http://www.nytimes.com/2001/10/15/nyregion/15SAFE.html
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October 15, 2001 Experience is Outracing Old Protocols for Anthrax
By SHAILA K. DEWAN
But yesterday, bioterrorism experts said that no unusual precautions are
recommended for suspected anthrax contamination. The Health Department lab technicians, who according to officials were
wearing protective masks, gloves and gowns, actually exceeded the safety standards
recommended by the the federal Centers for Disease Control and Prevention for
a laboratory setting. The C.D.C. recommends biosafety Level 2, on a scale of
up to four, in testing for anthrax — the same level it recommends for
salmonella. Level 3 sometimes requires a respirator; Level 2 does not. If anything, said Terri Rebmann, an infectious disease specialist with the
Center for the Study of Bioterrorism and Emerging Infections at St. Louis
University, the new anthrax exposures show how protocol will necessarily
change as law enforcement and health officials gain more practical knowledge. "Did he smell it? Did he put it to his face?" she asked about
the police officer, who was not wearing gloves when he handled a suspicious
envelope that later turned out to be contaminated. "We need to find out
exactly, if we can, how that happened, because that would tell us a lot about
how it's transmitted. Right now our basic training says it can't be spread
from hand to hand." There have been no other reported incidents of exposure of officials or
medical personnel involved in anthrax investigations in New York, Nevada, or
Florida. For law enforcement, training and advice about hazardous substances come
from a variety of sources, like the F.B.I., the Department of Justice, and
the so-called Blue Book, or the Medical Management of Biological Casualties
Handbook, issued by the United States Army Medical Research Institute of
Infectious Diseases. For anthrax, the Blue Book recommends standard precautions, like those that
might be used by a medic taking a patient's blood, not safety measures used
with contagious airborne diseases like tuberculosis. But law enforcement officials tend to use greater safety measures,
especially when entering a situation where not much information is available.
Yesterday, specially trained firefighters in San Jose, Calif., suited up and
donned masks and gloves before entering an airplane where a mysterious powder
had been seen. It turned out to be confetti. But it could have been anything, said David Huseman, an advanced life
support education coordinator for the San Jose Fire Department, where
officers have been trained to respond to weapons of mass destruction, such as
biohazards, since the F.B.I. warned that the Bay Area was the third-most-likely
target for terrorist attacks several years ago. "If you don't get concrete information of what you're dealing with,
you're going to go with the highest level of protection," Mr. Huseman
said. The fact that investigators in New York knew that a case of anthrax had
been confirmed should have made them even more cautious, Mr. Huseman said.
"That's like walking into a burning building without your fire
protection gear." But Mayor Rudolph W. Giuliani said at yesterday's news conference that
adequate precautions had been taken at NBC. "A balance has to be struck
here between sufficient precautions and making people so frightened and so
upset that they're not going to be able to conduct their lives, which means
having people walking around in spacesuits all over the city of New
York," he said. "The reality is that I think they balanced that
correctly." Mr. Huseman agreed that bioterrorist threats are so new that there is as
yet no clear division between appropriate action and overreaction. "It's kind of like when H.I.V. and AIDS became a problem," he
said. "People became very paranoid, and people reacted and responded in
a certain way, and you need to change that through education." |
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