A Public Health Approach to Combating Bioterrorism Tarrant County Public Health Peggy Wittie, PhD Epidemiology Surveillance & Response Manager / Bioterrorism Preparedness Coordinator Tarrant County:

Overview Commonalities with Other Counties Commonalities with Other Counties Satellite Systems for DownlinkingSatellite Systems for Downlinking RedBatRedBat Redundant Communication SsytemsRedundant Communication Ssytems Regional Media CampaignRegional Media Campaign Cross County CooperationCross County Cooperation

Overview – cont. Differences with Other Counties Differences with Other Counties Quadrant Health TeamsQuadrant Health Teams Operable Broadcast FAXOperable Broadcast FAX Evaluation of 2 Syndromic SystemsEvaluation of 2 Syndromic Systems Laboratory CapacityLaboratory Capacity

Health Response Teams (HRT)- Organization - 4 quadrants in county 4 quadrants in county At least 1 satellite office in each quadrant with a HRT At least 1 satellite office in each quadrant with a HRT Each team has one Epidemiology Investigator and one Health Response Nurse Each team has one Epidemiology Investigator and one Health Response Nurse

Health Response Teams - Functions - Assist community partners in bioterrorism preparedness Assist community partners in bioterrorism preparedness Assist and train Community Emergency Response Teams (CERT) Assist and train Community Emergency Response Teams (CERT) Investigate potential bioterrorism risks and threats Investigate potential bioterrorism risks and threats

Texas Health Alert Network S tatewide, secure intranet S tatewide, secure intranet Connects 65 Regional & Local Public Health Departments Connects 65 Regional & Local Public Health Departments

Texas Health Alert Network Provides secure network for communicable disease reporting system / maintenance only by public health professionals Provides secure network for communicable disease reporting system / maintenance only by public health professionals Maintains physician, veterinarian, pharmacists, ICPs, EMTs, & hospital laboratory contact database Maintains physician, veterinarian, pharmacists, ICPs, EMTs, & hospital laboratory contact database Broadcast FAX can be used to send alerts to 1450 FAX numbers of Tarrant County providers Broadcast FAX can be used to send alerts to 1450 FAX numbers of Tarrant County providers Provides additional workstation resources Provides additional workstation resources

Syndromic Surveillance Two hospitals are currently partners Two hospitals are currently partners Software for seven additional hospitals that are interested in joining Software for seven additional hospitals that are interested in joining Will conduct evaluation of syndromic surveillance to study trends Will conduct evaluation of syndromic surveillance to study trends Comparison of EMSystems and RedBat Syndromic Surveillance Systems Comparison of EMSystems and RedBat Syndromic Surveillance Systems

Syndromic Surveillance Buying webserver to facilitate web-based reporting Buying webserver to facilitate web-based reporting EMSystems—developing -based reporting system EMSystems—developing -based reporting system Novell—developing integrated browser-based communicable disease intake form for direct input into TxEDSS & NEDSS Novell—developing integrated browser-based communicable disease intake form for direct input into TxEDSS & NEDSS

Communications Equipment Ten hand-held radios (800 MHz) linking TCPHD with public safety agencies (law enforcement, fire, & emergency management) Ten hand-held radios (800 MHz) linking TCPHD with public safety agencies (law enforcement, fire, & emergency management) Four hand-held radios (450 MHz) linking TCPHD with smaller, local fire and HazMat agencies Four hand-held radios (450 MHz) linking TCPHD with smaller, local fire and HazMat agencies Satellite phones Satellite phones

BT Training Tarrant County has conducted assessment of staff BT training needs Tarrant County has conducted assessment of staff BT training needs Developed strategic plan, Public Health Ready, to train public health workforce Developed strategic plan, Public Health Ready, to train public health workforce BT trainers will train workforce to assure readiness & cross-training BT trainers will train workforce to assure readiness & cross-training

Environmental Health Industrial Hygienist available for indoor air quality assessments Industrial Hygienist available for indoor air quality assessments Industrial Hygienists critical to investigations of anthrax scare in Washington, DC Industrial Hygienists critical to investigations of anthrax scare in Washington, DC HazMat teams had no training heating vents, air conditioning controls, air flow patterns, structural integrity of buildings HazMat teams had no training heating vents, air conditioning controls, air flow patterns, structural integrity of buildings

BT Laboratory Capacity Will receive certification as “Confirmatory Lab” Will receive certification as “Confirmatory Lab” Will do confirmatory tests for Category A agents, except smallpox, and certain toxins Will do confirmatory tests for Category A agents, except smallpox, and certain toxins For smallpox, do screening tests, such as for monkey pox For smallpox, do screening tests, such as for monkey pox

Regulatory & Food Borne Laboratory Capacity North TX Regional Lab for 39 counties—for Milk & Dairy North TX Regional Lab for 39 counties—for Milk & Dairy Water testing for cities in 39 county area without own labs Water testing for cities in 39 county area without own labs Can do enteric pathogen testing – shigella, salmonella, Ecoli 0157 Can do enteric pathogen testing – shigella, salmonella, Ecoli 0157 Looking at cooperative agreements between commercial and government laboratories to build surge capacity Looking at cooperative agreements between commercial and government laboratories to build surge capacity