March 18, 2003 Preparedness Tips from the School of Public Health
On March 17, the federal government raised the homeland security threat level to “orange" (White House statement). Public
concern regarding potential terrorist attacks has become elevated, and
many people are looking for bioterrorism-related information.
The Johns Hopkins Center for Civilian Biodefense Strategies has prepared answers to the following frequently asked questions about bioterrorism.
Does it make sense for me to put together an emergency family plan and supply kit? Yes. There
are some helpful checklists of actions to take during normal times that
will allow you to act more effectively during a crisis. Some
simple steps, such as devising a plan for getting in touch with family
members after a disaster, are useful whether the event is a terrorist
attack or something more common such as a hurricane, tornado, flood, or
You should recognize, however, that some preparedness
items or actions that could prove valuable in some emergency situations
might not be useful in the special case of bioterrorism. Bioterrorism
is different from terrorist attacks that involve explosives or
chemicals. How will I know when a terrorist attack has occurred and what I should do to protect my family and myself?
bioterrorist attack is likely to be covert – we will know we have been
attacked only when people begin to get sick and seek medical attention.
Although some cities have begun to deploy sensors designed to detect
bioweapons in the air, these systems are few in number and are unproven
technologies in urban settings. In our judgment, it is far more likely
that we will realize a bioterrorist attack has occurred when doctors and
nurses diagnose the first victims of such an attack.
bioweapon is released, some time passes before people infected the
bioweapon agent become ill. This “incubation period” differs from one
bioweapon agent to another. For example, exposure to the anthrax
bacteria may cause symptoms as soon as 24 hours later; smallpox symptoms
typically don’t begin until 9-14 days after infection.
yourself and your family in the context of bioterrorism will require
that you listen for information and advice from medical and public
health authorities. These are experts who deal with infectious diseases
An explosion of any kind is immediately obvious, of
course. Similarly, a chemical attack is also immediately apparent. Most
chemical weapons act within seconds or minutes – people in the vicinity
of the attack become obviously ill very quickly. If you find yourself in
the vicinity of such an attack, you should quickly leave the area,
moving upwind if possible. Will sealing windows with duct tape and plastic sheeting help protect me during a bioterrorist attack? No. A
release of a biological agent is most likely to be “covert” - that is,
terrorists will not announce the attack before it happens or afterwards.
This means you would not know ahead of time to seal your windows and
prevent contaminated air from reaching you. Duct tape and plastic sheeting can slow down the movement air from outside to inside, but does not stop such movement. BE
AWARE that using some non-electric space heaters inside such sealed off
areas can lead to dangerous build up of carbon monoxide!! Should I buy a gas mask? No. A
gas mask would only protect you if you were wearing it at the exact
moment a bioterrorist attack occurred. A biological or chemical
terrorist attack is likely to occur without notice. To wear a mask
continuously or “just in case” a terrorist attack occurs, is
impractical, if not impossible.
To work effectively, masks must
be specially fitted to the wearer, and wearers must be trained in their
use. This is usually done for the military and for workers in
industries and laboratories who face routine exposure to chemicals and
germs on the job. Gas masks purchased at an Army surplus store or off
the Internet carry no guarantees that they will work. Should I purchase disposable masks as part of a home emergency disaster kit? Again,
a bioterrorist attack will likely be covert, so you will not know when
to put on the mask. By the time the attack is recognized – days or even
weeks after the release of the bioweapons agent – it is too late to don a
Paper masks offer little, if any, protection against chemical weapons.
generally, there may be disaster situations in which it will be
important to avoid breathing in dangerous substances. For example, an
explosion may produce fine debris or toxic gases that can hurt your
lungs. Wearing a simple mask in such situations may be helpful. Be
prepared to improvise – use what you have on hand to create a barrier
between the air and your mouth and nose.
There are different
opinions as to what sorts of barriers work best and there are few solid
facts. Anything that fits snugly over your nose and mouth, including any
dense-weave cotton material, can help filter contaminants in an
emergency. There are also a variety of face masks readily available in
hardware stores that are rated based on how small a particle they can
filter in an industrial setting. For the moment, you have to decide what
is best for you and your family.
It is very important that the
mask or other material fit your face snugly so that most of the air you
breathe comes through the mask, not around it. Do whatever you can to
make the best fit possible for children. Simple cloth facemasks can
filter some of the airborne particles or germs you might breathe into
your body, but will probably not protect you from chemical gases.
Still, something over your nose and mouth in an emergency is better than
nothing. If I decide to buy disposable masks, what type should I buy? There
are many kinds of disposable masks. About N95 masks: these are a type
of simple, inexpensive paper mask often mentioned in emergency
preparedness literature. The filtering ability of the N95 mask – a
measure of how much material can pass through the paper in laboratory
tests – is quite high. N95 masks effectively protect against infection
in hospital settings in which health care professionals have time to
make sure the masks fit properly.
In the setting of civilian
response to a bioterrorist attack, it is not clear than an N95 mask
would be any more effective than other paper masks or provide more
protection than a cotton undershirt wrapped around the nose and
mouth. (Manufactured masks may, however be more comfortable and more
The reason for this is that paper masks often fail
to fit the face snugly, and a lot of air leaks in around the edges of
any paper mask instead of getting filtered through the paper. This is
why it is important to make sure that any mask you use or create fits
tightly around your face. Should I have my own supply of antibiotics in case there is a bioterrorist attack? There
are a number of different germs a bioterrorist might use to carry out
an attack. Many antibiotics are effective for a variety of diseases,
but there is no antibiotic that is effective against all diseases.
Further, no antibiotics are effective against virus germs. Thus, no
single pill can protect against all types of biological weapon attacks.
Keeping a supply of antibiotics on hand poses other problems because the
antibiotics have a limited "shelf life" before they lose their
strength. Antibiotics can also cause serious side effects. They should
only be taken with medical guidance. What can I do to protect my family and myself during a bioterrorist attack? Unfortunately,
there is little that individuals can do in advance to protect
themselves from a bioterrorist attack. However, there is much that
government agencies, health care institutions, and public health
departments can and should be doing to improve the capacity to protect
the public following a bioterrorist attack. Medical institutions and
public health agencies, in particular, have not received adequate
attention and resources to cope with disasters like bioterrorism. You
can express your concern regarding adequate protections against the
potential threat of bioterrorism to your elected officials and local
leaders. Local health departments have an important responsibility for
helping protect your community against outbreaks of infectious disease,
whether they occur in nature or because of a malicious terrorist
act. They can assist you with additional bioterrorism-related concerns
that are pertinent to your own community. In addition, you can contact
your congressional representatives to discuss what measures the federal
government is taking to provide local authorities with adequate
resources to deal with national security threats. JHU Preparedness Website Public Affairs Media Contacts for the Johns Hopkins Bloomberg School of Public Health: Tim Parsons or Kenna Brigham @ 410-955-6878 or firstname.lastname@example.org.