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In the Wake of Hurricane Andrew

Sharon McDonnell, MD, MPH; W. Gary Hlady, MD, MS
JAMA. 1995;273(23):1832. doi:10.1001/jama.1995.03520470040017.
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To the Editor.  —We are concerned that the article by Ms Friedman1 inaccurately presents the facts regarding Hurricane Andrew and is misguided in some of its recommendations for responding to sudden-impact natural disasters.First, 14 deaths occurred because of the hurricane, not 58 as reported.2 Active surveillance of morbidity after the hurricane indicated no increase in enteric or respiratory illness. In the acute recovery phase of the hurricane and also during subsequent months, surveillance detected no cases of typhus, no waterborne outbreaks of dysentery or other waterborne diseases, and no increase in animal rabies. A single case of Hantavirus infection, a human rabies case acquired overseas, and an outbreak of typhoid all occurred more than 1 year later, with epidemiologic and environmental investigation yielding no evidence that they were related to the hurricane. Immunization was not a part of the disaster response, and the assertion that it should


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