Survey on Eve of Anthrax Attacks Showed Need for Bioterrorism Training

HHS Agencies Working With Partners on Broad Training Initiative

Press Release Date: September 5, 2002

A survey taken shortly after September 11, 2001, showed that on the eve of last year's anthrax attacks, primary care doctors felt unprepared for bioterror incidents that could expose their patients to the unusual diseases that might be spread by terrorists. The survey was sponsored by the Agency for Healthcare Research and Quality (AHRQ), which is an agency of the Department of Health and Human Services (HHS), and the American Academy of Family Physicians (AAFP).

Researchers led by the AAFP's John Hickner, M.D., and Frederick M. Chen, M.D., of AHRQ, found that three-quarters of doctors said at that time they felt unprepared to recognize bioterrorism-related illnesses in their own patients. The national survey of family physicians, conducted in October 2001, also found that 38 percent rated their knowledge of the diagnosis and management of bioterrorism-related illnesses as poor.

"Physicians today need to be ready to recognize and respond to unusual symptoms that might signal a bioterror attack," said HHS Secretary Tommy G. Thompson. "In the event of a surreptitious release, primary care doctors might be the first to spot the danger signs, and their knowledge and rapid action could be crucial for the nation."

Thompson said HHS is supporting wide new training, information and communication resources throughout the nation's public health and health care systems. Earlier this year, HHS provided more than $1 billion in new grants to states and major metropolitan areas to support training, communications, disease surveillance and epidemiology networks as well as hospital improvements.

In the survey, roughly 18 percent of the 614 family physicians said that they had previous bioterrorism training, and these doctors were much more likely than the others to report having the skills and knowledge necessary for responding to a bioterrorist attack. Nearly all the family physicians agreed that it was important to be trained to identify a bioterrorist attack, and 93 percent said they would like to have such training.

Family physicians felt more comfortable responding to natural disasters and public health emergencies such as natural infectious disease outbreaks involving well-known pathogens. But being familiar with the public health system for such events did not prepare them for knowing what to do in case of a bioterrorist attack. While 93 percent of the doctors said that they report notifiable infectious disease cases to their health department, only 57 percent reported knowing at the time of the survey whom to call to report a suspected bioterrorism case.

The findings underscore the importance of preparedness for primary care physicians. Because the symptoms caused by many bioterrorism agents mimic those of common illnesses, patients may seek care first from their primary care physicians. The AAFP, which represents more than 93,500 physicians and medical students, promotes Web-based training resources for physicians through its Web site (http://www.aafp.org/btresponse). AHRQ is expanding the medical providers' bioterrorism training Web site that it sponsors at the University of Alabama at Birmingham (http://www.bioterrorism.uab.edu) to include courses for the nation's 265,000 primary care physicians.

The AHRQ effort is part of a broad initiative by several HHS agencies to provide training and information for health care providers:

• The Centers for Disease Control and Prevention (CDC) supports the Centers for Public Health Preparedness program. It funds centers, based at universities and elsewhere, to train state and local health care providers and public health officials. More than 200,000 have received training so far. In addition, CDC is collaborating with the Association of American Medical Colleges to launch a new program called "First Contact, First Response" that will provide curricula through medical schools for medical students and physicians. CDC is also working with the Association of Public Health Laboratories to provide more training and information to public health lab workers in dealing with biothreat agents.
• The National Institutes of Health (NIH) has been working to educate physicians about biodefense through a variety of efforts, including educational conferences in the Washington, D.C. area, providing monthly biodefense lectures to internal medicine residents who rotate through the NIH inpatient ward and providing technical assistance to physicians on an ad hoc basis.
• HHS has also provided training in emergency care for first-responders through its National Disaster Medical System.
• The Health Resources and Services Administration plans to launch a $60 million training program aimed at hospital workers next year.
• CDC's Health Alert Network also links over 1 million medical, public health and emergency workers with up-to-date information on any disease outbreaks. The network reaches all 50 states and is being further expanded to reach every county health department in the nation.

For further information, see "On the Front Lines: Family Physicians' Preparedness for Bioterrorism," in the September 2002 issue of the Journal of Family Practice.

For more information, please contact AHRQ Public Affairs, (301) 427-1364: Bob Isquith (301) 427-1539 (RIsquith@ahrq.gov); Farah Englert (301) 427-1865 (FEnglert@ahrq.gov).

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Internet Citation:

Survey on Eve of Anthrax Attacks Showed Need for Bioterrorism Training. Press Release, September 5, 2002. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/news/press/pr2002/anthraxpr.htm

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