Disaster planning and preparedness

¶ … difficult step in responding to an attack using biological weapons is identifying the incident for what it is. This requires alert clinicians and medical staff who are able to identify cases of disease that can be attributed to conscious and purposeful infection by an enemy agent (Gerberding et al. 2002). In the given scenario, there is abundant evidence that something is wrong, and the hospital staff recognized the sudden influx of patients with respiratory complaints as the possible beginnings of an epidemic, and the concentration of infection centered on the convention definitely suggests a deliberate act of bioterrorism. There are many possible causes for the upper respiratory infection that is the most common complaint from the attendees at the convention. Given the previous use of anthrax in terrorist attacks, the fact that it is easily aerosolized, and the increased fatality of the agent when it is inhaled (making it a more effective weapon for the terrorists), it is likely that Bacillus anthracis was the particular biological agent of choice in this scenario (Gerberding et al. 2002).

There are several ways to test and ensure that a biological attack had indeed occurred. Anthrax spores would be found in the air ducts where they were released, which would confirm both that the attack occurred and the method used (Center for Disease Control and Prevention 2009). Cultures can also be taken from patients to confirm the agent used and, in many cases, even to identify the specific strain and the possible origin of the agent used (CDC 2009). Despite this, there are few reliable methods for detecting and diagnosing biological attacks, largely due to the lack of real-world data with which to develop such systems (Bravata et al. 2004). If it is indeed an anthrax attack, antibiotic regimens should be given immediately to all persons who had been present in the convention center, regardless of symptoms (Snyder 2003).

The first response must be to quarantine the convention center and have a team comb through all possible areas and systems by which the agent could have been introduced. Halting further spread of the infection and determining the precise agent is of paramount importance in forestalling a possible epidemic (Gerberding et al. 2002). All patients already in area hospitals should be isolated as much as possible, and medical staff and other patients closely monitored for symptoms of the infection. This will prevent further spread of the disease while efforts are coordinated to determine the details of the attack and (hopefully) identify and apprehend the perpetrators. The details of the scenario suggest that the infection is not highly contagious without direct exposure, or an increased number of convention attendees and medical staff in hospitals would be reporting symptoms, therefore the movement of people not directly exposed to the agent should not be heavily restricted (CDC 2009).

Quarantine of the convention center and the people in attendance during the convention, however, should be enforced using whatever appropriate law enforcement units are most readily available, from local police to the National Guard, if necessary. Using this as an immediate precaution until the agents and the level of contagion is ascertained is the best method for preventing an epidemic and diminishing the efficacy of the attack, which has benefits beyond the immediate situation (Bravata 2004). Due to the apparently low level of contagion, the need for public awareness is not urgent, but it is still necessary. Warnings to stay away from the convention area and to report to a local hospital if symptoms developed after being in the area or in contact with someone who had been at the convention should be issued (CDC 2009).

The known details of the attack, however, should not be released, as it is likely to create panic and bolster the terrorists' optimism. Federal assistance should be immediately sought, not necessarily for control of the spread of the disease but for the investigation and apprehension of suspects. All available resources should be called in as soon as possible in order to counter the attack. As far as treatment of the attack goes, mass prophylaxis of all convention attendees and those who have come into contact with infected individuals should be mandated, especially if anthrax is identified as the specific agent used (CDC 2009). Thos who refuse antibiotics should be kept under quarantine, by the use of force if necessary, and monitored for the development of symptoms. Human rights codes do not permit for the forced use of medication, especially on non-prisoners, but neither can the public be exposed to a possible infection (CDC 2009).