Bioterrorism Preparedness and Readiness Program
"Emergency Preparedness for Families of Children with Special Needs."
http://www.chkd.org/documents/CareConnections/EmergencyPreparednessforFamilies.pdf
Norfolk Medical Reserve Corps
The mission of the Norfolk Medical Reserve Corps (NMRC) is to organize and train local medical, health and community volunteers to support and/or supplement existing medical emergency and public health response efforts in the city of Norfolk. To volunteer or for more information call 683-2229.
Information for the General Public
For more information on Bioterrorism Preparedness and Readiness
visit the Virginia Department of Health @ http://www.vdh.state.va.us/epi/bio.htm
.
Links to Related Web Sites:
CDC Bioterrorism Agents List
www.bt.cdc.gov/Agent/Agentlist.asp
Anthrax as a Biological Weapon
http://jama.ama-assn.org/issues/v281n18/ffull/jst80027.html
USAMRIID's Medical Management of Biological Casualties
Handbook
http://usamriid.detrick.army.mil/education/bluebookpdf/USAMRIID%20Blue%20Book%205th%20Edition.pdf
(2 MB)
ACIP Anthrax Vaccine Recommendations
www.cdc.gov/mmwr/preview/mmwrhtml/rr4915a1.htm
Postal Service (USPS) Emergency Preparedness Plan
http://www.usps.com/news/2002/epp/welcome.htm
Preparing for Terrorism: A Family Guide
A terrorist attack would likely come without any warning.
The best way to prepare is to have a disaster plan in place.
Your family should create a plan that includes emergency contacts,
identification information, meeting locations, disaster supply
kit and more. Be sure to practice your plan. Terrorism does
not mean you have to change your life, just be prepared.
Identify Meeting Locations:
Most families are not together 24 hours a day. You should
consider how family members will find each other in a disaster
situation. Meeting location points should be identified for
the most commonly frequented locations, such as work or school.
For example, if a crisis occurs at school, a location for
both parents and children to meet should be in your plan.
Before, During and After a Terrorist Incident
BEFORE
- Be alert and aware of your surroundings.
- Take precautions when traveling. Be aware of conspicuous
or unusual behavior.
- Do not accept packages from strangers. Do not leave luggage
unattended.
- Learn where emergency exits are located.
- Be ready to enact your Family Disaster Plan.
DURING
- Building Explosion – leave as quickly and calmly
as possible.
- If items are falling from above – get under a sturdy
table or desk.
- Fire – stay low to the floor and exit as quickly
as possible. Cover nose and mouth with a wet cloth. If a
door is hot to the touch, do not open it – seek an
alternate escape route.
- Stay below the smoke at all times.
AFTER
- If you are trapped in debris – use a flashlight.
Cover your mouth with a piece of cloth. Tap on a pipe or
wall so that rescuers can hear where you are. Use a whistle
if available and shout as a last resort – shouting
can result in inhalation of dangerous amounts of dust.
- Assisting victims – untrained persons should not
attempt to rescue people in a collapsed building. Wait for
emergency personnel to arrive.
- Chemical Agent – authorities will instruct you to
either seek shelter and seal the premises or
evacuate immediately.
Develop Family Emergency Contact List
Put these contact numbers on your refrigerator and in
your wallet or purse:
911
Out-of-town Family Contact
Schools
Work
Neighbors
County Emergency Management
Family Disaster Plan
Discuss the type of hazards that could affect your family.
Determine escape routes from your home and places to meet;
including a child’s school, a neighbor or a public place.
Have an out-of-state friend as a family contact, so all your
family members have a single point of contact. Have at least
two ways of contact, e-mail, telephone, etc.
Make a plan now for what to do with your pets if you need
to evacuate.
Post emergency telephone numbers by your telephones and in
your wallet or purse, and make sure your children know how
and when to call 911.
Stock non-perishable emergency supplies and a disaster supply
kit.
Take First Aid, CPR and disaster preparedness classes.
Disaster Supply Kit
Water – At least 1 gallon daily per person for 3 to
7 days.
Food – At least enough for 3 to 7 days
Blankets / Pillows, etc.
Clothing
First Aid Kit/ Medicines
Special Items – for babies or elderly
Toiletries
Moisture wipes
Flashlight/ Batteries
Radio – Battery operated and NOAA weather radio.
Cash – Banks and ATMs may not be open or available for
extended periods.
Keys
Toys, Books and Games
Important documents
Tools
Vehicle fuel tanks filled
Pet care items
Duct Tape
Information provided by the Federal Emergency
Management Agency
Fact Sheet on Anthrax
What is anthrax?
Anthrax is a rare infectious disease caused by the bacterium
Bacillus anthracis. It can occur in wild and domestic hoofed
animals, especially cattle, sheep, goats, camels, and antelopes.
It can also occur in humans when they are exposed to the bacterium.
There are three forms of anthrax infection: cutaneous (skin),
inhalation (lungs), and gastrointestinal (stomach and intestine).
If people have been intentionally exposed, as in a bioterrorist
release, breathing in the spores or contact with skin would
be the most likely routes of exposure.
How common is anthrax and who can get it?
Anthrax can be found globally. It is most common in agricultural
regions where it occurs in animals. It is more common in developing
countries or countries without veterinary public health programs.
Anthrax is reported more often in some regions of the world
(South and Central America, Southern and Eastern Europe, Asia,
Africa, the Caribbean, and the Middle East) than in others
and is extremely rare in the United States. When anthrax affects
humans, it is usually due to an occupational exposure to infected
animals or their products. However, anthrax is considered
to be one of a number of potential agents for use in biological
terrorism.
How is anthrax spread?
Getting anthrax from another person is very rare. Anthrax
is generally spread through the following three methods:
Skin (cutaneous) - Most anthrax infections occur when people
touch contaminated animal products like wool, bone, hair,
and hide. The infection occurs when the bacteria enters a
cut or scratch in the skin.
Inhalation - Some anthrax infections occur when people
breathe in the spores of the bacteria. (A spore is the form
that certain bacteria take in unfavorable growing conditions.
When in better conditions, like the human lung, the bacteria
will begin to grow and cause disease.)
Gastrointestinal - Some people may get anthrax by eating
infected meat.
What are the symptoms of anthrax?
Skin (cutaneous) - First, the exposed skin itches.
Then, a large boil-like sore appears. The sore becomes a black
scab. If not treated, the infection can spread to the lymph
nodes and bloodstream.
Inhalation - First, people have cold or flu-type symptoms.
These symptoms can get worse, result in serious breathing
problems, and cause some people to stop breathing.
Gastrointestinal - People may have fever; pain in their
abdomen; loose, watery bowel movements;
and blood in their vomitus.
How soon after exposure would symptoms develop?
Symptoms develop between one and seven days after exposure
but prolonged periods up to 60 days are possible.
Can anthrax be spread person to person?
Inhalation (lung) anthrax is not spread from person to person.
Even if you develop symptoms of inhalation anthrax, you are
not contagious to other persons. If you develop cutaneous
(skin) anthrax, the drainage from an open sore presents a
low risk of infection to others. The only way cutaneous (skin)
anthrax can be transmitted is by direct contact with the drainage
from an open sore. Anthrax is not spread from person to person
by casual contact, sharing office space, or by coughing and
sneezing.
How is anthrax diagnosed?
Anthrax is diagnosed when the Bacillus anthracis bacterium
is found in the blood, skin lesions, or respiratory secretions
by a laboratory culture. It can also be diagnosed by measuring
specific antibodies in the blood of infected persons.
What is the treatment?
There are several antibiotics that are used successfully to
treat anthrax. The United States has a large supply of these
antibiotics and can quickly manufacture even more if needed.
Is there a way to prevent infection?
Persons exposed to anthrax spores via a bioterrorist act will
be given antibiotics to prevent infection. There is a vaccine
against anthrax, but it is not generally available, nor is
it recommended except for those at high risk, such as laboratory
scientists handling the bacterium or members of the armed
forces.
Do I need to disinfect myself or my belongings if I believe
I was exposed to anthrax?
Most threats regarding anthrax have proven to be hoaxes. However,
in the event of a possible exposure, there are certain actions
to take to avoid possible infection. If you have a skin exposure,
you can shower with soap and water to reduce the chance of
getting the cutaneous or gastrointestinal forms of the disease.
Your clothes do not pose any significant health risk to you.
Washing the clothes in the regular laundry will safely remove
any possible anthrax. You do not need to discard the clothes.
To be inhaled, anthrax spores must first be aerosolized (dispersed
in the air) which is difficult to do. In the unlikely event
that you inhale spores, medical evaluation and treatment is
needed.
For more information or questions about Anthrax call 683-8384.
Fact Sheet on Cutaneous Anthrax
What is cutaneous anthrax?
An uncommon cutaneous (skin) infection due to a bacterium
(Bacillus anthracis) that is found in the environment and
typically causes illlness in animals. Cutaneous (skin) anthrax
is marked by a boil-like lesion that eventually forms an ulcer
with a black center.
How is cutaneous anthrax contracted?
The infection occurs when the bacteria enter a cut or scratch
in the skin. Most cutaneous anthrax infections occur when
people touch animal products (like wool, bone, hair, and hide)
that come from an animal that died of anthrax.
Can cutaneous anthrax be spread from person to person?
If you develop cutaneous anthrax, the drainage from the open
sore presents a low risk of infection to others. The only
way cutaneous anthrax can be transmitted is by direct contact
with the drainage from an open sore. Cutaneous anthrax is
not spread from person to person by casual contact, sharing
office space, or by coughing and sneezing.
How is cutaneous anthrax treated?
The cutaneous form of anthrax responds well to several antibiotics.
The United States has a large supply of these antibiotics
and can quickly manufacture more if needed. With treatment,
complete recovery from cutaneous anthrax is usual.
How is cutaneous anthrax diagnosed?
Cutaneous anthrax is diagnosed when the Bacillus anthracis
bacterium is found in the skin lesion by a laboratory culture.
It can also be diagnosed by measuring specific antibodies
in the blood of persons who are suspected of having infection.
Can I die from cutaneous anthrax?
Cutaneous anthrax is not usually fatal. If treated with appropriate
antibiotics, most individuals make a full recovery.
Protocols for Mail Handling
General:
Every business and organization should assess and review their
protocols for handling mail.
Common sense and care should be used in inspecting and opening
mail or packages.
Examine unopened envelopes for foreign bodies or powder.
Do not open letters with your hands: use a letter opener.
Open letters and packages with a minimum of movement to avoid
spilling any contents.
Each organization should assess whether it is a possible target
for criminal acts. Based on this assessment, you may wish
to take additional precautions such as wearing gloves and
restricting the opening of mail to a limited number of trained
individuals.
What Types of Letters May be Suspect:
Any letter or package that has suspicious or threatening messages
written on it Letters with oily stains
Envelopes that are lopsided, rigid, bulky, discolored or have
a strange odor
Envelopes with no return address
Unexpected envelopes from foreign countries
No postage or non-cancelled postage
Improper spelling of common names, places or titles
FOR SUSPECT ENVELOPES:
DO NOT OPEN THE ENVELOPE OR PACKAGE.
LEAVE it and EVACUATE the room.
KEEP others from entering.
NOTIFY your supervisor, who should call 911 or the local law
enforcement authorities.
FOR PACKAGES THAT ARE OPENED AND WHICH CONTAIN SUSPICIOUS
MATERIAL
DO NOT PANIC
Anthrax organisms can cause skin infection, gastrointestinal
infection or pulmonary infection.
To do so, the organism must be rubbed into abraded skin, swallowed,
or inhaled as a fine, aerosolized mist. It does not leap into
one's body. All forms of disease are generally treatable with
antibiotics.
Anthrax cannot be easily aerosolized out of an envelope or
package containing powder. The same facts and conditions are
generally true for other bacteria likely to be considered
as biological weapons.
CONTAIN THE EXPOSURE
Close off the room (doors and windows), do not allow anyone
other than qualified emergency personnel to enter.
Close the package or envelope to limit additional exposure.
Do not clean powder up; keep others away.
Do not touch your eyes, nose or any other part of your body.
If possible, wash your hands thoroughly with soap and water.
If clothing is heavily contaminated, don't brush vigorously.
If possible, close down the buildings heating/air conditioning/ventilation
system.
Make a list of all people who had actual contact with the
powder for investigating authorities.
NOTIFY APPROPRIATE AUTHORITIES
Immediately contact:
911 or your local law enforcement authorities,
your local FBI field office, and
your local health department.
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Smallpox
What is smallpox?
Smallpox is a serious infectious disease that no longer occurs
anywhere in the world. It was caused by a virus called variola.
The last naturally acquired case in the world occurred in
1977. Since smallpox has been eliminated from all countries,
a single case would be considered an international public
health emergency.
How was smallpox spread?
By close contact with the respiratory discharges of a person
with the disease or contact with objects contaminated by an
ill individual.
What were the symptoms of smallpox?
The symptoms of smallpox started with chills, high fever,
headache, joint and muscle pains (especially backache), nausea
and vomiting. The classic smallpox skin rash appeared several
days after the other symptoms. The skin rash became raised
and then pus-filled. The pustules ruptured, then dried and
crusted over. The rash was painful, most dense on the face,
arms, and legs, and caused severe itching and burning. Many
people who had this disease died from it, and it left permanent
scars on many who survived. Some milder forms of smallpox
also occurred.
How soon after exposure did symptoms appear?
The symptoms appeared from 8-16 days after the exposure, with
an average of 10-12 days.
How long could an infected person spread smallpox?
Infected persons spread the disease until all of the crusts
had dropped off the skin and disappeared. This usually happened
by about two weeks after the rash began. Smallpox was considered
a highly communicable disease, meaning that it was easily
spread from one person to another. After having this disease,
a person could not get it again.
How was it diagnosed?
Smallpox was diagnosed by various laboratory tests that detected
the virus.
What was the treatment for smallpox?
Patients with this disease were usually hospitalized, but
there was no specific treatment for it. Treatment included
keeping the patient as comfortable as possible by keeping
the skin clean, trying to control the itching, and relieving
the pain and other symptoms as much as possible. Antibiotics
were used only if bacterial infections developed as a complication.
How could smallpox be prevented?
Smallpox has been eradicated because the vaccine was effective
and used widely to prevent cases. Isolation of persons with
disease, appropriate disinfection of articles that came in
contact with patients, and vaccination of contacts helped
prevent the spread to others. Today, samples of the virus
are held under tight security in only two research laboratories
in the worlds.
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