Public Health Emergency Preparedness

Bioterrorism Q&A

What is bioterrorism?

Bioterrorism is the intentional use of infectious biological agents, or germs, to cause illness.

Has there been any evidence of a recent widespread biological release in New York City?

In Fall 2001, the New York City Department of Health and Mental Hygiene (DOHMH) investigated an outbreak of anthrax that was associated with letters sent to major media outlets in the City that had been intentionally contaminated with anthrax spores. Most of these New York City residents had cutaneous (skin) infections. One woman died from the inhalational form of this disease and her exact source of exposure remains unknown. However, there was no evidence of a widespread release of anthrax in New York City last fall.

How has the DOHMH been preparing to address the possibility of a biological release in New York City?

Many of the federal, state, and local agencies (including the DOHMH) have been working together for several years to prepare for the detection and response to a bioterrorist event in New York City. In cooperation with the Office of Emergency Management (OEM), which coordinates the City's overall preparedness planning, DOHMH has established a comprehensive surveillance system to improve our ability to detect and respond to the release of a biological agent.

As part of this plan, the DOHMH is continuously looking for any indication of bioterrorism in the City. DOHMH regularly asks all healthcare providers in New York City to be alert for any unusual disease clusters, and to immediately report such occurrences to us. Additionally, several surveillance systems are in place to quickly detect an increase in unusual illnesses, including monitoring of 911-ambulance calls and emergency department visits. The response plan includes coordinating with OEM and other City, State, and federal agencies; alerting hospitals and the medical care community; communicating with the public; and ensuring that appropriate medical care and prevention services are provided.

Should New York City residents buy gas masks to protect themselves and their families?

DOHMH strongly discourages purchasing gas masks for protection against biological agents. Gas masks are intended for short-term use and would only provide protection if worn at the time of a known release. Unless a mask was worn all the time, which is impractical as well as dangerous, it would not protect against a covert (surprise) release of biological agents. Masks also need to be fitted properly. Improper use of gas masks can cause serious injury or even death by accidental suffocation, especially among persons with underlying heart or lung disease.

Should New York City residents stockpile antibiotics to protect themselves against bioterrorism?

DOHMH strongly recommends against stockpiling antibiotics. The inappropriate use of antibiotics is not without risk and may cause the development of antibiotic-resistant strains of common bacterial diseases. Improper use of antibiotics may also cause serious side effects including: diarrhea, abdominal symptoms, rash, allergic reactions, and potentially dangerous interactions with other medications. Individuals who stockpile antibiotics would also be more likely to use expired medications. Finally, stockpiling of antibiotics could lead to shortages of national supplies for routine or emergency use.

A large stockpile of pharmaceuticals -- including antibiotics that are effective against the most likely bacterial biological agents -- has been created by the federal government and is available for rapid shipment to the affected area, if necessary. OEM and DOHMH have developed a detailed plan to ensure the ability to rapidly distribute medications from this national stockpile to all those at-risk through emergency clinics that would be set up in multiple locations throughout the five boroughs, in the event that a biological release were to occur in New York City.

Is the city's water supply safe from bioterrorism?

Most bioterrorism experts agree that reservoirs are an unlikely target for bioterrorism. Methods already in place to filter and clean the drinking water supply are considered effective against most biological agents. Chlorine, for example, protects drinking water from other water-borne bacteria and would neutralize most biological agents. Additionally, the large quantity of water in New York City's water supply would significantly dilute a biological agent before it reaches the tap, limiting its potential to do harm.

Is there anything specific that New Yorkers can do to prepare for a possible bioterrorism event?

The best way for a family to safe is to be as prepared as possible before any disaster strikes. Consistent with long-standing guidelines on disaster preparedness, families should plan to provide for all their necessities for a 3- to 4-day period, in the event that they have to remain inside their home for their safety. They also might consider putting together a family emergency plan, so that all family members (e.g., schoolchildren or homebound relatives) could be cared for in case the main caregivers are unable to return home at their usual times.

DOHMH, along with other government agencies and health institutions, will do everything possible to protect the health of all persons who live, work, or are visiting in New York City. Were a biological release to occur in New York City, the public would be informed immediately through the news media of measures that could be taken to protect their health. If antibiotics or vaccines were recommended, instructions would be provided on where to receive these medications in emergency clinics that would be established by the City in multiple locations throughout the five boroughs.

What if my fears about bioterrorism are having a serious impact on my family and work life?

After the events of September 11th, 2001 it is reasonable for individuals to feel anxious about their personal safety. If your fear grows to the point that it stops you from doing things that you would normally do, it might be helpful to talk with a professional counselor. Your healthcare provider can make a referral, or you can call one of the following help lines:

English LifeNet:	(800) 543-3638	(800) LIFENET
Spanish LifeNet:	(877) 298-3373	(877) AYUDESE
Chinese LifeNet:	(877) 990-8585
American Red Cross:	(212) 787-1000