• C Bern, J Sniezek, G M Mathbor, M S Siddiqi, C Ronsmans, A M Chowdhury, A E Choudhury, K Islam, M Bennish, and E Noji.
• Respiratory and Enteric Virus Branch, Centers for Disease Control, Atlanta, GA 30333.
• Bull. World Health Organ. 1993 Jan 1;71(1):73-8.

AbstractCyclones continue to pose a dangerous threat to the coastal populations of Bangladesh, despite improvements in disaster control procedures. After 138,000 persons died in the April 1991 cyclone, we carried out a rapid epidemiological assessment to determine factors associated with cyclone-related mortality and to identify prevention strategies. A nonrandom survey of 45 housing clusters comprising 1123 persons showed that mortality was greatest among under-10-year-olds (26%) and women older than 40 years (31%). Nearly 22% of persons who did not reach a concrete or brick structure died, whereas all persons who sought refuge in such structures survived. Future cyclone-associated mortality in Bangladesh could be prevented by more effective warnings leading to an earlier response, better access to designated cyclone shelters, and improved preparedness in high-risk communities. In particular, deaths among women and under-10-year-olds could be reduced by ensuring that they are given special attention by families, neighbours, local authorities, and especially those in charge of early warnings and emergency evacuation.

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