Department of Health and Human Services

Disaster Surveillance

Following any type of natural disaster, officials must be prepared to rapidly respond and meet the needs of the affected community. Public health surveillance is particularly important in disasters because of the vulnerability of the affected population to sudden changes in their environment and the need to quickly share information on the health status of the community with a range of partners.

Disaster Surveillance allows public health to:

• Estimate the magnitude and scope of health problems in disaster affected populations
• Detect disaster-related outcomes and monitor trends of public health importance in the affected community:
  • single high-priority disease cases and outbreaks
  • injury and poisoning clusters
  • behavioral health outcomes and trends
  • chronic disease exacerbation and healthcare needs
• Assess levels of healthcare utilization in the affected communities
• Evaluate control and prevention efforts
• Monitor the safety of relief and recovery workers
• Facilitate planning and inform the overall response

Electronic Surveillance in the Disaster Setting

Custom surveillance modules in NC DETECT:

Hurricane related health outcomes: Acute illness syndromes Injuries and poisoning categories Chronic disease categories Behavioral health syndromes and outcomes Healthcare utlization indicators Extreme heat related healthcare visits Wildfire related respiratory healthcare visits Food poisoning syndrome Chemical exposure syndromes (including neurotoxicological outcomes) Radiological exposure syndromes

NC DETECT users have monitored illness and injury effects after hurricanes Isabel, Ophelia and tropical storm Hanna, wildfires in Eastern North Carolina, heat waves and analyzed ED use at select hospitals by Hurricane Katrina evacuees. Before NC DETECT, similar surveillance relied on manual, active surveillance methods.

Active Surveillance in the Disaster Setting

Surveillance in facilities without electronic capability (e.g., evacuation centers, special needs shelters, and field hospitals) may require the need for active surveillance. Active surveillance is often implemented in these settings for a short period of time following a major disaster. The following are different types of active surveillance forms for monitoring community health status.

When used during a disaster, these paper-based forms can be integrated into NC DETECT!

1. North Carolina Disaster Mortality Surveillance Form

   Purpose: Identify the number of deaths related to the disaster and provide basic mortality information.

   Setting: Form should be filled out by medical examiners, coroners, Disaster Mortuatry Operational Response Teams (DMORT), hospital, nursing home, or funeral home staff during a disaster. This form does not replace the death certificate.

   How to use this form: Use this form for all known deaths related to the disaster. Complete one form per decedent. Send completed forms to designated public health official.

   Download the form: (Word, PDF)

2. North Carolina Disaster Morbidity Surveillance Form

   Purpose: To capture individual-level active surveillance of medical conditions and other disaster-related outcomes when timely, detailed, patient-level information is needed for response efforts.

   Setting: Form should be filled out by public health staff or medical personnel in acute care facilities (e.g., shelters with medical staff, special needs shelters, field hospitals, Disaster Medical Assistance Teams (DMAT)).

   How to use this form: Use the one-page form to record information about the chief complaints and specific infectious syndromes, behavioral health conditions, injuries, and chronic diseases that best describe the reason the patient is currently seeking care. One form should be filled out per patient. This form also may be filled out by abstracting information from patient records. Send completed forms to designated public health official.

   Download the form: (Word, PDF)

3. North Carolina Disaster Aggregate Morbidity Surveillance Form

   Purpose: To collect aggregate morbidity data when detailed individual-level patient information is not necessary or is too cumbersome to collect. This form serves as a summary of key disaster-related outcomes observed in a facility and can be used for moniotring population level trends.

   Setting: Form should be filled out by public health staff or medical personnel in acute care facilities (e.g., shelters with medical staff, special needs shelters, field hospitals, Disaster Medical Assistance Teams (DMAT)).

   How to use this form: Fill out the form based on individual forms or data from an existing surveillance or reporting system, or by reviewing patient logs and triage records. Send completed forms to designated public health official.

   Download the form: (Word, PDF)

4. North Carolina Shelter Assessment Form (Environmental Inspections of Shelters)

   Purpose: To standardize and record environmental assessments of shelters and evacuation centers. This form can serve as a basis for sharing timely environmental health information related to shelters and evacuation centers with local and state health officials.

   Setting: Shelters and Evacuation Centers

   How to use this form: Instructions are provided on the form for designated environmental health staff tasked with inspecting and assessing shelters and evacuation centers.

   Download the form: (Word, PDF)

For questions regarding public health surveillance in the disaster setting:

Aaron Fleischauer, PhD, MPH

Aaron.Fleischauer@dhhs.nc.gov

Lana Deyneka, MD

Lana.Deyneka@dhhs.nc.gov

North Carolina Division of Public Health

Raleigh, NC 27603