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A MODEL RESPONSE TO BIOTERRORISM: Pennsylvania Region 13-WMD Task Force

This lecture, part of a series by Allegheny County Health Department, covers organizing community to protect against bioterrorism, threats, diagnosis, and agencies for response. It details the Pennsylvania-Region 13 Metropolitan Medical Response System's mission objectives, funding, committees, planning, and types of biological agents for surveillance and early recognition. Criminal and medical intelligence combine for threat assessment, notifications, and contact information for health officials. The lecture provides epidemiological information, clues, and public health concerns related to bioterrorism preparedness.

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A MODEL RESPONSE TO BIOTERRORISM: Pennsylvania Region 13-WMD Task Force

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  1. A MODEL RESPONSE TO BIOTERRORISM: Pennsylvania Region 13-WMD Task Force J. David Piposzar, MPH http://info.co.allegheny.pa.us/services/achd/

  2. This lecture is one of series produced by the Allegheny County Health Department (PA), Bethlehem Health Bureau (PA) and the City of Elizabeth Department of Health & Human Services (NJ). • The organizers of this project are scholars in the Northeast Regional Public Health Leadership Institute, Class of 2000. For information contact: dcw01@health.state.ny.us

  3. J. David Piposzar, MPH • Emergency Management Coordinator, Allegheny County Health Department • Penn State University • BS, Zoology • University of Pittsburgh • MPH, Graduate School of Public Health • Delta Omega, National Public Health Honorary • Recipient of EPA Region III Partnership Award for contributions to chemical emergency preparedness and prevention

  4. Mr. Piposzar is a career public health employee with 25 years of service in all aspects of public health. He coordinates health department emergency management functions with other federal, state, county and municipal agencies. He is a member of the Allegheny County Emergency Planning Committee, where he chairs the Medical and Health Subcommittee. He authored a “Multi-hospital Emergency Medical Plan for Hazardous Materials Emergencies” and developed and implemented a nationally recognized training program. His work has been recognized by EPA, the Ford Foundation, and Allegheny County government, among others.

  5. Learning Objectives • Understand the factors necessary to organize a community to protect against bioterrorism. • Understand the basic threats from bioterrorism. • Understand how bioterrorism events are diagnosed.

  6. Performance Objectives • Begin organizing your community to be able to respond to bioterrorism. • Know what organizations and agencies are necessary to respond to bioterrorism at the local, state and Federal level.

  7. PENNSYLVANIA-REGION 13 Metropolitan Medical Response System A Regional, System-Based Approach to Mass Casualty & Nuclear, Biological, and/or Chemical (NBC) Terrorism Preparedness

  8. PITTSBURGH

  9. Mission Objectives 1. Formalize regional mutual aid agreements and plans. 2. Establish an interoperable communication system. 3. Develop a specialized equipment pool. 4. Ensure specialized training is available. 5. Apply for grant funding.

  10. 6. Foster networking and sharing of information. 7. Develop criminal intelligence protocol’s and procedures. 8. Deliver highly trained and equipped teams of responders at the local and regional levels. 9. Ensure the highest level of Life Safety response at a responsible cost to taxpayers.

  11. Funding • $600,000 Metropolitan Medical Response System (MMRS) • $395,000 MMRS-RISC TEAM Project • $300,000 Department of Justice • $28,500 FEMA

  12. Committees Policy Communications / 9-1-1 Fire / Haz Mat Medical / Health Training Law Enforcement

  13. Salt Lake City Minneapolis / St. Paul Cleveland St. Louis Portland Sacramento Pittsburgh Oakland Hampton Roads Charlotte Long Beach Nashville Tucson Albuquerque New Orleans El Paso Austin Tulsa Oklahoma City Fort Worth MMRS Planning

  14. MMRS PLANNING • 300+ individuals • 87 organizations and • 65 hospitals • Monthly meetings- 3rd Thursdays • E-mail network & secure web site

  15. Region 13 Plans • Surveillance and notifications • Mass immunization • Mass Patient Care- • RISC TEAM • Pharmaceutical cache • Mental Health • Mass fatality management • Environmental surety

  16. Types - Biological Agents • Bacteria: Plague, Anthrax, Tularemia • Viruses: Smallpox, VEE, Viral Hemorrhagic Fevers (Ebola) • Toxins: Botulinum, Ricin, SEB Anthrax - vegetated

  17. SURVEILLANCE- EARLY RECOGNITION • Physicians and nurse gatekeepers • Infection control practitioners • Laboratories • Pharmacies • Veterinarians • Coroners/ medical examiners • 911- Centers

  18. EMS Regional Offices • Pittsburgh Poison Center • Police special protection units/security details • USDA, FDA, food & water protection • Duty officers- PaDEP, EPA, PaDOH, ACHD • School nurses • Employers

  19. Criminal Intelligence + Medical Intelligence = Threat assessment

  20. Notifications to Health Officials Reportable diseases Unusual disease occurrences Suspect cases- “syndromic” surveillance Allegheny County Health Department 412-687-2243 Pa. Department of Health S.W District 412-565-5101

  21. Epidemiological Information • Travel history • Infectious contacts • Employment history • Activities over the preceding 3 to 5 days

  22. Epidemiologic Clues • Large epidemic with high illness and death rate • HIV(+) individuals may have first susceptibility • Respiratory symptoms predominate • Infection non-endemic for region • Multiple, simultaneous outbreaks • Multi-drug-resistant pathogens • Sick or dead animals of multiple types • Delivery vehicle or intelligence information

  23. Public Health Concerns • Mass Immunization and Mass Prophylaxis • Antibiotics • Antidotes • Vaccines • Acquisition & distribution methods

  24. Pharmaceutical Cache • List of pharmaceuticals to provide care for the first 24 hours of response to an incident. • Plans to store and replace “dated” drugs through agreements with distribution center. • Plans to distribute & dispense

  25. Rx Cache

  26. Hospital Preparedness • UPDATE HOSPITAL DISASTER PLANS: • notification procedures • lock-down procedures • mass decontamination capability • mass casualty triage capability • PPE for staff • pharmaceuticals and equipment • medical staff training and recognition • medical treatment protocols (adult & pediatric)

  27. Integration with NDMS • National Disaster Medical System • VA and Hospital affiliates • Plan for forward movement of patients if we are overwhelmed • Plan to receive patients from other cities if they are overwhelmed

  28. Mental Health Services • Coordination with existing mental health providers • Counseling services for responders • Counseling for victims, families, and community

  29. Mortuary Services • Based on existing mortuary services • Mutual aid and federal D-Mort support • Defining temporary morgue needs • Enhancing PPE for morgue workers • Special decontamination requirements

  30. Environmental Surety • Protection of water and food supplies • Plans and procedures to restore facilities • Criteria for re-occupancy

  31. Communications • Enhance communications among agencies • BMSI and Carnegie Mellon Research Institute-secure web site • Hospital bed availability • Plans and procedures • Training materials • Response actions in real time

  32. REGIONAL INCIDENT SUPPORT AND COORDINATION TEAM (RISC TEAM)

  33. Recommendations: • SUPPORT DEVELOPMENT OF CRITICAL SURVEILLANCE SYSTEMS • HELP IDENTIFY PERSONNEL TO BUILD “ MEDICAL SURGE CAPACITIES” • WORK QUIETLY AND EFFICIENTLY TO MINIMIZE PUBLIC ANXIETIES OR FEAR • MOBILIZE COMMUNITY RESOURCES • SUPPORT TRAINING/EDUCATION OF MEDICAL PERSONNEL • ENHANCE COMMUNICATIONS & PARTICIPATE IN PLANNING !

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