NCJ Number
191570
Date Published
1999
Length
10 pages
Annotation
This chapter examines the capabilities of managing the medical consequences of a biological attack, the issues policy makers face when dealing with those consequences, and the resources available for an effective response.
Abstract
Although terrorist attacks in the United States have been limited, they could potentially kill millions of people; one estimate shows three million could be killed from an aerosol attack in the Washington, DC, area. Lethal natural outbreaks could occur as well. The current health system is not prepared to deal with a large biological attack, despite significant planning efforts. A wide range of biological agents are at terrorists' disposal. Table 9-1 lists some pathogens, their incubation period, response needs, and longer-term needs. The first order of business for first responders is to find out whether the cause of the incident is biological and, if so, identify it. Then they need to determine whether it is naturally occurring or had human involvement. For naturally occurring diseases, traditional containment approaches can be made. For manmade releases, the containment process is more difficult, given the latency of the symptoms of some agents. The four major ways to prevent illness in those exposed are: physical protection, decontamination, administering vaccines, and prophylaxis and treatment. Inhaled anthrax affects the lungs and lymph nodes, with death occurring possibly 5 days later. The botulinum toxin causes a life-threatening neuromuscular paralysis. Ricin kills the lining of the airways and lungs and eventually results in death. Three Enhanced Disaster Medical Assistance Teams deal with weapons of mass destruction and assist first responders, arriving at the scene 12 hours after notification. Sixty Chemical/Biological Rapid Deployment Teams diagnose the agents involved, help those exposed, and support the remediation of the consequences. Only 167 of the estimated 6,400 hospitals in the country can provide services to address those affected by biological agents. Enough occupancy and medical supplies are other concerns for the aftermath of an incident. Storage capacity for protective gear, academic health centers that train health professionals, and a large pharmaceutical industry are other factors to consider for readiness. Although the military was ready to deal with chemical and biological agents in the Gulf War, their destruction by friendly forces still created problems. Other issues will continue to be present in managing the medical consequences of biological attacks: adequacy of personnel, facility resources, materials, and awareness of potential problems associated with various civil and military health delivery systems. Footnotes