Local public health departments have long experience in responding to infectious disease outbreaks and other local emergencies with public health implications. The USA has made progress and learned important lessons about the challenges of bioterrorism preparedness in the last few years. No matter what threats are posed to the county, the Allegan County Public Health Department is ready to react and adjust to any public health threat.

The Centers for Disease Control and Prevention (CDC), in conjunction with local, state and federal partners, has developed a number of federal initiatives designed to strengthen state and local preparedness. For example, the Health Alert Network (HAN) is a nationwide, integrated information and communication system serving as a platform for distribution of health alerts, dissemination of prevention guidelines and other information.

The National Electronic Disease Surveillance System (NEDSS) is a system designed to rapidly report unusual outbreaks of disease so that trained epidemiologists can investigate them further to determine if there has been a deliberate pathogen release. If such a release has been detected, the Strategic National Stockpile (SNS) Program ensures the availability and rapid deployment of life-saving pharmaceuticals and other medical supplies and equipment necessary to counter the effects of nerve agents, biological pathogens and chemical agents.

Local public health departments have long experience in responding to infectious disease outbreaks and other local emergencies with public health implications. The USA has made progress and learned important lessons about the challenges of bioterrorism preparedness in the last few years. No matter what threats are posed to the county, the Allegan County Public Health Department is ready to react and adjust to any public health threat.

The Centers for Disease Control and Prevention (CDC), in conjunction with local, state and federal partners, has developed a number of federal initiatives designed to strengthen state and local preparedness. For example, the Health Alert Network (HAN) is a nationwide, integrated information and communication system serving as a platform for distribution of health alerts, dissemination of prevention guidelines and other information.

The National Electronic Disease Surveillance System (NEDSS) is a system designed to rapidly report unusual outbreaks of disease so that trained epidemiologists can investigate them further to determine if there has been a deliberate pathogen release. If such a release has been detected, the Strategic National Stockpile (SNS) Program ensures the availability and rapid deployment of life-saving pharmaceuticals and other medical supplies and equipment necessary to counter the effects of nerve agents, biological pathogens and chemical agents.

• Anthrax: starts with flu-like symptoms. It does not spread from person-to-person.
• Smallpox: starts with fever, aches, vomiting and progresses to body blisters. It spreads directly from person-to-person through airborne transmission.
• Plague: symptoms include fever, chills and cough. It spreads directly from person-to-person through airborne transmission.
  Botulism: symptoms include difficulty speaking, seeing and/or swallowing. It does not spread from person-to-person, but has been associated with food-borne contamination.
• Tularemia: symptoms include fever and a pneumonia-like illness. It is not spread from person-to-person.
• Viral Hemorrhagic Fevers (VHFs): start with fever, fatigue, dizziness, muscle aches and exhaustion. Some VHFs (Ebola, Marburg, Lassa and Machupo) have been known to be transmitted from person-to-person through close contact.

Antibiotics and vaccines present their own unique issues. For instance, for some infectious agents like anthrax, antibiotics are only effective when taken before symptoms occur. Antibiotics can also cause side effects and should only be taken with medical supervision. Finally, taking antibiotics that are not medically indicated before a bioterrorism event occurs can limit their effectiveness should a bio-terrorism act ever take place.

The anthrax vaccine is only available to military personnel and many public health experts question its effectiveness. Moreover, six to seven doses over a period of about a year are required for maximal effectiveness to be achieved. A supply of smallpox vaccine is stored centrally, and the vaccine is not generally available to the public. Routine administration of the vaccine up to its discontinuation in the 1970s was associated with vaccine-caused deaths and illness.

Gas masks were designed for use by the military in case of a chemical attack. A mask would protect you only if you were wearing it at the time of an attack. To wear a mask continuously or just in case a terrorist attack occurs is impractical, if not impossible.

There are other problems with gas masks. To work effectively, masks must be specially fitted to the wearer, and wearers must be trained in their use. This is usually done for the military and for workers in industries and laboratories who face routine exposure to chemicals and pathogens on the job.

Also, gas masks were not designed to protect against biological agents. Gas masks purchased at an Army surplus store or off the internet do not carry any guarantees that they will work.

Many antibiotics are effective for a variety of diseases, but there is not one antibiotic that is effective against all diseases. Thus, not a single pill that can protect against all types of biological weapon attacks. Keeping a supply of antibiotics on hand poses other problems because the antibiotics have a limited shelf life before they lose their strength.

There is currently not any justification for taking antibiotics as a generic protection. Also, it should be known that antibiotics can cause side effects. Using antibiotics when not necessarily will eventually make them not effective against the infectious agents they are used to fight, by promoting the rise of resistant strains.

CDC does not recommend that influenza vaccination be considered as a way to avoid confusing influenza disease with suspected Anthrax illness. Influenza vaccine is the primary means to prevent influenza and its severe complications, including pneumonia, hospitalization and death. Complications most often occur among persons older than 65 years and among persons younger than 65 years who have certain medical conditions.

Many other infectious agents (including Anthrax) can cause illnesses that begin with flulike symptoms (fever, body aches and headaches). The flu shot can prevent 70-90 percent, but not all, influenza infections. The vaccine does not prevent flu-like illness caused by agents other than influenza.

Influenza vaccine should be targeted toward groups that are at increased risk of complications and toward health care workers. The CDC recommends that these groups be prioritized for vaccine available in October and that efforts to vaccinate these groups continue throughout the influenza season. Lower influenza vaccine coverage of high risk persons could lead to an increase in influenza-related hospitalizations and deaths. Receipt of influenza vaccine in November and later is encouraged for those who live with highrisk persons, for healthy people aged 50-64 years, and for others who wish to reduce their chances of getting influenza.

If you believe you have been exposed to an infectious bio-agent or if you develop symptoms which you believe might be associated with such an exposure, immediately contact your primary health care provider to discuss your possible exposure. Your primary health care provider may chose to contact your local health department, which has access to information that can help your physician determine a course of action to best evaluate and treat your symptoms based on the circumstances of the possible exposure incident.

One area not receiving much attention is mental health and the services that will be needed to screen, identify and treat those that will suffer greatly from surviving a bioterrorist event not to mention the millions of Americans some experts predict will need treatment for psychological trauma suffered on September 11, 2001. PTSD is the inability to cope and function in daily life following a traumatic event. The most common symptoms include:

• Re-living the event through recurring nightmares or other intrusive images that occur at any time. People who suffer from PTSD also have extreme emotional or physical reactions such as chills, heart palpitations or panic when faced with reminders of the event.
• Avoiding reminders of the event, including places, people, thoughts or other activities associated with the trauma. PTSD sufferers may feel emotionally detached, withdraw from friends and family, and lose interest in everyday activities.
• Being on guard or being hyper-aroused at all times, including feeling irritability or sudden anger, having difficulty sleeping or concentrating, or being overly alert or easily startled.

A psychiatrist, psychologist, licensed professional counselor, licensed clinical social worker or other qualified healthcare professional who provides counseling related to trauma can identify whether a person has PTSD and can discuss options for appropriate treatment. If you believe you are suffering from PTSD contact your primary health care provider to discuss your situation. For more in-depth information, visit Post-Traumatic Stress Disorder Alliance.

• Radiation is a form of energy that is present all around us.
• Different types of radiation exist, some of which have more energy than others.
• Amounts of radiation released into the environment are measured in units called curies. However, the dose of radiation that a person receives is measured in units called rem.

• People are exposed to small amounts of radiation every day, both from naturally occurring sources (such as elements in the soil or cosmic rays from the sun), and man-made sources. Man-made sources include some electronic equipment (such as microwave ovens and television sets), medical sources (such as x-rays, certain diagnostic tests, and treatments), and from nuclear weapons testing.
• The amount of radiation from natural or man-made sources to which people are exposed is usually small; a radiation emergency (such as a nuclear power plant accident or a terrorist event) could expose people to small or large doses of radiation, depending on the situation.
• Scientists estimate that the average person in the United States receives a dose of about one-third of a rem per year. About 80% of human exposure comes from natural sources and the remaining 20% comes from man-made radiation sources – mainly medical x-rays.
• Contamination refers to particles of radioactive material that are deposited anywhere that they are not supposed to be, such as on an object or on a person’s skin.
• Internal contamination refers to radioactive material that is taken into the body through breathing, eating, or drinking.
• Exposure occurs when radiation energy penetrates the body.

• Radiation can affect the body in a number of ways, and the adverse health effects of exposure may not be apparent for many years.
• These adverse health effects can range from mild effects, such as skin reddening, to serious effects such as cancer and death, depending on the amount of radiation absorbed by the body (the dose), the type of radiation, the route of exposure, and the length of time a person was exposed.
• Exposure to very large doses of radiation may cause death within a few days or months.
• Exposure to lower doses of radiation may lead to an increased risk of developing cancer or other adverse health effects later in life.

• Possible terrorist events could involve introducing radioactive material into the food or water supply, using explosives (like dynamite) to scatter radioactive materials (called a “dirty bomb”, bombing or destroying a nuclear facility, or exploding a small nuclear device.
• Although introducing radioactive material into the food or water supply most likely would cause great concern or fear, it probably would not cause much contamination or increase the danger of adverse health effects.
• Although a dirty bomb could cause serious injuries from the explosion, it most likely would not have enough radioactive material in a form that would cause serious radiation sickness among large numbers of people. However, people who were exposed to radiation scattered by the bomb could have a greater risk of developing cancer later in life, depending on their dose.
• A meltdown or explosion at a nuclear facility could cause a large amount of radioactive material to be released. People at the facility would probably be contaminated with radioactive material and possibly be injured if there was an explosion. Those people who received a large dose might develop acute radiation syndrome . People in the surrounding area could be exposed or contaminated.
• Clearly, an exploded nuclear device could result in a lot of property damage.People would be killed or injured from the blast and might be contaminated by radioactive material. Many people could have symptoms of acute radiation syndrome. After a nuclear explosion, radioactive fallout would extend over a large region far from the point of impact, potentially increasing people’s risk of developing cancer over time.

Your community should have a plan in place in case of a radiation emergency.

• Check with community leaders to learn more about the plan and possible evacuation routes.
• Check with your child’s school, the nursing home of a family member, and your employer to see what their plans are for dealing with a radiation emergency.
• Develop your own family emergency plan so that every family member knows what to do.
• At home, put together an emergency kit that would be appropriate for any emergency. The kit should include the following items:
  • A flashlight with extra batteries
  • A portable radio with extra batteries
  • Bottled water
  • Canned and packaged food
  • A hand-operated can opener
  • A first-aid kit and essential prescription medications
  • Personal items such as paper towels, garbage bags, and toilet paper

After a release of radioactive materials, local authorities will monitor the levels of radiation and determine what protective actions to take.

• The most appropriate action will depend on the situation. Tune to the local emergency response network or news station for information and instructions during any emergency.
• If a radiation emergency involves the release of large amounts of radioactive materials, you may be advised to “shelter in place,” which means to stay in your home or office; or you may be advised to move to another location.
• If you are advised to shelter in place, you should do the following:
  • Close and lock all doors and windows.
  • Turn off fans, air conditioners, and forced-air heating units that bring in fresh air from the outside. Only use units to re-circulate air that is already in the building.
  • Close fireplace dampers.
  • If possible, bring pets inside.
  • Move to an inner room or basement.
  • Keep your radio tuned to the emergency response network or local news to find out what else you need to do.
• If you are advised to evacuate, follow the directions that your local officials provide. Leave the area as quickly and orderly as possible. In addition –
  • Take a flashlight, portable radio, batteries, first-aid kit, supply of sealed food and water, hand-operated can opener, essential medicines, and cash and credit cards.
  • Take pets only if you are using your own vehicle and going to a place you know will accept animals. Emergency vehicles and shelters usually will not accept animals.

• Radioactive Iodine is a byproduct of nuclear fission processes in nuclear reactors and nuclear weapons. You can protect yourself from the effects of cancer-causing radioactive iodine with FDA Approved IOSAT™ or ThyroShield™ Potassium. Iodide (KI). A non-prescription drug, Potassium Iodide protects against radioactive iodine by preventing its absorption by the thyroid gland located in the neck. Potassium Iodide must be taken during or before exposure to radioactive iodine to be effective.
• Potassium iodide (KI) should only be taken in a radiation emergency that involves the release of radioactive iodine, such as an accident at a nuclear power plant or the explosion of a nuclear bomb. A “dirty bomb”, most likely will not contain radioactive iodine.
• A person who is internally contaminated with radioactive iodine may experience thyroid disease later in life. The thyroid gland will absorb radioactive iodine and may develop cancer or abnormal growths later on. KI will saturate the thyroid gland with iodine, decreasing the amount of harmful radioactive iodine that can be absorbed.
• KI only protects the thyroid gland and does not provide protection from any other radiation exposure.
• Some people are allergic to iodine and should not take KI. Check with your doctor about any concerns you have about potassium iodide.