Hostname: page-component-5d59c44645-ndqjc Total loading time: 0 Render date: 2024-02-22T20:22:10.644Z Has data issue: false hasContentIssue false

Influenza A (H3) Outbreak at a Hurricane Harvey Megashelter in Harris County, Texas: Successes and Challenges in Disease Identification and Control Measure Implementation

Published online by Cambridge University Press:  05 March 2019

Leann Liu*
Affiliation:
Harris County Public Health, Houston, Texas (Dr. Aisha Haynie is no longer affiliated with the agency)
Aisha Haynie
Affiliation:
Harris County Public Health, Houston, Texas (Dr. Aisha Haynie is no longer affiliated with the agency)
Sherry Jin
Affiliation:
Harris County Public Health, Houston, Texas (Dr. Aisha Haynie is no longer affiliated with the agency)
Ana Zangeneh
Affiliation:
Harris County Public Health, Houston, Texas (Dr. Aisha Haynie is no longer affiliated with the agency)
Eric Bakota
Affiliation:
Harris County Public Health, Houston, Texas (Dr. Aisha Haynie is no longer affiliated with the agency)
Benjamin D. Hornstein
Affiliation:
Harris County Public Health, Houston, Texas (Dr. Aisha Haynie is no longer affiliated with the agency)
Dana Beckham
Affiliation:
Harris County Public Health, Houston, Texas (Dr. Aisha Haynie is no longer affiliated with the agency)
Brian C. Reed
Affiliation:
Harris County Public Health, Houston, Texas (Dr. Aisha Haynie is no longer affiliated with the agency)
Jennifer Kiger
Affiliation:
Harris County Public Health, Houston, Texas (Dr. Aisha Haynie is no longer affiliated with the agency)
Michael McClendon
Affiliation:
Harris County Public Health, Houston, Texas (Dr. Aisha Haynie is no longer affiliated with the agency)
Elizabeth Perez
Affiliation:
Harris County Public Health, Houston, Texas (Dr. Aisha Haynie is no longer affiliated with the agency)
Michael Schaffer
Affiliation:
Harris County Public Health, Houston, Texas (Dr. Aisha Haynie is no longer affiliated with the agency)
Les Becker
Affiliation:
Harris County Public Health, Houston, Texas (Dr. Aisha Haynie is no longer affiliated with the agency)
Umair A. Shah
Affiliation:
Harris County Public Health, Houston, Texas (Dr. Aisha Haynie is no longer affiliated with the agency)
*
Correspondence and reprint requests to Leann Liu, 2223 West Loop South Freeway, 6 FL, Houston, TX 77027 (e-mail: leann.liu@phs.hctx.net).

Abstract

When Hurricane Harvey landed along the Texas coast on August 25, 2017, it caused massive flooding and damage and displaced tens of thousands of residents of Harris County, Texas. Between August 29 and September 23, Harris County, along with community partners, operated a megashelter at NRG Center, which housed 3365 residents at its peak. Harris County Public Health conducted comprehensive public health surveillance and response at NRG, which comprised disease identification through daily medical record reviews, nightly “cot-to-cot” resident health surveys, and epidemiological consultations; messaging and communications; and implementation of control measures including stringent isolation and hygiene practices, vaccinations, and treatment. Despite the lengthy operation at the densely populated shelter, an early seasonal influenza A (H3) outbreak of 20 cases was quickly identified and confined. Influenza outbreaks in large evacuation shelters after a disaster pose a significant threat to populations already experiencing severe stressors. A holistic surveillance and response model, which consists of coordinated partnerships with onsite agencies, in-time epidemiological consultations, predesigned survey tools, trained staff, enhanced isolation and hygiene practices, and sufficient vaccines, is essential for effective disease identification and control. The lessons learned and successes achieved from this outbreak may serve for future disaster response settings. (Disaster Med Public Health Preparedness. 2019;13:97-101)

Type
Report from the Field
Copyright
Copyright © 2019 Society for Disaster Medicine and Public Health, Inc. 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

1. National Weather Service. https://www.weather.gov/hgx/hurricaneharvey. Accessed May 8, 2018.Google Scholar
2. Harris County Flood Control District. Harris County Has Never Seen a Storm Like Harvey. https://www.hcfcd.org/hurricane-harvey/. Accessed May 8, 2018.Google Scholar
3. Overview of Influenza Surveillance in the United States. https://www.cdc.gov/flu/weekly/overview.htm. Accessed May 8, 2018.Google Scholar
4. Figueroa, A, Gulati, RK, Rainey, JJ. Estimating the frequency and characteristics of respiratory disease outbreaks at mass gatherings in the United States: findings from a state and local health department assessment. PLoS ONE. 2017;12(10):e0186730. https://doi.org/10.1371/journal.pone.0186730. Accessed May 8, 2018.Google Scholar
5. Jimenez, D, Quiroga, M, Santiago, A, et al. Epidemiologic notes and reports surveillance of shelters after Hurricane Hugo - Puerto Rico. MMWR Morb Mortal Wkly Rep. 1990 Jan 26;39(3);41-42,47.Google Scholar
6. Lee, L, Fonseca, V, Brett, K, et al. Active morbidity surveillance after Hurricane Andrew-Florida, 1992. JAMA. 1993 Aug 4;270(5):591-594.Google Scholar
7. Waring, SC, Brown, BJ. The threat of communicable diseases following natural disasters: a public health response. Disaster Manag Response. 2005 Apr-Jun;3(2):41-47.Google Scholar
8. Watson, JT, Gayer, M, Connolly, MA. Epidemics after natural disasters. Emerg Infect Dis. 2007 Jan;13(1):1-5.Google Scholar
9. Connolly MA. Communicable disease control in emergencies: a field manual. http://apps.who.int/iris/bitstream/handle/10665/96340/9241546166_eng.pdf;jsessionid=95A19216E21CB0A165791D6D197F4A64?sequence=1. Accessed December 27, 2018.Google Scholar
10. Ridpath, , A, Bregman, B, Jones, L, et al. Challenges to implementing communicable disease surveillance in New York City evacuation shelters after Hurricane Sandy, November 2012. Public Health Rep. 2015 Jan-Feb; 130(1):48-53.Google Scholar
11. Lee, EL, Palacio, H, Shah, U, et al. Widespread outbreak of norovirus gastroenteritis among evacuees of Hurricane Katrina residing in a large “megashelter” in Houston, Texas: lessons learned for prevention. Clin Infect Dis. 2007 Apr;44(8):1032-1039.Google Scholar