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Bioterrorism and Health System Preparedness

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Slide Presentation by Sarah Dawn McNutt, M.D.

On April 30, 2002, Sarah Dawn McNutt, M.D., made a presentation in a Web-assisted teleconference at Session 2, which was entitled "Promoting Clinician Readiness."

This is the text version of Dr. McNutt's slide presentation. Select to access the slides or to access the streaming video of Bioterrorism and Health System Preparedness.

Promoting Clinician Readiness

Sarah Dawn McNutt, M.D.
Research Associate
Department of Emergency Medicine
Center for Disaster Preparedness
University of Alabama at Birmingham

Slide 1

Bioterrorism: Challenges of Training

  • Rare Diseases.
  • Never Seen or Diagnosed by Today's Clinicians.
  • Non-traditional Routes of Infection.
  • Emerging Patterns of Resistance.
  • Increased Virulence.

Slide 2

The Biological Terrorist Spectrum

This slide shows a graph of the biological terrorist spectrum plotted linearly against the numbers of casualties on the X-axis with the likelihood of occurrence on the Y-axis. As the likelihood of occurrence decreases, the numbers of casualties increases, according to this graph. Hoaxes are likely to fall at the beginning of the spectrum, with a high likelihood of occurrence and low numbers of casualties, and mass casualty devices and agents that are State sponsored fall at the end of the spectrum, with a high number of casualties but low likelihood of occurrence.

Slide 3

What Caused These Legions

This slide shows a picture of a child with many lesions on his face.

Slide 4

Picture Gallery

This slide shows the picture gallery of the UAB Web site, with pictures of organisms or symptoms that prompt visitors to the Web site to click on the picture to learn more about the agent or infection.

Slide 5

Learning Module

This slide shows another aspect of the UAB Web site which poses hypothetical scenarios for clinicians in an interactive format. Clinicians must read the scenario and guess from give options which "condition" a patient in the Emergency Room has come down with.

Slide 6

Screensaver Intervention:

16.7 percent increase in correct responses.

This slide shows a bar graph that measures the effectiveness of the screensaver intervention. At baseline and pre-ED, clinicians had 38.8 percent correct responses, and post-ED 59.1 percent correct responses. After the intervention, clinicians had 52.4 percent correct responses pre-ED and 75.8 percent post-ED.

Slide 7

Web Site Usage
Weeks 1-19
22 Oct 2001-28 Feb 2002

  • 12,180 Unique Visitors.
  • 580,300 Total Hits.
  • 70 Countries.
  • 883 CME certificates issued.

Slide 8


This slide shows a picture of the organism neisseria meningitis, which is naturally occurring, next to a picture of bacillus anthracis, which is bioterrorism. Below these this comparison it reads public health preparation = bioterrorism preparation.

Slide 9

Medical Specialties

First Point of Care:

  • Emergency Medicine.
  • Primary Care Providers:
    • Internal Medicine.
    • Pediatrics.
    • Ob/Gyn.
    • Family Practice.
  • Hospital Infection Control.
  • Initial Diagnostics:
    • Pathology.
    • Radiology.

Consultative Specialties:

  • Infectious Disease.
  • Pulmonology and Critical Care.
  • Dermatology.
  • Nephrology.
  • Surgical Subspecialties.
  • Other Medical Subspecialties.

Slide 10

Agents of Concern

Category A:

  • Smallpox.
  • Anthrax.
  • Plague.
  • Tularemia.
  • VHF's.
  • Botox.

Category B:

  • Q fever.
  • Brucellosis.
  • Glanders.
  • VE, WEE and EEE.
  • Ricin toxin.
  • Epsilon toxin.
  • Staph enterotoxin B.

Category C:

  • Nipah virus.
  • Hantavirus.
  • Tick-borne HF's.
  • Tick-borne Encephalitis.
  • Yellow fever.
  • MDR TB.

Slide 11

October 9, 2001, CNN


October 9, 2001 Posted: 4:41 PM EDT (2041 GMT)

Federal officials said Tuesday their investigation into a deadly anthrax infection in Florida included a closer look at forensic evidence gathered in the weeks since the September 11 terrorist attacks, especially items traced to the suspected hijackers, such as luggage, documents and cars.

The bacteria is blamed for the death of photo editor at the supermarket tabloid The Sun. A mailroom employee also tested positive for exposure to anthrax, but is not exhibiting symptoms of the disease.

Elsewhere in Florida, officials Tuesday were checking reports of a "white powdery residue" in the mail of two locations in Naples, on the west coast. Reports of possible anthrax virus in Weston and Deerfield Beach, on the east coast, proved unfounded.

This slide also features a picture of hundreds of people standing outside the Florida Health Department Annex.

Slide 12

This slide features another view of the UAB Web-based learning module, where clinicians can receive CME credits.

Current as of June 2002

Internet Citation

Promoting Clinician Readiness. Presentation by Sarah Dawn McNutt at Web-Assisted Teleconference, "Bioterrorism and Health System Preparedness: Emerging Tools, Methods, and Strategies." Agency for Healthcare Research and Quality, Rockville, MD.

Return to Bioterrorism and Health System Preparedness Teleconference


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