡事件。
根据疾病控制与预防中心（CDC）的灾害相关死亡率监测表，DSHS 制定了一份特定于该州的 1 页表格，并收集了（最好每天）关于人口统计学、死亡日期和地点、死因和死亡情况的数据。在宣布的灾区、德克萨斯州墨西哥湾沿岸各县或已知有疏散避难所的各县（2008 年 9 月 8 日至 10 月 13 日）的居民、非居民或救援人员中，任何直接或间接与“艾克”有关的死亡都被定义为病例，其中包括撤离人员、受灾人员。分析后的数据每天都与州应急行动中心和疾病预防控制中心共享。
该监测系统共确定了 74 名在德克萨斯州直接（10 人[14%]）、间接（49 人[66%]）或可能（15 人[20%]）与“艾克”有关的死亡事件。大多数死亡病例（n=57）是由法医报告的。在被监测的 44 个县中，有 16 个县报告了死亡事件。大多数死亡发生在哈里斯县和加尔维斯顿县（分别为 28 人和 17 人）。死者年龄从 1 岁以下到 85 岁不等，平均年龄为 46 岁（中位数为 50 岁）；70%是男性。在这 74 例死亡中，47 例（64%）是由损伤引起的，23 例（31%）是由疾病引起的，4 例（5%）原因不明。在损伤中，一氧化碳中毒（13 例[18%]）和溺水（8 例[11%]）是导致与损伤相关的死亡的主要原因。心血管衰竭（12 例[16%]）是与疾病相关的死亡的主要原因。
使用主动死亡率监测系统来定义与飓风有关的死亡是可能的。“艾克”飓风使用的主动死亡率监测表为 DSHS、州应急管理官员和疾病预防控制中心提供了宝贵的每日信息，了解该州的死亡特征。与“艾克”有关的大多数死亡都是由伤害（直接和间接）引起的，如一氧化碳中毒和溺水，通过教育公众，这些伤害可能是可以预防的。
