CDC Chief: System Hurt Anthrax Reax

By THE ASSOCIATED PRESS

Filed at 6:19 a.m. ET

ATLANTA (AP) -- The nation's response to anthrax bioterrorism was hampered by a long-neglected, money-starved public health system, the director of the Centers for Disease Control and Prevention says.

And the country's readiness for more such attacks is weakened by old labs, crumbling buildings and outdated technology that slows the detection of outbreaks, Dr. Jeffrey Koplan said in an interview at CDC headquarters Friday.

``We've had 30-plus years of neglect of the public health system and underinvestment in it,'' he said. ``If we want to be as effective as we can be, whether it's a bioterrorist threat or an infectious disease, we've got to make that investment.''

Koplan also asserted that CDC's quick response prevented far more deaths and hospitalizations.

``I think we've done a highly competent, very effective job,'' he said. ``We've all learned a huge amount in six weeks. You could speak to a 12-year-old in the street and have him give you pretty reasonable information about anthrax.''

He said the weakest links in the system are far-flung -- state and local health departments that are not trained to recognize bioterrorism outbreaks and that are lacking in the proper technology to alert each other quickly.

For example, a county could have three cases of a suspicious disease and never know that a neighboring county was seeing a similar outbreak, he said. Such a breakdown could slow the government's ability to treat people.

``That's the front line of where a bioterrorist event occurs,'' he said. ``We've got to get health departments at a common level of high capability.''

Congress is negotiating a package that could provide more than $3 billion to improve the nation's preparedness for bioterrorism.

The CDC director said he hoped a large chunk of that money goes to improving CDC facilities. Important computers are covered with plastic to protect them from leaky roofs in Atlanta, and termites have chewed through laboratory floors, he said.

``We have first-class scientists working in third-class facilities,'' he said. ``We're woefully behind.''

Koplan reported no progress in the investigation into who unleashed anthrax-by-mail attacks that killed four people and sickened 13 others.

He cautioned that the threat from anthrax is not over, even though no new cases have been reported since a New York hospital worker died of inhalation anthrax Oct. 31.

``We can't sound an all-clear until they catch the perpetrators,'' he said. ``Whoever did this can do it again.''

Koplan and his agency came under criticism for keeping too quiet when the first anthrax attack surfaced in Florida. Some lawmakers and nongovernment public health experts said the CDC should have done more to calm people's fears and quash rumors about how anthrax is spread.

Koplan said each step the agency took was based on solid science at a time when doctors faced a ``learning curve'' because inhalation anthrax had not been seen in humans in a quarter-century.

He also urged Americans to keep the bioterrorism threat in perspective, weighing it against the 20,000 deaths caused each year by flu, or the continuing danger posed by smoking.

``Probably the most dangerous thing you do in a day is get in your car and drive somewhere,'' Koplan said. ``We and the public as well need to keep some balance in our minds.''

The CDC director said he is pressing for an expansion of the Epidemic Intelligence Service program -- the ``disease detectives'' who track outbreaks around the world.

Koplan would like to see more of the detectives, both at CDC headquarters and deployed to states to shore up their response to infectious diseases, including potential bioterrorist attacks.

When it became clear that the public health system was facing deliberately released spores of a deadly agent like anthrax, Koplan said he felt ``that sick feeling that we were dealing with a major bioterrorist event.''

He said the feeling comes back from time to time as he thinks about the continuing threat posed by terrorists who would twist biology and science for harm.

``For someone who has spent their career in health,'' he said, ``it may be naive, but it really is tough to stomach seeing it used to kill people.''

^------

On the Net:

CDC bioterrorism site: http://www.cdc.gov

ALL INFORMATION, DATA, AND MATERIAL CONTAINED, PRESENTED, OR PROVIDED HERE IS FOR GENERAL INFORMATION PURPOSES ONLY AND IS NOT TO BE CONSTRUED AS REFLECTING THE KNOWLEDGE OR OPINIONS OF THE PUBLISHER, AND IS NOT TO BE CONSTRUED OR INTENDED AS PROVIDING MEDICAL OR LEGAL ADVICE.  THE DECISION WHETHER OR NOT TO VACCINATE IS AN IMPORTANT AND COMPLEX ISSUE AND SHOULD BE MADE BY YOU, AND YOU ALONE, IN CONSULTATION WITH YOUR HEALTH CARE PROVIDER.