Transcript Public Health Issues Associated with Biological and Chemical

Public Health Issues Associated with
Biological and Chemical Terrorism
Scott Lillibridge, MD
Director
Bioterrorism Preparedness and Response Activity
National Center for Infectious Diseases
Centers for Disease Control and Prevention
HHS Activities Related to Biological
and Chemical Terrorism




Office of Emergency Preparedness
National Institutes of Health
Food and Drug Administration
Centers for Disease Control and Prevention
Lessons from the 1994 Sarin
Release in Tokyo





Health communications
Syndrome response
Surveillance (biological, chemical)
Laboratory preparedness
Importance of health care providers
Public Health and Medical Concerns Related
to Biological and Chemical Terrorism


Agents that cause morbidity
Agents that cause mortality
Health Presentations at the
Community Level



Overt event
Event of unknown etiology
Threats and hoaxes
Public Health Issues Associated with
Chemical Terrorism



Localized casualties
Limited secondary spread
Limited delayed onset
Public Health Issues Associated with
Biological Terrorism




Event spread over days to weeks
Victims migrate
Unexplained deaths may be first clue
Secondary spread
Special Public Health Considerations
Related to Biological & Chemical Terrorism




Wide range of biological and chemical threats
Person to person spread - most worrisome
Severity/lethality
Availability of a therapy
Key Issues Related to Public Health
Preparedness



Threats trigger public health and medical action
Clinical presentation linked to alert
Community health assets linked to state and
federal responders
Critical Tasks for
Public Health Response






Means of transmission
Population at risk
Suggest control measures
Coordinate lab assays
Geographic area
Implement surveillance
FY99 CDC Bioterrorism Funding
$121,750,000
Response
(Surveillance
& Epidemiology)
$16.75M
Planning
$3M
Stockpile
(Vaccine, Drugs)
$51M
Laboratory
$23M
Health Alert
(Communications)
$28M
Priority CDC Extramural Activities






Preparedness planning
Surveillance and epidemiology
Laboratory capacity for biologic and chemical
agents
Health communication systems
Training
Establish key liaisons
Priority CDC Intramural Activities





Expand CDC’s capacities for epidemiologic
response
Create a rapid diagnosis laboratory system
Maintain a National Drug & Device Stockpile
Training
Administer the Select Agent Rule
Selected CDC Collaborations for
Biological and Chemical Preparedness



USAMRC: Chemical and Biological
Preparedness/Training
Air Force/Army: Epidemic Intelligence Service
Training
VA: Pharmaceutical Stockpile
The “Ideal”
Who Should Health Care Providers Call for Assistance
Regarding Biological or Chemical Emergencies
Health Provider
Clinic/Hospital Authorities
(Infectious Disease Authorities/Poison Control)
County Health Officer/Epidemiologist
State Health Officer/Epidemiologist
Federal Health Partners-CDC
CONCLUSION
Key Issues for Health Providers




Training
Linkages/coordination
Early identification of covert release
Building critical infrastructure
Points of Contact

US Public Health Service
– 1-800-872-6367
– www.cdc.gov/ncidod/diseases/bioterr.htm

Domestic Preparedness Information Line
– 1-800-368-6498
– www.nbc-med.org

National Response Center
– 1-800-424-8802

National Disaster Preparedness Office (DoJ)
– (202) 324 8186

U.S. Army Medical Research Institute of
Infectious Diseases (USAMRIID)
– Commander
 (301) 619-2833
– Operational Medicine Division
 (301) 619-4276
– 24 hr Biological Incident Hot Line
 1-888-USA-RIID (1-888-872-7443)
– www.usamriid.army.mil

U.S. Army Medical Research Institute for
Chemical Defense (USAMRICD)
– Chemical Casualty Care Division

(410) 671-3393