Pediatric Terrorism and Disaster Preparedness: A ... - PHE Home

Vaccination
Large-scale vaccination may be recommended in some outbreaks related to bioterrorism, namely
smallpox. Vaccination may be offered to an affected community, county, State, or the entire
Nation. Large-scale smallpox vaccination clinics are intended to supplement the concurrent
“surveillance and containment” strategy, (also called “search and containment” and “ring
vaccination”). Surveillance and containment requires that individuals who are ill with smallpox
are quickly identified and isolated, followed by rapid identification and vaccination of their
contacts within 4 days of exposure.
For additional information about vaccination strategies to be used during a smallpox outbreak,
see http://www.bt.cdc.gov/agent/smallpox/response-plan/index.asp.
Large-scale vaccination clinics may offer vaccination to anyone who does not have medical
contraindications to receiving the vaccine under emergency circumstances. The Advisory
Committee on Immunization Practices (ACIP) is reviewing and refining the contraindications to
smallpox vaccination after an event for people who have not been exposed.
Information for Families
During a bioterrorist attack, one of the most important and challenging roles for the local
pediatrician is providing information to families with children. During the anthrax attacks of
2001, public health and medical facilities were inundated with requests for information and
medical evaluation. As a result, these same agencies have prepared communication messages and
information sheets that can be shared with families before and during a crisis. Parents will want
information that is age-appropriate for their children, as well as suggestions for ways to answer
their children’s questions. Pediatricians may want to consider accessing some of these materials
and having them available before an emergency occurs.
A number of organizations have developed materials to help educate children and their families
about emergencies and bioterrorism. More information can be obtained from the following
organizations and their Web sites:
• American Academy of Pediatrics
http://www.aap.org/terrorism/resources/federal_resources.html
• The Department of Health and Human Services
http://www.os.dhhs.gov/emergency/index.shtml
• The National Child Traumatic Stress Network
http://www.nctsnet.org/nccts/nav.do?pid=ctr_aud_prnt
Category A Agents
See also Table 4.3.
Anthrax
Bacillus anthracis, the etiologic agent of anthrax, is a gram-positive, anaerobic, spore-forming,
bacterial rod. The three virulence factors of B. anthracis are edema toxin, lethal toxin and a
capsular antigen. Human anthrax has three major clinical forms:
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