Leveraging bioterrorism preparedness for non-bioterrorism events: a public health example

Area of Science:

• Public Health
• Epidemiology
• Infectious Disease Control

Background:

• A deceased healthcare worker with active, untreated tuberculosis prompted a large-scale public health response.
• Existing bioterrorism preparedness infrastructure and planning were leveraged for the response.

Purpose of the Study:

• To describe the adaptation and implementation of bioterrorism response strategies for a non-bioterrorism public health emergency.
• To evaluate the effectiveness of an integrated public health approach to mass tuberculosis screening and contact tracing.

Main Methods:

• Utilized Incident Command System (ICS) principles and bioterrorism response plans for mass screening.
• Adapted procedures for Strategic National Stockpile (SNS) medication distribution for tuberculosis prophylaxis.
• Coordinated with community partners and multiple agencies for efficient contact investigation.

Main Results:

• Screened over 2,500 individuals for tuberculosis rapidly.
• Achieved a high skin test reading return rate of 91.6%.
• Identified 5.9% of individuals infected with tuberculosis, with no active cases found.

Conclusions:

• Bioterrorism preparedness enhanced the public health response to a large-scale tuberculosis event.
• Integrated public health approaches and inter-agency coordination are crucial for managing mass health emergencies.
• The adapted strategies demonstrated improved public health capacity for "traditional" emergencies.