Protecting Yourself From Bioterrorism

After the 911 terrorist attacks, The National League of Cities conducted a preparedness survey of 456 communities and towns. Here are their findings.

Survey Question
All Cities Medium Towns Small Towns
Does your city have a terrorism response or prevention plan in place? 55% 83% 59% 40%
Has your city ever had anti-terrorism training?
In the last year?
In the last two years?
Locals who will now conduct an overall reassessment.
52% 66% 52% 48%

Population Key - Cities = 100,000+; Medium Towns = 10,000 - 100,000;
Small Towns = 10,000 and fewer

Officials pretty much agree on one thing, extremist assaults are not likely over yet. In fact, as of Saturday, October 6th, experts state there is 100% assurance of additional terrorist attacks.

Disturbingly, we've heard the same advice over and over - rely on the government to supply your defense if a biological or chemical attack occurs. Like a broken record, government spokes people like Health and Human Services Secretary Tommy Thompson stressed there is plenty of vaccine should a bio-chem agent zap our air, water or and/food supplies. This is simply false.


Over the past week, the truth has filtered out sparingly. Certain vaccines available in limited quantity, but most are in reserve for the military and medical people. Fair enough. Both of these allocations are completely understandable, but implying there is adequate vaccine for everyone does no one any favors. It only staves off panic right now.

Should a bio-chem attack occur and we anxiously await shots, can you imagine the chaos and anger erupting once we understand "the cure" might not be for us? Better that we grasp that truth now than after dispersal.

The morning of October 5th, on Pueblo's 590 AM station, the 6 a.m. news stated our local health department is finally getting inquiries - lots of them - about anthrax, smallpox and plague vaccines. They told the public that the available vaccines are reserved for the military. Some doctors are refusing to give shots until they get "official word" from the federal government about who can and who can't have them.

During Senate hearings October 3rd, officials discussed how well-prepared the government is (or isn't) to face biowarfare. CNN broadcast Health Secretary Tommy Thompson admission there are problems, particularly at the state and local level, but reassured that the U.S. is prepared to handle "any contingency, any consequence from any kind of bioterrorism attack."

Senator Robert Byrd, D-W.Va. was heard to snort, "Will you still love me if I tell you I don't believe that?"

Secry. Thompson acknowledged the health system does have "gaps".
2 A GAO Official testified our preparation is "fragmented."3 "Fragmentation" and "gaps include areas that need addressing immediately and should have been done resolved a long time ago.

In a Newsweek poll released Sept. 29th, more than 8 out of 10 people think an attack with biological or chemical weapons is at least somewhat likely. Fewer than half think the government is ready to handle one.


1. How would hospitals cope with a huge influx - possibly tens of thousands of sick people - at one time?

A single biological or chemical attack on a U.S. city would probably overwhelm local medical resources. What if there were more than one? Some suggestions include military field tents which could be set up in 72 hour to handle the masses, but would these suffice in the dead of winter?

Tommy Thomsom says we have 7,000 doctors and medical assistance teams throughout America to deal with an extensive assault. That may be so, but a successful attack could be overwhelming. Joe Zelinka, public safety program coordinator at the Council of Governments stated we could be talking about tens of thousands of victims which "would absolutely crush our medical system."

One suggested solution would be to discharge other patients, but due to rising medical costs, people in hospital already tend to be quite ill. People are entering the hospital for frivolous reasons.

Around the country, hospitals have closed and consolidated as they struggle to cope with rising costs. Military hospitals also have shut down, further limiting the number of beds.

Additionally, the national nursing shortage means hospitals are already understaffed.

2. Many physicians and labs aren't trained to recognize the symptoms of anthrax, smallpox or plague.

Should sick people wander into their doctor's office or hospital, how many healthy people would become infected? (Smallpox is highly contagious once the rash appears. Health experts estimate one person will spread the disease to at least 10 people.)

3. How would they handle administering enormous numbers of vaccines?

Most vaccines must be given very rapidly - some before the onset of symptoms. Literally thousands of medical people would be needed since federally supplied antibiotics were purchased and stored in bulk. Doses for each person would have to be counted out by hand from huge bottles.

4. Vaccination protocol

Vaccination issues have yet to be resolved. Some say only people who have had contact with the sick should be vaccinated, while others say that entire cities where smallpox was found would need inoculations.

There is a lack of standard operating procedures or signed agreements in place with private air cargo and land transport to move the stockpiles to contaminated areas.

5. Problems with federally stored vaccines

Areas of concern involve whether or not the vaccines could be stolen, storing conditions are too hot rendering them ineffective, outdated product which should have been rotated (sound familiar?) and poor tracking systems which show vaccine in stock which isn't and vice versa. You can read the details of these Senate hearings at

6. How well is your own community prepared?

Local governments have much of the initial burden to furnish medical treatment after an attack. Local public health systems will have to provide patient care, immunizations or prophylactic drug treatments for exposed groups, deal with fatalities and decontaminate the environment.

Don't wait until an event to find out how well prepared your community is. Ask! Phone or visit your state and local emergency preparedness departments.

Start with your city, county and state government officials; they can direct you to the specific people in charge. Check with the local health department and hospitals to see what disaster plans are practiced. Call the city and/or county's emergency management team to see what measures are in place. Be polite, but be persistent until you are satisfied with the answers. You, the public pay their salary, so they owe you an honest answer.

October 11th, Stan and I attended Pueblo County's public preparedness forum which discussed localemergency readiness measures. Representatives participated from both hospitals, the FBI, Office of Emergency Management, the school district, police and sheriff's departments, Pueblo's Chemical Weapons Depot, Pueblo County Commissioners and the fire department. They
claim our community is better prepared thanmost for good reason.

Since our area hosts a weapons depot, the government funded a $4.5 million emergency preparedness program with state-of-the-art capabilities a few years ago. For that reason, as we heard a number of times at this meeting, Pueblo is "ahead of the game."

The CDC has set forth certain Procedures for State and Local Public Health Officials in case of a bioterrorist attack. In broadstroke, pictured right is the blueprint. For more details, click on the link above.


One radio talk show host in Colorado Springs last week mistakenly told everyone to quit worrying about smallpox if you had been vaccinated as a kid. Well, "as a kid" is more years ago than most of us want to remember and that vaccination quit being effective three years after it was given. Some studies show the antibodies to be present for five to ten years, but even so, even those who received the recommended single-dose vaccination as children no longer have immunity. "People vaccinated before 1972 lost most of their immunity within 10 years."

Since these shots ceased in the 70s, it's safe to say none of us are protected against smallpox now. There can be severe side effects to the smallpox vaccine and it's not available to the general public.

In researching this disease, conflicting information popped up. This is what the CDC states for treatment.

"In people exposed to smallpox, the vaccine can lessen the severity of or even prevent illness if given within 4 days after exposure... There is no proven treatment for smallpox but research to evaluate new antiviral agents is ongoing. Patients with smallpox can benefit from supportive therapy (intravenous fluids, medicine to control fever or pain, etc.) and antibiotics for any secondary bacterial infections that occur."

This is what Johns-Hopkins says about treatment:

"Treatment of smallpox is limited to supportive therapy and antibiotics as required for treating secondary bacterial infections. There are no proven antiviral agents effective in treating smallpox."

Early treatment is vital. By the time symptoms show - generally within 12 days, treatment is much less successful and is fatal 30% of the time.

Currently the U.S. has 15.4 million doses of the smallpox vaccine available and the World Health Organization has about 500,000. Another 40 million doses are on order and should be ready by the end of 2002.


While the anthrax preventative vaccine is about 93% effective, it takes 18 months to complete the series of shots. It is in too-short supply and reserved for the military. As of October 5th, the sole manufacturer of the military's anthrax prevention, BioPort Corporation still can not meet FDA standards for production. BioPort has not made a single dose of anthrax vaccine since 1998.

Anthrax usually is susceptible to penicillin, doxycycline, and fluoroquinolones.

According to Tommy Thompson, the nation's health secretary, there are enough antibiotics for anthrax in a federal stockpile to treat 2 million people for 60 days.

Until the pharmacies manufacture much more of these defense agents, one would be wise not to count on receiving a vaccine.

When Secry. Thompson was asked what ordinary citizens should do to avoid an outbreak, well, judge the advice for yourself:

"I would strongly tell Mr. and Mrs. Citizen ... be very vigilant. Be very vigilant about your activities. And anything suspicious, and any kind of cold or anything mysterious dealing with your body -- illness or infections of rashes or coughing -- get to a doctor. And ask that doctor if he or she knows anything about smallpox, anthrax, botulism.

"I would not suggest that they buy a gas mask. I would not suggest they go out and buy a lot of (antibiotics). I would strongly just urge them to be more alert than they have in the past."


Though there are other biologicals that could be used in a terrorist attack (see our newsletter Part 3) bubonic plague rounds out the most likely trio. Early treatment of pneumonic plague is essential. Plague is almost 100% fatal if not treated within a day of the onset of symptoms. While there is no vaccine against plague, several antibiotics are effective, including streptomycin, tetracycline, and chloramphenicol.

Without supplying specific numbers, MSNBC reports that the government has antibiotic tablets, streptomycin and gentamicin, stored with millions more available from pharmacies.

Prophylactic antibiotic treatment for 7 days will protect persons who have had face-to-face contact with infected patients.

The CDC's National Pharmaceutical Stockpile program (NPSP) states the following regarding their priorities for acquiring and maintaining adequate supplies of vaccine and disease treatments.

"Expert panels convened by CDC prioritized the following biological agents: smallpox, anthrax, pneumonic plague, tularemia, botulinum toxin and viral hemorrhagic fevers. Because anthrax, plague and tularemia can be effectively treated with antibiotics that are immediately available, purchasing these products for the NPSP formulary was given first priority. The NPSP also has a cache of vaccine available to address smallpox threats."

If this advice works for you and you're comfortable with level of protection, great! However many people have asked what measures they personally can take. Some folks want gas masks, etc. but don't have a clue what to look for. Hopefully this information on the following pages will give you adequate pointers.



1Source: '100-percent chance' of another attack
2Change needed to combat bioterror threat
3U.S. Is Still Vulnerable To Attacks, Experts Say Numerous 'Targets of Opportunity' Cited
4Where Would You Put All The Sick?; October 5, 2001;
5A Common Sense Guide to Being Prepared;
6CDC's Bioterrorism FAQ; update October 5, 2001;
7Center For Civilian Biodefense Studies
8 Military's Sole Supplier of Anthrax Vaccine Still Can'tMake It; October 6, 2001;
9Defending Against An Attack
10Are We Safe?,1597,313043-412,00.shtml
11National Pharmaceutical Stockpile

Other References:
Bioterrorism Preparations Vary Widely Bioterrorism Interactive-
Seeking a Treatment for Terrorism, Health Agencies Step Up Preparations for Biological Attack; October 5, 2001;
Facts about: Anthrax, Botulism, Pneumonic Plague, Smallpox
CDC's Agent List