The Second National Symposium On Medical And Public Health Response To Bioterrorism Public Health Emergency And National Security Threat Washington 2000

Papers include: bioterrorism: how prepared are we?; the emerging threat of bioterrorism; Congressional efforts to address bioterrorism; finding the right balance against bioterrorism: historical trends related to bioterrorism; the threat of biological attack; nuclear blindness: an overview of the biological weapons programs of the Former Soviet Union & Iraq; Aum Shinriukyo: once & future threat?; the prospect of domestic bioterrorism; potential biological weapons threats; epidemiology of bioterrorism; vaccines in civilian defense against bioterrorism; & vaccines, pharmaceutical products, & bioterrorism: challenges for the U.S. Food & Drug Administration.

Perhaps the most frightening apparition of our times is the possibility that a biological agent (bacterim, virus, or toxin) will be used to attack our unprotected civilian population and inflict mass casualties. Until the Fall of 2001, anthrax attacks delivered through the mail to various U.S. senators, to the Governor of New York, and to various media offices, the previously expected use of a weapon of mass destruction against the United States has been a nuclear device that explodes or a chemical cloud that is set adrift. However, today, of all the weapons of mass destruction (nuclear, chemical, and biological), the biological weapons are the most feared by many defense experts but these are the ones that our country is least prepared to deal with Like the concept of a "nuclear winter," the potential destructiveness of a biological attack can come in many forms and is presently very hard to detect and control, and its results could be catastrophic. The unleashing of biological agents against an unprotected civilian population also, in some cases, constitutes the ultimate medical disaster with the capability to completely overwhelm the present health care system. Patients might go to health facilities in unprecedented numbers and demands for intensive care could well exceed available medical resources. Discerning the threat of bioweapons and appropriate responses to them are critical if we are to prevent the devastating effects of bioterrorism.

The severe budget cuts by fed., state, and local governments are leaving public health (PH) departments understaffed and without the basic capabilities required to respond to crises. Nearly 10 years ago during the 9/11 and anthrax tragedies, it became clear the PH system was out-of-date to face modern health threats -- and an historic investment was made to help upgrade the system. Significant progress was made to improve how we prevent, identify, and contain new disease outbreaks and bioterrorism threats and respond to the aftermath of natural disasters. Now, the economic situation is putting almost a decade of gains at risk. The latest budget cuts will exacerbate the vulnerable areas in U.S. emergency health preparedness. A print on demand report.

Bioterrorism poses a unique challenge to the medical care and public health systems. Unlike an explosion or chemical attack, which results in immediate and visible casualties, the public health impact of a biological attack can unfold gradually over time. Until a sufficient number of people arrive at the emergency rooms and doctors' offices complaining of similar illnesses, there may be no sign that an attack has taken place. The speed and accuracy with which the doctors and laboratories reach the correct diagnoses and report their findings to public health authorities has a direct impact on the number of people who become ill, and the number that die. The nation's ability to respond to a bioterrorist attack, therefore, depends crucially on the state of preparedness of its medical care systems and public health infrastructure. Public health experts have for years complained about the deterioration of the public health system through neglect and lack of funding. They warn that the nation is ill equipped and insufficiently prepared to respond to a bioterrorist attack. For example, they point out that there are too few medical personnel trained to spot biological attacks, a shortage of sophisticated laboratories to identify the agents, and inadequate supplies of drugs and vaccines to counteract the threat. They also contend that inadequate plans exist for setting up quarantines and emergency facilities to handle the sick and infectious victims. Improving public health preparedness and response capacity offers protection not only from bioterrorist attacks, but also from naturally occurring public health emergencies. Public health officials are increasingly concerned about our exposure and susceptibility to infectious disease and food-borne illness because of global travel, ubiquitous food imports, and the evolution of antibiotic-resistant pathogens. This book reviews critical issues in the US public system and its vulnerability or lack thereof to bioterrorism.

On March 3-4, 2008, the Institute of Medicine (IOM) Forum on Medical and Public Health Preparedness for Catastrophic Events hosted a workshop titled "Medical Countermeasures Dispensing." The overall objective was to discuss a range of solutions to rapidly provide medical countermeasures to protect large numbers of people prior to or during a public health emergency, such as a bioterrorist attack or infectious disease outbreak. The United States is currently unprepared to confront the range of threats it is facing, such as an intentional anthrax release, severe acute respiratory syndrome (SARS), or pandemic influenza, and it must plan aggressively to counteract the threat of these and other future public health emergencies. Countermeasure dispensing must harness all types of imaginative partnerships between public and private institutions, working together in ways tailored to meet individual community needs. This workshop summary highlights the presentations and subsequent discussion that occurred at the workshop.