Bioterrorism Presentation

Sharon F. Grigsby, MBA

Executive Director
Bioterrorism Preparedness Program
Public Health
Department of Health Services
County of Los Angeles
1

The events of Fall 2001

Challenged Us All
Our Sense of Invulnerability
Our Self-Confidence
Our Awareness of Public Infrastructure,
and
Our Definitions of First Responders
2

Will the first response to a BT

attack be this

. or this?

Its more likely to look like

this.

or this.

Government Responds
January 2002, President approves
$1.1 billion for Bioterrorism Preparedness
All fifty states, the territories and 4 major
metropolitan areas receive funding

HHS Funding Sources

Centers for Disease Control and Prevention
Focus on infectious disease control, public health needs
Los Angeles, Chicago, New York, D.C. funded
Los Angeles receives $24.6 million

Health Resources and Services Administration

Funding to States for Hospital Preparedness
Los Angeles receives $3.6 million

Office of Emergency Preparedness

Funding provided for Metropolitan Medical Response Systems
for 120 largest cities
LA, Long Beach, Glendale funded in LA County

CDC Funds Public Health for

Bioterrorism, Emerging Infectious
Diseases and other Public Health
Emergencies

Develop Comprehensive BT Plans

Upgrade Disease Surveillance and Investigation
Implement HASTEN with Health Providers
Enhance Public Health Laboratory Capability
Develop Risk Communication Capacity
9

Lessons Learned from Anthrax Threats

Inadequate internal communication
system

Need real time communication with most

physicians

Public communication strategy essential

Full time central coordination essential
10

Los Angeles County Public Health

th
Threat Activities Pre-Sept 11
1999 CDC Funding of $800k
Development of Epidemiology & Surveillance
Capacity
Development of Emergency Communications
HASTEN
Enhance Lab Capacity

11

The Role of Public Health

Being Prepared
Education of medical

community
Education of public
Training of special response teams
Participation in exercises for different scenarios
Development of communication systems
Development of interagency protocols

12

The Role of Public Health

Initial Response to BT Induced Disease
Early detection through surveillance/ rapid
assessment of reports
Mobilize laboratory
Rapid confirmation of agent, site, initial at-risk
population, prophylaxis and/or treatment
Alert medical community, ERs, labs

Implement disease specific plans (e.g.

Smallpox)

Determine resource needs and possible quarantine

Coordinate with partner agencies
(local/state/national)

13

The Role of Public Health

Continued Response to BT Induced Diseases
Closely monitor communication network for new
information
Provide, accurate, timely information to public
Continue epidemiologic investigation to refine at risk
population
Assess environmental contamination
Provide or coordinate testing/ prophylaxis/
treatment to at-risk population
Access biological stockpiles as necessary
14

BT Challenges in Los Angeles

Large geographical area/mobile population

real-time reporting & mapping applications

Victims and/or those they infect may disperse before
attack recognized
communication strategy focusing on effective use of
news media

Victims may present at geographically dispersed

medical offices and hospitals
health provider/facility communication and reporting
network
15

BT Challenges in Los Angeles

Early signs/symptoms nonspecific
Provider education through multiple means
Medical and laboratory communities not
familiar with rare BT diseases
establish syndromic surveillance
provide training to increase awareness
enhance collaboration between medical
community and Public Health

16

CDC Public Health Bioterrorism

Preparedness and Response Grant
$24.6 million
Six Focus Areas
Planning
Surveillance and Epidemiology
Biological Laboratory Capacity
Health Alert Network System
Public Information and Risk Communication
Training
17

Los Angeles County Department of Health Services

Bioterrorism Response
T h o m a s L . G a r t h w a it e , M . D .
D ir e c t o r a n d C h ie f M e d ic a l O ffic e r

J o n a t h a n E . F ie ld in g , M . D . , M . P . H .
D ir e c t o r o f P u b lic H e a lt h a n d H e a lt h O ffic e r
D H S B io t e r r o r is m C o o r d in a t o r
P U B L IC H E A L T H P R O G R A M S

E M E R G E N C Y M E D IC A L S E R V IC E S A G E N C Y

Jonathan E. Fielding, M.D., M.P.H.

Director and Health Officer

Virginia Price Hastings

Director

John F. Schunhoff, Ph.D.

Chief of Operations

John Celentano, M.D.

Chief of Operations

-Surveillance
-Bioterrorism
-Community-wide Disease Reporting
-Health Community Communications
-Laboratory
-Quarantine
-Mass Immunization & Prophylaxis
-Smallpox Plan

-Operational Medicine/Departmental
-Disaster Coordination
-Security
-NPS Plan
-Hospital Preparation for PPE/Decon Education/Training for
Hospitals, First Responders Force Protection and Others
-MMRS
-DMAT and NMRT-West Teams
-Coordination with Fire, Law and State and Federal Government

18

Assessment and Planning

Assess existing public health preparedness

status, including legal preparedness.

Prepare Countywide response plan.
Complete Regional response plan.
Plan and implement exercises to test all
aspects of response plans.
Develop plan for National Pharmaceutical
Stockpile use.

19

Surveillance and Epidemiology

Enhanced electronic disease surveillance
Integrated Data Repository
Establish and exercise mass prophylaxis
plans
Develop Epi Rapid Response Teams

20

Enhanced Surveillance
Activities
Surveillance for influenza (data collected by state)
ACD-Coroner Project

Collaborating with the Office of the Coroner to monitor unexplained

deaths
Provides data on all non-trauma coroners cases to monitor for possible
infectious causes.

Animal illness/death surveillance (web-based)

ED Syndromic Surveillance

ReddiNet: CDC grant to explore adaptation for surveillance needs

ED syndromic surveillance and rapid reporting pilot in 4 hospitals

21

Laboratory Capacity
Increase ability for rapid testing and
identification of biological agents.
Train local labs for bioterrorism
preparedness.
Increase availability of lab staff trained for
bioterrorism.
Relocate and renovate lab.
22

Communications and Technology

Develop systems for secure electronic
exchange of public health information.
Create mechanisms for broadcast messages
and alert notifications.
Improve communications technology:
pagers, radios, satellite phones.

23

Health Information and Risk

Communications
Develop public health bioterrorism
messages for pre and post event use.
Prepare materials in multiple languages.
Train departmental spokespersons.

24

Education and Training

Assess public and staff needs for education
on bioterrorism.
Develop courses and curricula for
bioterrorism preparedness.
Develop partnerships with community
stakeholders to disseminate information.
Test effectiveness of educational programs
and revise.

25

Providing Information to the

Public
Bioterrorism website: www.labt.org
52,800 hits in since October 1, 2001

Health Info Line

Over 1,200 calls in October and November
55% related to anthrax

Community Presentations
Over 200 since September 11, 2001

Brochures
Over 35,000 distributed
26

END

27