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From the Centers for Disease Control and Prevention
March 22/29, 2000

Storm-Related Mortality—Central Texas, October 17-31, 1998

JAMA. 2000;283(12):1560-1561. doi:10.1001/jama.283.12.1560-JWR0322-2-1

MMWR. 2000;49:133-135

On October 17, 1998, a series of storms moved across the central and south regions of Texas, dropping up to 22 inches of rain in some areas and spawning several tornados. Sixty Texas counties (24%) reported flooding during October 17-19. Thirty-six counties became eligible for federal and/or state assistance as a result of damages suffered from this storm system during October 17-31. Estimated flood damage was approximately $900 million, including damage to 12,000 homes, 700 businesses, and public property. This report summarizes findings of an epidemiologic investigation of 31 deaths associated with the storm system.

Epidemiologic information was obtained from the Bexar and Travis county medical examiners and from Justice of the Peace and Department of Public Safety officers in the nine counties that reported storm-related deaths. Information collected about the decedents included name, sex, race/ethnicity, age, circumstances and location of injury, cause of death, body of water involved, and date and time of injury. Data (e.g., cause of death and age) were supplemented in some cases by information provided by the Bureau of Vital Statistics. A case was defined as a death directly or indirectly related to the storm system during October 17-20, 1998. To capture all storm-related deaths, traumatic deaths were examined that occurred during October 17-31. A directly related death was defined as one resulting from physical contact with storm product (e.g., flood water, hail, lightning, or wind). An indirectly related death was defined as one that did not result from physical contact with a storm product, but would not have happened if the storm had not occurred.

Thirty-one deaths were considered directly or indirectly related to the storm (29 directly and two indirectly). Deaths occurred in 24 separate incidents in nine Texas counties. Thirty of the victims were Texas residents, and one was a Louisiana resident visiting Texas. Decedents ranged in age from 2 months to 83 years (median: 38 years); 20 decedents were males.

Cause of death for the 31 decedents included drowning (24 [77%]), cardiac origin (three [10%]), multiple trauma (three [10%]), and hypothermia (one [3%]). Of the 29 deaths directly related to the storm, 24 were caused by drowning. Three persons died of multiple trauma, one of hypothermia after submersion in water, and one of cardiac arrhythmia induced after he became trapped in a water crossing (i.e., a road traversing a low-lying area that is subject to flooding). Two died indirectly from the storm: one man died while awaiting rescue by emergency personnel who were unable to reach his residence because of flooding, and a second man died in his truck in a water crossing on his property.

Twenty-two of the 29 cases with known circumstances occurred because a vehicle was driven into high water. These deaths occurred in 16 separate incidents. Four of these incidents resulted in multiple deaths. Of the 16 water-crossing incidents, 11 (69%) occurred at locations known to reporting authorities to have a history of flooding. Of the 16 water-crossing incidents, 10 (63%) involved trucks and/or sport-utility vehicles.

Of the other deaths with known circumstances, three were in persons who drowned in their homes and one was in a person who drowned near a boat dock on his property. Two persons died from tornado-related trauma, and one man died of a heart attack.

Most (14 [45%]) deaths occurred on the second day of the storm. No deaths were reported after October 19, though rain and flooding persisted through October 31. Time of the incident leading to death was known for 21 of the 29 cases with known circumstances; 19 deaths occurred within a 24-hour period. Seven deaths occurred during midnight-4 AM.

Reported by:

C Kremer, D Zane, J Underwood, S Stanley MD, D Stabeno, D Simpson, MD, D Perrotta, State Epidemiologist, Texas Dept of Health. Health Studies Br, Div of Environmental Hazards and Health Effects, National Center for Environmental Health; and an EIS Officer, CDC.

CDC Editorial Note:

The south central Texas region historically has been susceptible to damage and loss of life resulting from heavy rains. This period of flooding was the second most costly in terms of deaths and the most costly in monetary terms.1

Flooding is the most common type of natural disaster worldwide, accounting for an estimated 40% of all natural disasters.2 Flash flooding is the leading cause of weather-related deaths in the United States, accounting for approximately 200 deaths per year.2

In the United States, the most common cause of flood-related deaths is drowning.3 More than half of flood-related drownings occur when a vehicle is driven into hazardous flood waters.35 In the Texas floods, 76% of the deaths with known circumstances occurred because a motor vehicle was driven into flood waters.

The findings in this report are subject to at least two limitations. First, interpretation of storm-related deaths may have varied among medical examiners and Justice of the Peace and Department of Public Safety officials. For example, subjective determination was used to ascertain two deaths indirectly related to the storm, based on the criterion that the deaths would not have happened if the storm had not occurred. Although definitions and methods have been proposed, no standardized method for determining disaster-attributed mortality exists. Second, some post-storm impact deaths may have occurred outside of the study period.

Water-crossing incidents in the Texas floods occurred in vehicles ranging in size from a full-sized produce truck to a compact car. This finding underscores the importance of educating persons residing in flood-prone locations about the hazards of driving vehicles through areas inundated by flash floods and through swiftly moving flood waters.6

West Gulf Coast River Forecast Center, National Weather Service, Significant floods in the WGRFC area, 1866-1997. Available at http://www.srh.noaa.gov/wgrfc. Accessed on November 20, 1998.
French  JGHolt  KW Floods. Gregg  MBed.The public health consequences of disasters. Atlanta, Georgia US Department of Health and Human Services, Public Health Service, CDC1989;69- 78
Frazier  K The violent face of nature: severe phenomena and natural disasters.  New York, New York William Morrow and Company, Inc.1979;
Staes  COrengo  JCMalilay  JRullan  JNoji  E Deaths due to flash floods in Puerto Rico, January 1992: implications for prevention. International Journal of Epidemiology. 1994;23968- 75Article
CDC, Flood-related mortality—Georgia, July 4-14, 1994. MMWR. 1994;43526- 30
National Weather Service/American Red Cross/Federal Emergency Management Agency, Flash floods and floods...the awesome power!: a preparedness guide.  Washington, DC US Department of Commerce, National Oceanic and Atmospheric Administration, National Weather Service/American Red Cross1992;(report no. NOAA/PA 92050, ARC 4493).