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Introduction: CBRN for Public Health Bonnie Henry, MD, MPH, FRCPC Public health CBRN course.

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Presentation on theme: "Introduction: CBRN for Public Health Bonnie Henry, MD, MPH, FRCPC Public health CBRN course."— Presentation transcript:

1 Introduction: CBRN for Public Health Bonnie Henry, MD, MPH, FRCPC Public health CBRN course

2 Course Faculty Dr Daniel Kollek Dr Dan Cass Dr Brian Schwartz Dr Doug Sider Dr Chris Mackie Dr Bonnie Henry

3 Course Objectives (1) To understand the potential for a CBRN incident and how to assess local risk Describe the role of the health system, and public health, in preparedness, mitigation, response to and recovery from a CBRN incident

4 Course Objectives (2) To understand the roles of other organizations including police, fire and emergency medical services and emergency management in a CBRN incident To understand the Incident Management System and define and use a Public Health IMS model

5 Overview of Course Day 1 Precourse review Roles of Public Health CBRN introduction Review of provincial initiatives Disaster concepts Hazard Identification and Risk Analysis exercise Incident Management System

6 Overview of Course: Day 2 Focus on biological incidents and public health Personal Protective Equipment Mass vaccination/prophylaxis clinics Psychosocial support Rapid community needs assessment Crises communication

7 Public Health Roles Public Health Roles Early Detection Mass Patient Care Mass Immunization/Prophylaxis Epidemiologic investigation Communication Command and Control

8 Public Health Roles (2) Public Health Roles (2) Mass Fatality Management Evacuations/sheltering (humans and animals) Environmental Surety Community Recovery (rapid health risk assessment, mental health etc)

9 Precourse Review 1. Forms of anthrax include all of the following except: a.Neurological b.Cutaneous c.Gastrointestinal d.Pulmonary Answer: a 2. Appropriate Personal Protective Equipment to be worn while handling specimens suspicious for anthrax include: a.Surgical mask, Tyvek suit and goggles b.N95 mask, face shield, gloves, hat and boots c.Powered air purifying respirator, gown, gloves d.Surgical mask, eye protection, gloves, gown if necessary Answer: d

10 Precourse Review 3. Botulism is caused by: a.A neurotoxin produced by a spore that is ingested b.Septicemia caused by a gram negative bacillus c.A coronavirus d.Handling livestock Answer: a 4. Symptoms of botulinum poisoning include all of the following except: a.Visual disturbance b.Difficulty swallowing c.Paralysis on one side of the body d.Generalized weakness (hypotonia) in an infant Answer: c

11 Precourse Review 5. Which of the following statements is incorrect regarding Plague? a.Caused by a gram negative bacillus b.May cause fatal pulmonary infection c.Incision and drainage of buboes is the key to appropriate treatment d.May be passed from person to person via large droplets Answer: c 6. Appropriate management of pneumonic plague includes all of the following except: a.Droplet precautions until patient has completed 72 hours of antimicrobial therapy b.Doxycycline 100 mg. twice daily for post-exposure prophylaxis following confirmed or suspected bioterrorism exposure c.Post exposure vaccination d.sputum or tracheal aspirates for Gram’s, Wayson’s, and fluorescent antibody staining Answer: c

12 Precourse Review 7. An identified case of smallpox: a.Should be treated aggressively with antibiotics b.Is a public health emergency c.Should be assumed to be due to a failure of precautions at a BSL 4 laboratory d.Should be managed using droplet and contact precautions Answer: b 8. Post exposure to someone with smallpox, public health may require quarantine of contacts for what time period? a.7-19 days after last exposure b.1-21 days after last exposure c.1-17 days after last exposure d.Quarantine is not necessary after exposure to smallpox Answer: a

13 Precourse Review 9. Nerve Agents: a.Are more toxic in liquid form than in gaseous when released b.Stimulate acetylcholinesterase c.Result in tachycardia and large pupils d.Are lethal due to bronchorrhea and copious secretions Answer: d 10. Cyanide: a.Is almost impossible to obtain b.Works by inhibiting cellular aerobic respiration c.Is classified as a blister agent d.Produces tearing and salivation Answer: b

14 Precourse Review 11. Treatment for cyanide poisoning: a.Must be started within 2 hours of the exposure b.Is often extremely effective c.Has significant potential toxicity due to methemoglobinemia d.Includes decontamination with copious washing and dilution Answer: c 12. Which of the following is not a radiological/nuclear hazard? a.Alpha particle b.Beta particle c.Gamma ray d.Delta ray Answer: d

15 Precourse Review 13. When treating victims exposed to radiation, one must: a.Wear full protective equipment, including a level C air purifying respirator b.Stabilize and treat injuries first and foremost (wearing level D protection), as contamination of the health care worker is unlikely c.Decontaminate first; if the patient succumbs from their injuries they likely would have died from radiation sickness d.Not treat the patient until a formal dose assessment is performed Answer: b 14. With respect to Acute Radiation Sickness, which one of the following is true? a.If, in the first 6 hours after a suspected exposure, there are no symptoms of exposure serious ARS is unlikely b.Distance, time and administration of potassium iodide are the 3 most important factors in determining the level of illness c.The absorbed dose is measured in Curies d.The most serious manifestation is bone marrow stimulation Answer: a

16 Precourse Review 15. Potassium Iodide should not be used: a.In pregnant women b.In children or infants c.In persons situated more than 20 kilometres from an incident d.In a nuclear event involving I 131 Answer: c 16. What is the most effective way of protecting the public after a critical event? a.Assessment at hospital emergency departments b.Shelter in place and evacuation when necessary c.Mass administration of chelating agents d.Distribution of N95 respirators Answer: b

17 Questions?

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