Welcome to our 1st Illinois Public Health Association (IPHA) Weekly Preparedness Blog. We will be posting preparedness informational blogs each Friday morning on the IPHA Website. Our preparedness blogs will combine past historical events and personal experiences with current readiness threats and assessments, presented in serial groups of singular blogs presented over many weeks addressing one general topic. For example, our first series will consist of evaluating bioterrorism threats and present-day levels of preparedness. Future series will not only look at terrorism threats, but also natural disasters and common emergency events.

WEEK ONE - FEBRUARY 7, 2018

by David Culp, Emergency Preparedness Coordinator, Illinois Public Health Association

Over the past two decades, millions of federal, state and local funds have been spent and thousands of staff hours expended in the United States to prepare for, prevent and respond to a bioterrorism attack. Has this money and time been well spent or wasted? Is America safer today from a bioterrorism attack than it was at the beginning of the 21st Century? How real is the Bioterrorism Threat?

When I was stationed at USAMRIID (United States Army Research Institute for Infectious Diseases), prior to and during Desert Shield/Desert Storm, there were significant concerns the Iraqi Military would use Anthrax against American and Coalition troops. Throughout Desert Shield, and more pointedly in the days leading up to Desert Storm, we in the Bacteriology Division at USAMRIID were working nearly around the clock to measure the effectiveness of the Anthrax Vaccine in preparation and anticipation of Iraqi forces utilizing Anthrax weapons in response to a coalition offensive. Fortunately, the Iraqi government chose not to use or did not have available Anthrax weapons to deploy.

In my conversations with American medical personnel participating in Desert Storm, there was significant enough concern from United States and Coalition leadership that Anthrax Vaccine was provided to troops prior to the offensive commencing. The Iraqi situation during Desert Shield/Storm portrays the insidious nature of bioterrorism; though the actual risk of “successful” utilization of a bioweapon by an adversarial nation state or a terrorist organization may be very low, the ability of biological agents to cause morbidity and mortality, along with extremely high levels of panic in an affected population, cannot be ignored or underestimated.

We need only look at the Domestic United States Anthrax Attacks of October 2001 for indications of how much fear, turmoil and discord is brought forth from an actual or supposed bioterrorism event. Throughout the Autumn of 2001 and continuing today, “White Powder Incidents” have made headlines and raised anxiety of those exposed or potentially exposed to Anthrax or another type of biological agent. The most recent high-profile example being Vanessa Trump, wife of Donald Trump Jr., who was exposed to a white powder substance from a letter this week; established to not be a biological agent, but still requiring laboratory testing and decontamination to “rule out” potential exposure and infection. Though the very high majority of the white powder incidents over the past fifteen plus years have been due to non-biological threat substances, the fear and uncertainty impact they have caused has been exponentially more significant than their actual threat, not to mention the response time and resources needed to alleviate the threat and associated anxieties.

It was largely due to the concerns of a hostile nation, such as Iraq or a terrorist organization such as Al-Qaeda, disseminating an agent of bioterrorism that significant expenditures of bioterrorism prevention and response funds were initiated at the onset of the 21st Century to assist states and local jurisdictions in preparing for, identifying and responding to a bioterrorism event. Beginning with the establishment of the Bioterrorism Grant, subsequently the Public Health Emergency Preparedness (PHEP) Grant, federal funds were provided to state and local health departments for bioterrorism event preparedness, agent identification, risk communication and health/medical response elements.

Focus and funding on bioterrorism event preparedness and response by federal, state and local health departments has brought forth many accomplishments: (1) increase in overall health and medical event preparedness; (2) enhanced coordination, collaboration and cooperation between public health agencies and their emergency response partner agencies and (3) increased understanding of the risks associated with biological agents. We have noted, beneficially, a transition from a strict focus on solely bioterrorism preparedness to an all hazards health and medical preparedness for all types of emergency events.

Notwithstanding the significant gains in preparedness for emergency events in general and bioterrorism events in particular, we must remain diligent to build on these accomplishments, especially in the backdrop of diminishing funding. Every type of emergency event has a health and medical aspect to it and public health will always have a response element to an emergency event.

Bioterrorism may be a Low Probability Event, but it is a High Impact Event. For two years I worked as a military laboratory technician at USAMRIID for the alleged perpetrator of the October 2001 Anthrax Letters, Dr. Bruce Ivins, who, though he possessed good microbiological skills, completely lacked any type of the modern molecular biological skills; yet was able to reportedly manufacture in Bacteriology Division Laboratories a very high quality, deadly Anthrax powder. As we will discuss in upcoming blogs, there is much greater scientific expertise present in many locals of today’s world with ability to prepare even more deadly agents of bioterrorism.

Comments? email dculp@ipha.com