Public Health Preparedness

National advisory committee on children and terrorism makes first recommendations for preparedness

Integrating the special needs of children into Federal, State, regional, and local disaster planning for terrorist events is critical. The National Advisory Committee on Children and Terrorism, created by the 2002 Public Health Security and Bioterrorism Preparedness and Response Act, issued its first report in June 2003. The committee's recommendations, based on those developed at a consensus conference of a multidisciplinary group of experts, were outlined in a recent article by David Markenson, M.D., F.A.A.P, E.M.T.P., and Irwin Redlener, M.D., F.A.A.P., of the National Center for Disaster Preparedness.

The recommendations address the particular vulnerabilities of children to terrorist attacks and disasters and represent a first step in improving disaster and terrorism preparedness for children. The recommendations focus on eight major areas: emergency and prehospital care; hospital care; terrorism preparedness and response to biological, chemical, and radiological agents; physical protection; decontamination; and the Strategic National Stockpile (SNS).

For example, it is recommended that the SNS stock and deploy pediatric forms and dosing schedules for medications to counteract bioterrorism agents. The recommendations also define chemotherapy and chemoprophylaxis protocols for specific scenarios ranging from attacks with smallpox or hemorrhagic fever to nerve agents like sarin. They also call for the study of investigational vaccines in children (the current anthrax vaccine is approved only for people 18-65), development of a pediatric preparation of potassium iodide for exposure to radioactive iodine, and design of decontamination systems so that they can be used for children of all ages, including infants. This work was supported in part by the Agency for Healthcare Research and Quality (HS13855).

See "Pediatric terrorism preparedness national guidelines and recommendations: Findings of an evidence-based consensus process," by Drs. Markenson and Redlener, in Biosecurity and Bioterrorism: Biodefense Strategy, Practice, and Science 2(4), pp. 301-319, 2004.

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