The Role of the Veterinarian in

Hurricanes and Other Natural

Disasters
ROSCOE M. MOORE, JR.,' YVETTE M. DAVIS, AND
RONALD G. KACZMAREK
United States Public Health Service
Center for Devices and Radiological Health
Food and Drug Administration
Rockville, Maryland 20852

INTRODUCTION

Hurricanes can create multiple public health challenges, ranging from outbreaks of
infectious disease to the creation of animal control problems. The training, expertise,
and clinical experience of veterinarians enable them to make important contributions
in planning for and responding to hurricanes. The purpose of this paper is to discuss
several of the multiple roles veterinarians can fulfill. The role of the veterinarian during
natural disasters has been previously described in general by Moore et al. This paper
will focus on the role of the veterinarian before, during, and after hurricanes.
Meteorologists define a hurricane as a rotating wind system that whirls counter-
clockwise in the Northern Hemisphere, forms over tropical water, and has a sustained
wind speed of at least 74 miles per hour. Hurricanes typically begin as tropical cyclones,
which is the term for all wind circulations rotating around an atmospheric low over
tropical waters. It is presently thought that many tropical cyclones originate over
Africa in the region just south of the Sahara. They start as an instability in a narrow
east-to-west jet stream that forms in that area between June and September as a result
of the great temperature contrast between the hot desert and the cooler, more humid
region to the south. Studies show that the disturbances generated over Africa have
long lifetimes and that many of them cross the Atlantic. In the twentieth century an
average of 10 tropical cyclones each year whirled out across the Atlantic; six of these
became hurricanes. The hurricane season is designated as the period from June 1
through November 30. The Saffir/Simpson hurricane scale categorizes the intensity of
hurricanes from 1 (least intense, causing minimal damage) to 5 (most intense, causing
catastrophic damage). Based on 100 years of record keeping on hurricanes, the National
Weather Service has observed that on the average, a category 4 or higher hurricane
strikes the United States once every five years.*
In the period 1900-1982, 136 hurricanes struck the United States directly; 55 of
these were of at least category 3 intensity. Florida felt the effects of both the highest
number (51) and the most intense of these storms, with Texas, Louisiana, and North
Carolina following in descending order.3

'Address correspondence to Dr. Roscoe M. Moore, Jr., Office of International Health, Office
of the Assistant Secretary for Health, Parklawn Building, Room 18-85, 5600 Fishers Lane,
Rockville, Maryland 20857.
361
368 ANNALS NEW YORK ACADEMY OF SCIENCES

In 1985, six hurricanes struck the United States mainland; two were of category 3
or higher. Hurricane Gloria was measured as a category 5 hurricane over the Atlantic
Ocean; it struck Cape Hatteras, North Carolina, as a category 4,and went on to strike
Long Island as a category 3. Hurricane Elena struck Florida, Alabama, and Mississippi
as a category 3.4 The year 1985 was an abnormally devastating year for hurricanes,
because during the preceding years the number of hurricanes that occurred was below
average.2
Hurricanes are characterized by a 10-mile-thick inner spinning ring of towering
clouds and rapid upper motion, which is defined as the Hurricane’s eyewall; it is here
that condensation and rainfall are intense and winds are most violent. Out beyond the
eyewall, the hurricane forms into characteristic spiral rain bands, which are alternate
bands of rain-filled clouds. In the typical hurricane, the entire spiral storm system is
at least 1,000 miles across, with hurricane force winds of 100 miles in diameter and
gale force winds of 400 miles in diameter. It is estimated that an average hurricane
produces 200 billion tons of water a day as rain. Most of the flooding associated with
hurricanes does not come from the intense rain but from what is known as the “storm
surge.” Depending on the strength of the storm and local conditions where the storm
comes ashore, the storm surge may cause the sea to rise as much as 20 feet higher than
normal. The destructive power of a hurricane is determined by the way storm surge,
wind, and other factors are combined.2 During Hurricane Camille in August 1969, one
of the strongest hurricanes to hit the United States in this century, the storm surge was
estimated to be 30 feet high.2 In September 1989, when the eye of Hurricane Hugo
struck the coast of South Carolina north of Charleston, peak wind velocities in Charles-
ton were measured at 135 miles per hour, and there was an accompanying tidal surge
of 12- 17 feet.5
It is important to recognize the devastating effect a hurricane can have on the
infrastructure of a community. During Hurricane Hugo, electric power failure was
caused by fallen trees and lumber that crushed cars and roof tops. In addition to the
damage and destruction to homes and buildings, approximately 900,000 persons in
North and South Carolina were without electric power. As a result of flooding and
fallen trees and lumber, streets became impassable, thus making it very difficult to
secure such essentials as food and gas5
The veterinarian is uniquely qualified for disaster intervention by virtue of extensive
medical training. Veterinary medical education encompasses extensive instruction in
multiple clinical as well as scientific disciplines, including pharmacology, microbiology,
physiology, and biochemistry. The clinical training of veterinarians provides them with
substantial experience in a number of fields, ranging from the management of zoonotic
diseases to emergency triage.
Veterinarians are currently utilized to a great extent in many public health agencies.
They occupy key positions in state, local, and federal health agencies. Such positions
range from state epidemiologist to public health veterinarian at both the state and local
levels. At the federal level, veterinarians are well represented in various agencies within
the Public Health Service, including the Centers for Disease Control, the National
Institutes of Health, and the Food and Drug Administration. Private practitioners
engaged in various specialties abound throughout the United States and should be
included as valuable resources in case of catastrophic emergencies.
The role of the veterinarian features a number of important tasks-before, during,
and after a hurricane. These tasks include (1) control of disease vectors, (2) control of
disease transmission, (3) herd management, (4) animal health care, ( 5 ) the search
and rescue operation, (6) animal control, (7) maintenance of medical supplies, (8)
information dissemination, (9) disaster assessment, and (10) pre-disaster planning.
MOORE el al.: HURRICANES AND THE ROLE OF VETERINARIANS 369

CONTROL OF DISEASE VECTORS

The veterinarian should have a key role in disease prevention and control of vector-
borne diseases, both during and after a hurricane. The population of mosquitoes can
increase dramatically after a hurricane-induced flood. The human population may be
more susceptible to mosquitoes because of the loss of housing. Thus, the population
may be subject to a number of diseases that can be transmitted by mosquitoes, including
malaria, dengue, and St. Louis encephalitis. An outbreak of malaria occurred in Haiti
after a torrential rain associated with a hurricane in 1963. It was estimated that
approximately 75,000 excess cases of malaria occurred during this outbreak.6
Flies can also greatly increase in number after a disaster. Flies can multiply in
garbage and carcasses of animals, both of which may be increased after a hurricane.
Infectious agents transmitted by flies include Shigella and enterovir~ses.~
During Hurricane Hugo (September 1989), when the northeastern coast of Puerto
Rico was struck by the hurricane, an estimated 10,300 persons were housed in 161
temporary shelters. At least one case of head lice was reported in 22% of the shelters
to which persons were evacuated during the disaster. Outbreaks of head lice infestation
were confirmed in 18% of the shelters.* The veterinarian should have a major role in
vector control and the prevention of the diseases associated with them. In addition,
monitoring the adverse effects of insecticides used in the eradication of disease vectors
is also a key role of the veterinarian.
As an illustration of the necessity of such a role, in 1972 floods from Hurricane
Agnes in Pennsylvania led to fears of an outbreak of California encephalitis. To reduce
this threat, flooded areas in 12 counties were sprayed with pesticides. Four million
kilograms of contaminated beef and poultry had to be destroyed as well9 The role of
the veterinarian in this situation would be the detection and control of adverse effects
associated with the use of insecticides.
The potential for water-borne diseases may increase after a hurricane as a result of
flooding or the compromise of the water supply. Water treatment plants may be
destroyed or overwhelmed as a result of a hurricane. Contamination of a water treat-
ment system may occur through breaks in the lines or a decrease in pressure that allows
sewage to enter the line. Failure or contamination of a water system may lead to disease
transmission. In 1967, an outbreak of leptospirosis occurred in Portugal after a flood.
In 1975, an outbreak of 9000 cases of typhoid fever was reported in Sangli Town,
India.’ This outbreak was not caused by a natural disaster, but it clearly illustrates the
potential for disease transmission when water treatment facilities fail.

CONTROL OF DISEASE TRANSMISSION

During a hurricane, an adverse change in the environment occurs. This may cause
the mass destruction of habitats. Existing infectious diseases are exacerbated by disrup-
tion of accommodation and the subsequent overcrowding of the human and animal
populations. Existing communicable diseases exacerbated by impaired food and water
supplies could lead to outbreaks of food poisoning, typhoid, cholera, infectious hepati-
tis, and gastroenteritis7
A hurricane-induced disaster situation may necessitate the overcrowding of live-
stock, which may give way to the transmission of infectious disease. Therefore, another
important role of the veterinarian should be the careful monitoring of animal popula-
tions to detect the transmission of disease. Attention should be given especially to the
identification of the disease agent and assessment of the magnitude of the problem.
370 ANNALS NEW YORK ACADEMY OF SCIENCES

With regard to control of zoonotic disease, the combined knowledge of the physician
and the veterinarian is more effective than that of either professional alone.
The water supply of a community affected by a hurricane-induced disaster may be
compromised, thus increasing the potential for transmission of water-borne disease.
A disaster may compromise food safety and hygiene because of the loss of power,
refrigeration, and/or transportation. The veterinarian’s training in food and meat
hygiene, as well as knowledge of milk, poultry, and fish hygiene and water sanitation,I0
is valuable in the maintenance of food safety and hygiene. At the time of a disaster,
veterinarians will be needed to decide which food is potentially unsafe and which is
acceptable for human consumption. Quality assurance with regard to milk and meat
inspection are two examples. The veterinarian should have a key role in the maintenance
of milk hygiene, with the responsibility of ensuring an adequate as well as safe and
wholesome supply of milk to the disaster victims. Monitoring of the milk supply would
be a major task that involves multiple sampling and analytic procedures. Internal
organs that are rendered unfit as a result of the disaster would have to be rejected, and
other animal by-products would be saved as appropriate.ll It would be the primary
responsibility of the veterinarian to make such decisions.
The role of the veterinarian is particularly important in primary preventive medicine
on the farm. This essential role indirectly influences both the quality of food available
and the transmission of disease via the food animals to the victims of a hurricane.
During the rescue and remedy phase of the hurricane, the veterinarian can also
serve in an important public health role. The veterinarian would be involved in the
recovery and disposal of animal remains. l 2 This is important because carcasses encour-
age the influx of rodents and flies that may act as carriers of disease. Diseases transmit-
ted in this way include Shigella and the enteroviruses.

HERD MANAGEMENT
Farms, homes, industry, animal products processing plants, and slaughterhouses
may be badly damaged or totally destroyed as a result of a hurricane. The destruction
of pastures and feed stores present an added problem in the maintenance of livestock
after a disaster, especially if that particular storage site or pasture is a source for
livestock outside of the immediate area of the disaster.
The veterinarian has a key role in the management of animal populations. If it is
possible to evacuate livestock from the disaster area, veterinarians should decide to
which animals initial efforts will be directed. From the point of view of economics, initial
efforts are usually directed to the most valuable farm animals such as high-genealogy
reproducers and other valuable livestock. Veterinarians may have to perform this
function within the constraints placed upon them by livestock owners who may not
willingly permit veterinarians to select and identify animals for triage.
In the event that livestock evacuation is possible, the gathering and transport of
the animals should be under the direction of the veterinarian. In a true disaster situation,
animal evacuation may not be practical. If animals cannot be evacuated, then veterinari-
ans have an essential role in the development of instructions for management until
mass human reentry is allowed. Such management information would be provided by
the livestock owner’s private practitioner and/or guidelines developed (as part of
emergency preparedness plans) by veterinarians at the state or local government level.

ANIMAL HEALTH CARE

Another major role of the veterinarian during a hurricane-induced disaster situation
would be the therapeutic intervention of disease states and/or illnesses in animals that
MOORE ef al.: HURRICANES AND THE ROLE OF VETERINARIANS 371

are secondary to disaster effects. Distribution of drugs, the interventions used, and the
animals on which the interventions will be used should be decided by the veterinarian.
The veterinarian should also oversee the maintenance of surveillance and record keep-
ing of mortality, fertility, and production during the therapeutic intervention."
During and after a hurricane, the veterinarian would also be involved in the primary
care of laboratory animals, companion, and food-and-fiber animals. In addition, veteri-
narians would be concerned with the dispersal, disposition, and treatment of trauma-
tized animals in the disaster situation. According to Dr. Casper,') with regard to the
care of sick, injured, and stray animals, a triage system should be developed during a
mass casualty situation. Decisions on treatment or euthanasia should be made by a
veterinarian, in accordance with preexisting guidelines developed in coordination with
state and local officials and other interested parties. The structural facilities of veterinar-
ians, animal control agents, and humane societies should be made available for use as
animal shelters or treatment staging areas.I0

THE SEARCH AND RESCUE OPERATION

Dogs and horses would be useful in the search and rescue phase of disaster interven-
tion. Horses can often traverse areas inaccessible by vehicles. Search dogs are able to
locate missing persons even if they are hidden from view. They are trained to pursue
specific individuals by following the scent left from the particles that have drifted from
the body to the ground and surrounding vegetation. Dogs also scan the air for human
scent in a particular area and can effectively search for an unspecified number of
missing persons in the aftermath of a hurricane. They can work in many situations and
surroundings, for example, in dense brush and high grass, in the woods, on the water,
in rock and mud slides, in floods, and in all types of weather. The Search and Rescue
Dog Committee of the National Association of Search and Rescue estimates that a
single dog team can be as effective as 20 to 30 trained human searchers in locating
missing persons in a given period of time.I4
Veterinarians should be an integral component of search operations during the
disaster, providing primary care as well as therapeutics for sick and injured animals
that are participating in the relief effort, thereby insuring the maintenance of health of
this limited resource.

ANIMAL CONTROL

The destruction of buildings, fences, and other enclosures as a result of hurricanes

may lead to the release of animals that subsequently roam about unrestricted, thus
endangering the health and safety of humans. The unrestricted roaming about of
domestic animals leads to increased interaction with wildlife, as well as with the
human population. Such interaction enhances the probability of these animals becoming
vectors of disease transmission, as well as reservoirs of pathogenic agents otherwise
confined to the wildlife population. As a result, the probability of human exposure to
zoonotic diseases is enhanced. Is
Animal bites are a major concern because they are associated with rabies transmis-
sion. Additionally, these bites cause adverse effects such as pain, anxiety, disfigurement,
and wound infections caused by organisms such as Pasteurella multocida and Clostrid-
ium tetuni. l 6 Earthquakes, like hurricanes can destroy important boundaries that serve
to restrict the roaming about of animals. For example, after the earthquake in Guate-
mala in 1976, a marked increase in the incidence of dog bites was observed, with a
resultant increase in medical costs.'
312 ANNALS NEW YORK ACADEMY OF SCIENCES

Inasmuch as stray animals present a significant threat to humans,15 such animals

should be caught and confined by designated authorities in order to minimize risk of
injury to humans, as well as to minimize the probability of zoonotic disease transmis-
sion. Injured animals found to be in pain and/or suffering may need to be euthanized.”

MAINTENANCE OF MEDICAL SUPPLIES

The availability of medical and veterinary supplies may decrease sharply after a
hurricane because of dislocation of the transportation system and property destruction.
Concurrently, there may be increased need for such supplies for mass medical care.
Decreased supply coupled with increased demand may lead to the reuse of medical
supplies. The improper reuse of medical supplies may result in the transmission of
infectious agents. For example, the human immunodeficiency virus (HIV) has been
transmitted from patient to patient by the reuse of needles in health care facilities in
the former Soviet Union. The hepatitis B virus (HBV) has been transmitted by reused
acupuncture needles in both the United States and Europe.” Given that the ebola virus
is a blood-borne virus, reuse of needles in the veterinary setting may lead to the
transmission of this agent. Veterinarians, because of their experience and training in
microbiology, pharmacology, and other related disciplines, can help insure the proper
disinfection/sterilization of medical and veterinary supplies.
It is crucial to note that disinfectiodsterilization of medical devices may not be
adequate even during non-disaster situations. Studies by Moore et a1.‘* in three states
found that high-level disinfection of endoscopes was not always achieved in actual
practice, and approximately 10% of sterilizers failed the spore strip challenge test,19 a
standard test of sterilizer effectiveness.

INFORMATION DISSEMINATION

The veterinarian also has a potential role in information dissemination. Prior to

and during an emergency, the veterinarian can be the individual who conveys accurately
information about the hurricane to the public.
During and after a hurricane, it may also be necessary to broadcast over public
information systems (provided they are not interrupted as a result of damage caused
by the hurricane) instructions for treatment and quarantine of humans and animals,
as well as instructions on the handling of specimens. Specific problems regarding
livestock management may also be addressed in this manner.

DISASTER ASSESSMENT

Veterinarians should also have a role in the assessment of the impact of the hurricane
on human, as well as animal populations. Veterinarians should be involved in the
collection and reporting of census information on human and animal populations, as
well as economic resources; this may require conducting emergency surveys to provide
information on the status of these resources once a hurricane has occurred.20
The importance of disaster assessment was illustrated when Hurricane Hugo struck
the northeastern coast of Puerto Rico on September 18, 1989, and an estimated 10,300
persons were displaced from their residences to temporary shelters. Because of the
potential for outbreaks of infectious disease (such as gastroenteritis) among shelter
residents, the Puerto Rico Department of Health conducted active public health surveil-
lance of the shelters from September 25 through October 3. The surveillance system
MOORE et aL: HURRICANES AND THE ROLE OF VETERINARIANS 373

was designed to (1) obtain information about the occurrence of infectious diseases; (2)
determine the availability of shelter facilities such as water, toilets, electricity, and
medical care; (3) monitor sanitation; (4)identify health-related topics about which to
educate shelter residents; and ( 5 ) assist in resource allocation.* The veterinarian’s
extensive knowledge in disease and disease processes among affected populations quali-
fies himher for an essential role in such surveillance systems.
There are many other potential roles for the veterinarian with regard to disaster
assessment.*OFor example, veterinarians should help to develop ways in which to use
collected information to determine whether hazardous substances that may be released
subsequent to the impact of a hurricane may affect human or animal health. Veterinari-
ans should also perform animal studies to assess public health effects secondary to the
hurricane, leading to subsequent development of health advisories in accordance with
the findings. This process may need to be repeated and refined in order to remedy the
adverse effects resulting from the current disaster and assist in prevention of future
disasters.

PRE-DISASTER PLANNING

The potential role of the veterinarian in pre-disaster planning is virtually unlimited.

In 1989 the Committee on Local Disaster Management of the American Veterinary
Academy on Disaster Medicine, chaired by Dr. J. Casper, suggested that during the
planning stage of disaster preparedness existing laws should be surveyed to determine
(1) which agencies are in charge, in order to avoid overlapping functions and (2) who
within the agency will take responsibility to avoid confusion during the disaster.I3
Coordination and integration of plans with a number of agencies are essential. The
expertise of the veterinarian should be integrated at each of these levels: (1) the United
States Public Health Service, (2) federal emergency management, (3) Department of
Agriculture, (4) state/local government, and ( 5 ) local veterinary practitioners.
The veterinarian should have an active role in the following activities, which involve
coordination and integration of multiple agencies20: (1) the assessment of essential
resources needed in the emergency; (2) the use of alternative resources to meet essential
demands during and following an emergency; (3) the development of plans and proce-
dures regarding interagency sharing of resources, including energy, equipment, food,
materials, services, transportation, and work force needed during an emergency; (4)
the development of programs to assure the availability of such resources during an
emergency; and ( 5 ) the development of response strategies and procedures necessary
for disaster preparedness.
A disaster emergency-response team should consist of a veterinary task force, which
includes an experienced clinical animal health expert, a veterinary public health expert
for food inspection and other public health issues, and a veterinary epidemiologist.
The activities of such a task force of veterinarians should be coordinated with other
disaster planners. Veterinarians should work in concert with local officials and scientists
of various disciplines, who have the capability of predicting the type of natural disasters
that are likely to occur in a given area. This interdisciplinary pooling of knowledge
would facilitate accurate anticipation and preparedness for any potential disaster. When
Hurricane Hugo struck the northeastern corner of Puerto Rico, thousands of residents
of low-lying and flood-prone areas escaped harm because of timely hurricane warnings
and effective This illustrates the importance of optimal pre-disaster pre-
paredness in minimizing the devastating effects of a disaster.
374 ANNALS NEW YORK ACADEMY OF SCIENCES

THE ROLE OF THE VETERINARIAN IN THE PRIVATE SECTOR

Veterinarians in the private sector should be prepared to play the major role in a
disaster situation by making their supplies, equipment, and premises available as both
human and animal medical aid posts in the impact zone.I2 Veterinary hospitals that
feature current drugs, surgical instruments, respirators, X-ray capability, and steriliza-
tion equipment are adequately equipped to address life-threatening emergencies involv-
ing the human population. The veterinary clinic could be used as a shelter or treatment
area, and also for sterilization and surgical procedures during a hurricane-induced
disaster situation. Primary drugs and supplies, including disinfectants, emergency drugs
for trauma and shock, antibiotics, narcotics, as well as anesthesia facilities, should be
made available; they will be important in the treatment of human and animal injury. lo
In some states, under emergency conditions the state is empowered to cause a veterinar-
ian to surrender his or her animal hospital for use in the care of human patients.22 In
addition to yielding their hospitals for human use, veterinarians in the private sector
could also volunteer to become integral members of the triage and emergency medical
team, working in concert with other medically trained personnel to provide basic first
aid, as well as human lifesaving procedures to disaster victims.I0
Private practitioners are in an ideal position to play a role in the surveillance of
any abnormalities, deaths o r illnesses found in animal populations that may be associ-
ated with the effects of a natural disaster and/or subsequent environmental pollution.
In this way, animal populations can serve as sentinels during a disaster situation.

SUMMARY

Hurricanes create a multiplicity of complicated problems and hazards ranging from

outbreaks of infectious disease to animal control problems precipitated by destruction
of property. A multidisciplinary response is required to solve such problems. The pool
of knowledge derived from various professionals interacting with multiple levels of
government agencies (federal, state, and local) will provide the expertise needed.
Because the veterinarian is trained to deal with disease involving populations of
animals (e.g., herds or flocks) as well as individuals, and because of his/her intensive
clinical training, the veterinarian is uniquely qualified to deal with the disaster situation.
The veterinarian possesses extensive knowledge in disease and disease processes and
has the capability of disease and injury management in affected populations, which
qualifies him/her for an essential role, with unlimited potential as a member of any
disaster relief team.
There is considerable potential for veterinarians to play a role in responding to
natural disasters. The areas of disease control, animal care, animal control, protection
of the food supply, disinfection/sterilization, and planning are all areas where veterinar-
ians can take an active part. Inclusion of the veterinarian in the process of planning
for and responding to natural disasters will yield significant public health benefits.

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