Journal of the New Zealand Medical Association, 20-August-2004, Vol 117 No 1200
Bioterrorism: Guidelines for Medical and Public Health Management
Donald A Henderson, Thomas V Inglesby, and Tara O’Toole (eds). Published by AMA Press, 2002. ISBN 1-57947-280-X. Contains 256 pages. Price US$29.95
This book provides a series of articles discussing six potential bioterror agents or toxins that cause anthrax, smallpox, plague, botulism, tularaemia, and viral hemorrhagic fevers; and how we can prepare for public health disasters involving these agents. These agents are all ‘Category A’ agents because of their potentially devastating impact on both individuals and society if used as agents of biologic warfare.
A strong public health system is needed to respond to bioterrorism threats, however it is the early recognition by clinicians of uncommon illnesses, which can provide the early alert that public health emergency responses require. This in turn requires all front-line healthcare professionals to be aware of the presentations of these diseases. The articles included in this book, although previously published in JAMA prior to the events of September 11, 2001, have been updated to provide up-to-date information invaluable for healthcare professional education.
The anthrax attacks in the United States in 2001, and indeed the ‘white powder’ incidents in New Zealand have given a new sense of urgency to biodefence planning in many countries. Five case reports describe in detail a number of the individual anthrax cases resulting from the 2001 attacks.
In his Foreword, Anthony Fauci states:
‘Much was learned from the anthrax attacks of 2001; encouragingly, the survival rate of patients with inhalation anthrax was considerably higher than previously reported, perhaps due to rapid diagnosis, aggressive therapy with multidrug antibiotic regimens, and state-of-the-art general medical supportive care’.
Other potential bioterrorism agents are also considered comprehensively. Their history, epidemiology, microbiology, pathogenesis and clinical presentation, diagnosis, prevention, infection control, and medical management are all covered and illustrated with some excellent photographs. The discussion on the use of smallpox vaccine for mass vaccination and ring vaccination is particularly relevant to New Zealand. With a limited stockpile of vaccine, a focussed selective programme will be required.
Finally, bioterrorism preparedness and response are analysed, including the scientific and legal implications of quarantine as a possible public health tool in the event of a bioterror attack. Of critical importance is the development of a public communication strategy to dispel rumours and minimise social disruption.
This book tells us that, to effectively meet future public health threats, all healthcare professionals must be alert and prepared. It has some excellent illustrations, a comprehensive bibliography, and is a ‘must read’ for clinicians, nurses, epidemiologists, public health specialists and national and District Health Board (DHB) emergency planners.
Lance C Jennings
Canterbury Health Laboratories
Canterbury District Health Board
issue | Search journal |
Archived issues | Classifieds
| Hotline (free ads)
Subscribe | Contribute | Advertise | Contact Us | Copyright | Other Journals