Incident Annexes - Biological - Draft - Copy

Owned by Wayne Martin
Apr 18, 2022
4 min read

Incident Annexes – Biological

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PURPOSE

 

The purpose of the Biological Incident Annex is to outline the actions, roles, and responsibilities associated with response to a disease outbreak of known or unknown origin.

 

A biological incident includes naturally occurring biological diseases (communicable and non-communicable) in humans and those biological agents diagnosed in animals having the potential for transmission to humans as well as terrorist events. This annex outlines biological incident response actions including threat assessment notification procedures, laboratory testing, joint investigative/response procedures, and activities related to recovery.

 

SCOPE

 

The objectives of a response to a biological terrorism event, an epidemic or pandemic, an emerging infectious disease, or a novel pathogen outbreak are to:

 

Detect the event through disease surveillance and environmental monitoring.

 

Identify population(s) at risk and determine protective measures.

 

Coordinate with public health to determine the source of the outbreak.

 

Quickly frame the public health, law enforcement, and international implications.

 

Control and contain any possible epidemic/pandemic (including providing guidance to State, tribal, and local public health authorities).

 

Augment and surge public health and medical services.

 

Identify the cause and work to prevent the recurrence of any potential resurgence or additional outbreaks.

 

Assess the extent of residual biological contamination and decontaminate as necessary.

 

The unique attributes of this response require separate planning considerations that are tailored to specific health concerns and effects of any disease (e. g. terrorism versus natural outbreaks, communicable versus non-communicable, etc.).

 

Specific operational guidelines, developed by respective organizations to address the unique aspects of a particular biological agent or planning consideration, will supplement this annex, and are intended as guidance to local public health and medical planners and the community.

 

CONCEPT OF OPERATIONS

 

Biological Agent Response

 

The key elements of an effective biological response include (in non-sequential order):

 

  • Rapid detection of an outbreak.

  • Rapid dissemination of key safety information and necessary medical precautions.

 

  • Swift agent identification and confirmation.

  • Identification of the population(s) at risk (to include animals and marine life).

  • Determination of how the agent is transmitted, including an assessment of the efficiency of transmission.

 

  • Determination of susceptibility to prophylaxis and treatment.

  • Definition of the public health and medical services, human services, and mental health implications.

 

  • Control and containment of the epidemic/pandemic.

  • Decontamination of items and individuals, if necessary.

 

Identification of the law enforcement implications/assessment of the threat.

 

Augmentation and surging of local health and medical resources.

 

Protection of the population through appropriate public health and medical actions.

 

Dissemination of information to enlist public support.

 

Response options may include assessment of environmental contamination and cleanup/decontamination of bioagents that persist in the environment; and providing consultation on the safety of food products that may be derived from directly or environmentally exposed animals or marine life.

 

Tracking and preventing secondary or additional disease outbreak.

 

Determination of a Disease Outbreak

 

The initial indication of a major disease outbreak, intentional or naturally occurring, may be the recognition by public health and medical authorities that a significantly increased number of people are becoming ill and presenting to local healthcare providers.

 

One tool to support this process is the Bio-surveillance Common Operating Network (BCON). BCON leverages the individual capabilities of multiple surveillance systems by integrating and analyzing domestic and international surveillance and monitoring data collected from human health, animal health, plant health, and food and water monitoring systems. This integrated cross-domain analysis allows for enhanced situational awareness and potentially reduced detection time, thus enabling more rapid and effective biological incident response decision-making.

 

As a result of the nature in which disease outbreaks may be recognized, critical decision-making support requires integrated surveillance information, identification of the causative biological agent, a determination of whether the observations are related to a naturally occurring outbreak, and identification of the population(s) at risk.

 

The immediate task following any notification is to identify the population affected, vulnerabilities, and the geographic scope of the incident. The initial public health and medical response includes some or all of the following actions:

 

Targeted epidemiological investigation (e.g., contact tracing).

 

Dissemination of key safety information and necessary medical precautions.

 

Intensified surveillance within healthcare settings for patients with certain clinical signs and symptoms.

 

Intensified collection and review of potentially related information (e.g., contacts with nurse call lines, laboratory test orders, school absences, over-the-counter pharmacy sales, unusual increase in sick animals, wildlife deaths, decreased commercial fish yields).

 

Organization of Federal public health and medical response assets (in conjunction with State, tribal, and local officials) to include personnel, medical and veterinary supplies, and material (e.g., the Strategic National Stockpile and Veterinary Stockpiles).

 

If there is suspicion that the outbreak may be deliberate, the Department of Justice/Federal Bureau of Investigation may establish a Joint Operations Center which may be integrated into the Joint Field Office structure, if established, to coordinate investigative and intelligence activities among Federal, State, tribal and local authorities. Within the Joint Operations Center structure locally and Department of Justice/Federal Bureau of Investigation’s Strategic Information and Operations Center in Washington, D. C. responsible public health officials would be integrated into the command structure to coordinate the interaction between law enforcement and public health investigations.

 

 

Actions

 

  • Review data indicating increased potential for a major disease outbreak

  • Coordinate with public health on tracking trends/progression of any outbreak.

 

  • Collect information on mitigation, prophylaxis, and/or treatment.

  • Identify any implications for law enforcement.

  • Take stock of type and quantity of personal protective equipment on hand.

  • Assure adequate inventory of PPE.

  • Determine any additional medical personnel or resources needed.

  • Coordinate with City/County/Institution officials on implementing prevention/mitigation strategies.

 

Disseminate information to enlist public support and participation on best practices for prevention/mitigation.

 

Track and attempt to prevent secondary or additional disease outbreaks.

 

 

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