HURRICANE RECOVERY INFORMATION
Initial Medical Screening and Ongoing Public Health Surveillance in Hurricane Evacuation Centers
The Centers for Disease Control and Prevention (CDC) is recommending an initial medical intake in evacuation centers housing hurricane evacuees, to be followed by ongoing public health surveillance. This guidance is intended specifically for persons in evacuation centers and does not necessarily apply to evacuees who may be in other residential settings. This medical intake screening and surveillance are important to ensure that the evacuees receive the health care they need. This two-phase process is envisioned as follows.
First, CDC recommends an initial medical intake screening for evacuees in evacuation centers. The goals of this initial screening are to--
- rapidly identify and triage persons who have medical conditions that require acute medical care (e.g., dehydration, serious wound infections)
- identify persons who have chronic health problems (e.g., hypertension and diabetes) and other conditions (e.g., pregnancy or disabilities) that require referral for additional medical attention, special services, or medications
- assess persons for communicable diseases of public health significance to prevent introduction and transmission of these conditions in the group setting
The general principles of the medical intake screening are that it should be--
- able to be completed rapidly, by persons who may have differing levels of medical training
- based on risk assessment
- focused on identifying persons who require additional evaluation and treatment, rather than being a comprehensive medical assessment
- sufficiently flexible as ongoing surveillance identifies new issues
To facilitate the intake screening, CDC has provided an interim form to be used for medical intake assessment and triage of evacuees who are entering an evacuation center. The form can be used to identify evacuees who may need additional medical evaluation and treatment. The first page contains registration information for use by facility, local, and state authorities. The remaining pages can be used for anonymous reporting of medical conditions among evacuees. These forms are available on the CDC website: emergency.cdc.gov/disasters/hurricanes/katrina/evacueeform.asp.
After initial screening is completed, a second phase of public health surveillance for evacuation centers is ongoing monitoring for conditions of public health importance among the evacuees. This information will serve to direct the public health response by 1) determining the secondary impact of the hurricane on evacuated populations, 2) identifying disease outbreaks and other events of public health concern, and 3) helping to direct distribution of state and federal resources.
To accomplish this objective, an interim form titled Aggregate Hurricane Morbidity Report Form: for Active Surveillance in Facilities Serving Evacuees is intended to be used for surveillance for medical conditions of public health importance among evacuees residing in evacuation centers. The form can be used on a daily basis to record numbers of evacuees with specific infectious syndromes, mental health conditions, injuries and chronic diseases who might benefit from possible public health interventions. The selected syndromes vary in clinical specificity. Syndromic surveillance categories (e.g., fever, gastrointestinal illness, respiratory illness) are included for use when specific clinical information or diagnoses are unavailable. Specific conditions and illnesses (e.g., bloody diarrhea, generalized rash–suspected chickenpox) are listed for use when clinical information or diagnosis is available.
Individuals completing these forms should submit them to the appropriate state or local public health authorities. State or local public health authorities should modify contact information on these forms as needed to facilitate reporting from within their jurisdiction. CDC is interested in receiving completed forms after they have been submitted to or reviewed by state or local agencies.
The information derived through both these surveillance efforts will be invaluable for identifying events of public health concern among facilities and across States and for directing interventions and other resources to areas of greatest need. For questions and additional information about the surveillance activities, please contact CDC at 770-488-7100 or at eocanalysis@cdc.gov.
Page last modified July 7, 2006