Evaluation of active mortality surveillance system data for monitoring hurricane-related deaths-Texas, 2008.
BACKGROUND
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.
Division of Environmental Hazards and Health Effects, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia 30341, USA. echoudhary@cdc.gov
Ekta
E
Choudhary
David F
DF
Zane
Crystal
C
Beasley
Russell
R
Jones
Araceli
A
Rey
Rebecca S
RS
Noe
Colleen
C
Martin
Amy F
AF
Wolkin
Tesfaye M
TM
Bayleyegn
D000059:Accidents / Q000401:mortality; D002423:Cause of Death; D055867:Cyclonic Storms / Q000401:mortality*; D005260:Female; D017408:Guidelines as Topic; D006801:Humans; D008297:Male; D011159:Population Surveillance; D011634:Public Health / Q000379:methods; D013781:Texas / Q000453:epidemiology; D014798:Vital Statistics; D014947:Wounds and Injuries / Q000401:mortality