NCJ Number
189849
Journal
Emerging Infectious Diseases Volume: 6 Issue: 6 Dated: November/December 2000 Pages: 1-4
Date Published
2000
Length
4 pages
Annotation
This document provides the lessons learned from a full-scale bioterrorism exercise.
Abstract
During May 2000, local, State, and Federal officials, and the staff of three hospitals in metropolitan Denver participated in a bioterrorism exercise called Operation Topoff. Participants learned that a Yersinis pestis aerosol had been covertly released three days earlier at the city’s center for the performing arts. This led to more than 2,000 cases of pneumonic plague, many deaths, and hundreds of secondary cases. The exercise required State health department personnel to develop new working relationships with Federal government agencies. Although lines of authority were clear, much time was spent in consultation and debate through scheduled bridge calls. Many people joined these calls and decision-making became inefficient. Another lesson learned was that organization was inadequate. In addition to the surveillance, field investigation, and emergency management coordination teams, teams were needed to address laboratory testing, mass fatalities, legal problems, information technology, infection control, public and professional communications, and antibiotic and vaccine administration. The magnitude of the simulated epidemic and the fact that infection was spreading quickly overwhelmed the available resources. As more cases were identified, the question emerged of who should receive antimicrobial prophylaxis, close contacts of infectious cases or key workers. The process of isolating plague patients became impossible because the hospital had too many patients, worried-well people, and too few health care workers and empty rooms. The single most important lesson learned was that unless controlling the spread of the disease and triage and treatment of ill persons in hospitals require equal effort, the demand for health-care services will not diminish.