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![]() Persons using assistive technology might not be able to fully access information in this file. For assistance, please send e-mail to: mmwrq@cdc.gov. Type 508 Accommodation and the title of the report in the subject line of e-mail. Deaths Associated with Hurricanes Marilyn and Opal -- United States, September-October 1995The 1995 hurricane season was one of the most severe in U.S. history and included 11 hurricanes. During a 2-week period, the two most damaging storms -- hurricanes Marilyn and Opal -- made landfall in the United States. To characterize the deaths attributed to these storms, CDC contacted medical examiners/coroners (ME/Cs) in the affected areas. This report summarizes the findings of these investigations. Hurricane-related deaths can occur before (preimpact), during (impact), and after (postimpact) a hurricane strikes land. Deaths determined by local ME/Cs to be "disaster-related" are those directly (i.e., resulting from the environmental force of the hurricane) or indirectly (i.e., death caused by an injury or illness associated with hurricane-related events such as evacuation, clean-up, or loss of electricity {1}) related to the storm. Hurricane Marilyn, September 1995 On September 15, Hurricane Marilyn, a category two (on a scale of one to five) storm with sustained winds of 105 mph, made landfall in the U.S. Virgin Islands (USVI). The hurricane passed directly over St. Thomas (1990 population: 48,166) and affected St. John (1990 population: 3504) and St. Croix (1990 population: 50,139) in the USVI, and the islands of Culebra (1990 population: 1542) and Vieques (1990 population: 8602) in the Commonwealth of Puerto Rico (Figure_1). Gale-force winds, heavy rains, and storm surges of 3-5 feet resulted in damages reported at approximately $3 billion; more than 80% of the residential dwellings in St. Thomas were damaged or destroyed (2). ME/C offices in the USVI and the Institute of Forensic Sciences in Puerto Rico provided information about hurricane-related deaths reported from September 15 through October 4. Specific information included characteristics about decedents (e.g., age and sex) and the circumstances of death (e.g., date of injury, date of death, location, cause of death, and other circumstances). ME/Cs reported 10 deaths that were related, directly or indirectly, to Hurricane Marilyn (Table_1). The mean age for the seven decedents whose ages were known was 56.5 years (range: 17-107 years); eight were male. Of these 10 deaths, six were reported by the ME/Cs from St. Thomas and St. John, two from St. Croix, and two from Puerto Rico. One death occurred preimpact; the other nine occurred during the impact phase of the hurricane. The preimpact death occurred in Puerto Rico when the decedent was electrocuted while moving a TV antenna in preparation for the storm. Eight of the deaths, including the second death in Puerto Rico, were boat-related (i.e., the victims were on boats when the hurricane struck). Drowning was reported as the cause of seven of these boat-related deaths; head trauma was reported as the cause of one death. A 107-year-old woman died in an emergency shelter in the USVI; her death, although possibly precipitated by the circumstances of the hurricane, was attributed to natural causes. Hurricane Opal, October 1995 On October 4, Hurricane Opal, a category three storm with sustained winds of 115 mph, moved across the Gulf of Mexico and made landfall approximately 20 miles east of Pensacola, Florida. Gale-force winds and storm surges of 10-15 feet caused severe damage throughout the panhandle of Florida; the coastal areas were affected most severely (M. Mayfield, National Hurricane Center, personal communication, 1995). Although the hurricane was downgraded to a tropical storm (i.e., sustained wind speeds of 39-74 mph) soon after landfall, accompanying heavy rains and high winds caused extensive damage as the storm moved northward across southern and northeastern Alabama, through northwestern Georgia, and into North Carolina (Figure_2). In addition to the seven counties in Florida that were initially declared federal disaster areas, disaster declarations also had been issued for 37 counties in Alabama, 47 counties in Georgia, and 13 counties and the eastern band of the Cherokee Reservation in North Carolina (3). Data on deaths reported during October 4-25 attributed to the storm were provided by the offices of the ME/Cs in all counties in Alabama, Florida, and Georgia for which state or federal disaster declarations were issued, and in other counties without disaster declarations where hurricane-related deaths were reported; in addition, CDC contacted counties adjacent to those meeting the above criteria. In North Carolina, the chief ME in the State Department of Environment, Health, and Natural Resources was contacted for information on the entire state. ME/Cs were asked to provide information about decedents and circumstances of any death attributed to the hurricane. All eligible counties except one in Alabama and one in Georgia were contacted. A total of 27 hurricane-related deaths were reported by the ME/Cs: two deaths occurred in Florida, 12 in Alabama, 11 in Georgia, and two in North Carolina. Of these, one occurred during the preimpact phase of the storm, 13 during the impact phase, and 13 during the postimpact phase. Decedents ranged in age from 4 years to 87 years, and 21 were male. For the 26 decedents aged 20-87 years, the mean age was 52.4 years. Of the 27 deaths, the cause of death for 24 was considered accidental *; the other three deaths were attributed to natural causes but were considered hurricane-related because circumstances created by the hurricane contributed to the deaths. One death resulted from exacerbation of chronic obstructive pulmonary disease following strenuous activity during clean-up activities, and two deaths resulted from myocardial infarctions that also were attributed to strenuous clean-up activities. Thirteen deaths were related to falling or fallen trees; of these, nine occurred during the impact phase when victims were struck by trees falling on or near their residence (six), place of employment (one), or motor vehicle (two). Three occurred when vehicles struck trees lying in the road, and one occurred when the decedent was struck while cutting down a tree that had partially fallen during the storm. Four deaths were attributed indirectly to power outages: one death from carbon monoxide poisoning associated with the use of a gas generator and three from house fires started by candles (two) or a propane cooking device (one). Motor vehicles were implicated in seven of the deaths, including persons in motor vehicles that were struck by falling trees or that ran into downed trees (five). Five other deaths occurred during the postimpact phase: one person drowned in a swollen creek; one was electrocuted while repairing a downed power line; one sustained massive chest trauma after a tractor overturned; and two suffered heart attacks while repairing damage and clearing debris. Table_2 Deaths attributed to Hurricane Opal, by phase of storm, location, age, sex, and cause and circumstance of death -- Alabama, Florida, Georgia, and North Carolina, October, 1995 Reported by: N George-McDowell, MD, F Landron, MD, St. Thomas, St. John; J Glenn, MD, St. Croix, US Virgin Islands. MS Conte Miler, MD, Institute of Forensic Sciences, C Deseda, MD, Commonwealth Epidemiologist, Puerto Rico Dept of Health. CF McConnell, MD, District 1; M Herman, MD, District 14; R Hopkins, MD, State Epidemiologist, Florida Dept of Health and Rehabilitative Svcs. W Moncrief, Autauga County; HA Mack, Sr, Baldwin County; D Childs, Barbour County; D McGee, Bibb County; G Long, Blount County; T May, Bullock County; P Tuctchtone, Jr, Butler County; B Hulsey, Calhoun County; D Collier, Jr, Chambers County; B Rodgers, Cherokee County; W Lathan, Clarke County; RD Rush, Clay County; EL Dryden, Cleburne County; T Whitehead, Coffee County; J Harper, Conecuh County; AW Wingfield, Coosa County; N Hobson, Covington County; RK Turner, Crenshaw County; E Bankston, Dale County; T Wilson, DeKalb County; T Ellison, Elmore County; RH Johnson, Escambia County; W Phelps, Etowah County; K Mixon, Geneva County; ND Holman, Henry County; R Byrd, Houston County; RM Brissie, MD, Jefferson County; JW Story, Lee County; W Pringle, Lowndes County; HE Bentley, Macon County; DC Hibbs, Marshall County; L Riddick, MD, Mobile County; W Chambless, MD, Montgomery County; J Williams, Pike County; RT Gibbs, Randolph County; J Key, Russell County; J Wyatt, Saint Clair County; J Jones, Shelby County; J Castelberry, Talladega County; D Philips, Jr, Tallapoosa County; K Warner, MD, Tuscaloosa County; RD Green, Jr, Walker County; R Scherer, Bur of Health Care Standards, D Williamson, MD, Alabama Dept of Public Health. DG Starnes, Bartow County; R Ballard, Butts County; SH Eady, Carroll County; T Headrick, Catoosa County; BT Chancellor, Chattahoochee County; E Rainwater, Chattooga County; E Darby, Cherokee County; M Lindsey, Clay County; AP Dickson, Clayton County; JL Burton, MD, Cobb County, DeKalb County, and Gwinnett County; D Williams, Coweta County; J Gray, Dade County; WO Burnham, Dawson County; R Daniel, Douglas County; RC Vollrath, MD, Fannin County; CJ Mowell, Jr, Fayette County; F Talley, Floyd County; RA Ingram, Jr, Forsyth County; SA Zaki, MD, Fulton County; JB Hensley, Gilmer County; J Carver, Gordon County; D Wall, Habersham County; M Merck, Hall County; RB Hightower, Sr, Haralson County; JC Kindon, Harris County; LF Hooks, Heard County; R Stewart, Henry County; JF Smith, Lamar County; B McKinney, Lumpkin County; H Tante, Marion County; JE Worley, Meriwether County; LM Ballew, Murray County; JD Kilgore, Muscogee County; R Wheeler, Newton County; S Clark, Paulding County; F Chapman, Pickens County; L Litesey, Polk County; J Belflower, Quitman County; L Hunter, Rabun County; BF Lunsford, Randolph County; HS Ellison, MD, Rockdale County; JL Hall, Spalding County; E Stone, Stewart County; JC Cosby, Talbot County; R Stahlkuppe, Towns County; EM Smith, Troup County; B Erwin, MD, Union County; WE McGill, Walker County; JC Rowe, Walton County; R Barrett, White County; BJ Dixon, Whitfield County; KE Toomey, MD, State Epidemiologist, Div of Public Health, Georgia Dept of Human Resources. JD Butts, MD; M Moser, MD, State Epidemiologist, North Carolina Dept of Environment, Health, and Natural Resources. Federal Emergency Response Agency. American Red Cross, Falls Church, Virginia. Emergency Response Coordination Group, Office of the Director; Surveillance and Programs Br, and Disaster Assessment and Epidemiology Section, Health Studies Br, National Center for Environmental Health, CDC. Editorial NoteEditorial Note: Before Hurricane Hugo in 1989, most hurricane-related deaths occurred during the impact phase, usually along the coastline, and were attributed to drowning from hurricane-related storm surges. For example, following Hurricane Camille, which struck the Gulf of Mexico coast in 1969, most of the 256 storm-related deaths were attributed to drowning that resulted from 25-foot storm tides near the coast and flash floods further inland (4). Since then, however, improvements in forecasting technology and evacuation procedures have decreased the number of deaths attributed to drowning from storm surges during recent hurricanes (5). Consequently, an increasing proportion of deaths occurring during the impact phase of recent hurricanes have been attributed to the effects of the high winds rather than storm surges (1). In addition, since Hurricane Hugo, the proportion of deaths that occur during the postimpact phase has increased. Many of these deaths and nonfatal injuries result from electrocutions from contact with downed power lines, chain saw lacerations, and trauma from falling trees (6,7). During Hurricane Marilyn, no deaths directly related to the impact phase of the storm occurred on any of the islands, possibly reflecting the effectiveness of measures to evacuate and shelter the population at risk. However, eight of nine persons who died during the impact of the storm were at sea at the time of death, suggesting that warnings should be strengthened to emphasize risks of being aboard a vessel during a hurricane. In USVI and other areas where substantial numbers of persons reside on boats, these persons should be encouraged to evacuate to shelters on land. Many of the deaths attributed to Hurricane Opal occurred among persons in inland counties after the hurricane had been downgraded to a tropical storm, suggesting that persons in these areas may not have recognized or been fully informed about the risks associated with severe storms. In particular, because the use of motor vehicles during and after the storm was associated with several deaths, risks related to driving during or immediately following a severe storm should be emphasized, and persons should be encouraged to remain off the roads. In addition, because many deaths occurred after the storm during surveying efforts or clean-up activities, emergency notifications should stress the persistent risks of environmental hazards (e.g., downed trees and power lines) even after the storm has passed. References
When a death occurs under "accidental" circumstances, the preferred term within the public health community is "unintentional injury." Figure_1 ![]() Return to top. Table_1 Note: To print large tables and graphs users may have to change their printer settings to landscape and use a small font size. TABLE 1. Deaths attributed to Hurricane Marilyn, by phase of storm *, location, age, sex, and cause and circumstance of death -- U.S. Virgin Islands and Puerto Rico, September 1995 ================================================================================================== Phase Age Cause of storm Location (yrs) Sex of death Circumstance of death ------------------------------------------------------------------------------------------------ Impact St. Thomas 62 M Drowning On boat during impact; body found washed up on shore Impact St. Thomas 46 M Drowning On boat during impact; body found washed up on shore Impact St. Thomas 50 + M Drowning On boat during impact; body found washed up on shore Impact St. Thomas 55-65 + M Drowning On boat during impact; body found washed up on shore Impact St. Thomas 50 + M Head trauma On boat when mast or other part of boat broke and struck him on head; body found washed up on shore Impact St. John 48 F Drowning On boat during impact, Impact St. Croix 59 M Drowning On boat during impact; body found washed up on shore Impact St. Croix 107 F Natural causes In shelter and died during impact Preimpact Puerto Rico 17 M Electrocution Received an electric shock while on roof removing a TV antenna Impact Puerto Rico 53 M Asphyxia by On boat during impact; body submersion found 4 days later ------------------------------------------------------------------------------------------------ * Deaths were categorized as occurring before the hurricane made landfall (preimpact), during the storm (impact), or after the storm had passed (postimpact). + The exact age could not be determined by the medical examiner. ================================================================================================== Return to top. Figure_2 ![]() Return to top. Table_2 Note: To print large tables and graphs users may have to change their printer settings to landscape and use a small font size. TABLE 2. Deaths attributed to Hurricane Opal, by phase of storm *, location, age, sex, and cause and circumstance of death -- Alabama, Florida, Georgia, North Carolina, October, 1995 ======================================================================================================== Phase Age Cause of storm State/County (yrs) Sex of death Circumstance of death ------------------------------------------------------------------------------------------------------ Impact Ala., Henry 28 M Thermal burns House fire started by candle used during the storm Impact Ala., Jefferson 30 M Multiple blunt Working on train. Train accident + force injury caused victim to be ejected and run over by train Impact Ala., Jefferson 51 M Carbon monoxide Using a gas generator in an poisoning unventilated space because of power outage Impact Ala., Etowah 33 F Multiple trauma Tree fell on mobile home Impact Ala., Etowah 35 M Multiple trauma Tree fell on mobile home Postimpact Ala., Coffee 73 M Multiple blunt While surveying damage, struck force trauma by automobile that ran into a tree Postimpact Ala., Coffee 58 F Multiple blunt While surveying damage, struck force trauma by automobile that ran into a tree Postimpact Ala., Clay 86 M Massive trauma Tractor overturned while clearing to chest debris Postimpact Ala., Chambers 34 M Electrocution Electrocuted while repairing a downed power line Postimpact Ala., Chambers 61 M Cardiac arrest Suffered a heart attack while repairing damaged fence Postimpact Ala., Lee 87 M Myocardial Suffered a heart attack while infarction cleaning up debris Postimpact Ala., Coffee 70 M Chronic Strenuous exercise during clean-up obstructive activities exacerbated lung condition pulmonary disease Preimpact Fla., Okaloosa 76 F Multiple blunt Mobile home hit by tornado injuries to head Impact Fla., Escambia 36 M Crushing head Hit by falling tree while injury working at gas station during storm Impact Ga., Carroll 20 F Blunt force Pinned by falling tree and bled trauma to death once tree was removed Impact Ga., Cobb 50 M Asphyxia due to Outside when struck by falling mechanical tree impairment of respiration Impact Ga., Fulton 74 M Multiple blunt Tree fell through roof of force trauma residence and crushed legs Impact Ga., Spaulding 45 M Blunt force Tree fell on cab of pickup while trauma to head in motor vehicle Impact Ga., Haralson 26 M Massive head and Tree fell on cab of truck while neck trauma in motor vehicle Impact Ga., Haralson 55 F Massive head Motor vehicle accident trauma attributed to rain from storm Postimpact Ga., Gilmer 53 M Blunt force Struck by a tree he was cutting trauma to head down in yard Postimpact Ga., Fulton 34 M Blunt force Hit fallen tree in the road trauma while riding motorcycle Postimpact Ga., Floyd 58 F Multiple blunt Traffic lights not working due to force trauma power outage. Motor vehicle accident occurred in an intersection Postimpact Ga., DeKalb 4 M Thermal burns House fire started by candles used for light after storm Postimpact Ga., Murray 62 M Smoke inhalation Explosion caused by propane cooking device used because of power outage Impact N.C., Buncombe 60 M Compressional Tree fell on mobile home asphyxia Postimpact N.C., McDowell 68 M Drowning Fell into swollen creek while surveying damage ------------------------------------------------------------------------------------------------------ * Deaths were categorized as occurring before the hurricane made landfall (preimpact), during the storm (impact), or after the storm had passed (postimpact). + When a death occurs under "accidental" circumstances, the preferred term within the public health community is "unintentional injury." ======================================================================================================== Return to top. Disclaimer All MMWR HTML versions of articles are electronic conversions from ASCII text into HTML. This conversion may have resulted in character translation or format errors in the HTML version. Users should not rely on this HTML document, but are referred to the electronic PDF version and/or the original MMWR paper copy for the official text, figures, and tables. An original paper copy of this issue can be obtained from the Superintendent of Documents, U.S. Government Printing Office (GPO), Washington, DC 20402-9371; telephone: (202) 512-1800. Contact GPO for current prices. **Questions or messages regarding errors in formatting should be addressed to mmwrq@cdc.gov.Page converted: 09/19/98 |
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