November 29, 2001
Planning
for Bioterrorism
A
preview of selected text from the upcoming book:
“Physical and
Biological Hazards of the Workplace, Second
Edition”
By Peter H. Wald, MD and
Gregg M. Stave, MD
Concerns about biological
warfare and bioterrorism have existed for
several decades, and have been heightened by the
horrific events of September 11, 2001 , and
their aftermath.
Several countries are
known to have had biological warfare programs
and stocks of agents are known to exist. At
least 35 agents and organisms have been
classified as possible bioterrorism concerns.
The most widely discussed are anthrax, botulism,
plague, tularemia, and smallpox (Table 20-5.).
An epidemic of anthrax occurred in the former
Soviet Union following an accidental release
from a military facility in Sverdlovsk in 1979.
As of this writing, in October 2001, there had
been more than a dozen exposures to anthrax sent
through the mail in the US , resulting in
several cases of cutaneous anthrax and one
fatality due to inhalation anthrax. These
episodes have led to heightened fears about the
possibility of further small and also
large-scale bioterroism activities.
While publicized
incidents of bioterrorism lead to significant
fears, it should be kept in mind that the actual
risk of being involved in an event is extremely
small. The dissemination of large quantities of
bioterroism agents and organisms fortunately has
many significant technical challenges.
A prudent response to
concerns involves different actions for
individuals, professionals, and organizations.
In general, people should be reassured that
their personal risk is very low, and that they
should take reasonable precautions in everyday
life. This includes not handling suspicious
looking mail and packages, and accessing their
local emergency response system as needed. The
practices of hoarding antibiotics or using
antibiotics without a medical diagnosis should
be discouraged.
For the medical and
emergency response community, there is a need to
learn to recognize the signs and symptoms of
bioterrorism agents and organisms (Table 20-5.).
This is of special concern because many of these
diseases are otherwise uncommon, or, as in the
case of smallpox, have not been seen for
decades.
Significant improvements
in the public health infrastructure are needed
to enhance readiness for bioterrorism. Increased
funding of these activities is likely in light
of the events of 2001.
The animal care community
also plays a role in surveillance, since some of
the organisms involved are animal pathogens.
Veterinarians, farmers, and others who work with
and care for animals need to recognize potential
public health implications of certain problems
seen in animals.
Organizations and
companies that handle mail and packages need to
develop prudent handling procedures to recognize
and isolate suspicious items. Medical,
maintenance, safety, and security staffs, and
emergency response personnel should receive
appropriate training.
Finally, concerns about
bioterrorism should be kept in perspective in
the context of the everyday risks to life and
health. Most preventable morbidity and mortality
is due to addictions (especially tobacco) and
modifiable lifestyle factors, and treatable
diseases and risk factors. Individuals,
healthcare personnel and health systems should
maintain and increase the focus on these more
mundane issues, as they will ultimately have the
greatest impact on life and health.
CLICK
HERE to view Table 20-5. Potential Biological
Warfare Agents
Courtesy of Michael
Hodgson, M.D., http://occenvmed.net/biocard16.doc
, accessed 10/16/01
Bioterrorism Websites
http://www.bt.cdc.gov
http://www.hopkins-biodefense.org
http://biotech.law.umkc.edu/blaw/govdocs.htm
http://biotech.law.umkc.edu/blaw/Bioterror.htm
http://www.ama-assn.org/ama/pub/category/6206.html
http://www.usamriid.army.mil/education/bluebook.html
http://miemss.umaryland.edu/WMDSupplement.pdf
http://www.nbc-med.org
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“Physical
and Biological Hazards of the Workplace, Second
Edition”
by Peter H. Wald, MD and Gregg M. Stave, MD
NEW! Now extensively
updated and expanded, this practical
"how-to" reference provides an
overview including basic information on either
the physical type or underlying biology of
workplace hazards. The new edition includes
updated references and latest research.
Biological agents are covered in equal depth,
from the fundamentals of microbiology and
infectious disease, to the specific details of
organic hazards like wood dust and endotoxins.
Release date, December 2001. Hardcover, 600
pages.
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