MORBIDITY ON KAUAI BEFORE AND AFTER HURRICANE INIKI

Background. On September 11, 1992, Hurricane Iniki, a Class III/IV sto rm, passed directly over Kauai. This study is the first attempt to mea sure increases in injuries and other health outcomes among an entire p opulation in the impact zone of a hurricane. Methods. Medical chart da ta were abstracted from all facilities providing primary and emergency care on Kauai. Incidence of injury, cardiovascular disease, and asthm a for the a-week period following Hurricane Iniki were compared to tho se for the a-week period preceding Iniki. Results. A total of 1,584 in juries were treated in the post-Iniki period compared with 231 injurie s treated in the pre-Iniki period (relative risk = 6.86, 95% confidenc e interval 5.98-7.87), Open wounds constituted over half of these inju ries, Physician visits for asthma and cardiovascular disease were also significantly increased in the post-Iniki period (relative risks, res pectively: 2.81, 95% confidence interval 1.93-4.09; 2.73, 95% confiden ce interval 1.51-4.94). Conclusions. Significant increases in the inci dence of injuries, asthma, and cardiovascular disease occurred followi ng Hurricane Iniki. Although no changes occurred in the proportion of patients needing hospitalization, additional injuries and illnesses af ter a natural disaster can burden existing medical facilities in a rur al community with limited resources. Disaster preparedness plans need to include methods to increase services and supplies at existing medic al facilities. (C) 1997 Academic Press.