Bioterrorism Preparedness

Anthrax fact sheet-http://www.bt.cdc.gov/agent/anthrax/

Small pox fact sheet-http://www.bt.cdc.gov/agent/smallpox/vaccination/needtoknow.asp

Radiological emergencies-http://www.bt.cdc.gov/radiation/emergencyfaq.asp

Ebola Hemorrhagic Fever Fact Sheet -http://www.cdc.gov/vhf/ebola/resources/pdfs/Ebola-FactSheet.pdf

Telephone notification numbers- Infection control, Epedemeologist, Local & State Health Dept., Local EMS, Local Law Enforcement Agency, Regional Poison Control & Program. Prompt communicaton Four potential microorganisms Anthrax (Bacteria) Botulinum (toxin) Plague (Bacteria) Small pox (virus)

Individual and family planning check listshttp://www.bt.cdc.gov/disasters/hurricanes/readiness.asp http://www.nhc.noaa.gov/HAW2/english/disaster_prevention.shtml http://www.nhc.noaa.gov/HAW2/english/intro.shtml http://www.bt.cdc.gov/disasters/hurricanes/recovery.asp/

Suggested contents of a disaster kit-

How to protect your pets -http://www.bt.cdc.gov/disasters/hurricanes/readiness.asp

Web address for American Red Cross-http://www.redcross.org/

Local American Red Cross web address-http://www.my-redcross.org/

Web address for FEMA -http://www.fema.gov/

Web address for National Hurricane site -http://www.nhc.noaa.gov/

Detection of OutbreaksUnannounced (Covert)Announced (Overt) Detection can be Symptom based: In response to high risk syndromeEpidemiological: Epi principles

Transmission type

Standard precautionsHandwashingGloves/ MasksGownEye protection face shield

Primary Prevention (Pre-exposure)Immunization (active)Drug prophylaxisTraining & Education

Secondary Prevention (Incubation Period)Diagnosis (Class & Agent specific)Passive immunization (immune serum)Pre treatment (drugs)

Tertiary Prevention(Crisis Management of overt disease)Diagnosis TreatmentCommunication

Infection Control Practices for Patient ManagementTwo tier precautionsPatient placementPatient transportCleaning, disinfecting & sterilization of equipmentsDischarge managementPost mortem care

Isolation & Quarantine

According to the Centers for Disease Control and Prevention (CDC) in order to contain the spread of a contagious illness, public health authorities rely on many strategies. Two of these strategies are isolation and quarantine. Both are common practices in public health, and both aim to control exposure to infected or potentially infected persons. Both may be undertaken voluntarily or compelled by public health authorities. The two strategies differ in that isolation applies to persons who are known to have an illness, and quarantine applies to those who have been exposed to an illness but who may or may not become ill.

Frequently asked questions -http://www.cdc.gov/ncidod/dq/isolationquarantine.htmResources for Attorneys -http://www.cdc.gov/ncidod/sars/factsheetlegal.htm

Isolation procedureStandard precautionsSome will need transmission based precautions

Standard precautions

Patient placementSmall scaleLarge scale Involve Triage & isolation strategies, grouping patients with similar syndrome

Patient TransportLimited essential movement

Avoid transmission with Healthcare Facility

Cleaning, disinfecting, sterilization of instruments & equipmentsStandard procedure (Printed document should be available)

Discharge managementPatient need to be declared non infectious before discharge

Home care is desirable

Post mortem careInform all concern

Autopsy with standard procedure, despatch material with all care & precautions, for testing elsewhere if req.

Funeral instruction should be readily available

Post exposure managementDecontamination of patients & Environment. Bathing of harmful patients avoided

Prophylaxix & Post exposure immunization

Triage* & Mgmt. of large scale exposure cases

Psychological aspect of bioterrorism (public, patient & healthcare workers)

Stay tuned

Cancel non essential services

Evaluation of discharge

Consider resources available

Consider large loss of life

Laboratory support consideration

Drug availability

* TriageAprocessforsortinginjuredpeopleintogroupsbasedontheirneedfororlikelybenefitfromimmediatemedicaltreatment.Triageisusedinhospitalemergencyrooms,onbattlefields,andatdisastersiteswhenlimitedmedicalresourcesmustbeallocated.2.Asystemusedtoallocateascarcecommodity,suchasfood,onlytothosecapableofderivingthegreatestbenefitfromit.3.Aprocessinwhichthingsarerankedintermsofimportanceorpriority:"FormillionsofAmericans,eachweekbecomesastressfultriagebetweenworkandhomethatleavesthemfeelingguilty,exhaustedandangry"

The following are links to current drug information related to Anthrax:

Cipro (Ciprofloxacin Hydrochloride) for Inhalation AnthraxCipro: Approved Dosing for Children (PDF - 177KB)(labeling approved 5/18/2005)Cipro (Ciprofloxacin): Use by Pregnant and Lactating WomenInformation for Consumers on Cipro: Questions and AnswersDoxycycline and Penicillin G Procaine for Inhalational Anthrax (Post-Exposure)Emergency Use Authorization (EUA) for the Pre-Event Provision and Potential Use of Doxycycline Hyclate Tablet Emergency Kits for Inhalational Anthrax (PDF - 97KB)(4/13/2009)Public Health Emergency Home Preparation Instructions for Doxycycline. Includes the pamphlet, "In an Emergency: How to Prepare Doxycycline for Children and Adults Who Cannot Swallow Pills"" (updated 7/2/2008)Palatability Evaluations of Doxycycline Solid Dosage Tablets Ground and Mixed in Food or Drinks(Issued and posted 7/3/2002)Public Health Emergency Home Preparation Instructions for Doxycycline. Includes the pamphlet, "In an Emergency: How to Prepare Doxycycline for Children and Adults Who Cannot Swallow Pills"" (updated 7/2/2008)Palatability Evaluations of Doxycycline Solid Dosage Tablets Ground and Mixed in Food or Drinks(Issued and posted 7/3/2002)

Stability and Dose Uniformity Evaluations of Doxycycline Solid Dosage Tablets Ground and Mixed in Food or Drinks(Issued and posted 7/3/2002)Doxycycline (Vibramycin, Monodox, Doryx, Doxy , Atridox, Periodox, Vibra-Tabs ): Use by Pregnant and Lactating WomenInformation for Consumers on DoxycyclineInformation for Consumers on Penicillin G Procaine

Levaquin (levofloxacin) Information for Inhalational AnthraxAmoxicillin (Amoxil, Larotid, Trimox, Wymox) Use by Pregnant and Lactating Women(Posted 11/20/2001)Commentary on Non-Labeled Dosing of Oral Amoxicillin in Adults and Pediatrics for Post-Exposure Inhalational Anthrax(updated 12/30/2013)Safety of Long Term Therapy with Penicillin and Penicillin Derivatives(12/17/2001)Draft Guidance for Industry on Developing Drugs to Treat Inhalational Anthrax (Post-Exposure (PDF 51KB)(Issued and posted 3/18/2002)Federal Registernotice: Optional Format:(PDF - 41KB)Related InformationAnthrax Findings Presented by NIH Researcher11/12/2001

Hurricane Preparedness and Personal/Family disaster planning

According to the National Hurricane Center, history teaches that a lack of hurricane awareness and preparation are common threads among all major hurricane disasters. By knowing your vulnerability and what actions you should take, you can reduce the effects of a hurricane disaster. The goal of Hurricane Preparedness is to inform the public about the hurricane hazards and provide knowledge which can be used to take

ACTION. Information can be used to save lives at work, home, while on the road, or on the water.

Individual and family planningchecklists-http://www.bt.cdc.gov/disasters/hurricanes/readiness.asp http://www.nhc.noaa.gov/HAW2/english/disaster_prevention.shtml http://www.nhc.noaa.gov/HAW2/english/intro.shtml http://www.bt.cdc.gov/disasters/hurricanes/recovery.aspSuggested contents of a disaster kit-How to protect your pets -http://www.bt.cdc.gov/disasters/hurricanes/readiness.aspWeb address for American Red Cross-http://www.redcross.org/Local American Red Cross web address-http://www.my-redcross.org/Web address for FEMA -http://www.fema.gov/Web address for National Hurricanesite-http://www.nhc.noaa.gov/Special Information from the March of Dimes Preparing for Disasters: Special Information for People Caring for Infants or Newborns Preparing for Disasters: Special Information for Pregnant Women