February 2002 • Volume 8 • Number 2 |
 Family physicians are answering patients' questions about anthrax and smallpox, AAFP President Warren Jones, M.D., tells a reporter with Conus Communications, a satellite news service. |
The National Press Club in Washington, D.C., came to the Academy with a request: Headline the club's "NewsMaker" press conference on bioterrorism Dec. 14. The Academy sent two FP experts -- AAFP President Warren Jones, M.D., of Ridgeland, Miss., and Jonathan Temte, M.D., Ph.D., associate professor in the family medicine department at the University of Wisconsin, Madison, an infectious disease researcher and clinician.
"We are educating ourselves and other health care professionals to calm our patients' fears and serve on the front lines of the war on bioterrorism," Jones told reporters at the event.
"As family physicians, we would be the first to have contact with patients who may be suffering from a nuclear, biological or chemical attack," he said. "We must be prepared to recognize, treat and report such attacks."
Referring to maps indicating how widespread family physicians are across the nation -- in rural and urban areas -- Jones explained, "We are where patients are. We need to be a one-stop shop for answers to questions our patients have about bioterrorism."
ANTHRAX
"What's the most likely tool for bioterrorists?" asked one reporter. "Anthrax is the largest concern out there," said Temte. "It can be delivered in such a way that it doesn't have the potential to spread back to whoever's starting the outbreak. And as we've seen, it's highly deadly."
The envelope delivered to the office of Senate Majority Leader Thomas Daschle, D-S.D., contained about 20 billion spores of anthrax -- 10 billion per gram, said Temte. "That was enough to kill 2 million people."
Noting that five out of 11 people contaminated with anthrax at various locations had died, he said, "That we have such a low level of disease and mortality is a testament to how well I think the public health containment and education system did progress, even though there were a lot of problems up front."
Temte stressed the difficulty of identifying anthrax contamination: "Inhalation anthrax includes symptoms of fever, cough and malaise. This looks like an awful lot of common disorders, including meningitis, congestive heart failure, pneumonia and gastroenteritis."
SMALLPOX
 "The real force multiplier in biological terrorism is panic, misinformation and paranoia," Jonathan Temte, M.D., Ph.D., tells reporters at the National Press Club. |
"Unfortunately, we are all unvaccinated for smallpox," said Temte. "Even for those of us with doughnuts on our arms from 30 years ago, immunity no longer really exists."
So why aren't Americans being immunized against smallpox? "The vaccine available here is from the 1970s and early 1980s," Temte explained. "It was made in a way that would be totally unacceptable today. We'd consider it a dirty vaccine."
A safer vaccine is being made, he said, but there is no indication now for mass immunization.
The day before the NewsMaker press conference, Jones had attended a Partnership Awareness meeting at the CDC in Atlanta to discuss preparing for a smallpox bioterrorism attack. He described the ring vaccination concept recommended in CDC's draft response plan: Identify those who have come in contact with each smallpox victim and vaccinate them to limit the spread of the disease.
Replying to a reporter, Jones said, "If you're asking, 'Should people have prescriptions for smallpox immunization in their pockets and go and activate them?' -- that would not necessarily be wise. There are risks, even death, associated with smallpox immunization."
USING TRUST TO COUNTER TERROR
"The real force multiplier in biological terrorism is panic, misinformation and paranoia," said Temte. "Misinformation can enhance the terror within bioterrorism."
The reduction of public panic will require relationships built on trust, he said.
Jones showed survey results indicating Americans trust doctors to tell the truth more than they trust the president, police officers or business leaders. "If we don't know the answers to our patients' questions, we need to find the answers and get back with the patients to maintain the high levels of trust they have in us," he said.
Jones noted AAFP's bioterrorism information Web site -- http://www.aafp.org/btresponse/ -- a resource base to help family physicians recognize terrorist threats and events, treat patients appropriately and help patients recognize such threats without overreacting.
For faxed copies of two patient handouts on the Web site, see "Quick Fax" .
FP Report is published by the
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Copyright © 2002 by
American Academy of Family Physicians.