How is the Health Department working to become prepared to respond, if needed, to a terrorist attack?

In the last year, the Cape May County Health Department has made major inroads in preparing its response in the event of a public health threat stemming from a terrorist act. The Health Department conducts a daily review of symptoms reported by people who seek help at emergency rooms at all Cape May County hospitals. The hospitals report this information daily, enabling the department to more readily detect emerging patterns of infectious disease, including foodborne illness or any unusual patterns of respiratory distress. With this surveillance system in place, county public health officials can better respond in real time to a health crisis in progress.

The Health Department’ Public Health Preparedness Committee is conducting emergency management exercises attended by personnel from all sectors of emergency response. These exercises are helping to clarify the roles and responsibilities of hospitals, emergency service workers, law enforcement and agencies such as the CDC, so they may better work together in the event of an emergency.

In the near future, the New Jersey Department of Health and Senior Services is expected to finalize its award of a $500,000 grant to the Health Department. This new funding will enhance existing systems to build a highly competent public health infrastructure offering Cape May County residents the highest degree of readiness and public health protection. This funding will be used to hire specialized personnel to focus on emergency preparedness for bioterrorist events, emerging infectious diseases and other public health threats. Work accomplished in the next year by specially trained personnel will exponentially expand department efforts to fight man made and naturally occurring public health threats.

Terrorism is the illegal use of force or violence to create fear, panic or cooperation, or to collect ransom.

There have been many reports and much speculation on the potential tactics a terrorist may employ on the United States. The following outline some of the potential methods and consequences should such an attack occur. Monitor local media outlets for official threat assessment information. The following page contains links to pages with information about specific types of terrorist attacks: Terrorist Attack FAQs

The following information and links to general emergency preparedness information can help prepare you and your family for a potential terrorist attack. If you believe that you have been exposed to a nuclear, biological or chemical agent, or if you believe an intentional biological threat will occur or is occurring, please contact your local police and/or your local health department.

Preparing for a terrorist event is similar to preparing for any other type of emergency. It begins with making sure that you have the supplies and plans in place to take care of yourself and your family. It is also good to plan to help your neighbors and your community, particularly those with special needs who may have trouble or are unable to prepare for themselves. The following links take you to other pages on our site where we discuss how to best prepare. These techniques help during terrorist events, hurricanes, blizzards as well as any type of emergency or disaster you may face. For more information on how you should prepare, visit the following page: Preparedness Steps

One of the many unsettling characteristics of chemical agents is that some of them cannot be seen or smelled. Citizens can protect themselves by observing the following rule of thumb: If a single person is on the ground, choking or seizing, it is likely this individual is having a heart attack or some sort of seizure. However, if several people are down, coughing, vomiting, or seizing, they could be reacting to the presence of a toxic substance. Evacuate the area immediately and dial 911, making sure to tell the dispatcher that a hazardous gas may be present. View a guide for what signs to look for depending on where you are on the following page: Signs of Poison Gas Attack Page

By now, the media has repeatedly broadcast that biological agents can be dispersed from commercial sprayers, such as crop dusters. Often omitted from these reports is the fact that, among other complications, commercial equipment would have to be modified for such an attack strategy to have a chance of success.

Still, crop dusters are out of place over cities, and the FBI has already placed restrictions about where they can fly. Were I to see one over a metropolitan area, I would immediately go indoors, shut all windows and doors, turn off the air conditioner, and notify authorities. The same would hold true for any other unusual spraying activities. For instance, a person tending a rooftop garden would not raise my suspicions, but an individual deliberately spraying a substance from a rooftop, or a truck dispersing a misty substance through side vents, would.

Keep in mind that occasionally local authorities employ helicopters and other means to spray approved pesticides to control mosquitoes and other pests. Officially sanctioned spraying activities are announced well in advance, repeatedly. A call to local authorities can confirm whether any spraying that you might observe would fall into that category.

By now, the media has repeatedly broadcast that biological agents can be dispersed from commercial sprayers, such as crop dusters. Often omitted from these reports is the fact that, among other complications, commercial equipment would have to be modified for such an attack strategy to have a chance of success.

Still, crop dusters are out of place over cities, and the FBI has already placed restrictions about where they can fly. Were I to see one over a metropolitan area, I would immediately go indoors, shut all windows and doors, turn off the air conditioner, and notify authorities. The same would hold true for any other unusual spraying activities. For instance, a person tending a rooftop garden would not raise my suspicions, but an individual deliberately spraying a substance from a rooftop, or a truck dispersing a misty substance through side vents, would.

Keep in mind that occasionally local authorities employ helicopters and other means to spray approved pesticides to control mosquitoes and other pests. Officially sanctioned spraying activities are announced well in advance, repeatedly. A call to local authorities can confirm whether any spraying that you might observe would fall into that category.

Frankly, it may not be apparent that a biological agent has been dispersed until people begin falling ill several days later. For most biological agents, the initial symptoms would resemble a flu-like malaise. Across the nation, local, state, and federal authorities are putting capabilities in place to improve the ability to detect abnormal public health problems rapidly -- to distinguish between multiple cases of the flu or a possible biological agent attack.

As the normal cold and flu season rolls around in the next few months, please do not jump to the conclusion that you have been infected with a biowarfare agent if you begin to feel achy or have the sniffles. In fact, people catch colds throughout the year. You are more likely to get hit by lightning than to be the victim of a bioterrorist attack.

For more information, please visit this page: Biological Disaster Preparation

No. Keeping a stockpile of antibiotics is, in short, a bad idea. While antibiotics would be used to treat individuals who might fall ill during a disease outbreak, the use of these medications should always be done at the direction of a physician. People who self-medicate themselves or their children could very well do more harm than good because adverse side effects may occur. Moreover, overuse of antibiotics, as well as their misuse (to treat illnesses such as colds), is harmful as it reduces the ability of these drugs to work in serious health emergencies.

The US government keeps a cache of antibiotics and other medical supplies that can arrive in an area in which an outbreak has occurred within 12 hours.

Poisoning of a city's water supply is much more easily said than done. However, citizens can protect themselves by boiling their drinking water, which will kill any microorganisms that may have survived the municipal filtration systems. Another option is to use a personal water filtration system.

The electronic and print media can be very useful sources of information, especially when events are developing at a rapid pace. However, reporters can occasionally pass along faulty or inaccurate information. Local, state, and national public health, public safety, and emergency management officials would be the most reliable sources of information. As soon as the circumstances are understood, these officials will call press conferences to convey accurate information and instructions to the public. Subsequent press conferences will be called as frequently as possible to update the public about the steps that local, state, and federal government organizations are taking to address the situation and what individuals can do to help themselves and their fellow citizens. In a genuine disaster, the Emergency Broadcast System would also probably be employed to give instructions to citizens.

The chances that terrorists will turn to poisonous substances instead of conventional bombs are very, very remote. Various news reports have noted that citizens are opting to purchase protective masks as a way to defend against chemical or biological terrorism. There are several important factors to bear in mind when considering this option.

In order for a mask to protect you against a chemical weapons attack, you would need to carry the mask with you at all times -- 24 hours a day, 7 days a week -- and be prepared to put it on immediately if chemical emergency was suspected. To guard against a biological attack, you would need not only to carry the mask but also wear it at all times, since the presence of biological agents is not obvious without advanced sensors. Gas masks capable of effectively protecting people from either chemical or biological agents are not a "one size fits all" purchase. At this point, there are many different sizes and brands of masks available on the open market. It is critically important to make sure that the mask fits you properly -- a loose gas mask defeats the purpose. Reputable dealers would be able to provide instructions not only on finding the right mask fit, but also on how to put it on, how to maintain it, and how to take care of the filters the mask uses as a barrier against microscopic particles.

All that being said, if you would feel more comfortable purchasing a gas mask, by all means, go ahead. Steer clear of Internet auctions and classifieds. Make sure that the seller can answer your questions about fit and upkeep. For the record, I personally do not carry a gas mask with me. I take the subway to and from work daily, and I continue to go to meetings and other events in large buildings. Note also that the only nation that has issued gas masks to all of its citizens in recent history is the state of Israel during the Gulf War. During the Gulf War, more Israelis died attempting to put on their gas masks than from Scud missile attacks.

Media reports that a handful of terrorist organizations have been exploring chemical and biological weapons are accurate, including the terrorist organization Al Qaeda. The terrorist group headed by Usama bin Laden may well have acquired a rudimentary chemical weapons capability, but that does not automatically translate into an ability to conduct a mass casualty attack with a chemical warfare agent. When all is said and done, there are no guarantees that terrorists groups may not overcome the technical hurdles involved. However, for the reasons discussed below, the technical hurdles to actually developing an effective large-scale chemical or biological weapons program -- as opposed to investigating or experimenting with them -- may well turn out to be so sizeable that terrorists would choose to remain reliant on more conventional means of attack.

Chemical weapons formulas have been published and publicly available for decades. Mustard agents came of age during World War I, and nerve agents were discovered in the mid-1930s. The production processes used over seventy years ago are still viable. The ingredients and equipment a group would need to produce these agents are readily available because they are also the same items that are used to make various commercial items that we use everyday -- from ballpoint pens, to plastics, to ceramics, to fireworks. Scientists with a solid chemical background could likely make certain agents in small quantities.

However, 2 factors stand in the way of manufacturing chemical agents for the purpose of mass casualty. First, the chemical reactions involved with the production of agents are dangerous: precursor chemicals can be volatile and corrosive, and minor misjudgments or mistakes in processing could easily result in the deaths of would-be weaponeers. Second, this danger grows when the amount of agent that would be needed to successfully mount a mass casualty attack is considered. Attempting to make sufficient quantities would require either a large, well-financed operation that would increase the likelihood of discovery or, alternatively, a long, drawn-out process of making small amounts incrementally. These small quantities would then need to be stored safely in a manner that would not weaken the agent's toxicity before being released. It would take 18 years for a basement-sized operation to produce the more than 2 tons of sarin gas that the Pentagon estimates would be necessary to kill 10,000 people, assuming the sarin was manufactured correctly at its top lethality.

The options for delivering poison gas range from high to low tech. Theoretically, super toxic chemicals could be employed to foul food or water supplies, put into munitions, or distributed by an aerosol or spray method. Because of safeguards on our food and water supplies as well as the difficulty of covertly disbursing sufficient quantities of agent, this method is unlikely to be an effective means to achieving terrorist aims. Chemical agents could also be the payload of any number of specially designed or modified conventional munitions, from bombs and grenades to artillery shells and mines. However designing munitions that reliably produce vapor and liquid droplets requires a certain amount of engineering skill. Finally, commercial sprayers could be mounted on planes or other vehicles. In an outdoor attack such as this, however, 90% of the agent is likely to dissipate before ever reaching its target. Effective delivery, which entails getting the right concentration of agent and maintaining it long enough for inhalation to occur, is quite difficult to achieve because chemical agents are highly susceptible to weather conditions.

Oftentimes, obtaining biological agents is portrayed as being as easy as taking a trip to the country. The experience of the Japanese cult Aum Shinrikyo proves that this is not the case. Isolating a particularly virulent strain in nature---out of, for example, the roughly 675 strains of botulinum toxin that have been identified---is no easy task. Despite having skilled scientists among its members, Aum was unable to do so. Terrorists could also approach one of the 500 culture collections worldwide, some of which carry lethal strains. Within the United States, however, much tighter controls have been placed on the shipment of dangerous pathogens from these collections in recent years.

Terrorists cannot count on just filling the delivery system with agent, pointing the device, and flipping the switch to activate it. Facets that must be deciphered include the concentration of agent in the delivery system, the ways in which the delivery system degrades the potency of the agent, and the right dosage to incapacitate or kill human or animal targets. For open-air delivery, the meteorological conditions must be taken into account. Biological agents have extreme sensitivity to sunlight, humidity, pollutants in the atmosphere, temperature, and even exposure to oxygen, all of which can kill the microbes.

Biological agents can be dispersed in either dry or wet forms. Using a dry agent can boost effectiveness because drying and milling the agent can make the particles very fine, a key factor since particles must range between 1 to 10 microns, ideally to 1 to 5, to be breathed into the lungs. Drying an agent, however, is done through a complex and challenging process that requires a sophistication of equipment and know-how that terrorist organizations are unlikely to possess. The alternative is to develop a wet slurry, which is much easier to produce but a great deal harder to disperse effectively. Wet slurries can clog sprayers and undergo mechanical stresses that can kill 95% or more of the microorganisms.

While it is impossible to know what is happening behind closed laboratory doors worldwide, anyone trying to genetically engineer a weapon to attack Americans would encounter an incredibly tall technical challenge. America, like many other nations, is populated by a wide range of ethnic groups and there is a long history of interracial marriages that makes it extremely difficult to target just one group, much less the entire country. While some governments may attempt genetic engineering of biowarfare agents, as the USSR did by hardening some agents against antibiotic treatment, terrorists just beginning to explore bioweapons would probably find this type of advanced work to be extremely difficult.

Part of what terrorists count on to "terrorize" is that it is never really possible to know where they will strike next. Conventional wisdom says that terrorists intent on causing mass casualties would target large buildings, sporting arenas, or transit systems. Given my knowledge of how difficult it would be for terrorists to successfully execute a poison gas or germ attack, I have no concern about frequenting such locations.

The "pill in the water supply" is a myth about chemical terrorism that is not true. All metropolitan water supplies have certain safeguards in place between their citizens and the reservoir. Everyday, water goes through various purification processes and is tested repeatedly. If terrorists were to attempt to poison a reservoir, they would need to disperse truly huge amounts of agent into the water -- smaller amounts would be diluted -- and the vessels required for such a feat would be difficult to miss. Many cities have implemented heightened security around their reservoirs in order to further monitor any questionable activities.

The "pill in the water supply" is a myth about chemical terrorism that is not true. All metropolitan water supplies have certain safeguards in place between their citizens and the reservoir. Everyday, water goes through various purification processes and is tested repeatedly. If terrorists were to attempt to poison a reservoir, they would need to disperse truly huge amounts of agent into the water -- smaller amounts would be diluted -- and the vessels required for such a feat would be difficult to miss. Many cities have implemented heightened security around their reservoirs in order to further monitor any questionable activities.

Crop dusters are routinely employed in the agricultural industry to spread fertilizers, pesticides, and seeds. Indeed, crop dusters could be employed to spread a chemical warfare agent. However, anyone trying to commandeer a crop duster for this purpose would have to understand a multitude of factors in order to execute a chemical weapons attack. First, they would have to know how to load the spreader. Second, they would have to be able to actually take-off in a loaded crop duster, a difficult task given that the heavy weight of the loaded spreading apparatus makes take-off in a crop duster quite challenging. To use a basic analogy, the difference between taking off in a regular small aircraft versus a crop duster is similar to the difference between handling a nimble sports car versus a fully loaded double-trailer truck. Pilots of crop dusters are required to have a 1-year apprenticeship to learn how to operate and fly the aircraft safely. Someone with limited piloting experience in light aircraft would be considerably challenged to translate those basic skills into an ability to get a loaded crop duster successfully off the ground.

On average, crop dusters carry between 300 to 600 gallons of material, although there are some that have an 800-gallon capacity. A 300-gallon tank could hold more than a ton of the nerve agent sarin. According to Pentagon calculations, a ton of sarin is enough to kill 10,000 people outdoors. Chemical agents, however, are very susceptible to the wind. Once in the air, the pilot would have to know how to operate the spreader and understand the meteorological patterns in the intended target area. The pilot would have to know the correct altitude over the target area to fly in order to disperse the agent effectively. In cities, where meteorological conditions can vary from block to block -- with the wind whipping in currents between and around tall buildings -- spreading the agent in a manner that would achieve a lethal dose would not be a simple task.

Among other individuals, I have spoken at length about the ability of crop dusters to disperse chemical or biological agents with an experienced pilot and spokesperson for an aerial application business.

The sprayers of crop dusters are geared to spread their materials over fields in an efficient manner, laying down fertilizer, for example, so that it settles on the crop. The key to effective biological weapons agent dispersal is exactly the opposite, to achieve a superfine aerosol spray that lingers in the air instead of settling on the ground. To infect the human lung, the required particle size of a biological warfare agent is 1 to 10 ten microns, ideally to 1 to 5. Yet, the sprayers on the average crop dusters aim to disperse in 100 micron particle sizes or greater, a heavier weight that improves the chances of the materials settling on the target area. These sprayers cannot be "dialed down," so to speak, to consistently disperse the payload in the necessary micron size.

For more information, visit this page: Crop Dusters