Local public health departments have long experience in responding to infectious disease outbreaks and other local emergencies with public health implications. The USA has made progress and learned important lessons about the challenges of bioterrorism preparedness in the last few years. No matter what threats are posed to the county, the Allegan County Public Health Department is ready to react and adjust to any public health threat.
The Centers for Disease Control and Prevention (CDC), in conjunction with local, state and federal partners, has developed a number of federal initiatives designed to strengthen state and local preparedness. For example, the Health Alert Network (HAN) is a nationwide, integrated information and communication system serving as a platform for distribution of health alerts, dissemination of prevention guidelines and other information.
The National Electronic Disease Surveillance System (NEDSS) is a system designed to rapidly report unusual outbreaks of disease so that trained epidemiologists can investigate them further to determine if there has been a deliberate pathogen release. If such a release has been detected, the Strategic National Stockpile (SNS) Program ensures the availability and rapid deployment of life-saving pharmaceuticals and other medical supplies and equipment necessary to counter the effects of nerve agents, biological pathogens and chemical agents.
Bioterrorism is possible, but not probable. However,in light of the recent terrorist events, the threat from a biological agent seems more real and is more likely than ever. If an event takes place, its effects would depend greatly on the pathogen used, kind of attack, location and wind conditions.
- Anthrax: starts with flu-like symptoms. It does not spread from person-to-person.
- Smallpox: starts with fever, aches, vomiting and progresses to body blisters. It spreads directly from person-to-person through airborne transmission.
- Plague: symptoms include fever, chills and cough. It spreads directly from person-to-person through airborne transmission.
Botulism: symptoms include difficulty speaking, seeing and/or swallowing. It does not spread from person-to-person, but has been associated with food-borne contamination.
- Tularemia: symptoms include fever and a pneumonia-like illness. It is not spread from person-to-person.
- Viral Hemorrhagic Fevers (VHFs): start with fever, fatigue, dizziness, muscle aches and exhaustion. Some VHFs (Ebola, Marburg, Lassa and Machupo) have been known to be transmitted from person-to-person through close contact.
Antibiotics and vaccines present their own unique issues. For instance, for some infectious agents like anthrax, antibiotics are only effective when taken before symptoms occur. Antibiotics can also cause side effects and should only be taken with medical supervision. Finally, taking antibiotics that are not medically indicated before a bioterrorism event occurs can limit their effectiveness should a bio-terrorism act ever take place.
The anthrax vaccine is only available to military personnel and many public health experts question its effectiveness. Moreover, six to seven doses over a period of about a year are required for maximal effectiveness to be achieved. A supply of smallpox vaccine is stored centrally, and the vaccine is not generally available to the public. Routine administration of the vaccine up to its discontinuation in the 1970s was associated with vaccine-caused deaths and illness.
Gas masks were designed for use by the military in case of a chemical attack. A mask would protect you only if you were wearing it at the time of an attack. To wear a mask continuously or just in case a terrorist attack occurs is impractical, if not impossible.
There are other problems with gas masks. To work effectively, masks must be specially fitted to the wearer, and wearers must be trained in their use. This is usually done for the military and for workers in industries and laboratories who face routine exposure to chemicals and pathogens on the job.
Also, gas masks were not designed to protect against biological agents. Gas masks purchased at an Army surplus store or off the internet do not carry any guarantees that they will work.
Many antibiotics are effective for a variety of diseases, but there is not one antibiotic that is effective against all diseases. Thus, not a single pill that can protect against all types of biological weapon attacks. Keeping a supply of antibiotics on hand poses other problems because the antibiotics have a limited shelf life before they lose their strength.
There is currently not any justification for taking antibiotics as a generic protection. Also, it should be known that antibiotics can cause side effects. Using antibiotics when not necessarily will eventually make them not effective against the infectious agents they are used to fight, by promoting the rise of resistant strains.
CDC does not recommend that influenza vaccination be considered as a way to avoid confusing influenza disease with suspected Anthrax illness. Influenza vaccine is the primary means to prevent influenza and its severe complications, including pneumonia, hospitalization and death. Complications most often occur among persons older than 65 years and among persons younger than 65 years who have certain medical conditions.
Many other infectious agents (including Anthrax) can cause illnesses that begin with flulike symptoms (fever, body aches and headaches). The flu shot can prevent 70-90 percent, but not all, influenza infections. The vaccine does not prevent flu-like illness caused by agents other than influenza.
Influenza vaccine should be targeted toward groups that are at increased risk of complications and toward health care workers. The CDC recommends that these groups be prioritized for vaccine available in October and that efforts to vaccinate these groups continue throughout the influenza season. Lower influenza vaccine coverage of high risk persons could lead to an increase in influenza-related hospitalizations and deaths. Receipt of influenza vaccine in November and later is encouraged for those who live with highrisk persons, for healthy people aged 50-64 years, and for others who wish to reduce their chances of getting influenza.
If you believe you have been exposed to an infectious bio-agent or if you develop symptoms which you believe might be associated with such an exposure, immediately contact your primary health care provider to discuss your possible exposure. Your primary health care provider may chose to contact your local health department, which has access to information that can help your physician determine a course of action to best evaluate and treat your symptoms based on the circumstances of the possible exposure incident.
One area not receiving much attention is mental health and the services that will be needed to screen, identify and treat those that will suffer greatly from surviving a bioterrorist event not to mention the millions of Americans some experts predict will need treatment for psychological trauma suffered on September 11, 2001. PTSD is the inability to cope and function in daily life following a traumatic event. The most common symptoms include:
- Re-living the event through recurring nightmares or other intrusive images that occur at any time. People who suffer from PTSD also have extreme emotional or physical reactions such as chills, heart palpitations or panic when faced with reminders of the event.
- Avoiding reminders of the event, including places, people, thoughts or other activities associated with the trauma. PTSD sufferers may feel emotionally detached, withdraw from friends and family, and lose interest in everyday activities.
- Being on guard or being hyper-aroused at all times, including feeling irritability or sudden anger, having difficulty sleeping or concentrating, or being overly alert or easily startled.
A psychiatrist, psychologist, licensed professional counselor, licensed clinical social worker or other qualified healthcare professional who provides counseling related to trauma can identify whether a person has PTSD and can discuss options for appropriate treatment. If you believe you are suffering from PTSD contact your primary health care provider to discuss your situation. For more in-depth information, visit Post-Traumatic Stress Disorder Alliance.