Advance preparation for extreme heat can help prevent deaths among vulnerable individuals such as the elderly and those living alone, according to a report from the CDC.
"Heat-related deaths are preventable, and heat response plans should be in place before an extreme heat event. Interventions should focus on identifying and limiting heat exposure among vulnerable populations," the agency said in the June 7 issue of Morbidity and Mortality Weekly Report.
In one episode of excess heat in Philadelphia in 1993, the fatality rate was 7.5 per 100,000 and in another, in Chicago in 1995, the rate reached 9.7 per 100,000, the authors noted. Overall in the years 1999 to 2009, an average of 658 deaths from extreme heat occurred in the U.S.
For the current report, the authors detailed fatalities during a 2-week period last summer, when there were 32 heat-related deaths in a four-state area when a severe storm -- with winds up to 80 miles an hour -- left almost 4 million people without power, some for longer than a week. The resulting fatality rate was 0.11 per 100,000 population.
The temperatures in Maryland, Virginia, Ohio, and West Virginia from June 30 to July 13 ranged from 83 to 104 degrees, almost 10 degrees higher than normal.
Median age of those who died was 65, 72% were men, and three-quarters were living alone.
A total of 22 of the deaths occurred in the home, and in 20, air conditioning either was not available or not turned on.
Underlying conditions that may have contributed to the deaths included heart disease in 14 and chronic pulmonary disease in four.
During the same 2-week period in the years 1999 to 2009, there had been an average of just eight deaths associated with heat in those four states. As in the current report, most were in males 65 and older.
Vulnerable populations other than the elderly and the isolated are the very young, those with chronic diseases, and those with mental status impairments.
"Interventions during an [extreme heat event] include staying cool, hydrated, and informed about extreme heat alerts in the area and symptoms of heat illness," the report noted.
Symptoms can include fainting, heavy perspiration, and muscle cramps, according to the CDC.
Among the strategies that were implemented in the four affected states were visits to the elderly by the National Guard, college students, and wellness teams, as well as reverse 911 phone calls, Web and social media alerts, and press releases.
In addition, utility officials in Virginia and West Virginia helped identify areas with vulnerable populations and prioritized power repairs.
The report also suggested that municipalities consider opening "cooling stations," where residents without air conditioning can seek relief.
"However, qualitative studies suggest that cooling stations are not well used because of perceived and real barriers, including lack of transportation access, safety issues, stigma of public shelters, inability to bring pets, and limited operating hours," the authors pointed out.
A limitation of the report was the possibility of misclassification or underestimation of heat-related deaths.
"Interventions during an [extreme heat event] include staying cool, hydrated, and informed about extreme heat alerts in the area and symptoms of heat illness,"
The authors include employees of CDC and the state health departments of Maryland, Ohio, Virginia, and West Virginia.
Morbidity and Mortality Weekly ReportSource Reference: CDC "Heat-related deaths after an extreme heat event -- four states, 2012, and United States, 1999-2009" MMWR 2013; 62: 433-436.