Ability to Handle Bioterrorism Discussed at Hospital

At one point, Dr. Robert Rolf didn’t carry phone numbers of FBI agents in his Palm Pilot, but he does now, just in case there is a bioterrorism attack in Utah.

A panel of law-enforcement officers, government officials and University of Utah medical school professors participated in a panel discussion on bioterrorism Monday at University Hospital.

The panelists discussed recent efforts, expressed concerns and praised fellow clinicians during the hour-long event, which is part of a series sponsored by the hospital.

Dr. Andy Pavia, acting chief at the division of pediatric infectious diseases, was concerned about the current health-care system’s ability to handle a surge in demand during a crisis.

“We’ve shut down excess capacity,” Pavia said about today’s cost-conscious health care industry. He believes the current system is designed to handle only “average needs.”

But Pavia has been impressed by his fellow “infectious disease docs” in detecting recent cases of anthrax, especially in Florida, where the physician made the “presumptive diagnosis” within a few hours.

Because of the possibility of earthquakes along the Wasatch Front and chemical accidents from the Tooele army depot, hospital emergency departments in Utah have been sensitized to the possibility of handling a crisis, said Professor of Emergency Medicine Martin Caravati.

“The emergency department has been prepared and will be prepared,” Caravati said.

Sgt. Don Bird from the University of Utah Police Department coordinates the effort against weapons of mass destruction, which include nuclear, chemical and biological weapons.

Bird said the preparation for the Olympics has been demanding on his department’s resources. The UUPD has dedicated two full-time officers who “work on nothing but the Olympics.”

Bird said most of their preparations existed before Sept. 11. During disasters, his department would work closely with search and rescue teams and government agencies.

“There are a lot of plans for the Olympics,” Bird said. “You couldn’t read them all.”

Rolf, acting state epidemiologist for the Utah Department of Health, said there is no known exposure to anthrax in Utah, but his department has been responding to a number of concerned callers.

Rolf said the state created a hotline and has initiated around-the-clock coverage to respond to any possible incidents. The health department has also worked with clinicians in the state and federal agencies in prevention and detection measures.

Anthrax was not the only bioterrorism weapon on these panelists’ minds. They are also concerned with smallpox, which is more contagious than anthrax. It is also viral and not treatable by antibiotics, but vaccination is 100 percent effective.

Pavia is ambivalent about using smallpox vaccines. The current available supply may only be enough to immunize those who would have first contact with the victims, such as health-care providers.

“Immunizing a limited group would have a limited effect in slowing an epidemic,” Pavia said.

There has been consideration about increasing production of the vaccine, which has not been widely administered since the early ’70s, but smallpox vaccine has more side effects than other vaccines. Pavia is not sure about the wisdom of a large-scale inoculation program.

“It’s a hard decision,” Pavia said. “I’m glad I’m not making the decision.”

[email protected]