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Public Health Security and Bioterrorism Preparedness and Response Act of 2002


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Title: Public Health Security and Bioterrorism Preparedness and Response Act of 2002

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).

Public Health Security and Bioterrorism
Preparedness and Response Act of 2002
  • The Act addresses national, state, and local
    preparedness and response planning and security
  • 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
  • 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.

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.  

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.

Suspicious Packages
  • Guidance on Initial Responses to a Suspicious
    Letter / Container With a Potential Biological
  • 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
  • The document provides guidance on the initial
    response to a suspicious letter/container and
    other follow-up response plans.

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.

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

  • 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.

  • 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.

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.

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
  • 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

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

Asian Flu
  • Early in 1957 an Asian Influenza virus was
  • 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.

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
  • In early 1968 it spread to the United States
    later that year. where it caused about 34,000

  • (Severe Acute Respiratory Syndrome).
  • In 2003 Hong Kong came under siege from the SARS
  • 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

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.

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.

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.

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
  • 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.

Avian Flu (Bird Flu)
  • Information on Avian Flu and how it spreads can
    be found on the 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.

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.

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.

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.

 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
  • 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.

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.

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.

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

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

Pandemic Influenza
  • There are a series of checklists and planning
    tools for the workplace available on the website.