Public health is much better prepared to respond to a bioterrorist threat than it was before September 11, 2001

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Public health is much better prepared to respond to a bioterrorist threat than it was before September

11, 2001.

However, as we witnessed in the response to Hurricane Katrina and recent terrorist threats around the

world, more needs to be done to prevent and better respond to all hazards—future acts of bioterrorism, natural disas-

ters and other public health emergencies and their adverse health consequences. Steps that still need to be taken

include making a substantial investment in the recruitment, retention and training of the public health workforce;

ensuring a dependable distribution system for needed countermeasures; ensuring adequate funding is available for all

those responsible for preparedness; and protecting food and water supplies.

Ultimately, bioterrorism preparedness should go hand-in-hand with everyday public health activities. Programs such as

immunization and chronic disease prevention programs cannot be neglected to pay for bioterrorism preparedness. In

addition, careful attention needs to be paid to overtaxing public health professionals such as environmental health practi-

tioners and nurses who are already stretched with their everyday responsibilities. In many cases, preparedness for bioter-

rorism and other emergencies is added to their existing responsibilities without adequate training or additional resources.

Get the Facts on Bioterrorism Preparedness

Bioterrorism preparedness is the responsibility of a complicated

web of federal, state and local agencies and involves a wide array

of professionals from planners, public health officials, nurses, fire

and police personnel, to hospital and school personnel.

No state or city is fully prepared to respond to a bioterrorist

attack and its resulting health consequences.

All 50 states have now developed bioterrorism response plans.

All states have the systems necessary to rapidly detect a terrorist

event through mandatory reportable disease detection systems.

Thousands of state and local public health personnel have been

funded with federal bioterrorism dollars. Without this stream of

funding, these positions will be eliminated, exacerbating the

current public health workforce shortage.

Fewer than one-quarter of states and very few cities have

achieved “green” status for the Strategic National Stockpile.

Without this status, they won’t be able to receive countermea-

sures and medical supplies from the Strategic National Stockpile

to administer and distribute during a public health emergency.

Over 25 percent of states lack the capacity and infrastructure

in their laboratories to respond in the event of a bioterrorist


51 of 83 state and local Laboratory Response Network (LRN)

reference laboratories have had delays receiving CDC-supplied

reagents for detection of bioterrorist agents.

40 of the 51 State Public Health Laboratories have cited dif-

ficulty recruiting and retaining staff for bioterrorism pre-


Many hospitals remain insufficiently prepared. Hospitals, in gen-

eral, lack the ability to stockpile certain supplies and counter-

measures in the event of a public health emergency. In the

event or a bioterrorist attack or other public health emergency

as pandemic flu, there will not be enough beds to provide care

for a sharp increase in patients. Also, most hospitals do not have

plans that address how to respond to a shortage of health care

workers in the event of an emergency.

Sources: U.S. Department of Health and Human Services,Trust for America’s

Health,Association of Public Health Laboratories

800 I Street, NW 

Washington, DC 20001

Get The Facts

Bioterrorism Agents/Diseases

APHA supports an increase in funding for state and local all-hazards preparedness under the auspices of the

Centers for Disease Control and Prevention (CDC).

APHA encourages adequate funding levels for the National Bioterrorism Hospital Preparedness Program under

the Health Resources and Services Administration (HRSA).

APHA supports the Public Health Preparedness Workforce Development Act, which would create federally funded

scholarship and student loan repayment programs for public health students and professionals.

APHA supports full funding of the Covered Countermeasures Process Fund. An adequate compensation fund would

ensure that people who receive countermeasures—such as vaccines—and become ill, disabled or die, receive compensation for their

losses. Without such a fund, first responders and the public will hesitate to receive such countermeasures, as was witnessed during the

smallpox vaccination campaign. This fund would also provide increased certainty for industry as it would guarantee demand for

countermeasures, as people will be more likely to get vaccinated and receive a countermeasure if they have some protection against

the worst-case scenario.

APHA supports a $7.1 billion appropriation to help the nation prepare for pandemic influenza as another vital step

towards all-hazards preparedness. A “carve out” of these funds is necessary to ensure that states and localities have adequate resources

to prepare—not only for pandemic flu, but for other public health emergencies as well. This should not be at the expense of other

public health programs.

Legislative Activities APHA Is Supporting 

Agents and diseases used for bioterrorism are likely to be spread easily from person to person and cause severe

illness and death. Bioterrorism agents are classified into three categories—A, B and C—depending on how

easily they can be transmitted from person to person, how sick they make people and their death rates.

Category A agents are those that pose the highest risk to the public’s health and safety.

800 I Street, NW 

Washington, DC 20001

Anthrax is a Category A agent. A serious disease caused by a bacterium that forms spores, anthrax is not known to be

spread from one person to another. However, people can get infected with anthrax from animals, or when it is used as a

weapon, as it was in 2001. There are three types of anthrax: skin, lung and digestive. Anthrax ingested through the lungs is the

most severe, whereas anthrax infection on the skin can be cured with early treatment of antibiotics. In 2001, mail containing

anthrax was sent to members of Congress and the news media.

Ricin is a Category B agent that prevents cells from making the proteins they need, which causes cells in people it infects

to die. People can be exposed to ricin by inhaling or swallowing it, or through skin and eye contact. As it commonly takes the

form of a mist or powder, it was used as a weapon through the mail in 2004. The symptoms of ricin exposure vary depending

on how someone is exposed to it and can range from difficulty breathing to nausea to seizures. There is no specific treatment for

ricin poisoning; victims should seek medical attention immediately to minimize the health effects of the poisoning.

Hantavirus is a Category C agent. Although preventable by eliminating or minimizing your contact with rodents, han-

tavirus—a disease that can be fatal—does not have a specific treatment. Many of its symptoms are like those of the flu and

include fever and muscle aches, with advanced hantavirus causing lungs to fill with fluid.

Source: Centers for Disease Control and Prevention

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