Bioterrorism Presentation

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Bioterrorism Presentation

• Sharon F. Grigsby, MBA
• Executive Director
• Bioterrorism Preparedness Program
• Public Health
• Department of Health Services
• County of Los Angeles

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The events of Fall 2001 Challenged Us All

• Our Sense of Invulnerability
• Our Self-Confidence
• Our Awareness of Public Infrastructure,
• and
• Our Definitions of First Responders

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Will the first response to a BT attack be this
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. or this?
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Its more likely to look like this.
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or this.
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Government Responds

• January 2002, President approves
• 1.1 billion for Bioterrorism Preparedness
• All fifty states, the territories and 4 major
• metropolitan areas receive funding

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HHS Funding Sources

• Centers for Disease Control and Prevention
• Focus on infectious disease control, public
  health needs
• Los Angeles, Chicago, New York, D.C. funded
• Los Angeles receives 24.6 million
• Health Resources and Services Administration
• Funding to States for Hospital Preparedness
• Los Angeles receives 3.6 million
• Office of Emergency Preparedness
• Funding provided for Metropolitan Medical
  Response Systems for 120 largest cities
• LA, Long Beach, Glendale funded in LA County

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CDC Funds Public Health for Bioterrorism,
Emerging InfectiousDiseases and other Public
Health Emergencies

• Develop Comprehensive BT Plans
• Upgrade Disease Surveillance and Investigation
• Implement HASTEN with Health Providers
• Enhance Public Health Laboratory Capability
• Develop Risk Communication Capacity

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Lessons Learned from Anthrax Threats

• Inadequate internal communication system
• Need real time communication with most physicians
• Public communication strategy essential
• Full time central coordination essential

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Los Angeles County Public Health Threat
Activities Pre-Sept 11th

• 1999 CDC Funding of 800k
• Development of Epidemiology Surveillance
  Capacity
• Development of Emergency Communications HASTEN
• Enhance Lab Capacity

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The Role of Public Health

• Being Prepared
• Education of medical
• community
• Education of public
• Training of special response teams
• Participation in exercises for different
  scenarios
• Development of communication systems
• Development of interagency protocols

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The Role of Public Health

• Initial Response to BT Induced Disease
• Early detection through surveillance/ rapid
  assessment of reports
• Mobilize laboratory
• Rapid confirmation of agent, site, initial
  at-risk population, prophylaxis and/or treatment
• Alert medical community, ERs, labs
• Implement disease specific plans (e.g. Smallpox)
• Determine resource needs and possible quarantine
• Coordinate with partner agencies
  (local/state/national)

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The Role of Public Health

• Continued Response to BT Induced Diseases
• Closely monitor communication network for new
  information
• Provide, accurate, timely information to public
• Continue epidemiologic investigation to refine at
  risk population
• Assess environmental contamination
• Provide or coordinate testing/ prophylaxis/
  treatment to at-risk population
• Access biological stockpiles as necessary

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BT Challenges in Los Angeles

• Large geographical area/mobile population
• real-time reporting mapping applications
• Victims and/or those they infect may disperse
  before attack recognized
• communication strategy focusing on effective use
  of news media
• Victims may present at geographically dispersed
  medical offices and hospitals
• health provider/facility communication and
  reporting network

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BT Challenges in Los Angeles

• Early signs/symptoms nonspecific
• Provider education through multiple means
• Medical and laboratory communities not familiar
  with rare BT diseases
• establish syndromic surveillance
• provide training to increase awareness
• enhance collaboration between medical community
  and Public Health

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CDC Public Health Bioterrorism Preparedness and
Response Grant

• 24.6 million
• Six Focus Areas
• Planning
• Surveillance and Epidemiology
• Biological Laboratory Capacity
• Health Alert Network System
• Public Information and Risk Communication
• Training

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Los Angeles County Department of Health
ServicesBioterrorism Response
Jonathan E. Fielding, M.D., M.P.H. Director and
Health Officer John F. Schunhoff, Ph.D. Chief of
Operations -Surveillance -Bioterrorism -Community
-wide Disease Reporting -Health Community
Communications -Laboratory -Quarantine -Mass
Immunization Prophylaxis -Smallpox Plan
Virginia Price Hastings Director John Celentano,
M.D. Chief of Operations -Operational
Medicine/Departmental -Disaster
Coordination -Security -NPS Plan -Hospital
Preparation for PPE/Decon Education/Training for
Hospitals, First Responders Force Protection and
Others -MMRS -DMAT and NMRT-West
Teams -Coordination with Fire, Law and State and
Federal Government
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Assessment and Planning

• Assess existing public health preparedness
  status, including legal preparedness.
• Prepare Countywide response plan.
• Complete Regional response plan.
• Plan and implement exercises to test all aspects
  of response plans.
• Develop plan for National Pharmaceutical
  Stockpile use.

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Surveillance and Epidemiology

• Enhanced electronic disease surveillance
• Integrated Data Repository
• Establish and exercise mass prophylaxis plans
• Develop Epi Rapid Response Teams

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Enhanced Surveillance Activities

• Surveillance for influenza (data collected by
  state)
• ACD-Coroner Project
• Collaborating with the Office of the Coroner to
  monitor unexplained deaths
• Provides data on all non-trauma coroners cases
  to monitor for possible infectious causes.
• Animal illness/death surveillance (web-based)
• ED Syndromic Surveillance
• ReddiNet CDC grant to explore adaptation for
  surveillance needs
• ED syndromic surveillance and rapid reporting
  pilot in 4 hospitals

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Laboratory Capacity

• Increase ability for rapid testing and
  identification of biological agents.
• Train local labs for bioterrorism preparedness.
• Increase availability of lab staff trained for
  bioterrorism.
• Relocate and renovate lab.

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Communications and Technology

• Develop systems for secure electronic exchange of
  public health information.
• Create mechanisms for broadcast messages and
  alert notifications.
• Improve communications technology pagers,
  radios, satellite phones.

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Health Information and Risk Communications

• Develop public health bioterrorism messages for
  pre and post event use.
• Prepare materials in multiple languages.
• Train departmental spokespersons.

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Education and Training

• Assess public and staff needs for education on
  bioterrorism.
• Develop courses and curricula for bioterrorism
  preparedness.
• Develop partnerships with community stakeholders
  to disseminate information.
• Test effectiveness of educational programs and
  revise.

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Providing Information to the Public

• Bioterrorism website www.labt.org
• 52,800 hits in since October 1, 2001
• Health Info Line
• Over 1,200 calls in October and November
• 55 related to anthrax
• Community Presentations
• Over 200 since September 11, 2001
• Brochures
• Over 35,000 distributed

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END