UTMB Links

Division of Infectious Diseases

Pediatric Division of Infectious Diseases

UTMB – Institute for Human Infections and Immunity

Center for Biodefense & Emerging Infectious Diseases

Galveston National Laboratory

Center for Tropical Diseases

Center for Vaccine Development

Department of Microbiology & Immunology

   

|| Reporting Requirements || Clinical Microbiology Laboratory || Emergency Medical Services || Pharmacy || Anthrax ||
|| Botulism || Plague || Smallpox || Tularemia || References ||

Reporting Requirements
UTMB may be the initial site of recognition and response to bioterrorism or emerging infectious diseases events. If a bioterrorism event is suspected, local emergency response systems should be activated. Notification should immediately include Healthcare Epidemiology, Hospital Administration, local law enforcement, the FBI and the Galveston County Health District. (1)  For suspected emerging infectious diseases, Healthcare Epidemiology, Hospital Administration and the Galveston County Health District should be notified.

Contacts
Internal Contacts:

Healthcare Epidemiology:	office	772-3192
Healthcare Epidemiologist:	pager	643-2038
Director, Healthcare Epidemiology:	pager	643-3133
Administration/Public Affairs:	office	772-2618

External Contacts:

Local Police Department:	(409) 797-3702
Local Health Department:	(409) 765-2514
State Health Department:	(888) 963-7111
FBI Field Office	(713) 693-5000 (24 hours)
Bioterrorism Emergency Number, CDC Emergency Response Office:	(770) 488-7100

Potential Agents for Bioterrorism
Five diseases with recognized bioterrorism potential (anthrax, botulism, plague, smallpox and tularemia) and the agents responsible for them are described in this document.

Potential Agents for Emerging Infectious Diseases
Two diseases (Severe Acute Respiratory Syndrome [SARS] and avian influenza) are currently of concern but others may appear in the future.

Authority Statement
In the event of a bioterrorism event or expression of an emerging infectious disease, the Hospital Epidemiologist or his designee and the Medical Director will determine preferential admissions, limit visitation and activate the emergency management plan.

The Hospital Epidemiologist or his designee will define the triage questions to be asked that will define the population of concern.

Bioterrorism Readiness Plan

Detection of Outbreaks
1. Syndrome-based criteria
Rapid response to a bioterrorism-related outbreak requires prompt identification of its onset. Because of the rapid progression to illness and potential for dissemination of some of these agents, it may not be practical to await diagnostic laboratory confirmation. Instead, it will be necessary to initiate a response based on the recognition of high-risk syndromes.

2. Epidemiologic features
Epidemiologic principles must be used to assess whether a patient’s presentation is typical of an endemic disease or is an unusual event that should raise concern. Features that should alert healthcare providers to the possibility of a bioterrorism-related outbreak include:

• A rapidly increasing disease incidence (e.g., within hours or days) in a normally healthy population.

• An epidemic curve that rises and falls during a short period of time.

• An unusual increase in the number of people seeking care, especially with fever, respiratory, or gastrointestinal complaints.

• An endemic disease rapidly emerging at an uncharacteristic time or in an unusual pattern.

• Lower attack rates among people who had been indoors, especially in areas with filtered air or closed ventilation systems, compared with people who had been outdoors.

• Clusters of patients arriving from a single locale.

• Large numbers of rapidly fatal cases.

• Any patient presenting with a disease that is relatively uncommon and has bioterrorism potential (e.g., inhalation anthrax, or pulmonary tularemia or plague).

• See attached Clinical Pathways 1-5 for pneumonia, skin infections, neurological presentations, mediastinal syndrome, and gastrointestinal syndrome.