North Carolina and Medical Center Prepare for Bioterrorism
From Visions, Spring 2006
By Len B. Preslar Jr., President and CEO, North Carolina Baptist Hospital
All of us remember the tragedy of September 11, 2001, and the monumental efforts undertaken to protect our country from future threats.
One of the most frightening possibilities includes the use of biological agents such as smallpox, anthrax or even a genetically modified influenza virus. Bioterrorism poses a unique threat because germs can take several days to a few weeks to make people sick. By the time the first cases are identified, a few hundred to potentially thousands of individuals could have been infected. Travel by car or airplane could move the infection from coast to coast or around the world in a matter of weeks. In addition to the illness and deaths caused by disease, hysteria grips the country. Communities are paralyzed and medical facilities overwhelmed.
Fortunately, North Carolina is leading the nation in preparing for these types of disasters, and Wake Forest University Baptist Medical Center is part of these important efforts.
The North Carolina Division of Public Health and the North Carolina Hospital Association partnered to develop a system to significantly improve the state’s ability to recognize and respond to acts of bioterrorism. The North Carolina Hospital Emergency Surveillance System (NCHESS) electronically collects data from over 100 hospital emergency departments including our own. This data is compared to other departments and hospitals in our region and statewide to look for trends and identify patterns potentially related to bioterrorism. The system also helps to monitor outbreaks of influenza, meningitis or even unusual increases in the number of patients presenting to an emergency department with gastrointestinal complaints that could be related to food poisoning.
Experience has shown that public health problems often begin as a cluster of events — vomiting, rash, high fevers. Recognizing that these events are more than random occurrences provides an early warning of a potential epidemic or act of bioterrorism. Responding to a large-scale biological incident requires special equipment and training.
North Carolina has been recognized for developing a three-prong approach to dealing with disasters. State Medical Assistance Teams (SMAT) stand ready to provide care to those in need.
SMAT-III teams provide an immediate response. Local emergency medical services, fire and police respond, isolate, contain and treat patients.
If the event overwhelms local resources, SMAT-II or regional response teams are called to assist. These teams include physicians, nurses, pharmacists, paramedics and technicians who train regularly as a group. They are capable of responding within 24 hours to any location in North Carolina. Currently, there are eight SMAT-II teams in North Carolina, with one based at North Carolina Baptist Hospital. SMAT-II teams operate as part of the Regional Advisory Councils. These councils or RACs were originally set up to provide support for trauma centers, but now they also help to coordinate disaster response throughout the state. Our team participated most recently in relief efforts following Hurricane Katrina setting up a field hospital in Waveland, Mississippi.
SMAT-I Teams are deployed for major events such as hurricanes or mass casualty events. The Special Operations and Response Team (SORT) is a Winston-Salem-based group that served as the model for such teams nationally and was the first National Medical Response Team (now part of the Department of Homeland Security). This team responds to major disasters or stands by at major events such as the Democratic and Republican national conventions.
Experience with Hurricane Katrina and the potential threat of avian or “bird” flu point out a need for a planned, organized and well trained response to meet the challenge of hundreds of people seeking care at once. We are proud that our Medical Center and staff are part of a system that is the model for others. While we hope our teams are never needed, they are available at a moment’s notice.