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Webcast Transcript

Anthrax: What Every Clinician Should Know, Part 2

(November 1, 2001)

(View the webcast on the University of North Carolina School of Public Health site.)

Segment 3 of 10
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Dr. Lucille Norville Perez:
The nation’s Surgeon General is another teacher I have come to depend upon for his expertise, wisdom, and proven dedication to the American people. A longtime member of the National Medical Association, past president of Meharry Medical College, former director of the CDC and immediate past assistant secretary for the Department of Health and Human Services, he needs no introduction. Dr. David Satcher.

Dr. David Satcher:
Thank you very much, Dr. Perez, Dr. Caine, and all the distinguished panel members. First let me say I am very pleased to be here at Howard University, and I want to especially commend the National Medical Association, the Centers for Disease Control and Prevention, and the D.C. Department of Public Health for putting on this very important program for physicians throughout our country.

I want to just take a minute to say where we feel that we are in responding to this tremendous challenge, this bioterrorist attack that is ongoing. As you know, this all started in early October with the first patient in Florida who unfortunately died from inhalation anthrax. We have now had 16 confirmed anthrax cases in the country, 10 inhalation and 6 cutaneous. CDC, as you will hear later, is continuing to look at 5 other cases as suspected cases. Two of these cases have been in Florida, 4 in New York, 5 in New Jersey and 5 here in Washington, D.C. What I want to say is that I think we have already saved a lot of lives by responding appropriately, but we have lost 4 lives too many. We are here today because we really want to minimize the number of lives that are lost in this bioterrorist attack. In order to do that, we need a very strong and dynamic public health infrastructure. The public health infrastructure, from my perspective, is made up of 3 layers. One is the layer we talk a lot about: it’s the Centers for Disease Control and Prevention, and state and local health departments. We depend upon them for early detection, for investigation, for response. We have our best laboratories, perhaps the best laboratories in the world, concentrated in our public health infrastructure. The CDC also has a stockpile that includes antibiotics, vaccines, and other things that we anticipate might be needed in a bioterrorist attack. But more important perhaps, the CDC has very well-trained epidemiologists who have been sent all over the country to respond to this challenge.

The second level of the public health infrastructure, of course, and perhaps most important—the front line, in my opinion—are practicing physicians and other healthcare providers. Without your alertness, without your high level of suspicion (index of suspicion), the CDC would never be called to investigate a case that might be anthrax. So we are dependent upon the physicians on the front line and their interaction with their patients, who are also on that front line with them, in order to identify early cases of anthrax. And then to do what we have done so well to date, move in or determine how many people have been exposed, get them started on a course of antibiotics that can luckily prevent the development of this very serious disease. And that’s why we say that we have already saved a lot of lives, but we have lost 4 lives too many.

Today’s program is very important because it recognizes that this is an ongoing challenge, and unlike most of our infectious disease outbreaks, this is an outbreak that is being targeted by a terrorist who is thinking all the time and strategizing for the next move, and we have to try to respond. We have to try to be ready to respond and that means that we must evolve in our knowledge, continue to learn together, but also to become a better team, and I think that’s what’s so great about this program. It really is a program that can help to strengthen a team of people that should be working together all the time. A very strong public health infrastructure is the best defense against bioterrorism. So I am very pleased to be here today with this distinguished panel of presenters and responders in the audience. We believe that we can get on top of this very dangerous threat. As a nation we believe that we can get through this and move forward together. We will be stronger. We now know that none of us were really bioterrorist experts before. We may have thought we were, but we’ve learned since this attack that we are all learning together. So I am delighted to be with you and to share in this program. Back to Dr. Caine, our moderator.

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