Biosecurity 2002 takes stock of bioterrorism threats, solutions

Biosecurity 2002 ended with resounding praise from attendees and speakers; given the success of this year’s event, HMI and its collaborators have made plans to continue the program in 2003.

The four-day conference, held Nov. 18-21 in Las Vegas, Nevada, offered multiple perspectives to common challenges in the threat of bioterrorism, with presentations from scientists, public health officials, medical workers, and government representatives.

Conference participants gather at Biosecurity 2002

The conference, a collaboration between HMI, Harvard Medical School, the Harvard School of Public Health and Key3Media Events, Inc, drew over 1,100 attendees, including scientists, medical personnel, and first responders. A reception and floor show let these groups interact and exchange information—a first-time opportunity for many of them.

The challenges of bioterrorism
HMI President and CEO Dr. Robert Crone kicked off the conference with mixed emotions. Happy to be a part of the group assembled for the meeting, he expressed regret that the need for such a conference exists. "None of us—nor those who depend on us—are safe from any threat, anywhere in the world," said Crone.

Dr. Dennis Kasper of Harvard Medical School said he is optimistic about the country's ability to face the challenges presented by potential bioterrorist attacks, in part because of recent advancements in vaccine development. Kasper, who is William Ellery Channing professor of medicine, executive dean for academic programs, and professor of microbiology and molecular genetics, said that scientists now have the ability to "hone in on which proteins will make the most effective vaccines—without causing adverse reactions.”

In a keynote speech to a packed audience, Former Prime Minister of Israel Ehud Barak addressed the need for all nations to prepare for a biological attack. Bioterrorism "is not a regional threat in the Middle East—it is a worldwide threat," said Barak. "As we sit here, there are groups of terrorists working feverishly, trying to strategize the next attacks."

Ehud Barak, left, greets Dr. Robert Crone

Barak stressed the importance of a proactive response to the threats that exist today. Sitting idly makes nations powerless, which might result in a greater threat, he said. One key to winning the war will be the sharing of information between agencies and countries. Barak is in favor of using vaccinations to ensure first responders have the confidence to enter potentially contaminated scenes. Without this level of self-confidence, he said, an effective defense could be stopped because of individual panic.

Detection and surveillance
Tuesday’s session moved from Monday's analysis of the sciences involved in biosecurity to focus on the systems in place and still needed to increase the nation's surveillance, biodetection and early-warning capabilities.

First to address the topic was Colonel Patrick Kelly, MD, DrPh, of the Department of Defense Global Emerging Infections System at the Walter Reed Army Institute of Research (DoD-GEIS). The session covered the established to support global surveillance, training, research and response to emerging infectious disease threats. It works in concert with a network of medical units in cities around the world, including laboratories in Egypt, Indonesia, Kenya and Thailand.

The DoD also oversees the Early Warning Outbreak Recognition System (EWORS), a "hospital-based network of computerized linkages to detect emerging patterns" in patient symptoms, said Kelly. After successful implementation in Indonesia, EWORS is now being implemented in other parts of the world.

Lieutenant Colonel Julie Pavlin, MD, DoD-GEIS, talked about her work designing real-time, nontraditional surveillance methods. One such method is the Electronic Surveillance System for the Early Notification of Community-based Epidemics (ESSENCE), which monitors disease trends based on data from examinations of military personnel.

Dr. Miles Shore introduces Lt. Col. Julie Pavlin, MD, and Col. Patrick Kelly, MD, DrPh

Following the attacks on September 11, it was expanded to include every fixed military establishment in the world. Work is also being done to create a system to track the civilian population. The system is not perfect, Pavlin admits. "Nonspecific information cannot give you specific answers," she said. But her aspirations for ESSENCE are that "hopefully we would be able to know something is going on and help before (we) get to a crisis point."

Planning and preparedness
Wednesday’s session on planning and preparedness began with a look at the history of biowarfare from Dr. Matthew Meselson, Thomas Dudley Cabot professor of the natural sciences at Harvard University. "If we think about it—all the technology developed by our species that has been (used for) peaceful purposes has also been exploited for hostile purposes,” he said.

The session continued with Dr. Robert J. Blendon, professor of health policy and political analysis at the Harvard School of Public Health and JFK School of Government, who specializes in determining public opinion on health and medical issues.

"September 11 and the anthrax attacks have changed the United States," Blendon said. He said that there was no mention of terrorism in an August 2001 survey addressing top public concerns, but in October it topped the list, with 65% of respondents indicating it was a high priority. The level of concern remained high almost a year later.

Blendon noted that historically, people pay close attention to news coverage when they're very concerned, but as their level of anxiety drops, so does their level of knowledge on the topic. In the case of smallpox, despite extensive news coverage, most Americans are misinformed about the behavior of the disease and treatment options.

Blendon emphasized the importance of establishing a community spokespeople prior to any type of crisis, adding it's important to have the right person with the right credentials and education. "People trust individuals, not government. People don't trust elected officials telling them how a virus works, but they (will) trust a medical professional."

The consequences of bioterrorism
On the conference’s last day, Commander John Eldridge spoke about managing the consequences of a chemical attack or radioisotopes event. Eldridge covered methods for overseeing communications and initiating good epidemiology, and emphasized the need for increased education.

A panel discussion of first responders detailed some of the psychological impacts to people immediately affected by an event of terrorism. (See a Q&A with panelist Shauna Spencer of the Washington, DC Department of Mental Health, and with Sherry Adams, Director of the Department of Public Health.)

Based on the success of the conference and the positive response from attendees, Harvard Medical School, Harvard Medical International, the Harvard School of Public Health and Key3Media Events, Inc. will continue their partnership to offer BioSecurity 2003. Dr. Miles Shore, Bullard professor of psychiatry at Harvard Medical Schools and vice-chair for the BioSecurity Program Committee, said, “We received spontaneous enthusiastic comments regarding the program quality and the skill with which it was run.” Plenary sessions will explore common interests across disciplines and will expand on the content areas offered this year.

More information and complete coverage of Biosecurity 2002 is available at http://www.biosecuritysummit.com.