preparing for and responding to bioterrorism: information for the public health workforce

Northwest Center for Public Health PracticeUniversity of Washington School of Public Health and Community Medicine

1

Preparing for and Responding to Preparing for and Responding to Bioterrorism: Bioterrorism:

Information for the Public Health Information for the Public Health WorkforceWorkforce

UW Northwest Center for Public Health Practice2

Acknowledgements Acknowledgements Acknowledgements Acknowledgements

This presentation, and the accompanying instructor’s manual, were prepared by Jennifer Brennan Braden, MD, MPH, at the Northwest Center for Public Health Practice in Seattle, WA, for thepurpose of educating public health employees in the general aspects of bioterrorism preparedness and response. Instructors are encouragedto freely use all or portions of the material for its intended purpose.

The following people and organizations provided information and/or support in the development of this curriculum. A complete list of resources can be found in the accompanying instructor’s guide.

Patrick O’Carroll, MD, MPH Project Coordinator Centers for Disease Control and Prevention

Judith YarrowDesign and Editing Health Policy and Analysis; University of WA

Washington State Department of Health

Jeff Duchin, MD Jane Koehler, DVM, MPHCommunicable Disease Control, Epidemiology and Immunization Section

Public Health - Seattle and King County

Ed Walker, MD; University of WADepartment of Psychiatry


Emergency Response Planning Emergency Response Planning Emergency Response Planning Emergency Response Planning


Emergency Response Planning Emergency Response Planning Learning ObjectivesLearning Objectives

Emergency Response Planning Emergency Response Planning Learning ObjectivesLearning Objectives

Identify the different agencies involved in Identify the different agencies involved in response to a bioterrorism event response to a bioterrorism event

Describe the Incident Command System and Describe the Incident Command System and how this system may be integrated into an how this system may be integrated into an agency’s bioterrorism response plan agency’s bioterrorism response plan

Identify factors to consider and include in the Identify factors to consider and include in the development of a local emergency response development of a local emergency response planplan

Identify the different agencies involved in Identify the different agencies involved in response to a bioterrorism event response to a bioterrorism event

Describe the Incident Command System and Describe the Incident Command System and how this system may be integrated into an how this system may be integrated into an agency’s bioterrorism response plan agency’s bioterrorism response plan

Identify factors to consider and include in the Identify factors to consider and include in the development of a local emergency response development of a local emergency response planplan


Emergency Response Planning Emergency Response Planning Learning Objectives Learning Objectives

Emergency Response Planning Emergency Response Planning Learning Objectives Learning Objectives

Describe national and local efforts in the area of Describe national and local efforts in the area of BT preparedness and response BT preparedness and response

Describe the roles of public health in Describe the roles of public health in bioterrorism preparedness and responsebioterrorism preparedness and response

Describe national and local efforts in the area of Describe national and local efforts in the area of BT preparedness and response BT preparedness and response

Describe the roles of public health in Describe the roles of public health in bioterrorism preparedness and responsebioterrorism preparedness and response


Bioterrorism Preparedness and ResponseBioterrorism Preparedness and ResponseCrisis and Consequence ManagementCrisis and Consequence Management

Bioterrorism Preparedness and ResponseBioterrorism Preparedness and ResponseCrisis and Consequence ManagementCrisis and Consequence Management

Crisis management: law enforcement response Crisis management: law enforcement response to terrorist acts to terrorist acts Local, state, and federal law-enforcement agenciesLocal, state, and federal law-enforcement agencies

Consequence management: response to the Consequence management: response to the disaster focusing on the alleviation of damage, disaster focusing on the alleviation of damage, loss, hardship, or sufferingloss, hardship, or suffering Public health, medical, and emergency mgt Public health, medical, and emergency mgt

personnelpersonnel Falls under ESF-8 (Health & Medical Services) of Falls under ESF-8 (Health & Medical Services) of

Federal and State Disaster Response PlanFederal and State Disaster Response Plan

Crisis management: law enforcement response Crisis management: law enforcement response to terrorist acts to terrorist acts Local, state, and federal law-enforcement agenciesLocal, state, and federal law-enforcement agencies

Consequence management: response to the Consequence management: response to the disaster focusing on the alleviation of damage, disaster focusing on the alleviation of damage, loss, hardship, or sufferingloss, hardship, or suffering Public health, medical, and emergency mgt Public health, medical, and emergency mgt

personnelpersonnel Falls under ESF-8 (Health & Medical Services) of Falls under ESF-8 (Health & Medical Services) of

Federal and State Disaster Response PlanFederal and State Disaster Response Plan PDD-39

Community PreparednessCommunity PreparednessA Coordination of EffortsA Coordination of Efforts

Community PreparednessCommunity PreparednessA Coordination of EffortsA Coordination of Efforts

Partnerships between public health and:Partnerships between public health and: Clinicians and health care facilities Clinicians and health care facilities Law enforcementLaw enforcement Public safety: fire, HAZMAT Public safety: fire, HAZMAT Emergency management Emergency management

Coordinate response across agencies at the Coordinate response across agencies at the local, state, and federal levels local, state, and federal levels

Partnerships between public health and:Partnerships between public health and: Clinicians and health care facilities Clinicians and health care facilities Law enforcementLaw enforcement Public safety: fire, HAZMAT Public safety: fire, HAZMAT Emergency management Emergency management

Coordinate response across agencies at the Coordinate response across agencies at the local, state, and federal levels local, state, and federal levels


Local Emergency Response Planning Local Emergency Response Planning Committees (LEPCs) Committees (LEPCs)

Local Emergency Response Planning Local Emergency Response Planning Committees (LEPCs) Committees (LEPCs)

Established under the Emergency Planning and Established under the Emergency Planning and Community Right-to-Know ActCommunity Right-to-Know Act

Membership includes a wide variety of Membership includes a wide variety of stakeholders in the community stakeholders in the community

Develop comprehensive plans to prepare for Develop comprehensive plans to prepare for and respond to hazardous substance and respond to hazardous substance emergencies emergencies

Established under the Emergency Planning and Established under the Emergency Planning and Community Right-to-Know ActCommunity Right-to-Know Act

Membership includes a wide variety of Membership includes a wide variety of stakeholders in the community stakeholders in the community

Develop comprehensive plans to prepare for Develop comprehensive plans to prepare for and respond to hazardous substance and respond to hazardous substance emergencies emergencies

National RespondersNational RespondersNational RespondersNational Responders

Health and Human Health and Human Services (HHS)Services (HHS)

Centers for Disease Centers for Disease Control and Prevention Control and Prevention (CDC)(CDC)

Federal Emergency Federal Emergency Management Agency Management Agency (FEMA)(FEMA)

FBIFBI Environmental Environmental

Protection Agency Protection Agency (EPA)(EPA)

Department of Department of AgricultureAgriculture

Department of DefenseDepartment of Defense

Health and Human Health and Human Services (HHS)Services (HHS)

Centers for Disease Centers for Disease Control and Prevention Control and Prevention (CDC)(CDC)

Federal Emergency Federal Emergency Management Agency Management Agency (FEMA)(FEMA)

FBIFBI Environmental Environmental

Protection Agency Protection Agency (EPA)(EPA)

Department of Department of AgricultureAgriculture

Department of DefenseDepartment of Defense

State and Local RespondersState and Local RespondersState and Local RespondersState and Local Responders

Health care providers Health care providers and facilities and facilities

Local and state health Local and state health departments departments

Emergency Emergency management agencies management agencies

Search and Rescue, Search and Rescue, EMS, and HAZMAT EMS, and HAZMAT teamsteams

Volunteers Volunteers

Health care providers Health care providers and facilities and facilities

Local and state health Local and state health departments departments

Emergency Emergency management agencies management agencies

Search and Rescue, Search and Rescue, EMS, and HAZMAT EMS, and HAZMAT teamsteams

Volunteers Volunteers

Law enforcement, Law enforcement, National GuardNational Guard

State emergency State emergency management agencymanagement agency

Political leadersPolitical leaders Community service Community service

organizationsorganizations

Law enforcement, Law enforcement, National GuardNational Guard

State emergency State emergency management agencymanagement agency

Political leadersPolitical leaders Community service Community service

organizationsorganizations


The Emergency Response System The Emergency Response System The Emergency Response System The Emergency Response System

Emergency occurs and is detected by…

Local citizen Health surveillance system Clinician/hospital

Local health jurisdiction

Local emergency management office

Calls 911

Local law enforcement Fire EMSHAZMAT

FBI

State health dept

State Emergency Mgt Dept


Incident Command System Incident Command System DefinitionDefinition

Incident Command System Incident Command System DefinitionDefinition

A model for how to conduct and coordinate efforts A model for how to conduct and coordinate efforts in response to an emergencyin response to an emergency

Required to be used in HAZMAT incidents; also Required to be used in HAZMAT incidents; also used in other types of emergenciesused in other types of emergencies

Five major components Five major components Command Command Planning Planning Operations Operations LogisticsLogistics Finance/administration Finance/administration

A model for how to conduct and coordinate efforts A model for how to conduct and coordinate efforts in response to an emergencyin response to an emergency

Required to be used in HAZMAT incidents; also Required to be used in HAZMAT incidents; also used in other types of emergenciesused in other types of emergencies

Five major components Five major components Command Command Planning Planning Operations Operations LogisticsLogistics Finance/administration Finance/administration


Incident Command SystemIncident Command System Some Basic PrinciplesSome Basic Principles


Unity of commandUnity of command

Each person in an organization reports to Each person in an organization reports to only one designated persononly one designated person

Unified command structureUnified command structure

Used when more than one agency responds Used when more than one agency responds

All agencies involved in response establish a All agencies involved in response establish a common set of objectives and strategiescommon set of objectives and strategies

Unity of commandUnity of command

Each person in an organization reports to Each person in an organization reports to only one designated persononly one designated person

Unified command structureUnified command structure

Used when more than one agency responds Used when more than one agency responds

All agencies involved in response establish a All agencies involved in response establish a common set of objectives and strategiescommon set of objectives and strategies




Modular organization (expands or contracts as Modular organization (expands or contracts as required)required)

Common terminology Common terminology

Common names/titles used for all personnel Common names/titles used for all personnel and equipment and equipment

Modular organization (expands or contracts as Modular organization (expands or contracts as required)required)

Common terminology Common terminology

Common names/titles used for all personnel Common names/titles used for all personnel and equipment and equipment


Differences in Public Health and Law Differences in Public Health and Law Enforcement Investigations Enforcement Investigations

Differences in Public Health and Law Differences in Public Health and Law Enforcement Investigations Enforcement Investigations

Public HealthPublic Health Law EnforcementLaw Enforcement

Event Event RecognitionRecognition

Surveillance or calls Surveillance or calls from clinicians from clinicians

Announced by Announced by attacker or otherwise attacker or otherwise evident evident

Initial Data Initial Data CollectionCollection

Hypothesis Hypothesis generationgeneration

Questioning Questioning witnesses and witnesses and suspects, follow-up suspects, follow-up on tips on tips

Goal of Goal of InvestigationInvestigation

Effective disease Effective disease prevention and prevention and control measurescontrol measures

Prevention and Prevention and deterrence of future deterrence of future attacks, arrest of attacks, arrest of perpetrators perpetrators

Adapted from: Butler et al. EID, 2002


Emergency Operations PlanEmergency Operations PlanEmergency Operations PlanEmergency Operations Plan

A document that A document that

Assigns responsibility to organizations and Assigns responsibility to organizations and

individuals for carrying out specific actions individuals for carrying out specific actions

at projected times and places in an at projected times and places in an

emergency that exceeds the capability or emergency that exceeds the capability or

routine responsibility of any one agency routine responsibility of any one agency

A document that A document that

Assigns responsibility to organizations and Assigns responsibility to organizations and

individuals for carrying out specific actions individuals for carrying out specific actions

at projected times and places in an at projected times and places in an

emergency that exceeds the capability or emergency that exceeds the capability or

routine responsibility of any one agency routine responsibility of any one agency

BT and Emergency Response Plan Clearinghouse

bt.naccho.org


Emergency Operations PlanEmergency Operations PlanTypes of PlansTypes of Plans

Emergency Operations PlanEmergency Operations PlanTypes of PlansTypes of Plans

Describes the response to any emergency Describes the response to any emergency affecting the agency, county, or state affecting the agency, county, or state

Health-related emergency response plan a Health-related emergency response plan a subset of overall EOP subset of overall EOP

Lead and supporting agencies in an emergency Lead and supporting agencies in an emergency depend on the type of emergency depend on the type of emergency Roles designated by emergency support function Roles designated by emergency support function

(ESF) (ESF) ESF 8 = health and medical services; public health ESF 8 = health and medical services; public health

agency has lead role in response activities agency has lead role in response activities

Describes the response to any emergency Describes the response to any emergency affecting the agency, county, or state affecting the agency, county, or state

Health-related emergency response plan a Health-related emergency response plan a subset of overall EOP subset of overall EOP

Lead and supporting agencies in an emergency Lead and supporting agencies in an emergency depend on the type of emergency depend on the type of emergency Roles designated by emergency support function Roles designated by emergency support function

(ESF) (ESF) ESF 8 = health and medical services; public health ESF 8 = health and medical services; public health

agency has lead role in response activities agency has lead role in response activities


Emergency Operations PlanEmergency Operations PlanState and Local Roles State and Local Roles

Emergency Operations PlanEmergency Operations PlanState and Local Roles State and Local Roles

Public health terrorism plan integrated into or Public health terrorism plan integrated into or annexed to overall state/county EOP annexed to overall state/county EOP

Local government responds first Local government responds first State government State government

Assists local when capabilities overwhelmedAssists local when capabilities overwhelmed Responds first in certain emergenciesResponds first in certain emergencies Works with federal government when federal Works with federal government when federal

assistance necessary assistance necessary

Public health terrorism plan integrated into or Public health terrorism plan integrated into or annexed to overall state/county EOP annexed to overall state/county EOP

Local government responds first Local government responds first State government State government

Assists local when capabilities overwhelmedAssists local when capabilities overwhelmed Responds first in certain emergenciesResponds first in certain emergencies Works with federal government when federal Works with federal government when federal

assistance necessary assistance necessary WA's Emergency Management Plan

http://www.wa.gov/wsem/3-map/a-p/cemp/cemp-idx.htm



Developing a Local Public Health Developing a Local Public Health Emergency Operations PlanEmergency Operations Plan

Developing a Local Public Health Developing a Local Public Health Emergency Operations PlanEmergency Operations Plan

Establish a planning teamEstablish a planning team Analyze capabilities and hazardsAnalyze capabilities and hazards

Current resource baseCurrent resource base Geographic factors affecting responseGeographic factors affecting response Special needs populationsSpecial needs populations

Develop and implement the planDevelop and implement the plan ““Work” the planWork” the plan

Regular drills to: Regular drills to: Ensure understanding of procedures/rolesEnsure understanding of procedures/roles Test and update proceduresTest and update procedures

Establish a planning teamEstablish a planning team Analyze capabilities and hazardsAnalyze capabilities and hazards

Current resource baseCurrent resource base Geographic factors affecting responseGeographic factors affecting response Special needs populationsSpecial needs populations

Develop and implement the planDevelop and implement the plan ““Work” the planWork” the plan

Regular drills to: Regular drills to: Ensure understanding of procedures/rolesEnsure understanding of procedures/roles Test and update proceduresTest and update procedures Emergency Mgt Guide for

Business and Industry


Legal Issues to Consider in Legal Issues to Consider in Planning for a Health Emergency Planning for a Health Emergency


What is the legal authority for: What is the legal authority for: Undertaking actions to protect public health Undertaking actions to protect public health

and safety?and safety? Enforcing quarantine of infected individuals? Enforcing quarantine of infected individuals? Waiving legal liability to emergency workers?Waiving legal liability to emergency workers? Provision of disaster services by coroners, Provision of disaster services by coroners,

medical examiners, or mortuary workers?medical examiners, or mortuary workers? Access to, use of, and reimbursement for Access to, use of, and reimbursement for

private sector resources in an emergency?private sector resources in an emergency?

What is the legal authority for: What is the legal authority for: Undertaking actions to protect public health Undertaking actions to protect public health

and safety?and safety? Enforcing quarantine of infected individuals? Enforcing quarantine of infected individuals? Waiving legal liability to emergency workers?Waiving legal liability to emergency workers? Provision of disaster services by coroners, Provision of disaster services by coroners,

medical examiners, or mortuary workers?medical examiners, or mortuary workers? Access to, use of, and reimbursement for Access to, use of, and reimbursement for

private sector resources in an emergency?private sector resources in an emergency?




What are the legal responsibilities of different What are the legal responsibilities of different agencies/officials in emergency response?agencies/officials in emergency response?

What is the scope of authority of different What is the scope of authority of different agencies/officials in emergency response agencies/officials in emergency response efforts? efforts?

How do local laws compare with state and How do local laws compare with state and federal laws? What circumstances warrant early federal laws? What circumstances warrant early state or federal involvement? state or federal involvement?

What are the legal responsibilities of different What are the legal responsibilities of different agencies/officials in emergency response?agencies/officials in emergency response?

What is the scope of authority of different What is the scope of authority of different agencies/officials in emergency response agencies/officials in emergency response efforts? efforts?

How do local laws compare with state and How do local laws compare with state and federal laws? What circumstances warrant early federal laws? What circumstances warrant early state or federal involvement? state or federal involvement?


Workplace Emergency Response PlansWorkplace Emergency Response PlansWorkplace Emergency Response PlansWorkplace Emergency Response Plans

Workplace-specific emergency operations plan Workplace-specific emergency operations plan Plan should include a bioterrorism componentPlan should include a bioterrorism component Be familiar with your agency’s plan Be familiar with your agency’s plan

Who activates it and when it might be Who activates it and when it might be activatedactivated

Your responsibilitiesYour responsibilities Evacuation plansEvacuation plans Communication procedures (i.e., phone Communication procedures (i.e., phone

tree/call-down roster)tree/call-down roster)

Workplace-specific emergency operations plan Workplace-specific emergency operations plan Plan should include a bioterrorism componentPlan should include a bioterrorism component Be familiar with your agency’s plan Be familiar with your agency’s plan

Who activates it and when it might be Who activates it and when it might be activatedactivated

Your responsibilitiesYour responsibilities Evacuation plansEvacuation plans Communication procedures (i.e., phone Communication procedures (i.e., phone

tree/call-down roster)tree/call-down roster)


National PreparednessNational Preparedness1999 Initiative 1999 Initiative

National PreparednessNational Preparedness1999 Initiative 1999 Initiative

National Bioterrorism Preparedness and National Bioterrorism Preparedness and Response Initiative Response Initiative 1999 DHHS Initiative to prepare the nation to 1999 DHHS Initiative to prepare the nation to

respond to potential BT activityrespond to potential BT activity CDC designated lead in upgrading nation’s CDC designated lead in upgrading nation’s

public health capacity and in developing a BT public health capacity and in developing a BT preparedness and response planpreparedness and response plan

National Bioterrorism Preparedness and National Bioterrorism Preparedness and Response Initiative Response Initiative 1999 DHHS Initiative to prepare the nation to 1999 DHHS Initiative to prepare the nation to

respond to potential BT activityrespond to potential BT activity CDC designated lead in upgrading nation’s CDC designated lead in upgrading nation’s

public health capacity and in developing a BT public health capacity and in developing a BT preparedness and response planpreparedness and response plan

More on 1999 Initiative...

http://www.bt.cdc.gov/documents/RegMeetingSlides/Overview.pdf


National PreparednessNational PreparednessCDC Activities CDC Activities

National PreparednessNational PreparednessCDC Activities CDC Activities

CDC bioterrorism preparedness and CDC bioterrorism preparedness and response activities response activities Preparedness and preventionPreparedness and prevention Detection and surveillanceDetection and surveillance Diagnosis and characterization of biological Diagnosis and characterization of biological

and chemical agentsand chemical agents ResponseResponse

CDC bioterrorism preparedness and CDC bioterrorism preparedness and response activities response activities Preparedness and preventionPreparedness and prevention Detection and surveillanceDetection and surveillance Diagnosis and characterization of biological Diagnosis and characterization of biological

and chemical agentsand chemical agents ResponseResponse

More on CDC program...


National PreparednessNational PreparednessCDC Activities, cont. CDC Activities, cont.

National PreparednessNational PreparednessCDC Activities, cont. CDC Activities, cont.

CDC bioterrorism preparedness and CDC bioterrorism preparedness and response activities response activities Education and trainingEducation and training Improved communication systemsImproved communication systems

Health Alert Network Health Alert Network Laboratory Response Network Laboratory Response Network

National Pharmaceutical StockpileNational Pharmaceutical Stockpile

CDC bioterrorism preparedness and CDC bioterrorism preparedness and response activities response activities Education and trainingEducation and training Improved communication systemsImproved communication systems

Health Alert Network Health Alert Network Laboratory Response Network Laboratory Response Network

National Pharmaceutical StockpileNational Pharmaceutical Stockpile

More on CDC program...


National PreparednessNational PreparednessOther DHHS activitiesOther DHHS activities

National PreparednessNational PreparednessOther DHHS activitiesOther DHHS activities

Medical Consequence ManagementMedical Consequence Management: HHS : HHS

Office of Emergency Preparedness (OEP), Office of Emergency Preparedness (OEP),

expanding efforts to develop medical response expanding efforts to develop medical response

capabilities at local and national levelscapabilities at local and national levels

Medical Consequence ManagementMedical Consequence Management: HHS : HHS

Office of Emergency Preparedness (OEP), Office of Emergency Preparedness (OEP),

expanding efforts to develop medical response expanding efforts to develop medical response

capabilities at local and national levelscapabilities at local and national levels

Community PreparednessCommunity Preparedness Role of Public Health Role of Public Health


Coordinate preparedness and response Coordinate preparedness and response activities activities

Requires collaboration with medical Requires collaboration with medical professionals, first responders, and other professionals, first responders, and other partners partners

Provide information to health professionals, Provide information to health professionals, government leaders, and the publicgovernment leaders, and the public

Coordinate preparedness and response Coordinate preparedness and response activities activities

Requires collaboration with medical Requires collaboration with medical professionals, first responders, and other professionals, first responders, and other partners partners

Provide information to health professionals, Provide information to health professionals, government leaders, and the publicgovernment leaders, and the public

27



Detection and evaluation of biological disasterDetection and evaluation of biological disaster Requires robust surveillance, epidemiology, and Requires robust surveillance, epidemiology, and

disease investigation infrastructure, disease investigation infrastructure, plusplus new new detection methodsdetection methods

Facilitate medical management of exposed Facilitate medical management of exposed personspersons Provide information on diagnosis, treatment, Provide information on diagnosis, treatment,

prophylaxis, and infection control issuesprophylaxis, and infection control issues

Detection and evaluation of biological disasterDetection and evaluation of biological disaster Requires robust surveillance, epidemiology, and Requires robust surveillance, epidemiology, and

disease investigation infrastructure, disease investigation infrastructure, plusplus new new detection methodsdetection methods

Facilitate medical management of exposed Facilitate medical management of exposed personspersons Provide information on diagnosis, treatment, Provide information on diagnosis, treatment,

prophylaxis, and infection control issuesprophylaxis, and infection control issues

28



Coordinate and engage state and federal Coordinate and engage state and federal resourcesresources

Education, training, and informationEducation, training, and information

Surveillance, disease case and outbreak Surveillance, disease case and outbreak investigationinvestigation

Coordinate and engage state and federal Coordinate and engage state and federal resourcesresources

Education, training, and informationEducation, training, and information

Surveillance, disease case and outbreak Surveillance, disease case and outbreak investigationinvestigation

Public Health Preparedness and Response Capacity Inventory

http://www.phppo.cdc.gov/od/inventory 29



Inventory and address deficiencies in regional Inventory and address deficiencies in regional resourcesresources Hospital response capacity/preparednessHospital response capacity/preparedness EMS/first responder capacity/preparednessEMS/first responder capacity/preparedness Mass treatment and prophylaxisMass treatment and prophylaxis Mortuary capacity/preparednessMortuary capacity/preparedness Law enforcement/securityLaw enforcement/security

Inventory and address deficiencies in regional Inventory and address deficiencies in regional resourcesresources Hospital response capacity/preparednessHospital response capacity/preparedness EMS/first responder capacity/preparednessEMS/first responder capacity/preparedness Mass treatment and prophylaxisMass treatment and prophylaxis Mortuary capacity/preparednessMortuary capacity/preparedness Law enforcement/securityLaw enforcement/security

30


Summary of Key PointsSummary of Key PointsSummary of Key PointsSummary of Key Points

BT preparedness and response requires BT preparedness and response requires coordination between public health, clinicians, coordination between public health, clinicians, emergency management, first responders, and emergency management, first responders, and law enforcement officials.law enforcement officials.

The Incident Command System is a hierarchical The Incident Command System is a hierarchical and unified system of managing an emergency and unified system of managing an emergency response involving single or multiple agencies. response involving single or multiple agencies.

All agencies should include a bioterrorism All agencies should include a bioterrorism component in their overall emergency response component in their overall emergency response plan.plan.

BT preparedness and response requires BT preparedness and response requires coordination between public health, clinicians, coordination between public health, clinicians, emergency management, first responders, and emergency management, first responders, and law enforcement officials.law enforcement officials.

The Incident Command System is a hierarchical The Incident Command System is a hierarchical and unified system of managing an emergency and unified system of managing an emergency response involving single or multiple agencies. response involving single or multiple agencies.

All agencies should include a bioterrorism All agencies should include a bioterrorism component in their overall emergency response component in their overall emergency response plan.plan.


Summary of Key PointsSummary of Key PointsSummary of Key PointsSummary of Key Points

Emergency response planning in public health Emergency response planning in public health includes: includes: Development and evaluation of detection Development and evaluation of detection

systemssystems Development and evaluation of policies and Development and evaluation of policies and

response proceduresresponse procedures Awareness of relevant laws Awareness of relevant laws Evaluation and coordination of resourcesEvaluation and coordination of resources Education and training Education and training

Emergency response planning in public health Emergency response planning in public health includes: includes: Development and evaluation of detection Development and evaluation of detection

systemssystems Development and evaluation of policies and Development and evaluation of policies and

response proceduresresponse procedures Awareness of relevant laws Awareness of relevant laws Evaluation and coordination of resourcesEvaluation and coordination of resources Education and training Education and training


ResourcesResourcesNationalNational

ResourcesResourcesNationalNational

Centers for Disease Control and PreventionCenters for Disease Control and Prevention

Emergency Preparedness and Response Emergency Preparedness and Response

branch 24-hour notification telephone number branch 24-hour notification telephone number [(770) 488-7100] [(770) 488-7100] CDC Public Inquiry Hotlines: CDC Public Inquiry Hotlines:

English(888) 246-2675English(888) 246-2675 Español (888) 246-2857 Español (888) 246-2857

National Domestic Preparedness Office: National Domestic Preparedness Office:

1-202-324-9026 M-F 8am-5pm EST1-202-324-9026 M-F 8am-5pm EST

Centers for Disease Control and PreventionCenters for Disease Control and Prevention

Emergency Preparedness and Response Emergency Preparedness and Response

branch 24-hour notification telephone number branch 24-hour notification telephone number [(770) 488-7100] [(770) 488-7100] CDC Public Inquiry Hotlines: CDC Public Inquiry Hotlines:

English(888) 246-2675English(888) 246-2675 Español (888) 246-2857 Español (888) 246-2857

National Domestic Preparedness Office: National Domestic Preparedness Office:

1-202-324-9026 M-F 8am-5pm EST1-202-324-9026 M-F 8am-5pm EST

Bioterrorism Web site: Bioterrorism Web site: http://www.bt.cdc.gov


Resources Resources Washington StateWashington State Resources Resources Washington StateWashington State

Washington State Department of HealthWashington State Department of Health

Communicable Disease EpidemiologyCommunicable Disease Epidemiology 1-877-539-4344 - 24-hour emergency number1-877-539-4344 - 24-hour emergency number (206)-361-2914 (206)-361-2914

Julie Wicklund, BT Surveillance Epidemiologist Julie Wicklund, BT Surveillance Epidemiologist (206) 361-2881(206) 361-2881

Washington State Emergency Management Division

Washington State Department of HealthWashington State Department of Health

Communicable Disease EpidemiologyCommunicable Disease Epidemiology 1-877-539-4344 - 24-hour emergency number1-877-539-4344 - 24-hour emergency number (206)-361-2914 (206)-361-2914

Julie Wicklund, BT Surveillance Epidemiologist Julie Wicklund, BT Surveillance Epidemiologist (206) 361-2881(206) 361-2881

Washington State Emergency Management Division http://www.wa.gov/wsem/

http://www.doh.wa.gov


Resources Resources Emergency ManagementEmergency Management

Resources Resources Emergency ManagementEmergency Management

State Emergency Management duty officer State Emergency Management duty officer 1-800-258-5990 1-800-258-5990

Regional Emergency Coordinator,Region X Regional Emergency Coordinator,Region X 206-615-2266206-615-2266

FBIFBI Western WA and after hrs, Statewide: Western WA and after hrs, Statewide: (206) 622-0460 (206) 622-0460 Eastern WA: (509) 747-5195Eastern WA: (509) 747-5195

Federal Emergency Management Agency Federal Emergency Management Agency (FEMA)(FEMA) Incident Command System Self-study CourseIncident Command System Self-study Course

State Emergency Management duty officer State Emergency Management duty officer 1-800-258-5990 1-800-258-5990

Regional Emergency Coordinator,Region X Regional Emergency Coordinator,Region X 206-615-2266206-615-2266

FBIFBI Western WA and after hrs, Statewide: Western WA and after hrs, Statewide: (206) 622-0460 (206) 622-0460 Eastern WA: (509) 747-5195Eastern WA: (509) 747-5195

Federal Emergency Management Agency Federal Emergency Management Agency (FEMA)(FEMA) Incident Command System Self-study CourseIncident Command System Self-study Course

http://www.fema.gov

http://training.fema.gov/EMIWeb/crslist.htm


Resources Resources Emergency Response PlanningEmergency Response Planning

Resources Resources Emergency Response PlanningEmergency Response Planning

Bioterrorism and Emergency Response Plan Bioterrorism and Emergency Response Plan Clearinghouse Clearinghouse

Washington State Comprehensive Emergency Washington State Comprehensive Emergency Management Plan Management Plan

Emergency Management Guide for Business Emergency Management Guide for Business and Industry (FEMA)and Industry (FEMA)

Bioterrorism and Emergency Response Plan Bioterrorism and Emergency Response Plan Clearinghouse Clearinghouse

Washington State Comprehensive Emergency Washington State Comprehensive Emergency Management Plan Management Plan

Emergency Management Guide for Business Emergency Management Guide for Business and Industry (FEMA)and Industry (FEMA)http://www.fema.gov/library/bizindex.shtm

http://bt.naccho.org/


preparing for and responding to bioterrorism: information for the public health workforce

Documents