RESUMO
Hurricane Hugo struck the island of Montserrat during the night of 17th September, 1989. Sustained winds of 130 mph were experienced for 8 hours with damage to 93 per cent of buildings; 50 per cent seriously and 20 per cent destroyed. The main hospital lost its roof and most health centres were severely affected. Two thousand five hundred persons were rendered homeless, of whom 1,000 were housed in shelters. Three days after, environmental health surveillance revealed unsatisfactory conditions in shelters with inadequate water supplies and faecal disposal. Water was trucked to shelters and a pit latrine programme commenced so that by the first week of October, all shelters had acceptable faecal disposal facilities. Island-wide, symptom-based daily reports of disease surveillance was introduced 9 days after the hurricane for respiratory infections and gastroenteritis. This allowed daily monitoring of disease occurrence by locality, targeting of health education and environmental health measures, and made it easier to dispel rumors which occurred after the hurricane. There was an increase in gastroenteritis 10 - 14 days after, but this subsided as potable water supplies were established. One month after, 30 cases of fever of unknown origin were detected. At first suspected to be dengue fever, it turned out to be influenza A (hl, N1) (AU)