Public Health Security and Bioterrorism Preparedness and Response Act of 2002

1
Public Health Security and Bioterrorism
Preparedness and Response Act of 2002

• In an effort to further enhance federal and state
  efforts to prepare for and respond to the threat
  of bioterrorism and other public health
  emergencies, the 107th Congress enacted The
  Public Health Security and Bioterrorism Response
  Act of 2002 (H.R. 3448).

2
Public Health Security and Bioterrorism
Preparedness and Response Act of 2002

• The Act addresses national, state, and local
  preparedness and response planning and security
  issues.
• It reauthorizes or amends several important grant
  programs established under the Public Health
  Threats and Emergencies Act and the Public Health
  Service Act, and also provides significant new
  grant opportunities for states and local
  governments.
• The Public Health Security and Bioterrorism
  Preparedness and Response Act authorizes 1.6
  billion to implement state plans and conduct
  additional preparedness activities, subject to
  congressional appropriation.

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Public Health Security and Bioterrorism
Preparedness and Response Act of 2002

• The Act also addresses other related public
  health security issues.
• Some of these provisions include
• new controls on biological agents and toxins,
• additional safety and security measures affecting
  the nations food and drug supply,
• additional safety and security measures affecting
  the nations drinking water,
• measures affecting the Strategic National
  Stockpile and development of priority
  countermeasures to bioterrorism
• The CDC's Strategic National Stockpile (SNS) has
  large quantities of medicine and medical supplies
  to protect the American public if there is a
  public health emergency (terrorist attack, flu
  outbreak, earthquake) severe enough to cause
  local supplies to run out.  

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Bioterrorism and Healthcare Facilities

• Healthcare facilities may be the initial site of
  recognition and response to bioterrorism events.
• If a bioterrorism event is suspected, local
  emergency response systems should be activated.
• Notification should immediately include local
  infection control personnel and the healthcare
  facility administration, and prompt communication
  with the local and state health departments, FBI
  field office, local police, CDC, and medical
  emergency services.

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Suspicious Packages

• Guidance on Initial Responses to a Suspicious
  Letter / Container With a Potential Biological
  Threat
• The FBI DHS HHS/CDC have developed guidelines
  as recommendations for local responders, based on
  existing procedures (including recommendations
  from the International Association of Fire
  Chiefs).
• The document provides guidance on the initial
  response to a suspicious letter/container and
  other follow-up response plans.

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Suspicious Package Poster

• Spearheaded by the U.S. Postal Inspection Service
  and Department of Homeland Security, this effort
  to deliver a single message from the agencies
  most responsible for handling a wide range of
  security issues was joined by the Federal Bureau
  of Investigation and the Bureau of Alcohol,
  Tobacco, Firearms and Explosives.
• The new version of Poster 84 illustrates common
  characteristics of a suspicious mail piece and
  recommends actions to take in the event such a
  mail piece is identified.

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Mail Processing Safety

• The United States Postal Inspection Service has
  developed guidelines for mail processing centers
  with their Mail Center Security.

8
Pandemics

• A pandemic is a global disease outbreak.
• A flu pandemic occurs when a new influenza virus
  emerges for which people have little or no
  immunity, and for which there is no vaccine.
• The disease spreads easily person-to-person,
  causes serious illness, and can sweep across the
  country and around the world in a very short time.

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Pandemics

• Pandemics originating from new strains of virus
  occur with some regularity (roughly every 30 to
  40 years). 
• Pandemics are of concern because of the potential
  for millions of deaths.  In perhaps the worst
  case of an influenza A pandemic, that of 1918 -
  1919, some 30 million people died worldwide.

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Black Death

• In the 1300s Black Death spread throughout
  Europe and was responsible for the deaths of one
  quarter of the population of Europe.
• The disease is believed to have started in China
  earlier in the century and the Chinese are
  thought to have used infected bodies to
  contaminate their enemies.
• This helped the disease to spread as did ships
  that are thought to have carried the disease to
  Europe and the Mediterranean.
• Black death was spread by fleas that were carried
  by rats and other rodents.
• Because towns were overcrowded and unsanitary at
  the time, there was little to prevent the disease
  from spreading.
• From 1349-1350, between 20 and 40 percent of the
  English population died.

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Spanish Flu

• (1918-1919) The Spanish Flu Pandemic Influenza is
  hailed as being possibly the worst influenza
  pandemic to date.
• The Spanish Flu killed more people in a single
  year than the Black Death caused in Europe over 4
  years.
• The source of Spanish Flu was not widely known,
  but its effects were swift and often fatal.
• Shipping and trade helped spread the disease
  which occurred during the last year of World War
  I.

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Spanish Flu

• Up to one quarter of America was affected, and
  one fifth of the worldwide population.
• No one knows exactly how many people died during
  the 1918-1919 influenza pandemic.
• During the 1920s, researchers estimated that 21.5
  million people died as a result of the 1918-1919
  pandemic.

13
Asian Flu

• Early in 1957 an Asian Influenza virus was
  discovered.
• While infections spread easily amongst younger
  people, the highest death rate from the Asian
  Influenza was in elderly people.
• The Asian flu spread to the United States by June
  1957 where it caused about 70,000 deaths.

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Hong Kong Flu

• (1968-1972) The Hong Kong flu was responsible
  for a significant number of deaths, however, the
  flu was often treatable and controllable with
  antibiotics.
• In early 1968 it spread to the United States
  later that year. where it caused about 34,000
  deaths.

15
SARS

• (Severe Acute Respiratory Syndrome).
• In 2003 Hong Kong came under siege from the SARS
  virus.
• SARS originated in mainland China and was spread
  to other countries through international travel.
• In all, SARS caused more than 800 deaths, but
  there have been no reported cases in recent
  times.

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Influenza Pandemics

• A pandemic, or worldwide outbreak of a new
  influenza virus, could dwarf this impact by
  overwhelming our health and medical capabilities,
  potentially resulting in hundreds of thousands of
  deaths, millions of hospitalizations, and
  hundreds of billions of dollars in direct and
  indirect costs.

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Influenza Pandemics

• Despite annual vaccinations, the U.S. faces a
  burden of influenza that results in approximately
  36,000 deaths and more than 200,000
  hospitalizations each year. In addition to this
  human toll, influenza is annually responsible for
  a total cost of over 10 billion in the U.S.

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Avian Flu (Bird Flu)(H5N1, H7N9)

• Avian Influenza is a flu type virus that has been
  around for the last 100 years.
• While the disease is found world wide, until
  recent times, the virus only affected birds, but
  the virus has been passed on to humans from
  infected birds.
• The people who have been affected by the virus
  are mostly those who have handled the infected
  birds. The mortality rate is around 50 for
  humans infected with the virus.

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Avian Flu (Bird Flu)

• Avian influenza is usually an unapparent or
  nonclinical viral infection of wild birds that is
  caused by a group of viruses known as type A
  influenzas.
• These viruses are maintained in wild birds by
  fecal-oral routes of transmission. This virus
  changes rapidly in nature by mixing of its
  genetic components to form slightly different
  virus subtypes.

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Avian Flu (Bird Flu)

• Information on Avian Flu and how it spreads can
  be found on the www.flu.gov website.
• Worldwide, there are many strains of avian
  influenza (AI) virus that can cause varying
  amounts of clinical illness in poultry.
• Highly pathogenic avian influenza (HPAI) is an
  extremely infectious and fatal form of the
  disease that, once established, can spread
  rapidly from flock to flock.

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Avian Flu (Bird Flu)

• In some instances, strains of HPAI viruses can be
  infectious to people. Since midDecember 2003, a
  growing number of Asian countries have reported
  outbreaks of HPAI in chickens and ducks.
• The rapid spread of HPAI, with outbreaks
  occurring at the same time, is historically
  unprecedented and of growingconcern for human
  health as well as for animal health.

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Avian Flu (Bird Flu)

• Of great concern to the World Health Organization
  (WHO) is the possibility that the present
  situation, if the virus acquires human influenza
  genes, can give rise to humantohuman
  transmission and possibly another influenza
  pandemic in people.

23
H5N1 Avian Flu

• Highly pathogenic H5N1 is one of the few avian
  influenza viruses to have crossed the species
  barrier to infect humans, and it is the most
  deadly of those that have crossed the barrier.
• Currently, the highly pathogenic H5N1 avian
  influenza virus is considered to have the
  greatest potential for mutation to a pandemic
  virus given how widespread the virus is and
  because it has already caused illness and death
  in people.
• The virus has spread rapidly in bird populations
  throughout Asia, Europe, and Africa.

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 Swine Flu (H1N1)

• The H1N1 flu virus caused a world-wide pandemic
  in 2009.
• The number of people who died after contracting
  the H1NI virus in 2009 could be at least 15 times
  higher than previously reported.
• New research shows the death toll could actually
  be as high as 150, 000 to 575, 000 compared to
  the previously reported total of more than
  18,000.
• More than half of the deaths occurred in
  southeast Asia and Africa and most of those who
  died were people younger than 65 years old.
• It is now a human seasonal flu virus that also
  circulates in pigs
• The H1N1 flu virus spreads between people in the
  same way that seasonal flu viruses spread.
• The best way to prevent the H1N1 flu is to get
  the seasonal flu vaccine.

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Pandemic Preparedness

• National Strategy for Pandemic InfluenzaThe
  National Strategy for Pandemic Influenza , issued
  by President Bush November 1, 2005, guides our
  nation's preparedness and response to an
  influenza pandemic, with the intent of
• stopping, slowing or otherwise limiting the
  spread of a pandemic to the United States
• limiting the domestic spread of a pandemic, and
  mitigating disease, suffering and death and
• sustaining infrastructure and mitigating impact
  to the economy and the functioning of society.
• The Strategy charges the U.S. Department of
  Health Human Services with leading the federal
  pandemic preparedness.

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Business Planning for Pandemic Influenza

• In the event of pandemic influenza, businesses
  will play a key role in protecting employees'
  health and safety as well as limiting the
  negative impact to the economy and society.
• The Department of Health and Human Services (HHS)
  and the Centers for Disease Control and
  Prevention (CDC) have developed planning tools
  for businesses.
• These tools identify important, specific
  activities businesses, hospitals and governments
  can do now to prepare for pandemic emergencies.

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Pandemic Influenza

• The United States government maintains a one-stop
  web site for access to U.S. Government avian and
  pandemic flu information.
• Managed by the Department of Health and Human
  Services.

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Pandemic Influenza

• Information on planning and response to influenza
  pandemics can be found at http//www.pandemicflu.g
  ov/index.html.
• Planning tools for all levels are available on
  this web site.
• OSHAs Guidance on Preparing Workplaces for an
  Influenza Pandemic. OSHA 3327-02N 2007

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Pandemic Influenza

• There are a series of checklists and planning
  tools for the workplace available on the
  www.flu.gov website.