Early Detection Is the Key

With the threat of biological and chemical attacks on so many minds, are there steps individuals should take now to stave off potential problems? And what is Los Angeles County doing to prepare for possible attacks? KAREN KARLITZ spoke with two health care professionals.

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JONATHAN E. FIELDING

Director of Public Health and Health Officer for Los Angeles County

We have no evidence to date of a specific threat of a biological or chemical agent in Los Angeles. We have a heightened awareness and sensitivity, and we’re doing more than ever before to prepare.

But it’s important for everybody to understand the level of the terrorist threat compared with other things they do, such as driving in cars while talking on cell phones or being in areas that have a lot of gun violence. Many other things are more likely to befall one at this point.

Los Angeles County has developed emergency response plans for biological and chemical attacks, as well as for other disasters. We have been developing systems to speed the likelihood of early detection of a bioterrorist attack. We work closely with physicians and hospitals, and our staff educates physicians on how to recognize these illnesses. Let’s remember that the majority of doctors in this country--including myself--have never seen many of these diseases. We try to increase the index of suspicion on the part of physicians and have also made it easier for them to notify us.

If a problem occurs, most likely we’ll discover it from a physician or emergency room as one or more patients exhibit something not seen before. Early detection of a problem is extremely important. The incubation period--the period between exposure and symptoms--varies tremendously. The events of Sept. 11 added a sense of urgency to our efforts, but the general direction of increasing surveillance and laboratory capacity has been in the works for several years.

I think people should prepare by having available at home and in their cars the same things they would have for a disaster of any type. That information is on our Web site, www.lapublichealth.org .

We do not recommend the routine use of antibiotics for many reasons; different agents require different antibiotics. You can desensitize yourself by taking them, making them less effective if you do really need them.

I don’t think people should purchase gas masks. Most masks are not designed to protect against biologic agents. Primarily they provide a barrier to the introduction of chemical agents to the respiratory tract, and you must be wearing the mask at the time of the attack. Also, the masks are good only if their cartridges are changed every few hours, and this requires that they be taken off. If the mask is not fitted properly it won’t work and some agents can be absorbed through the skin.

If there is a real public health emergency, we will be very proactive with the media. We will be able to get messages everywhere and let people know what to do.