12/11/01: Interim
Smallpox Response Plan & Guidelines - CDC
11/29/01: United
States Army Medical Research Institute of Chemical Defense - Chemical Casualty
Care Division
Execellent Chemical Weapons source of information for medical professionals,
first responders, and public health department
staff. See "Training Materials" for printable/downloadable references.
11/16/01: Important New Content Now
Available:
St. Louis University Center for the
Study Of Bioterrorism & Emerging Infections
10/26/01:
CDC Anthrax Information Page For Health Care Providers
10/12/01: "
The Official CDC Advisory on How To Handle Antrax and Other Biological Threats"
Johns Hopkins University - Center
for Civilian Biodefense Studies
Johns Hopkins University - Interim
Actions Recommendations for Health and Public Health
(A MUST FOR ALL HEALTH PROFESSIONALS AND HOSPITALS)
Enhancing
Bioterrorism Preparedness and Response Post-September 11:
Interim actions for the Medical and Public Health Community
In the wake of the terrorist attacks of September 11, 2001,
the Johns Hopkins Center for Civilian Biodefense Studies has received many requests
for specific guidance regarding bioterrorism preparedness and response. In answer
to these requests, the Center is providing the following suggestions for hospitals,
physicians and public health practitioners
Hospitals
- Review all relevant disaster response plans and assure
appropriately designated staff are familiar with their content and strategies.
- Establish internal and external lines of communication.
Assure that medical staff are aware of the need to report suspicious cases
of illnesses to public health authorities, and are familiar with who these
authorities are. Have in place dedicated staff, phones and fax machines to
support rapid reporting.
- Hospital leaders should establish collaborative strategies
for communicating with neighboring hospitals, civic leaders, and public health
authorities.
- Quantify pharmaceutical and antibiotic supplies,
both at central and satellite facilities. Routinely update this list.
- Assess routine staffing and emergency call-up plans
and assure that these are supported with communication and transportation
strategies. Update the roster of essential personnel.
- Maintain ongoing primary and redundant communication
systems.
- Assure that appropriate health care professionals
(e.g., emergency dept and urgent care dept personnel, infection control and
infectious diseases professionals) are aware of the importance of reporting
unusual disease presentations, disease clusters and atypical patterns of hospital
use and know the mechanisms to do reporting.
Physicians
- Develop an increased awareness of the ongoing threat of
bioterrorism.
- Become familiar with and develop a working knowledge of
the most likely and dangerous pathogens as viewed by the CDC (Note link sites
and fact sheets below)
- Become familiar with relevant lines of communication,
and important and emergency phone numbers (hospital epidemiologist, state
epidemiologist, local health department (may be city or county), and the CDC
emergency number (see below)
- Monitor disease patterns and patient volumes in clinics
and offices. Immediately notify the appropriate authorities if you suspect
an unusual event or need medical guidance.
- Patients can also be referred to the CDC public inquiry
phone number (see CDC numbers below) regarding information
about infectious diseases and bioterrorism preparedness response efforts.
Have referral numbers for mental health and support services as needed.
- The Center is aware that a number of physicians have received
requests for prescriptions for antibiotics to be used in the event of a bioterrorist
attack. It should be known that Centers for Disease Control maintains a National
Pharmaceutical Stockpile of large quantities of antibiotics and vaccines that
could be distributed in the event of an epidemic brought on by an act of bioterrorism.
Public Health
- Local and state public health agencies should collectively
review bioterrorism response plans. Attention should be given to assuring
the integration of response plans, including mechanisms for sharing resources
and personnel as needed.
- Syndromic surveillance procedures should be put in place
to monitor and detect atypical disease presentations and clusters. Both passive
and active surveillance systems should be examined and refined across public
health agencies and with reporting sources.
- Establish and maintain capacity to accept reports of unusual
disease events twenty-four hours a day, seven days a week. Assure systems
of continual, bi-directional communication between public health agencies
and hospitals under their purview.
- Appropriately trained disease investigation staff should
be available for immediate mobilization and deployment as needed. Staffing
levels should be reviewed and plans put in place to determine non-urgent public
health functions and clinics should it be necessary to pull additional clinical
and field staff for urgent investigation activities.
- Assess communication systems, including procedures for
immediately contacting public health and political leaders. Systems should
be assessed to assure that appropriate authorities could be contacted at the
outset of an emergency. Mechanisms for maintaining ongoing communication,
including pagers, cell phones and wireless email systems, should be assessed
and tested. All staff that provide on-call and disease investigation response
and decision-making should be adequately resourced for 24/7 communication.
- Hold regular meetings with all appropriate government
and non-governments agencies and organizations to continually review and refine
plans.
Important
Web Sites and Information
CDC Emergency Number (770) 488-1700
CDC Emergency Chemical and Biological Hotline (770) 424-8802
CDC's Public Inquiry Number (404) 639-3534, (800) 311-3435
CDC's bioterrorism website: www.bt.cdc.gov
JAMA publications:
Anthrax
as a Biological Weapon: Medical & Public Health Management
Botulinum
Toxin as a Biological Weapon: Medical & Public Health Management
Plague
as a Biological Weapon: Medical & Public Health Management
Smallpox
as a Biological Weapon: Medical & Public Health Management
Tularemia
as a Biological Weapon: Medical & Public Health Management
Weapons
of Mass Destruction Events With Contaminated Casualties:
Effective Planning for Health Care Facilities
Fact sheets:
Other Resources
CIDRAP, Center for Infectious Disease Research And Policy
Centers For Disease Control
Bioterrorism Pages
National Association of County
and City Health Officials Bioterrorism Page
ELEMENTS OF EFFECTIVE BIOTERRORISM
PREPAREDNESS: A Planning Primer for Local Public Health Agencies
CDC National Pharmaceutical
Stockpile Program
CDC Health Alert Network
Defense Threat Reduction Agency
Website
APIC (Association for Professionals In Infection
Control & Epidemiology)
Feb 2001 USAMRIID's MEDICAL MANAGEMENT
OF BIOLOGICAL CASUALTIES HANDBOOK
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