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  **BROOKHAVEN NATIONAL LABORATORY    GCRC POLICY-20.0         PAGE 1 OF 2
  GENERAL CLINICAL RESEARCH CENTER                             
  POLICY**                                                     
  ----------------------------------- ------------------------ -----------
                                      PREPARED BY: B. Pyatt    
                                      Infection Control        

  SUBJECT: Bioterrorism               REVIEWED BY: W. Gunther  
                                      GCRC Manager             

                                      APPROVED BY: G. J. Wang  
                                      Medical Dept. Chair      

                                      EFFECTIVE DATE: 1-15-08  

                                      REVISION HISTORY: 3      
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**PURPOSE**

This document defines general infection control policies and procedures
regarding bioterrorism for the Medical Department. Healthcare providers
should be alert to illness patterns and diagnostic clues that might
signal an act of bioterrorism (BT). The following clinical and
epidemiological clues are suggestive of a possible (BT) event:

1.  A rapidly increasing disease incidence

2.  An unusual increase in the number of people seeking care, especially
    with fever, respiratory, or gastrointestinal symptoms

3.  Any suspected or confirmed communicable disease that is not endemic
    in New York (e.g. plague, anthrax, smallpox or viral hemorrhagic
    fever).

4.  Any unusual age distributions or clustering of disease (e.g.
    chickenpox or measles in adults)

5.  Simultaneous outbreaks in human and animal populations

6.  Any unusual temporal and/or geographic clustering of illness9e.g.
    persons who attended the same public event)

A national lab may be the initial site of recognition and response to a
bioterrorism event. If a bioterrorism event is suspected, local
emergency response systems should be activated. Immediate notification
should be made to OMC, the Director, Security, local and state health
departments, local police, CDC, Emergency Response Services (EMS) and
the Infection Control Practitioner.

**INTERNAL CONTACTS:**

Director: Sam Aronson**, 2772**

Deputy Director for Operations Michael Bebon, **3434** or cell phone
**631-453-4507**

Occupational Medicine Clinic Joseph Falco **3666**

Environmental Safety & Health: Robert Colichio, **8440,** beeper
**6114** or cell phone **631-831-4647**

Safeguards & Security Manager: Len Butera **4691 EMERGENCY 2222**

Pharmacy: Michael Genua, **3589**

Plant Engineering Edward Murphy, **3466**

Infection Control: Beatrice Pyatt, **3642** or beeper **5216**

**EXTERNAL CONTACTS:**

Bioterrorism Emergency No. CDC Emergency Response Office:
**1-770-488-7100**

CDC Hospital Infections Program: **1-404-6396413**

CDC Foodborne and Diarrheal Diseases Branch: **1-404-639-2888**

Federal Emergency Medical Agency: U.S. Public Health Service:
**212-264-2802**

HAZMAT: **202- 366-8553**

Suffolk Country Department of Health: **631-853-3000**

New York State Department of Health: **518-474-2011**

USAMRIID(U. S. Army Medical Research Institute of Infectious Diseases)
Bio-Safety Level (BSL) 3 and 4 Labs with special surge capacity and
advanced molecular typing techniques. **1-301-619-2833.**

**INFECTION CONTROL PRECAUTIONS:**

1.  **Standard Precautions**: Standard precautions apply to blood, all
    body fluids, secretions, nonintact

skin mucous membranes and excretions, except sweat. Gloves and gowns
should be used to prevent

exposure to blood and other potentially infectious fluids. Mask and eye
protection or face shield

should be used during procedures or activities that are likely to
generate splashes or sprays of blood,

body fluids, secretions or excretions. Appropriate hand hygiene is
always necessary.

> 2\. **Droplet Precautions**: Private room or cohort patient with same
> infectious agent. Use a mask if

within 3 feet of a patient

> 3\. **Contact Precautions**: Private room or cohort patients with same
> infectious agent. Use gloves when

entering the room and a gown if clothing is likely to have contact with
patient, environmental

surfaces or patient care equipment

4\. **Airborne Precautions**: Requires a negative pressure isolation
room and appropriate respiratory

protection such as the N95 respirator which has been fit-tested

5\. **Decontamination Guidelines**: In general, persons exposed to a
biological agent need only to

remove clothing, if heavily contaminated, and use shampoo, soap, and
water on themselves (shower).

The clothing should be bagged and laundered normally in hot water. No
precautions for effluent

water are needed. Dilute bleach solutions should **NEVER** be used on
people, only environmental

surface.

**ATTACHMENTS:**

1.  Recognizing and Diagnosing Illnesses Possible due to Bioterrorism
    [Tables
    1-4](http://dev.bnl.gov/medical/CRCInfectionControlManual/IC20-Att1.doc)

2.  Treatment and Prophylaxis [Tables
    1-2](http://dev.bnl.gov/medical/CRCInfectionControlManual/IC20-Att2.doc)

3.  Infection Control Precautions for Biological Agents
    [Table](http://dev.bnl.gov/medical/CRCInfectionControlManual/IC20-Att3.doc)

**NOTE:** These are just a few of the many agents a bioterrorist is
capable of using. If any of the above or other diseases are suspected or
noted, the person/persons are immediately isolated and the above
internal and external contacts are employed. The person/persons will
then be immediately transported to the nearest hospital when feasible.

The only official copy of this file is the one online at the Medical
Department website under "Clinical Research Center Policy Manual."
Before using a printed copy, verify that it is the most current version
by checking the document effective date on the website.