House Committee, Public Health Experts Debate a Uniform Bioterror Response

Public health experts testified before the House Energy and Commerce investigations subcommittee yesterday, debating the merits of a uniform system to respond to biological or chemical attacks and asking lawmakers to increase funding for local and state authorities' response measures, the AP/Nando Times reports. Frank Young, former chief of the federal Office of Emergency Preparedness, told the subcommittee, "We've got to have a similar message, devised by experts, coordinated across the land; to do less is not appropriate." However, Dennis O'Leary, president of the Joint Commission on Accreditation of Healthcare Organizations, said, "We cannot assume one single model will work. [Bioterrorism] can happen anywhere, in large cities, in rural areas." Dr. Lew Stringer, medical director of North Carolina's Division of Emergency Management, said that under the current system each "city is allowed to do it the way they think is best for them," adding, "They do have the right to decide what's best for them."

More Money Needed
State and local officials testifying before the subcommittee yesterday also asked for additional money to train health workers, to protect workers from infections and to procure medicines to treat outbreaks. Lawmakers have proposed adding $1.4 billion to the $350 million currently in the budget for bioterrorism (McQueen, AP/Nando Times, 10/10). Dr. Donald Henderson, director of Johns Hopkins' Center for Civilian Biodefense Studies and recently appointed chair of a federal advisory commission on bioterrorism, told a Senate committee this week, "If we are to detect and rapidly identify a new health problem, public health officials must be available 24 hours a day, seven days a week, to take calls from clinicians reporting cases which may be suggestive of ... a bioweapons-related disease. This is not possible in most areas of the country" (Baer, Baltimore Sun, 10/11). Besides boosting resources for state and local public health systems, lawmakers are considering increased funding for water systems and firefighters. The Association of Metropolitan Water Agencies, which represents more than 140 large publicly owned water suppliers, yesterday asked for $5 billion to "rehabilitate water and sewage systems" out of security concerns. Groups representing firefighters are today expected to ask Congress to increase a $100 million all-purpose grant program for fire departments to $1 billion per year for five years. Many departments had used the grant program for emergency-response equipment and training. In addition, fire chiefs will ask for an additional 75,000 firefighters, expanded search-and-rescue programs, additional medical response teams and improved tracking of how hazardous materials are transported (Borenstein, Philadelphia Inquirer, 10/11).

Using Newer Tests
As federal, state and local officials debate how to prepare for potential chemical or biological attacks, state public health laboratories, with the CDC's assistance, are "scrambling" to make use of high-tech lab equipment that can more quickly and precisely identify suspected infectious agents. These so-called molecular-test systems use antibody and DNA "probes" to detect suspected bioagents. By contrast, conventional techniques, which still are widely used in public health laboratories around the United States, are more "complex and time-consuming," involving filtering extraneous matter from samples and then culturing present bacteria. Conventional laboratory techniques were used to confirm that Bob Stevens, the Florida man who contracted anthrax and died last week, was infected with the bacteria. Those tests took nearly 24 hours, while the newer systems can provide a "more sensitive and speedier identification of infectious agents" within an hour or two. The CDC is working to "validate" the newer tests in potential bioterrorism cases, as well as to develop uniform guidelines for the new instruments and to supply state labs with kits of biological reagents needed to identify bioagents (Hamilton, Wall Street Journal, 10/11).