Planning bioterrorism

Are there plans to manufacture more vaccine in case of a bioterrorism attack using smallpox ... 

APIC Bioterrorism Task Force and CDC Hospital Infections Program Bioterrorism Working Group. Bioterrorism readiness plan a template for healthcare facilities. Available at http // www.cdc.gov/ncidod/hip/Bio/bio.htm. Accessed October 2001. 

Although we are concerned with the chemical industry in this text, the USEPA-developed Large Water System Emergency Response Plan Outline Guidance to Assist Community Water Systems in Complying with the Public Health Security and Bioterrorism Preparedness and Response Act of2002 (dated July 2003), with minor adjustments,... 

Disasters are frequently categorized based on their onset, impact, and duration. For example, earthquakes and tornadoes are rapid-onset events—short durations but with a sudden impact on communities. Hurricanes and volcanic eruptions have a sudden impact on a community however, frequently advance warnings are issued enabling planners to implement evacuation and early response plans. A bioterrorism attack may be... 

Agency for Healthcare Research and Quality (AHRQ). (2002). Bioterrorism emergency planning and preparedness questionnaire for healthcare facilities. Retrieved from http // www.ahrq.gov/about/cpcr/bioterr.pdf... 

Hodge, J., Brown, E., O Connell, J. (2004). The HIPAA Privacy Rule and hioterrorism planning, prevention, and response. Biosecurity and Bioterrorism Biodefense Strategy, Practice, and Science, 2(2), 75. 

Gostin, L. 0., Sapsin, J. W., Teret, S. P., Burris, S., Mair, J. S., Hodge, J. G., et al. (2002). Model State Emergency Health Powers Act Planning for and response to bioterrorism and naturally occurring infectious diseases. Journal of the American Medical Association, 288 S), 622-628. 

Hazard vulnerability risk assessments need to be reviewed at least on an annual basis. A new industry may have located to the area, or events of the world may have changed. For example, the threat of bioterrorism, emerging infectious diseases, or civil strife may become part of our reality. The emergency management plan may have to be revised, and an appendix may have to be added for newly identified risks. This process then leads to the next phase of disaster management—mitigation. 

Center for the Study of Bioterrorism and Emerging Infections. (2001). Mass casualty disaster plan checklist A template for healthcare facilities. Retrieved from http //www.apic.org/ bioterror/checklist.doc... 

The events of 9/11 and subsequent anthrax attacks underscored the need for U.S. health care organizations and public health agencies to be prepared to respond to acts of bioterrorism and other public health emergencies. Many states and health care organizations and systems have developed preparedness plans that include enhancing surge capacity to respond to such events. 

Burn Centers Are a Unique National Resource. Given the unique nature of burn care and the nationwide availability of highly specialized burn care systems established to address the complex nature of burn injuries, burn centers have been specifically recognized in federal bioterrorism legislation, with subsequent action of the U.S. Department of Health and Human Services (HHS) to incorporate burn centers in state and local disaster plans. Furthermore, although most burn surgeons have the expertise and training to treat burn—as well as trauma— victims in the event of a mass casualty, the reverse is not necessarily so, which supports the need for unique benchmarks to ensure that the needs of the burn-injured are met in the event of a terrorist incident. 

Most attention on the needs of children with respect to disaster planning has been seen in two federal agencies, both within the U.S. Department of Health and Human Services (HHS). The Health Resources and Services Administration has been actively promoting the incorporation of pediatric considerations in state-based disaster plans. This is an ongoing process, consistent with the language of federal bioterrorism preparedness legislation, which has required the inclusion of children s needs in state disaster plans. 

An often over-looked aspect of surveillance for bioterror events is surveillance of animal populations. Several of the agents considered to have bioterror potential are diseases of animals, for example, anthrax and brucellosis (Franz et al., 2001 Inglesby et al., 1999 USAM-RIID, 2005). A covert attack may first become apparent when animals become ill. The need to coordinate information from medical and veterinary sources was illustrated by the epidemiologic investigation during the 1999 West Nile Virus outbreak in New York City. Investigators found that there had been an outbreak in birds several weeks prior to the human outbreak (Fine Lay-ton, 2001). The current surveillance plan for monitoring West Nile Virus infection in the U.S. includes sentinel surveillance of several animal populations (CDC, 2003). 

Koplan, J. (2001). CDC s strategic plan for bioterrorism preparedness and response. Public Health Reports, H6(Suppi. 2), 9-16. 

In spite of this and other warnings, most primary care physicians have spent little time planning for terrorism. One reason may be the rarity of these events, especially on US soil. Until recently, the only reported case of bioterrorism in the United States was the 1984 salmonella attack in Oregon. It is unlikely that authors of family medicine textbooks written before September 2001 considered devoting significant space for discussions about how family physicians should respond to terrorist attacks. 

Compton, MT, Kotwicki, R, Kaslow, NJ, Reissman, DB, Wetterhall, SF. Incorporating Mental Health into Bioterrorism Response Planning. Public Health Reports, 120(Suppl. 1) 16-19, 2005... 

Bioterrorism effects can occur not only from a planned malicious activity, but at times, they are the unwanted and unanticipated result of accidental situations, for which, the ethical implications are clearly extremely different. An accidental explosion (Chernobyl) contaminated inland waters, caused short term bums and wounds, and permanent diseases such as leukemia in a planned war situation (Hiroshima) the effects were very similar. It is therefore very difficult to decide if infections coming from infected water results from occasional contamination by a person contaminating them with biological material, or from a planned terrorist action, aimed at harming the population drinking the water. 

In between, a sort of bioterrorism came to the New World in the fifteenth century, aimed to defeat the Indians. Spanish conquistador Pizarro gave clothing contaminated with the smallpox virus to natives in South America. During the French and Indian War (1754-1767) Sir Jeffrey Amherst, commander of British forces in North America, suggested the deliberate use of smallpox to reduce Native American tribes hostile to the British [116]. An outbreak of smallpox at Fort Pitt results in the opportunity to execute Amherst s plan. On June 24, 1763, Captain Ecuyer, Amherst s subordinate, gives blankets and a handkerchief from the smallpox hospital to the Native Americans and records in his journal, I hope it will have the desired effect. This was followed by an epidemic of smallpox among Native American tribes in the Ohio River valley, which may also have been spread by contact with settlers. Transmission of smallpox by fomites (on blankets) is inefficient compared with respiratory droplet transmission. 

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