What should I do to be prepared?

We continue to hear stories of the public buying gas masks and hoarding medicine in anticipation of a possible bioterrorist or chemical attack. We do not recommend either. As Secretary Thompson said recently, people should not be scared into thinking they need a gas mask. In the event of a public health emergency, local and state health departments will inform the public about the actions individuals need to take.

Does every city have an adequate emergency response system, especially one geared for a bioterrorist attack? How quickly can it be implemented?

The emergency response system varies from community to community on the basis of each community’s investment in its public health infrastructure. Some components of these emergency systems can be implemented very quickly, while others may take longer.

Are hospitals prepared to handle a sudden surge in demand for health care?

The preparedness level in hospitals depends on the biological agent used in an attack. Because a sudden surge in demand could overwhelm an individual hospital’s resources, hospitals collaborate with other hospitals in their area in order to respond to a bioterrorist attack on a citywide or regional basis. Hospitals are required to maintain disaster response plans and to practice applying them as part of their accreditation process. Many components of such plans are useful in responding to bioterrorism. Specific plans for bioterrorism have been added to the latest accreditation requirements of the Joint Commission on Accreditation of Healthcare Organizations. In an emergency, local medical care capacity will be supplemented with federal resources.

Are health department labs equipped/capable of doing testing?

CDC, the Association of Public Health Laboratories, and other officials are working together to ensure that all state health departments are capable of obtaining results of tests on suspected infectious agents. The nation’s laboratories are generally classified as Level A, B, C, or D. Level A laboratories are those typically found in community hospitals and are designated to perform initial testing on all clinical specimens. Public health laboratories are usually Level B; these laboratories can confirm or refute preliminary test results and can usually perform antimicrobial susceptibility tests. Level C laboratories, which are reference facilities and can be public health laboratories, perform more rapid identification tests. Level D laboratories are designed to perform the most sophisticated tests and are located in federal facilities such as CDC. CDC is currently working with public and private laboratory partners to develop a formal a National Laboratory System linking all four Levels.

Every state has a Laboratory Response Network (LRN) contact. The LRN links state and local public health laboratories with advanced-capacity laboratories, including clinical, military, veterinary, agricultural, water, and food-testing laboratories. Laboratorians should contact their state public health laboratory to identify their local LRN representative.