Tornado-related fatalities--five states, Southeastern United States, April 25-28, 2011.

During April 25-28, 2011, a massive storm system generated 351 tornadoes (including 15 registering 4 or 5 on the Enhanced Fujita [EF] scale*), killing 338 persons in Alabama, Arkansas, Georgia, Mississippi, and Tennessee. This was the third-deadliest tornado event in the United States, surpassing an April 1974 event that resulted in 315 fatalities. This event also was historic because of the record number of fatalities that occurred despite modern advances in tornado forecasting, advanced warning times, and media coverage. Risk factors for death and injury from tornadoes are sheltering in mobile homes, proximity to an EF-4 or EF-5 tornado, being an older adult (aged ≥65 years), lack of accessibility to safe rooms (e.g., basements or reinforced shelters), and a night-time tornado impact. To describe the fatalities by demographic characteristics, type of shelter used, cause of death, and tornado severity and location, CDC reviewed data from the American Red Cross (Red Cross), death certificates, and the National Weather Service (NWS). This report summarizes the results of that review. Among the 338 decedents, median age was 55.0 years (range: 4 days-97 years); approximately one third were older adults. On tornado impact, 46.7% of decedents were in single-family homes, and 26.6% were in mobile homes. The leading cause of death was traumatic injury, including 21.9% with head injuries. Half of the deadly tornadoes were rated EF-4 or EF-5 and were responsible for 89.5% of the deaths. To prevent tornado-related deaths, health messaging should encourage the public (especially older adults and residents of mobile/manufactured homes) to pre-identify an accessible safe room, prepare the room with personal protection items (e.g., blankets and helmets), and monitor local weather.