Printer Friendly

Surveillance of Morbidity During Wildfires - Central Florida, 1998.

Several large wildfires occurred in Florida during June-July 1998, many involving both rural and urban areas in Brevard, Flagler, Orange, Putnam, Seminole, and Volusia counties (1,2). By July 22, a total of 2277 fires had burned 499,477 acres throughout the state (Florida Department of Community Affairs, unpublished data, 1998). On June 22, after receiving numerous phone calls from persons complaining of respiratory problems attributable to smoke, the Volusia County Health Department issued a public health alert (2) advising persons with pre-existing pulmonary or cardiovascular conditions to avoid outdoor air in the vicinity of the fires. To determine whether certain medical conditions increased in frequency during the wildfires, the Volusia County Health Department and the Florida Department of Health initiated surveillance of selected conditions. This report summarizes the results of this investigation.

The surveillance system monitored the frequency of patient visits associated with selected conditions at seven hospitals in Volusia County and one hospital in Flagler County. The medical records departments of these eight hospitals furnished data about persons seen in the emergency departments (EDs) and/or admitted for the selected conditions during June 1-July 6, 1998. For comparison, the hospitals also provided the same information for June 1-July 6, 1997. Data from the eight hospitals were combined for analysis.

From 1997 to 1998, ED visits increased substantially for asthma (91%), bronchitis with acute exacerbation (132%), and chest pain (37%) (Table 1). ED visits for painful respiration decreased (27%). Changes in the number of admissions were minimal.

Reported by: B Sorensen, MD, M Fuss, Voiusia County Health Dept; Z Mulla, MSPH, W Bigler, PhD, S Wiersma, MD, R Hopkins, MD, State Epidemiologist, Florida Dept of Health.

Editorial Note: In response to the wildfires in Florida, infection-control practitioners and public relations professionals at these local hospitals were used as liaisons between the medical records staff at their respective hospitals and the health department. The data were used to quantify the extent of morbidity possibly related to the wildfires.

The findings in this report are subject to at least two limitations. First, the increase in the frequency of the conditions observed for this report did not necessarily result from the wildfires. Certain persons who suffered from these conditions may have never presented at a hospital because they chose not to seek medical care or were seen by their private physician. Second, coding practices differ slightly between hospitals and may change overtime within the same hospital.

This report illustrates that rapid surveillance of nonreportable diseases and conditions is possible during a public health disaster. The surveillance strategy included 1) identifying key staff in local hospitals well in advance of a disaster, 2) developing connections with these persons to ensure rapid access to critical information, and 3) providing simple data collection instruments that minimize confusion.

References

1. Karels J. 1998 wildland fire season in review. Florida Fire Service Today 1998;6:8-19.

2. Minshew P, Towle J. The 1998 Wildfires in Central Florida--Volusia County's own Armageddon. J Environ Health 1999 (in press).

   Frequency of emergency department visits and hospital admissions for
selected conditions and percentage change - Volusia and Flagler
[counties.sup.*], Florida, June 1-July 6, 1997 and June 1-July 6, 1998

                                    Emergency department visits
Diagnosis CICD-9-CM [codest.sup.+]) 1997                          1998
Asthma (493-493.91)                   77                           147
Acute bronchitis
 (466.0-466.19)                      134                           107
Bronchitis with acute
 exacerbation (491.21)                28                            65
Carbon monoxide poisoning
 (986)                                 2                             2
Chest pain (786.50-786.59)           218                           299
Conjuntivitis (372.30-372.39)         59                            79
Emphysema (492.0-492.8)                0                             1
Chronic obstructive
 pulmonary disease (496)              17                            17
Heat exhaustion (992.3-992.5)          7                            19
Painful respiration (786.52)          74                            54
Palpitations (785.1)                  19                            15
Shortness of breath/
 Wheezing (786.09)                    68                            90
Sinusitis (461.8-461.9)               46                            55
Total                                749                           950


                                             Hospital admissions
Diagnosis CICD-9-CM [codest.sup.+]) % Change                1997 1998
Asthma (493-493.91)                       91                  13   19
Acute bronchitis
 (466.0-466.19)                          -20                   5    4
Bronchitis with acute
 exacerbation (491.21)                   132                  56   56
Carbon monoxide poisoning
 (986)                                    --                   9    0
Chest pain (786.50-786.59)                37                  63   78
Conjuntivitis (372.30-372.39)             34                   0    0
Emphysema (492.0-492.8)                   --                   2    0
Chronic obstructive
 pulmonary disease (496)                  --                  11   11
Heat exhaustion (992.3-992.5)            171                   2    1
Painful respiration (786.52)             -27                   7    3
Palpitations (785.1)                     -21                   0    1
Shortness of breath/
 Wheezing (786.09)                        32                   1    1
Sinusitis (461.8-461.9)                   20                   0    0
Total                                     27                 169  174



Diagnosis CICD-9-CM [codest.sup.+]) % Change
Asthma (493-493.91)                       46
Acute bronchitis
 (466.0-466.19)                          -20
Bronchitis with acute
 exacerbation (491.21)                    --
Carbon monoxide poisoning
 (986)                                  -100
Chest pain (786.50-786.59)                24
Conjuntivitis (372.30-372.39)             --
Emphysema (492.0-492.8)                 -100
Chronic obstructive
 pulmonary disease (496)                  --
Heat exhaustion (992.3-992.5)            -50
Painful respiration (786.52)             -57
Palpitations (785.1)                      --
Shortness of breath/
 Wheezing (786.09)                        --
Sinusitis (461.8-461.9)                   --
Total                                      3


(*.)Seven hospitals in Volusia County and one in Flagler County.
(+.)International Classification of Diseases, Ninth Revision, Clinical
Modification.
COPYRIGHT 1999 U.S. Government Printing Office
No portion of this article can be reproduced without the express written permission from the copyright holder.
Copyright 1999 Gale, Cengage Learning. All rights reserved.

Article Details
Printer friendly Cite/link Email Feedback
Publication:Morbidity and Mortality Weekly Report
Geographic Code:1U5MD
Date:Feb 5, 1999
Words:821
Previous Article:Physician Advice and Individual Behaviors About Cardiovascular Disease Risk Reduction - Seven States and Puerto Rico, 1997.
Next Article:Tuberculosis Outbreaks in Prison Housing Units for HIV-Infected Inmates -- California, 1995-1996.
Topics:

Terms of use | Privacy policy | Copyright © 2022 Farlex, Inc. | Feedback | For webmasters |