|
Department of Health Services Emergency Preparedness Office
Kelvin Yamada, Environmental Specialist IV
Terrorism:
The unlawful use of force or violence against persons or property to intimidate or
coerce a government or civilian population in the furtherance of political or
social objectives.
What is Biological Terrorism?
The use or threatened use of biological organisms or their toxins against humans,
agriculture, or the environment for terrorist aims.
1984 The Dalles, Oregon
- Cult led by Bhagwan Shri Rajneeshee contaminated salad bars with salmonella
typhimurium.
- 751 residents fell ill.
- Change the voter ratio in favor of the cult.
- Dead rodents, raw sewage, salmonella in The Dalles water supply.
November 8, 2001
- The last case of systemic anthrax in the U.S. was in 1976, in a California weaver
working with imported yarns.
- Centers for Disease Control (CDC) discloses that 32,000 people have been prescribed antibiotics for anthrax.
- 5,000 were found at risk for infection (must take antibiotics for a full 60 days).
- That includes 10 victims of inhalation anthrax, of whom four died, and seven people
who suffered the skin variety.
Category A Diseases/Agents
- Can be easily disseminated or transmitted from person to person.
- Result in high mortality rates and have the potential for major public health impact.
- Might cause public panic and social disruption.
- Require special action for public health preparedness.
Anthrax, Botulism, Plague, Smallpox, Tularemia,
Viral hemorrhagic fevers (filoviruses [e.g., Ebola, Marburg] and arena viruses
[e.g., Lassa, Machupo)
Category B Diseases/Agents
Second highest priority agents include those that:
- Are moderately easy to disseminate
- Result in moderate morbidity rates
- Require specific enactments of CDC’s diagnostic capacity and enhanced disease surveillance
Brucellosis, Epsilon toxin of Clostridium perfringes
Food safety threats (e.g., Salmonella species, Escherichia coli, Shigella)
Glanders, Melioidosis, Psittacosis (Chlamydia psittaci)
Q fever, Ricin toxin, Staphylococcal enterotoxin B
Typhus fever, Viral encephalitis, Water safety threats, (e.g. Vibrio cholerae,
Cryptosporidium parvum),
Coxiells burnetti
Category C Diseases/Agents
Third highest priority agents include emerging pathogens that could be engineered for mass
dissemination in the future because of:
- Availability
- Ease of production and dissemination
- Potential for high morbidity rates and major health impact
Emerging infectious disease threats such as Nymph virus and hantavirus.
Federal Proposals to Enhance Biological Terrorism Response
CDC grants in seven separate focus areas:
- preparedness planning and readiness assessment
- surveillance and epidemiology capacity
- laboratory capacity-biologic agents
- laboratory capacity-chemical agents
- health alert network/training
- public information and communication
- education and training
Department of Health Services (DHS) Emergency Preparedness Office Bioterrorism Plan Development
- Enhance existing DHS infrastructure to respond to potential bioterrorism incidents.
- Incorporate local and federal resources into DHS’ bioterrorism response.
- Provide technical resources to local, state and federal agencies.
- Utilize California’s Standardized Emergency Management System (SEMS).
- Complete the DHS mission for public health disaster recovery.
DHS Disaster Mission
Preserve, protect, and restore the health of the
citizens in the disaster area through the provision, support, or restoration of
public health and medical care services and programs.
Components of SEMS
- incident command system
- multi-agency coordination
- master mutual aid agreement
- operational area concept
Plans and Guides--California DHS
http://www.dhs.cahwnet.gov
California Bioterrorism Surveillance and Epidemiologic Response Plan
California Hospital Bioterrorism Response Planning Guide
California Bioterrorism Surveillance and Epidemiologic Response Plan
The newly established Bioterrorism (BT) team of the Disease
Investigations and Surveillance Branch is part of a multidisciplinary DHS
initiative to strengthen public health infrastructure to detect, identify,
investigate, and control illnesses due to biological or chemical terrorist
attacks.
California Hospital Bioterrorism Response Planning Guide
“Early verbal and/or electronic communication
with local health departments will be essential in controlling or preventing,
not only disease transmission, but also fear and panic.”
“Reducing the incidence of
transmission of infectious agents…to staff, patients, and the community will
depend on how rapidly victims, including the worried-well can be triaged,
diagnosed, isolated when necessary, and treated.”
Regional Disaster Medical/Health Coordinator (RDMHC)
Health and Safety Code Section 1797.152
“In the event of a major disaster … a RDMHC in a region unaffected by the
disaster may coordinate the acquisition of requested mutual aid resources from
the jurisdiction in the region. ... may develop plans for the provision of
medical or public health mutual aid among the counties in the region.”
The Emergency Authority of the Local Health Officer
Health and Safety Code Sections
101040 and 101475
“The County (or City) Health
Officer may take any preventive measure which may be necessary to protect and
preserve the public health from any public health hazard during any “state of
war emergency,” “state of emergency,” or “local emergency” …within
his jurisdiction.”
DHS Joint Emergency Operations Center Role
- Coordinate information and resources in support of the medical and public
health disaster response.
- Acquire public health and medical personnel
- Acquire medical supplies, pharmaceuticals and equipment
- Coordinate resources and support for DHS field emergency response
activities.
- Ensure information flow to DHS and EMSA management and executive staff,
Office of Emergency Services (OES), and other agencies.
Primary DHS Response Programs
- Drinking Water Field Operations Branch
- Food and Drug Branch
- Radiologic Health Branch
- Environmental Management Branch
- Emergency Preparedness Office
- Nuclear Emergency Response Program
- Licensing and Certification
- Communicable Disease Control Division
- Environmental and Occupational Disease Control
Bioterrorism Laboratory Network Specifications
- CDC sponsored program
- Network coordination by contract with Association of Public Health
Laboratories (APHL)
- All labs/levels connected with redundancy
- Emphasis on rapid turn-around, accuracy
- Central point-of-contact for technology validation and transfer
- Scientific steering group
- Free research and development (R&D) labs to do R&D
- Partner with Department of Justice (DOJ) and others to serve needs
Public Health Laboratory Network
- A--clinical and small public health labs
- B--major county and small state public health labs
- C--major state public health labs
- second level confirmation
- D--research and development
- federal and private partners (Presbyterian Healthcare Services (PHS),
Department of Defense (DOD), National Library (NL), Industry)
National Pharmaceutical Stockpile (NPS)
NPS Components
A two-Tiered response
- 12-Hour Push Packages:
- Ready for deployment to reach designated airfield within 12 hours of
federal activation.
- Pre-positioned in environmentally controlled and secured facilities.
- Pre-configured for rapid identification and ease of distribution.
- Vendor Managed Inventory (VMI) Packages:
- Will be shipped to arrive within 24 and 36-hour periods.
- Are comprised of pharmaceuticals and supplies that
are delivered from one or more VMI sources.
- “Tailored" to provide specific materiel depending upon suspected or confirmed agent.
What Will the First Shipment (12 Hour Push Package) Look Like?
- 130+ air cargo containers
(50 each 43 x 60.5 x 80, 80 each 43 x 60 x 64)
- 5,000 square feet (10,500 cubic feet)
- 50 tons of materiel
- Fills one 747 aircraft, several smaller aircraft, or four 48 ft trucks
- Valued at over $3 million
- Accompanied by CDC technical support team
NPS Contents
Pharmaceuticals:
- Antibiotics; Doxycycline, Ciprofloxcin, Gentamicin, Erythromycin
- Mark I kits, diazepam, atropine, pralidoxime (2PAM)
IV Supplies:
- catheters, syringes, fluids, heparin-locks, administration sets
Airway Supplies:
- ventilators, ambu-bags, ET tubes, laryngoscopes, suction devices, oxygen masks, NG tubes
Other Emergency Medications:
- For hypotension, anaphylaxis, sedation, pain management
Bandages and Dressings
Vaccine
Agenda
|
