Abstract
IntroductionNatural disasters are increasingly common and devastating. It is essential to understand children’s health needs during disasters as they are a particularly vulnerable population. The objective of this study was to evaluate pediatric disease burden after Hurricane Harvey compared to the preceding month and the same period in the previous year to inform pediatric disaster preparedness.MethodsThis was a retrospective cross-sectional study of patients seen at pediatric emergency departments (ED) and urgent care centers (UCC) 30 days before (late summer) and after (early fall) the hurricane and from the same time period in 2016. We collected demographic information and the first five discharge diagnoses from a network of EDs and UCCs affiliated with a quaternary care children’s hospital in Houston, Texas. We calculated the odds of disease outcomes during various timeframes using binary logistic regression modeling.ResultsThere were 20,571 (median age: 3.5 years, 48.1% female) and 18,943 (median age: 3.5 years, 47.3% female) patients in 2016 and 2017, respectively. Inpatient admission rates from the ED a month after Harvey were 20.5%, compared to 25.3% in the same period in 2016 (P<0.001). In both years, asthma and other respiratory illnesses increased from late summer to early fall. After controlling for these seasonal trends, the following diseases were more commonly seen after the hurricane: toxicological emergencies (adjusted odds ratio [aOR]: 2.61, 95% [confidence interval] CI, 1.35–5.05); trauma (aOR: 1.42, 95% CI, 1.32–1.53); and dermatological complaints (aOR: 1.34, 95% CI, 1.23–1.46).ConclusionWe observed increases in rashes, trauma, and toxicological diagnoses in children after a major flood. These findings highlight the need for more medication resources and public health and education measures focused on pediatric disaster preparedness and management.
Highlights
IntroductionIt is essential to understand children’s health needs during disasters as they are a vulnerable population
Natural disasters are increasingly common and devastating
We observed increases in rashes, trauma, and toxicological diagnoses in children after a major flood. These findings highlight the need for more medication resources and public health and education measures focused on pediatric disaster preparedness and management. [West J Emerg Med. 2021;22(3)763-768.]
Summary
It is essential to understand children’s health needs during disasters as they are a vulnerable population. Floods are the most common natural disaster around the world and are becoming increasingly more frequent and devastating.[1] Studies have reported increases in illness and healthcare needs after hurricanes and major floods. Pediatric EDs and Urgent Care Visits in Houston after Hurricane Harvey communicable illnesses, and long-lasting psychological distress after floods.[1,2] After Hurricane Katrina in 2005, evacuees at a shelter in Houston, Texas, received medical care for fever, rash, gastrointestinal complaints and respiratory infections.[3,4] Similar observations were reported after Hurricane Rita in Louisiana in 2005.4 These studies highlight the importance of improving our understanding of the clinical impact of natural disasters, among vulnerable populations such as children. We aimed to fill this gap in the literature and describe the burden of disease in children after Hurricane Harvey in Houston, a major flooding event in one of the largest urban areas in the United States
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