Bioterrorism plans grow from variety of sources

As health care organizations race to develop a plan for treating patients exposed to bioterrorist agents, more resources are becoming available. Two of the most recent offerings are a comprehensive preparedness plan developed by the Stanford University Medical Center and a CD-ROM of bioterror information created by physicians for physicians.

A team of leading Stanford physicians, scientists, and medical staff members have developed a plan outlining ways to assess and treat victims of bioterrorism while limiting the potential spread of contamination. Stanford now is sharing the plan with hospitals, physicians, and public health agencies nationwide, reports Philip A. Pizzo, MD, dean of the Stanford University School of Medicine and former physician-in-chief of Children’s Hospital in Boston and professor of pediatrics at Harvard Medical School.

"We initially focused our efforts on the local community but then realized our work could benefit the greater medical community," Pizzo says. "We all share in the same mission of protecting the health and safety of all Americans, and it is critical that we share information and work together on a unified front."

The Stanford plan

Soon after anthrax cases began surfacing on the East Coast, leaders at the Stanford University Medical Center appointed the Bioterrorism and Emergency Preparedness Planning Task Force to update the medical center’s level of preparedness for dealing with potential cases of exposure to anthrax or other biological agents. The task force members represent all three entities of the medical center — Stanford Hospital & Clinics, Lucile Packard Children’s Hospital, and the Stanford University School of Medicine — and come from a variety of fields, including infectious diseases, microbiology, critical care medicine, pediatrics, emergency medicine, and psychiatry. Eric A. Weiss, MD, co-chair of the task force, explains that the task force also includes representatives who deal with patient care, security, and logistical issues within the hospitals.

For the Stanford bioterrorism plan on-line, go to

"We are extremely fortunate to have some of the nation’s top clinicians and researchers here at Stanford, and their expertise has been vital in helping us develop a plan for responding appropriately to anthrax cases and other incidents related to bioterrorism," Weiss says. "We know other hospitals are working on appropriate response plans as well, so by sharing our plan with them, we hope to free up their time to focus on other pressing issues."

He says the Stanford plan has two purposes — to ensure the health and proper treatment of the patient and to limit the potential exposure of medical staff and facilities. The Stanford plan is continually being modified and updated in accordance with frequent changes from the national Centers for Disease Control and Prevention and public health organizations, Weiss says. In addition, the task force continues working with law enforcement agencies and receiving input from medical centers throughout the country.

"The information about anthrax is changing rapidly," Weiss says. "The cases being treated on the East Coast vary from what has been reported in the medical literature and we have to adapt our understanding in light of these differences. We want to do everything possible to keep the information current."

Another source of information is available at the Bioterror Resource Center on the World Medical Leaders (WML) web site ( Access to the Bioterror Resource Center site will be restricted to physicians only. WML is sending a free CD-ROM to all hospital emergency rooms throughout the United States. It contains a lecture on emergency response to bioterrorist attacks titled "Bioterrorism for Physicians: A Practical Approach." The lecture focuses on a practical approach to recognition and management of biological terrorism.

Gerald Imber, MD, co-founder of World Medical Leaders, says bioterrorism has not been a subject of major interest in medical schools. The CD-ROM for emergency rooms is particularly important because it outlines how a hospital ER should respond to and be prepared for bioterrorism, he says. The lecture was presented by Paul Rega, MD, medical program director of the University of Findlay, senior medical officer of the Ohio-1 DMAT, and a recognized expert in the field. He also is the author of a definitive emergency manual on bioterror medicine.

"This is the most comprehensive site for information on bioterrorism in the world. It was developed because doctors are not familiar with the symptoms and treatment of the diseases caused by biological warfare, and we need to be," Imber says.

WML was founded to create a physicians-only Internet site where doctors from around the world could learn from and interact with the most exceptional faculty of medical educators and thought leaders available. More than 140,000 physicians are currently members and more than 120 county and state medical societies and hospital groups, and the Department of Defense also are affiliated.

The bioterrorism CD-ROM is being sent to all emergency rooms, but physicians also can request a copy by going to the WML web site.