Case Study on Bioterrorism - Essay Example

Case Study on Bioterrorism Introduction There have been historical cases of biohazards that have been determined to beeither natural or deliberate epidemic. These cases make it necessary for healthcare systems to institute measures that will proactively deal with such cases in future. The risk of such epidemics has been increased by continued global conflicts that continue to predispose nations to bioterrorism. This report highlights a hypothetical scenario of bioterrorist attack to identify how such occurrence might affect public health with available characteristics for distinguishing deliberate form natural epidemic based on the scenario also being highlighted. The report also includes possible reactions from both federal and local government agencies as they attempt to contain the situation. The last section is about what I would propose as a policy-maker in national strategy to improve early detection of bioterrorism. 1. Scenario of a Hypothetical Bioterrorist Attack Centers for Disease Control (CDC) have reported two confirmed and ten suspected cases of smallpox in Houston City. Within less than twenty-four hours since the confirmation, emergency rooms in Houston City become crowded as multiple patients report to the facility having similar symptoms. Majority of hospital staff fails to report to work the second day after the confirmation is reported by various media outlets with a number of staff with direct contact with patients also displaying the smallpox symptoms. Due to the number of people displaying smallpox symptoms, the Governor of Houston request vaccination to be conducted on all 3 million residents of the state within the next 72 hours. 2. Distinguishing the Outbreak Characteristics Form Natural Epidemic The above scenario of smallpox outbreak involves some characteristics that are not consistent with natural outbreak of the infection. Firstly, the rate of spread and appearance of initial symptoms differs with the general timelines for this infection. Patients infected with smallpox virus start showing symptoms from seven to 17 days. However, in this case, the symptoms were experienced fast as in the case of physicians and nurses who had attended to first group of patients. Based on the assertions made by Dembek, Kortepeter and Pavlin (2007, p.358), “Higher morbidity or mortality than is expected” is among the clues in identifying deliberate epidemic as there is a likelihood of the biological agent being “altered for greater pathogenicity, or individuals could be exposed to a higher inoculums than would be natural”. Additionally, the epidemic was concluded to be a bioterrorism attack because evidence indicates possibility of smallpox outbreak being very low since it had been eradicated with the last known natural case being reported in 1977 in Somalia (Slifka, 2005). With the advanced healthcare system in the US, most of the population has already been vaccinated against the infection. Therefore, the outbreak of smallpox in Houston city can be considered “uncommon” for the “geographical area” since there have been extensive vaccination against the infection over the years (Dembek, Kortepeter and Pavlin, 2007, p.358). While the outbreak was reported in Houston city, the first cases were from multiple locations with these individuals having no common patterns that could lead to identification of the first instance of infection. This is a feature of a deliberate epidemic as it provides for a possibility that the perpetrators released the biological agent at multiple locations (Dembek, Kortepeter and Pavlin, 2007). Similar trend in infection was also experienced in the anthrax infections, which were caused by contaminated letters mailed to recipients in various locations (Frerichs, 2008). 3. Response by Federal/Local Government While both federal and local governments should introduce emergency measures to contain the situation by preventing further spread and providing medical care for the infected, this measures should be introduced only after initial assessment of the situation has been undertaken. This assessment should start with the evaluation of preparedness to face the outbreak. Firstly, medical staff working within the affected regions should receive immediate directive from their seniors that they should all put on protective clothing, masks, gloves, and gowns to avoid infection, which should then be followed, be institution of quarantine system such as isolation rooms at hospitals for highly contagious smallpox patients. The available facility and staff should also provide room for possible surge to ensure continued. This will prepare the medical staff to avoid being overwhelmed by a surge in number of patients who demand medical attention (Ferguson, Keeling, Edmunds, Gani, Grenfell, Anderson & Leach, 2003). The authorities should then conduct immediate survey within the state and federal level to identify physicians and nurses with smallpox experience. Such experience will prove invaluable in containment process as this group of experienced practitioners could together with researchers from agencies, such as the CDC lead teams working at various identified points. Following the isolation of the infected individuals, there should be rapid diagnosis of the disease conducted under the predetermined conditions and immediate treatment procedures instituted for the infected (Ferguson, Keeling, Edmunds, Gani, Grenfell, Anderson & Leach, 2003). Having conducted all the preparatory stages, the assessment of available supply of smallpox vaccine should be conducted with the CDC making immediate steps to airlift reserved smallpox vaccine to the area. Given a possible outbreak that could affect multiple locations within the state, federal authority or even at a global scale, special criteria should be introduced. This procedure will allow for individuals who are at a higher of being infected including doctors and nurses handling the patients to be given priority in vaccination. All those exposed to the smallpox should be vaccinated since available research indicate if vaccine is given within four days after exposure there are high chances of reduced severity of or even prevention of the disease (Belongia and Naleway, 2003). 4. National Strategy to Improve Early Detection of Bioterrorism Being a policy-maker in the field of bioterrorism, there are a number of measures that can be adopted as national strategy to improve early detection of bioterrorism within US territory. This will specifically target measures that will “shorten notification time for an outbreak before extensive damage is done (Fefferman and Naumova, 2010, p.8). The priority for this national strategy for early detection of bioterrorism is based on establishing suitable level of preparedness and response capabilities in public and private healthcare system at local and state levels. The emphasis in these facilities is based on the fact that these are points where the initial signs of a bioterrorist attack will be observed with FEMA (2008, p.4) noting “the introduction of biological agents, both natural and deliberate, is often first detected through clinical or hospital presentation”. However, the early detection system will also recognize other areas that could help in process of detection. This includes investment in technologies, medical and syndromic surveillance systems for environmental detection. Fish and wildlife surveillance is also an area covered in the national strategy, which will make it possible to conduct investigation of mortality for early detection of biological agents and acts of bioterrorism. Identification of sources of contamination should be followed by immediate commencement of contingency measures resulting in arrest police detectives and disease detectives moving to stop the responsible terrorist or group of terrorists from propagating further harm (Frerichs, 2008). Conclusion Although the above scenario of a bioterrorism attack represents a hypothetical situation, it indicates the nature of such attacks especially when conducted in large scale. Such attacks and the response required for containment highlights the need for an effective national strategy to ensure early detection of bioterrorism attack. This strategy should focus on strengthening the ability of public and private healthcare facilities to deal possible outbreak of both natural and intentional outbreaks. References Belongia, E. A., & Naleway, A. L. (2003). Smallpox vaccine: the good, the bad, and the ugly. Clinical medicine & Research, 1(2), 87-92. Dembek, Z. F., Kortepeter, M. G., & Pavlin, J. A. (2007). Discernment between deliberate and natural infectious disease outbreaks. Epidemiology and infection, 135(03), 353-371. Fefferman, N. H., & Naumova, E. N. (2010). Innovation in observation: A Vision for Early Outbreak Detection. Emerging Health Threats, 32-18. doi:10.3134/ehtj.10.006 FEMA. (2008). Biological Incident Annex. Retrieved from: https://www.google.com/search?client=opera&q=FEMA+Biological+Incident+Annex&sourceid=opera&ie=utf-8&oe=utf-8&channel=suggest&gws_rd=ssl Ferguson, N. M., Keeling, M. J., Edmunds, W. J., Gani, R., Grenfell, B. T., Anderson, R. M., & Leach, S. (2003). Planning for smallpox outbreaks. Nature, 425(6959), 681-685. Frerichs, R. (2008). “American Anthrax outbreak of 2001”. UCLA, Retrieved from http://www.ph.ucla.edu/epi/bioter/detect/antdetect_intro.htm Slifka, M. K. (2005). The future of smallpox vaccination: Is MVA the key? Medical Immunology, 4(1), 2. doi: 10.1186/1476-9433-4-2 Read More