Good for What May Ail You Someday

When Dr. Angelo Salvucci’s children glanced over his shoulder at the text he was tapping out on the computer screen, they saw something a lot more disquieting than the dark forces lurking at Harry Potter’s school.

“At first, I wasn’t going to tell them about it, because I thought it would be too traumatic,” said the 47-year-old emergency room physician. “But we talked and I explained it: These diseases are just a part of life, and the book tells what you can do about them.”

His 9-year-old and 11-year-old weren’t put off by their father’s explanations of the illnesses that can be unleashed by bioterrorists. “It was like: ‘OK, it’s a part of life--now let’s go play soccer,’ ” he said.

Their reaction reflects the intent of “Biological Terrorism,” Salvucci’s concise guide to the illnesses that since Sept. 11 have seemed, sadly, less exotic.

Salvucci is chairman of the California Commission on Emergency Medical Services, a statewide panel that helps to regulate trauma teams and plan for disaster response. He also is medical director of emergency services for the health care agencies in Ventura and Santa Barbara counties.

Hardly light reading, his new 88-page handbook is subtitled “A Personal Safety Manual” and is aimed at removing a bit of the terror from bioterrorism.

“Many of these things can be easily defended against,” he said. “There’s always a role for personal preparedness.”

But how does one prepare for exposure to anthrax, to plague, to smallpox, to conditions as obscure and ominous-sounding as “glanders” and “Q fever”?

Some of Salvucci’s tips sound familiar: Dispose of clothing that might be contaminated. Scrub yourself thoroughly in a hot shower. “Remain calm,” he advises. “Public health officials will tell you what to do next.”

If a bomb or rogue crop-duster spews some biological agent, retreat to an above-ground room with few windows, Salvucci tells readers. Seal every opening--even electrical outlets--with tape and garbage bags.

As for antibiotics, Salvucci is careful to sound the standard warnings against stockpiling and unsupervised use of powerful drugs. However, he also acknowledges in his guide that “some people believe they will feel safer if they have antibiotics at home. If you are in a special situation or decide after reading this manual that you would like to store antibiotics at home, you should talk to your doctor.”

Salvucci, a Santa Barbara resident, said he keeps a couple of days worth of the antibiotic doxycycline in his home medicine chest--a hedge, he said, against a bioterror attack disrupting emergency supplies.

However, this practice runs counter to warnings from numerous health organizations.

“We’ve cautioned physicians against stockpiling for themselves or their patients,” said Peter Warren, a spokesman for the California Medical Assn. “He stands alone in giving this advice.”

In a draft of his book written before this fall’s anthrax attacks, Salvucci was skeptical that government reserves of antibiotics would be distributed efficiently after a bioterrorist attack.

However, he softened his view after massive stockpiles of Cipro reached people affected by Florida’s anthrax outbreak in just seven hours. “For the first time in a real event, the theoretical availability of supplies was tested” and not found wanting, he said, adding that an infusion of federal funds could provide additional access to medications.

Right now, 50-ton stores of emergency supplies--known as Push packages--are hidden in eight secret locations around the U.S.; next year, there might be as many as 12 locations, Salvucci said.

Salvucci’s self-published book, which is available through Amazon.com, provides quick summaries of more than a dozen diseases that could be spread by terrorists. It also offers physicians sample prescription forms listing preferred antibiotics and their recommended dosages. He is quick to point out, though, that medical knowledge in the field is limited. For instance, there are only two known patients with inhaled botulinum toxin who have been studied by physicians.

Iraq has admitted making some 5,000 gallons of the substance, which Salvucci describes as “the most potent toxin known to man.”

“And there could be multiple agents,” Salvucci said. “How do you treat someone who has anthrax and Q fever? What about multiple strains of the same organism?”

Like anthrax, Q fever is spread through spores that are highly infectious when inhaled. With such grisly possibilities, will Salvucci’s book simply raise people’s fears?

He doesn’t think so.

“There have been huge education efforts showing people how to react in fires and earthquakes,” he said. “Do those little red blinking lights on smoke detectors make people nervous?”