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Last Updated

09 Jan 2003

Source: Boston Globe, September 30, 2002.

CDC sees progress in terror response

But survey indicates some laboratories lack training, a plan

By Stephen Smith, Globe Staff

SAN DIEGO - Nearly a year after anthrax attacks killed five people, the nation's top disease tracker declared yesterday that considerable progress has been made in preparing the US health-care system to respond to bioterrorism.

But Dr. Julie Gerberding, the newly appointed director of the Centers for Disease Control, conceded that much work remains to be done in reforming a public-health network lambasted for its haphazard handling of the anthrax mailings.

''We're describing to you the truth that not everything is ready,'' Gerberding said at the premier gathering of infectious disease specialists, the Interscience Conference on Antimicrobial Agents and Chemotherapy. ''But our response capacity is much higher than it was a year ago.''

Still, survey results presented yesterday at the conference indicated that 15 percent of the laboratories that might handle rogue biological agents lack plans on dealing with bioterrorism. And 20 percent of the microbiologists who responded to the Internet survey reported that they had not received formal laboratory training on bioterrorism.

The study, conducted in July and August by researchers from the University of Missouri-Kansas City, demonstrates the continuing need to educate hospital laboratories in the detection and the handling of potential agents of bioterrorism, said lead researcher Susan Sharp.

Those hospital labs often would be the first to identify a threatening substance.

The specter of bioterrorism is compelling scientists who track and research diseases to become less hidebound by the almost compulsive circumspection that had come to define science in the past century, said Gerberding and Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases.

In fact, when the Bush administration awarded $1.75 billion to the National Institutes of Health for biodefense research, it came with a stern mandate, Fauci recalled.

An administration official told Fauci that it would not be acceptable for NIH researchers to spend several years studying bioterrorism and then pronounce ''we have learned a lot,'' the veteran scientist said. Instead, the government scientists are expected to develop treatments and vaccines - and to do it with lightning speed.

''We had to start thinking in a way that we as scientists had not thought before,'' Fauci said.

A similar change in thinking has emerged at the CDC. The experience with anthrax, Gerberding said, taught the agency that it needed to improve drastically its ability to communicate with physicians and with the public.

Part of that shift in attitude means CDC scientists must be willing to convey information in real time, even if they don't have an answer to every question.

''We must be in the mode of telling people, `This is what we know today. And be prepared - it might change tomorrow,''' Gerberding said.

To that end, CDC is addressing one of the most widespread complaints from a year ago, and one given voice yesterday by physicians who dealt with frantic patients in the months after the anthrax attacks.

Last fall doctors lamented that they often had to rely on the media and word of mouth for the latest information on how to distinguish a case of anthrax poisoning from a routine bout of flu. Gerberding promised yesterday that in the event of future biological attacks, doctors would be able to call a hot line staffed by a disease expert equipped to answer questions.

But the success of national strategies for dealing with bioterrorism will ultimately rely on the efficiency of local public-health systems. And specialists in the field warned during the infectious disease conference that significant improvements are still needed in public health, as well as in academic programs devoted to the field.

''Schools of public health have largely been dinosaurs slipping into tar pits over the past couple of decades,'' said Michael T. Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota.

Now, said Osterholm and other specialists, public-health authorities must begin acting less like academics and more like firefighters and police officers, prepared to respond swiftly whenever danger strikes.