Veterinarians key to bioterrorism preparedness initiatives

As first responders and animal disease experts, veterinarians are essential to the national Centers for Disease Control and Prevention's bioterrorism preparedness initiatives, said David A. Ashford, an epidemiologist at the CDC who investigated the anthrax attacks last fall.

During a July 16 session at the AVMA Annual Convention, Ashford provided a day-by-day review of the CDC's investigation and response to the bioterrorism attacks and pointed out areas where improvements are needed.

He emphasized the need for veterinarians to participate in preparation.

"Our role as a veterinarian in bioterrorism is multifaceted," Ashford said. He listed several areas in which all veterinarians can help improve the nation's preparedness for a biologic attack, including:

• Improving detection and reporting of disease incidence
• Developing emergency plans, which include communication, disease containment, and diagnostic strategies
• Conducting and participating in practice emergency scenarios
• Increasing laboratory capacity
• Strengthening partnerships among federal and state agencies and public and private health officials

These veterinary efforts, in concert with the efforts of the rest of the public health community, will help to fill the gaps in bioterrorism response that were revealed in fall 2001.

Bacillus anthracis avirulent Pasteur strain, nonhemolytic on sheep blood agar

One of the first gaps the CDC encountered was in the ability of the medical community to diagnose anthrax infection, particularly when the symptoms were atypical, as in the case of an elderly man who presented with pneumonia. Also, human clinical laboratories weren't fully prepared to diagnose anthrax infection, however, commercial, food, and veterinary laboratories were.

Ashford noted, however, that astute clinicians and laboratory staff helped quickly make the diagnoses.

Multi-agency coordination was also a concern, said Ashford, who explained that local agencies are the first and primary responders.

"Bioterrorism is a local preparedness effort," he said, explaining there must be better integration among local, state, and national agencies. "Our resources need to be focused in local agencies."

The demand for information from the public was also underestimated, Dr. Ashford said, explaining that the CDC and other government agencies fielded millions of telephone calls from the public about anthrax last fall.

He said in the event of future attacks "there is going to be a ferocious demand for information from the public."

Veterinarians, public health professionals, and government agencies should prepare communications plans now, in anticipation of future events, Ashford said.

But despite these weaknesses, Ashford said the attacks were handled well.

"We need to emphasize the potential magnitude of what we suffered," he said, explaining that more than 10,000 people were exposed to anthrax during the attacks, but only 22 people were infected, and only 5 died.

Ashford credited first responders with helping to keep the rate of infection and death low.

The CDC and other agencies processed thousands of clinical samples and more than 100,000 environmental samples. "This was the largest outbreak investigation ever conducted by the CDC, in terms of the number of personnel," he said.