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Active Morbidity Surveillance After Hurricane Andrew—Florida, 1992

Lore Elizabeth Lee, MPH; Vincent Fonseca, MD, MPH; Kate M. Brett, PhD; Jose Sanchez, MD, MPH; Robert C. Mullen, MPH; Lynn E. Quenemoen, MD, MPH; Samuel L. Groseclose, DVM, MPH; Richard S. Hopkins, MD, MSPH
JAMA. 1993;270(5):591-594. doi:10.1001/jama.1993.03510050057027.
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Objective.  —To describe the health status of and to detect disease outbreaks in the population affected by Hurricane Andrew in south Dade County, Florida.

Design.  —The Florida Department of Health and Rehabilitative Services and the US Army conducted active surveillance for gastrointestinal illness, respiratory illness, injury, and other index conditions by monitoring civilian and service member visits to care sites (civilian and military free care sites and hospital emergency departments) from August 30 (1 week after the hurricane's landfall) through September 30, 1992.

Setting.  —South Dade County, Florida.

Main Outcome Measures.  —Proportional morbidity: the number of daily visits for each index condition divided by the total number of visits, expressed as a percentage. Morbidity rate: the total number of daily visits by service members divided by the total number of service members, expressed as a percentage.

Results.  —Six index conditions accounted for 41.3% of visits to civilian free care sites: diarrhea (4.7%), cough (4.7%), other infection (9.6%), rash (5.4%), animal bite (1.2%), and injury (15.7%). At military free care sites, five index conditions accounted for 75.7% of civilian visits: injury (23.7%), dermatologic illness (12.4%), respiratory illness (9.9%), gastrointestinal illness (5.3%), and other medical conditions (24.4%). Two index conditions accounted for 54.1% of service member visits: injury (36.2%) and dermatologic illness (17.9%). During the 5 weeks after the hurricane, proportional morbidity from injury decreased; proportional morbidity from respiratory illness increased; and proportional morbidity from diarrhea was stable. No infectious disease outbreaks occurred.

Conclusions.  —Injuries were an important source of morbidity throughout the surveillance period, especially among service members. Enteric and respiratory agents did not cause disease outbreaks, despite alarming rumors to the contrary.(JAMA. 1993;270:591-594)


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