Transcript No Slide Title

UNDERSTANDING BIOTERRORISM:
The United States Conference of Mayors
Mayors Emergency, Safety & Security Summit
October 24, 2001
Tara O’Toole, MD, MPH
www. hopkins-biodefense.edu
Lethality Mirroring Nuclear Weapons
Bioweapons Program in Iraq
Gaseous Diffusion Plant
Germ fermenters at the former Bioweapons plant in Stepnogorsk,
Kazakhstan, which are now being dismantled with American aid.
Advances in Biotech, Genomics:
Potential for More Potent Bioweapons
• Understanding genetics of virulence, antibiotic
resistance
• Development of global profiles of
microorganisms
• New ways to control interaction of human cells
and microorganisms
• Manipulation of entire genomes
Global Interconnectedness and Vulnerability:
Enhanced Conditions for Swift Spread of Infectious Disease
• Antibiotic Resistance
• Urbanization - Crowding, Poor Sanitation,
Malnutrition
• Human Intrusion
• International Travel and Commerce
• Globalization of Food Supply
The Consequences of a Biological
Weapon Attack Would be an Epidemic
The response required is fundamentally
different from that demanded by natural
disasters,
conventional
explosives,
chemical terrorism or nuclear weapons
Child with Smallpox in Evolution
“Top 6” Bioweapon Agents
Smallpox
 Anthrax
Plague
 Tularemia
 Botulinum Toxin
 Viral Hemorrhagic Fevers
Contagious
Smallpox
• Worst case threat?
• Weaponized by Soviets - Others?
• Contagious - spreads via inhalation
• Vaccine effective even 3-4 days after
exposure
• No treatment, 30% mortality
• Current vaccine: 15m doses, more coming
Bioweapon Response - Vulnerabilities
• Public Health
• Medical Care
• Technologies
• Connectedness: Communications,
Coordination, Collaboration
Vulnerabilities –
Public Health “System”
• Fragmented
• Understaffed, underfunded
• No surge capacity
• Strategic / operational capabilities
Vulnerabilities –
Medical Care “System”
• No surge capacity – hospitals, pharmacies
• Autonomous organizations
• Hospitals, doctors not engaged in
Bioterrorism preparedness
Vulnerabilities – R + D + P Needs
• Rapid reliable diagnostics
• Vaccines, drugs for major agents
• Connect Response Sectors:
Information Flows
What Mayors Should Do?
1. Engage clinicians, hospital leaders
2. Connect Medicine and Public Health
3. 24x7 Public Health Response
- Outbreak investigation
- Distribution of drugs, vaccine
4. Assess Lab Capacity
5. Establish Communication Links
6. Identify technical advisors
Engage Hospitals
– Review disaster plans: mass casualty,
contagious dz
– Educate Staff
– Community – wide response
– Communications – external & internal
– Review Inventories of drugs, supplies