Should Southern California be confronted by an unannounced bioterrorism attack, it will be the responsibility of the region¹s Infectious Disease physicians to recognition the symptoms and implement treatment plans.
To prepare for such a possible scenario, the Infectious Disease Association of California (IDAC) will be addressed by Dr. Michael T. Osterholm‹one of the countries leading authorities on bioterrorism‹at its 14th Annual Emerging Issues in Infectious Diseases symposium in San Diego, May 1-2, 1999. Dr. Osterholm is Chairman of the Infection Control Advisory Network and former Chief of Acute Disease Epidemiology Section of the Minnesota Department of Health.
The use of biological agents‹bacteria, viruses, or toxins‹as tools of warfare or civilian terrorism has been prominent in the news as it relates to the current situations in Iraq and Yugoslavia. However, there are multiple countries, groups, and individuals with the motivation and ability to use biological agents against civilian populations. The perceived dominance of the United States as the leading world power and the rise of international and domestic extremist groups focused on destroying what they believe to be evil, it is likely that a biological terrorism disaster will occur in the United States in the near future. And given its visibility, mixture of ethicities, and influx of visitors, Southern California could be a likely target.
These biological agents have incubation periods of days, unlike chemical agents or explosive devices, which typically lead to severe disease or trauma within seconds to minutes at the site of exposure. For this reason, it is the physician and other emergency room personnel who will be the first line of defense when such a disaster occurs. Only through timely and comprehensive public health surveillance will the nature of the terrorist event become evident. Yet as a nation, our federal, state, and local infrastructure remains largely unprepared to deal with this likely event."
Diseases such as anthrax, smallpox, plague, and viral hemorrhagic fevers are likely to be suspected when patients with vague symptoms present to emergency rooms or physicians¹ offices. Only when patients present in number and require intensive care will we recognize the event. The health care system of any community, regardless of size, will be overwhelmed. Special medications or vaccines not generally available in standard pharmaceutical stocks potentially will be required. Health care professionals and laboratory personnel may need added physical protection. The psychological impact of the population will be substantial.
The current federal, state, and local response to bioterrorism largely relies on the well-established HAZMAT approach to disaster management. However, this framework for response will be of little use for such an event. Dr. Osterholm¹s presentation will outline the reasons for serious concern for biological terrorism today, including the health impact on civilians, populations, and the groups or individuals likely to be responsible for such an event; the possible agents and mechanisms of deployment; the implications for the health care and public health systems; and the lack of preparedness in the United States.
The IDAC Spring Symposium is being held at the Hilton Beach and Tennis Resort on San Diego¹s Mission Bay. Other presentations include caring for HIV patients, new malaria treatments and prevention, pharmacology, and establishing a travel medicine clinic.
Members of the news media are invited to attend this meeting. For information, contact Ron Goldman at (310) 216-9265.