Frequently Asked Questions
about Bioterrorism Concerns
following the September 11th tragedy

The following questions represent inquiries received from the public since the terrorist attacks of September 11th. Answers were compiled from information gathered from the Johns Hopkins Center for Civilian Biodefense Studies, the U.S. Department of Health and Human Services and the Florida Department of Health.

What is anthrax?

Anthrax is a disease caused by the bacterium Bacillus anthracis. It is not contagious and the illness cannot be transmitted from person to person. The form of the disease that health authorities are concerned about in bioterrorist attacks is inhalational anthrax. Inhalational anthrax occurs when a person breathes in anthrax spores. As early as a day or two after exposure, or as late as seven weeks afterward, the spores begin to grow rapidly and the victim develops fever, has difficulty breathing and feels miserable. Death typically occurs within a few days after these symptoms if the person doesn’t receive medical treatment. It is believed that antibiotics can stop the disease if they are taken at the time the anthrax spores begin to grow or very soon thereafter.
In the event of a bioterrorist attack, health authorities would conduct a rapid investigation, determine the place and time of the release, and identify individuals who need antibiotics. The federal government has stockpiled antibiotics for large-scale distribution in the event of a bioterrorist attack.

Is there an anthrax vaccine available?

The anthrax vaccine is not available commercially at all. The single manufacturer has discontinued production of the vaccine at the direction of the FDA, and the remaining stock has been restricted to military use because of the risk of troop exposure should anthrax be deployed as a bioterrorist weapon. Neither the Florida Department of Health nor any of its 67 county health departments stock the anthrax vaccine.

What is smallpox?

Smallpox is a disease caused by the Variola virus. Statistically, one out of three people who contract the disease die. The disease can spread from person to person, and transmission usually occurs only after the patient develops a fever and rash. There is no known treatment for the disease other than vaccination prior to exposure or shortly after the onset of the infection.

The last case of smallpox on the planet occurred in Somalia in 1977. In 1980, the World Health Organization certified that smallpox had been eradicated worldwide. Currently, the only known remaining samples of smallpox virus are held in secure facilities at the Centers for Disease Control and Prevention (CDC) in Atlanta, Georgia, and the Institute for Viral Preparations in Koltsovo, Russia.

Although destruction of all remaining samples of smallpox virus has been proposed, the United States government has decided to permanently store its samples of smallpox virus. Allegations and rumors of smallpox virus stocks in other locations have not been verified.

In 1972, the U.S. decided to stop routinely vaccinating its citizens against smallpox because many people were experiencing serious side effects. As a result of a successful worldwide eradication program, smallpox vaccine was removed from the commercial market in 1983 and is no longer a licensed product in the United States. The United States Public Health Service maintains an emergency stockpile of smallpox vaccine. At the present time, the vaccine is supplied only to certain laboratory workers who are at risk of infection with smallpox-like viruses as a result of their occupations. The CDC is authorized to release the vaccine only to these workers under an Investigational New Drug (IND) permit from the Food and Drug Administration (FDA). The IND does not allow the release of smallpox vaccine to any other person for any other reason. Neither the Florida Department of Health nor any of its 67 county health departments stock a vaccine against smallpox.

The federal government, including the CDC, is concerned about the threat of bioterrorism. Plans for a response to such an event are being developed at many government levels, but these plans do not include widespread use of smallpox vaccine at this point. The benefits and risk of reintroducing the smallpox vaccine to society are still being examined.

If I were vaccinated against smallpox before 1980, am I still protected?

Probably not. Vaccination has been shown to wear off in most people after 10 years, but may last longer if the person has been successfully vaccinated on multiple occasions.

Should I buy a gas mask?

No. A gas mask would only protect you if you were wearing it at the exact moment a bioterrorist attack occurred. Unfortunately, a release of a biological agent is most likely to be done covertly, that is without anyone knowing it. That means you would not know ahead of time to put on your mask. To wear a mask continuously or "just in case" a bioterrorist attack occurs is impractical if not impossible.

To work effectively, gas masks must be specially fitted to the wearer, and wearers must be trained in their use. This is usually done for the military and for workers in industries and laboratories who face routine exposure to chemicals and germs on the job. Gas masks purchased at Army surplus stores or via the Internet carry no guarantees that they will work. Gas masks found at surplus stores are likely to be sold as novelty items, with no promise of effectiveness against air contaminants. Moreover, there have been reports of accidental suffocation when people have worn masks incorrectly, as happened to some Israeli civilians during the Persian Gulf War.

Should I have my own supply of antibiotics?

There are a number of different germs a bioterrorist might use to carry out an attack. Many antibiotics are effective for a variety of diseases, but there is no antibiotic that is effective against all diseases. Thus, no single pill can protect against all types of biological weapon attacks. Keeping a supply of antibiotics on hand poses other problems because the antibiotics have a limited "shelf life," after which they lose potency.

There is currently no justification for arbitrarily taking antibiotics. Antibiotics can cause side effects and should only be taken with medical supervision.

Is it safe for me to drink water from the tap?

It would be extremely difficult for a bioterrorist to contaminate our drinking water supplies to cause widespread illness. There are two reasons. First, huge amounts of water are pumped daily through our water systems, most of which is used for industrial and other purposes; very little is actually consumed. Thus, anything deliberately put into the water supply would be greatly diluted. Secondly, water treatment facilities routinely treat the water supply and add chlorine in order to kill harmful germs.

What is the National Pharmaceutical Stockpile (NPS)?

The NPS is a large reserve of antibiotics, chemical antidotes and other medical supplies set aside for emergencies. The CDC reports that it has the capacity to move these stockpiled materials to affected areas in the U.S. within 12 hours of notification. There are a number of different stockpiles, strategically located around the country. In addition to the medical supplies already set aside, the federal government has made agreements with drug manufacturers to make large amounts of additional emergency medicine if needed.

What can I do to protect myself and my family?
No one can predict when disaster may next strike our country, or in what form. That’s why it’s important for all citizens to have a personal disaster plan in place. Your personal disaster plan need not be complicated, but it should address the following areas of concern:

Emergency Communications: Choose a friend or relative who lives out-of-town to serve as your family’s point of contact in an emergency, either by phone or by email. The contact should live far enough away so as to be unaffected by a local emergency. Furnish your contact with email addresses and telephone numbers so they can keep tabs on all family members within the affected area.

Meeting and Sheltering Options: Having a predetermined meeting place away from your home will save time and minimize confusion should your family have to evacuate your neighborhood. You may want to make overnight "host home" arrangements with a friend, family member or coworker if the evacuation order lasts more than a few hours. If an order is given to evacuate, be prepared to do so immediately, and be sure to include your pets in those evacuation plans.

Living without Utilities: A countywide emergency may disrupt water, gas and electrical power for several days. Be prepared to live without these utilities, especially if you have special needs that require electricity for life-support functions. It is important that you put together a disaster preparedness kit of essential supplies to get you through an emergency. Make sure these materials are easily transportable if you have to leave your home during the emergency:

Three to five days worth of water and nonperishable food supplies

• First aid supplies including prescription medications
• Battery powered radio and flashlights with extra batteries
• ID for each family member
• Change of clothing for each family member
• Sleeping bags or bedrolls
• Baby food or infant formula
• Pet supplies

Rumor often creates more havoc than the physical attack, and we would ask that during an emergency, all citizens monitor local media, click on Pinellas County’s Internet website (www.pinellascounty.org), or tune into your local cable television system to get the facts from Emergency Management about the situation and what you need to do to ensure your personal safety. Be calm and be patient until the all clear signal is given by emergency officials.

Each year, we have asked that our citizens maintain a heightened level of preparedness during hurricane season. In these uncertain times, your personal emergency preparedness strategy needs to be in place all year long. We hope nothing adverse will happen to affect our lives. But we know that preparedness now will allow us all to more comfortably get through whatever unexpected calamities the future may bring.

What if my fear about bioterrorism is having a serious impact on my family and work life?

Given the attacks that took place on September 11th, it is reasonable for citizens to feel anxious about their personal safety. Should your fear get to the point where it stops you from doing the things you world normally do in any given day, it might be helpful to talk with a professional. Your health care provider can make a referral if you do not already have someone in mind. In the wake of the attack on New York City and the Pentagon, we have learned how helpful it can be to talk over these concerns with a counselor or other mental health professional.

During a chemical or biological emergency, it is possible that contaminants in the outside air will require you to stay inside your home with the doors and windows closed until the emergency passes. Emergency personnel may come to your door to alert you, drive through your neighborhood with loud speakers or call you on the telephone. TV and radio stations would carry the announcement as well. If you are instructed to shelter in place, follow these important instructions:

• Close all windows and doors and seal door jambs, window sills, vents, etc with tape, wet towels or blankets.
• Turn off all ventilation systems including fans, air conditioners and heat pumps.
• Close fireplace dampers.
• Go to a protected area of the home away from windows and doors.
• Listen to news broadcasts over radio and television until the all clear signal is given.
• Do not leave your protected area until you are told that all is safe.

If you suspect chemical vapors have entered your home, cover your nose and mouth with a damp cloth. If you begin experience adverse symptoms from the exposure, call 9-1-1 and follow their instructions.

The safety of our citizens is of paramount concern to your government officials. Though no one can predict when disaster may next strike our country, or in what form, Pinellas County Emergency Management offers these few tips on how to be prepared for any eventuality which may disrupt one’s normal, daily routine.

Understand the Potential Threat

The first step in preparing your personal disaster preparedness plan is to realistically assess what local conditions could become a threat to your safety and well being. Don’t rely solely on the media (although the media can be an invaluable source of information during an emergency). Listen to the advice of local officials. Your federal, state and county emergency management officials have the facts and can help you calmly and logically assess the potential seriousness of any given situation.

Develop your Disaster Plan

Your personal disaster plan need not be complicated, but it should address the following areas of concern:

Emergency Communications: Choose a friend or relative who lives out-of-town to serve as your family’s point of contact in an emergency, either by phone or by email. The contact should live far enough away so as to be unaffected by a local emergency. Furnish your contact with email addresses and telephone numbers so they can keep taps on all family members within the affected area.

Meeting and Sheltering Options: Having a predetermined meeting place away from your home will save time and minimize confusion should your family have to evacuate their neighborhood. You may want to make overnight “host home” arrangements with a friend, family member or coworker if the evacuation order lasts more than a few hours. If an order is given to evacuate, be prepared to do so immediately, and be sure to include your pets in those evacuation plans.

Living without Utilities: A countywide emergency may disrupt water, gas and electrical power for several days. Be prepared to live without these utilities, especially if you have special needs that require electricity for life-support functions.

Assemble a Disaster Preparedness Kit

Whether you’re asked to evacuate your neighborhood or stay inside your home (shelter in place) during an emergency, having essential supplies on hand will make the experience more comfortable for your and your family. The supplies in your hurricane preparedness kit will serve you will in any countywide disaster. Make sure these materials are easily transportable if you have to leave your home during the emergency. Three to five days worth of water and nonperishable food supplies

• First aid supplies including prescription medications
• Battery powered radio and flashlights with extra batteries
• ID for each family member
• Change of clothing for each family member
• Sleeping bags or bedrolls
• Baby food or infant formula
• Pet supplies