Publications

The 2009 influenza A H1N1 pandemic raised important, practical questions about how to vaccinate large numbers of people quickly, especially during an emergency, and how to reach vulnerable populations such as children. To accomplish both of these objectives, the New York City Department of Health and Mental Hygiene (DOHMH) conducted one of the nation’s largest efforts to deliver influenza A (H1N1) 2009 monovalent vaccine. This effort included an elementary school---located vaccination campaign for children enrolled at that school who were aged 4 years and older and a community-based, mass-vaccination, points-of-dispensing campaign that was initially targeted to people aged 4 to 24 years and pregnant women, then expanded to other priority groups, and finally opened up to anyone in the general population aged 4 years and older for the last weekend. In addition, vaccination was available through private providers, hospitals, community health centers, DOHMH clinics, and pharmacies.

Although never employed as a bioweapon to date, R. prowazekii was studied as a candidate for airborne dissemination by Japan during World War II and by the former Soviet Union during the 1970s because of its potential lethality and its ability to spread between humans via lice. Typhus has the potential to produce fatal disease and has been identified by the CDC as a Category B biological agent.

The CDC has classified ricin toxin as a Category B threat agent. Category B agents are the second highest priority agents because they can be disseminated with moderate ease, they cause moderate morbidity and low mortality, and they “require specific enhancements of CDC’s diagnostic capacity and enhanced disease surveillance.”

Y. pestis was developed as an aerosol weapon that, when deployed, can cause primary pneumonic plague, a highly lethal, and contagious form of plague.

Glanders is caused by infection with the bacterium Burkholderia mallei, and melioidosis is caused by Burkholderia pseudomallei. Both have the potential to produce fatal disease and have been identified by the CDC as Category B biological agents. HHS has identified these diseases as top priorities for development of medical countermeasures.

Some HFVs are considered to be a significant threat for use as biological weapons due to their potential for causing widespread illness and death.  Ebola, Marburg, Junin, Rift Valley fever, and yellow fever viruses have been deemed to pose a particularly serious threat, and in 1999 the HFVs were classified as category A bioweapons agents by the U.S. Centers for Disease Control and Prevention (CDC).

F. tularensis is considered to be a serious potential bioterrorist threat because it is one of the most infectious pathogenic bacteria known—inhalation of as few as 10 organisms can cause disease—and it has substantial capacity to cause serious illness and death. The bacterium was developed into an aerosol biological weapon by several countries in the past.

Smallpox was used as a biological weapon during the French and Indian Wars, (1754 to 1767) , and in the 1980s, was developed into an aerosol biological weapon by the Soviet Union.

This article offers recommendations on what hospitals should do to prepare for an influenza pandemic and proposes specific actions and priorities for the purpose of making the discussion of hospital pandemic preparedness issues more operationally useful.

On 14 January 2005, ten heads of government from Europe and North America and the Director General of the World Health Organization (WHO; Geneva, Switzerland) were scheduled to meet for a 'Transatlantic Security Summit' in Washington, DC, USA, to discuss the threat of international terrorism. On the eve of the meeting, news broke that citizens from several European countries appeared to have become ill with smallpox; shortly thereafter suspected smallpox cases appeared in the USA. Although the assembled leaders did not know it at the time, a radical terrorist group had obtained seed strains of Variola major—the virus causing smallpox—and deliberately released the virus in a number of main transport hubs and sites of commerce throughout Europe and North America. On 14 January, the heads of states who gathered in Washington were confronted with one of the worst nightmares imaginable: the use of contagious and deadly disease as a weapon.