Bioterrorism Preparedness Program

Anthrax Information and Advisories

Status Report #1
What is the Health Department Doing
From Patricia A. Nolan, MD, MPH, Director of Health

October 18, 2001

Background

For the past 26 months, the Rhode Island Department of Health (HEALTH), working with the Hospital Association of Rhode Island, the RI Emergency Management Agency (EMA), the RI municipalities and the state’s hospitals, has been preparing for a bioterrorism emergency.

Although no evidence of a bioterrorism agent has been found in Rhode Island as of this writing, HEALTH went on a high alert within an hour of the tragic events of September eleventh. A staff member joined the RIEMA Emergency Operations Center as soon as it opened. HEALTH officials met the same day with senior staff members of all the acute care hospitals to review symptoms and emergency room protocols for the chief bioterrorism agents. All Rhode Island physicians received similar information. The state laboratory ordered extra testing supplies.

When incidents of bioterrorism occurred, first in Florida, then in New York and most recently in Washington, our focus increased in response to the needs of Rhode Island citizens.

On Monday, October 15, HEALTH activated our Emergency Response Plan to deal with these increasing needs while maintaining all of our other functions and programs.

Currently

• Our state epidemiologist or a specially trained public health nurse assess the risk of individuals who come in contact with a suspicious powder. Some days they conduct more than 50 interviews.
• The State Microbiology Laboratory accepted 23 suspicious materials for testing as of 10/17. (Samples are accepted only if submitted by a local, state or federal law enforcement agency through the EMA.) Each sample requires at least an hour to prepare and 48 to 72 hours to culture. Police are asked to send samples from large objects, rather than transport them to the laboratory since these objects may not fit under the air flow safety hood
• Our Family Health Information Line (1-800-942-7434) receives about 50 calls a day from the general public with questions about exposure, treatment or bio-agents. Additional calls in the evening and at night are handled by our on-call administrator and on-call physician. (272-5952)
• Our public information staff talks constantly with the media to inform the public about appropriate precautions. On Monday, senior staff members spoke with the press 27 times.
• Our web site (HEALTHRI.org) is updated frequently with information produced by our staff, the national Centers for Disease Control and the Department of Health and Human Services.
• Health Alert Network training for municipalities and hospitals continues uninterrupted.
• Special Alerts have been sent to police, emergency management directors through the EMA and directly to hospital laboratories.
• HEALTH issued a physician advisory in response to reports of an increased number of prescriptions for Ciprofloxacin ("Cipro"). In it, HEALTH strongly advised against prescribing prophylaxis or ordering nasal swabs or any diagnostic testing on asymptomatic patients in the absence of evidence of anthrax exposure established by epidemiological investigation.
• In response, the State Board of Pharmacy issued an advisory to all pharmacists in Rhode Island to discuss orders for Cipro extending beyond the typical 14 day supply with the prescribing physician. The advisory also states that if a pharmacist determines the medication is inappropriate, he or she may refuse to fill the prescription.

All Special Alerts and Advisories issued by the Department of Health can be found on our website at HEALTHRI.org. Just click on the line about Anthrax and Advisories at the top of our home page.