Know the Facts

The tragic events of September 11, 2001, have everyone concerned about additional terrorist acts, including those that may involve infectious diseases. The Center for Infectious Diseases at Lahey Hospital & Medical Center is active in preparing for such an emergency, and we want to pass on some available information so you can make sound decisions for yourself and your family.

The word “bioterrorism” describes the use of terrorist weapons that contain infections or chemicals that can cause illness and death. The bioterrorism threat affects many because it evokes fear among those communities that believe they may be the targets of one of these weapons. The “success” of a bioterrorism threat can be greatly reduced if you learn some basic facts to make sure these fears do not prevent you from having a normal life. A specific plan for managing bioterrorism has not been spelled out to the public because there are different types of substances that may be used and each of these chemicals needs to be addressed in a different way. Health care professionals and government officials are alert to the possibilities of a bioterrorism attack, and they will announce appropriate actions to be taken if an attack is suspected.

The type of bioterrorist attack most widely discussed is an aerosolized attack, in which an odorless, tasteless and colorless infection is transmitted through the air. The first sign of an aerosolized attack might be an unusual number of people getting sick in a short period of time, or the appearance of an illness that is rarely seen. Doctors are on the lookout for signs of unusual illness and they would quickly alert the community. Getting early treatment and preventing further spread of a disease between family and friends would be important goals. This would be rather challenging because, by the time people actually get sick, the infection would no longer be in the air.

Your doctors and the public health system are on the watch for unusual illnesses or unusual patterns of disease. Once a bioterrorist attack is suspected, the FBI, other national organizations and local law enforcement agencies will provide information to the public through television, radio and newspapers.

The first thing to remember is not to panic. Flu season will still come this year, and anybody can get sick with a cold, the flu or even a lung infection. Most of those getting sick will not be victims of bioterrorism. If you have any of the following symptoms, you should call your doctor:

  • Fever and diarrhea, especially bloody diarrhea
  • Fever, chest pain, severe cough (lung infection, pneumonia)
  • Fever and a rash
  • Fever and a severe headache, bizarre behavior or loss of consciousness

Again, these symptoms can occur with a number of infections; they do not necessarily equal bioterrorism but they do require medical attention.

If a bioterrorist attack is suspected by a reliable source, you may be directed to take antibiotics, depending on the exact type of infection. The government has large supplies of antibiotics in the National Pharmaceutical Stockpile (NPS). NPS is a large reserve of antibiotics, antidotes and medical supplies that can be brought to an affected area within 12 hours of an attack. We do not recommend that you get antibiotics to keep at home, or start taking antibiotics before a bioterrorist attack has been identified. Various germs require different antibiotics, and since antibiotics may have side effects they should only be taken with medical supervision.

Yes, it would be very difficult to contaminate our drinking water. First, we use such huge amounts of water every day that any germs put into the drinking supply would be diluted (present only in very small amounts). Second, municipal water is filtered and chlorine is added, killing most harmful germs.

Bioterrorism Fact Sheet (from Lahey Hospital & Medical Center’s Center for Infectious Diseases)

Recommended Web Sites

http://www.bt.cdc.gov/

The Centers for Disease Control and Prevention’s Public Health Emergency Preparedness and Response guide contains up-to-date information about potential biowarfare agents and plans as well as guidelines for response if a bioterrorism act is confirmed.

http://www.idsociety.org/BT/ToC.htm

The Infectious Disease Society of America’s Bioterrorism Information and Resources includes medical summaries for the most common bacterial and viral agents, clinical pathways for management, teaching slide sets for ID professionals and extensive Web links.