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Index
A
Acceptable exposure limit, 37, 52, 56
Acetylcholinesterase (AChE), 60-61, 113, 115, 146, 148, 169
See also Cholinesterase
Acoustic detectors, 53, 55, 57, 58, 59, 84, 256-257
Acquired immune deficiency syndrome, see Human immunodeficiency virus
Adenosine 5'-triphosphate, 87
Advance Lightweight Chemical Protection program, 38
AEL, see Acceptable exposure limit
Aeromedical Isolation Team, 26
Aerosols and vapors, 2, 22, 162
atropine, 113
biologic agents, 137, 138, 140, 146, 152, 154
covert exposure, 41
decontamination, 106
detection and measurement, 44, 45, 47-51, 56, 86-87, 88-89, 226, 227
personal protective equipment, 35, 38
see also Respirators
Agency for Toxic Substances and Disease Registry, 75-76, 101
Agriculture
crop contamination, 22
AIDS, see Human immunodeficiency virus
Aircraft, see Unmanned aerial vehicles
American Psychiatric Association, 171, 250
American Psychological Association, 171, 250
American Red Cross, 167, 171, 250
American Society for Testing and Materials, 35
Aminophenones, 127
Analyte 2000, 93
ANL, see Argonne National Laboratory
Anthrax, 9, 10, 21, 69, 72, 79, 83, 89, 107, 131, 132, 133-136, 147, 162, 191, 192, 244
Antibiotics, see Drugs, antibiotics
monoclonal antibodies, 10, 61, 62, 81, 82, 119, 122, 144, 149, 152, 157, 158, 162, 192, 242
see also Immunoassays; Vaccines
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Anticonvulsants, see Seizures and anticonvulsants
Antidotes, see Drugs, antidotes/antitoxins
Antiinflammatory agents, 127
Anti-Terrorism and Effective Death Penalty Act of 1996, 17, 168
APA, see American Psychiatric Association; American Psychological Association
Argentine hemorrhagic fever, 146
Argonne National Laboratory, 81, 179
Assays, 5, 6, 44, 64, 72, 73, 79, 96, 145-146, 189
probe technologies, 80-83, 85-86
transducer technologies, 80, 83-86
see also Immunoassays
ASTM, see American Society for Testing and Materials
Atmospheric dispersion models, 179-182, 183, 193
ATP, see Adenosine 5'-triphosphate
Atropine methonitrate, 116, 121, 122
Atropine sulfate, 113, 114-115, 116, 121, 241
ATSDR, see Agency for Toxic Substances and Disease Registry
Automatic Chemical Agent Detection Alarm, 57
B
Battle Dress Overgarment (BDO), 38, 224
BChE, see Butyrylcholinesterase
ß-chlorovinyldichloroarsine, see Lewisite
Benzodiazepines, see Diazepam; Lorazepam; Midazolam
Biological agents and warfare, general
broad spectrum defenses, 158-161
chemical vs, 13-14
civilian response capabilities, current, 23-28
committee's approach, 2, 20-21
computer applications, 12
decontamination, 106-107
detection and measurement, 66-71, 78-96, 234-238, 255
list of, 263-264
nonspecific defenses, 10, 131, 158-161, 192
personal protective equipment, 41-42
surveillance and investigation, 66-74
terrorism scenarios considered, 21-22
see also Clinical diagnoses; Covert exposures of population; Drugs, antibiotics; Vaccines; specific agents
Biological Integrated Detection System (BIDS), 86-87
Biological Weapons Act of 1989, 16
Biological Weapons Convention, 16
Blister agents, 48, 52, 53, 54, 55, 58
see also Lewisite; Sulfur mustard
Blood agents and tests
chemical, 51, 52, 54, 60-64 (passim), 72, 76
see also Cyanide
Bolivian hemorrhagic fever, 146
Botulism, 9, 10, 21, 76, 83, 131, 148-152, 162, 163, 192, 245, 258
Breathing apparatus, see Masks, filtering; Respirators
Brucellosis, 11, 21, 72, 136-137, 163, 193, 245
Bubblers and impingers, 89-90
Butyrylcholinesterase, 118, 121, 122, 242
C
Calcium chelators, 124
Canadian Bacterial Disease Network, 69, 232
Capillary gas chromatography, 61
Carbamates, 115
Carboxyesterase, 122
CBDCOM, see Chemical Biological Defense Command
CBIRF, see Chemical Biological Incident Response Force
CBMS, see Chemical Biological Mass Spectrometer
CBNP, see Chemical and Biological Nonproliferation Program
C/B-RRT, see Chemical/Biological Rapid Response Team
CBWCA, see Chemical and Biological Weapons Control Act of 1991
CCHP, see Crimean Congo hemorrhagic fever
CCP, see Crisis Counseling Assistance and Training Program
Center for Mental Health Services, 167
Centers for Disease Control and Prevention (CDC), 26, 37, 190
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covert exposure surveillance, 7, 8, 41, 66-71, 73-74, 77
decontamination procedures, 101
inventory of resources, 232, 245, 257
legislation, 17
state-level cooperation, 7, 67-69, 73, 77
Central nervous system, 113, 114, 115, 117, 118, 121, 137, 169
ChE, see Cholinesterase
Chemical agents and warfare, general
biological vs, 13-14
civilian response capabilities, current, 23-28, 117-120, 124, 125-126, 128-130
committee's approach, 2, 20-21
computer applications, 12
detection and measurement, 5-6, 43-64, 226-231, 256-257
DoD hotline, 26-27
drug treatment, 112-130
list of, 261-262
probable actions, flow chart, 185
surveillance and investigation, 74-75
terrorism scenarios considered, 21-22
Tokyo subway incident, 30-31, 44, 75, 102, 166, 169
see also Drugs, antidotes/antitoxins; Personal protective equipment; specific agents
Chemical and Biological Nonproliferation Program, 19, 94
Chemical and Biological Weapons Control Act of 1991, 16-17
Chemical Biological Defense Command, 26
Chemical Biological Incident Response Force, 26, 86, 100
Chemical Biological Mass Spectrometer, 94
Chemical/Biological Rapid Response Team, 26
Chemical Stockpile Emergency Preparedness Program, 37, 103
Chemical Weapons Convention, 16
capillary gas chromatography, 61
gas chromatography, 54, 62-63, 86, 226, 227, 228
gas chromatography mass spectrometry, 6, 61, 86, 190
gas chromatography tandem mass spectrometry, 61, 62
high-performance liquid chromatography, 86
See also Spectroscopy
Cidofovir, 148
Cleaning agents, 98, 99-100, 103-104, 106, 122, 242-243
see also Showering
Clinical diagnoses, 3, 4, 5, 6, 41, 44, 59-64, 65, 71-77, 78, 96, 189, 190
biological agents, 133-134, 137-141 (passim), 144, 145, 146, 148-149, 152, 153, 156
communications requirements, 32, 33, 185, 189
computer tools, 175-176, 178, 191, 193, 194
cyanide, 125
inventory of resources, 233, 255, 257
nerve agents, specific, 114, 116
psychological impacts, 166, 169, 173
respiratory effects of agents, 40, 107, 113, 125, 134, 145, 152, 153
side effects, 115, 116, 121, 128, 131, 142, 150
triage and, 107
urinanalysis, 60, 61, 62, 72, 231
vomiting, 113, 138, 141, 152, 153, 156
see also Assays
Clothing
decontamination, 8, 98, 99, 109, 191
gloves, 4, 35, 36, 41, 98, 102, 106, 147
personal protective equipment, general, 4, 13, 34, 35, 38, 41, 223-225
phosgene, 123
CNS, see Central nervous system
Colorimetric sensors, 45, 54, 56, 60-61, 79, 83, 84, 226-231, 256
paper detectors, 45, 54, 55, 57, 226, 228
Combating Terrorism (PDD-62), 18
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Communications, 3-4, 29-33, 189, 190-191, 193, 232
computer applications, 12, 75-76, 174, 175-176, 183
covert exposure response, 68, 71, 75-76, 77
DoD hotline, 26-27
Emerging Infections Program (CDC), 68
infrastructure protection, 18
intelligence military, information, 3-4, 21, 24, 28, 29-33, 41, 121, 158, 174-175, 183, 187, 189
poison control centers, 74-75, 76
research recommendations, 4, 32, 34, 189, 190-191
triage and, 107
see also Epidemiological approaches
Computer applications, 3, 12, 174-183
atmospheric dispersion models, 179-182, 183, 193, 194
clinical diagnoses, 175-176, 178, 191, 193, 194
communications, 12, 75-76, 174, 175-176, 183
cost factors, 183
databases, 20, 30, 69, 73-74, 175-176, 194 inventory of resources, 221-259, 257, 259
detection and measurement, 8, 58, 73-74, 76-77, 175-176, 177-178
education and training, 3, 174-183, 191, 193, 194
emergency response personnel, 174-175, 176-177, 183
inventory of computer resources, 252-253
research recommendations, 12, 182-183, 193-194
Convulsions, see Seizures and anticonvulsants
Corticosteroids, 157
Cost factors, 2-3, 22, 28, 187
computer applications, 183
decontamination, 99, 103, 104, 105, 106
detection and measurement, 6, 46, 47-51, 57, 59, 63, 64, 87, 96, 183
drug treatments, 111, 116, 135
personal protective equipment, 39
Council of State and Territorial Epidemiologists, 71, 73
Covert exposures of population, 3, 22, 41, 44, 65-77, 175
CDC role, 7, 8, 41, 66-71, 73-74, 77
communications, 68, 71, 75-76, 77
computer tools, 8, 58, 73-74, 76-77, 175-176, 177-178
local preparedness, 65, 67-68, 70-71, 77
medical personnel, 6-7, 66, 67, 68
research recommendations, 7-8, 77
state-level preparedness, 7, 65, 67-68, 70-71, 77
see also Detection and measurement of agents
Crimean-Congo hemorrhagic fever, 147
Crisis Counseling Assistance and Training Program, 11, 167
Critical Incident Stress Debriefing, 11, 168, 170
Crop contamination, 22
CSEPP, see Chemical Stockpile Emergency Preparedness Program
CSTE, see Council of State and Territorial Epidemiologists
detection and measurement, 5, 44, 55, 60, 63-64, 128
drug treatment, 10, 125-127, 128-129, 163, 191, 192, 241, 259
Cyclone samplers, 89
Cyclosarin, 61
D
DARPA, see Defense Advanced Research Projects Agency
Databases, 20, 30, 69, 73-74, 175-176, 194 inventory of resources, 221-259, 257, 259
Data Elements for Emergency Department Systems, 69
Decontamination, 8-9, 19, 24, 91, 97-107, 108-109, 156, 185
cleaning agents, 98, 99-100, 103-104, 106, 122, 242-243; see also ''showering" infra
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computer applications for, 174, 178, 182, 183, 193, 194
cost factors, 99, 103, 104, 105, 106
defined, 97
drugs, antidote use and, 113, 114, 124
electronic technologies, 106-107
emergency response personnel, decontamination of, 99, 102
hospital facilities, 5, 6, 8, 100-106
inventory of products, 239-240, 258
mass, 104-106
medical personnel, 5, 6, 8, 100-103, 106
personal protective equipment, 36
psychological aspects of, 9, 102, 105, 107, 108, 109, 191
research recommendations, 8-9, 102-104, 105, 108-109, 191
showering, 8, 98, 99, 100, 104, 109, 122, 191
standard operating procedures, 8, 19, 24, 98-103, 105, 108-109, 191
Defense Advanced Research Projects Agency, 94, 133, 145, 148, 158, 160, 161, 234, 236-237, 244, 248, 249, 252
Defense Against Weapons of Mass Destruction Act of 1996, 17
Defense Authorization Act (FY97), 17
Defense Protective Service, 76
Defense Special Weapons Agency, 180, 253
Dengue fever, 132, 146, 147, 245, 258
Deoxyribonucleic acid, 74, 77, 80-81, 82, 92, 122, 136, 141, 146, 159, 160, 234, 235, 236, 237, 246
Department of Defense, 26-27
Chemical/Biological Rapid Response Team, 26
DARPA, 94, 133, 145, 148, 158, 160, 161, 234, 236-237, 244, 248, 249, 252
decontamination, 105, 240, 258
Defense Protective Service, 76
Defense Special Weapons Agency, 180, 253
detection technology, 46, 58, 90, 94, 232, 255, 256
drugs, antidotes, 113
Global Emerging Infections Surveillance and Response System, 69
hotline, 26-27
inventory of resources, 232, 255, 256, 257
vaccines, 133, 134, 136, 143, 146, 154
see also terms beginning "U.S."; specific agencies
Department of Energy, 17, 94, 171, 180, 181, 255, 256, 258
Department of Health and Human Services, 1, 25
funding, 17
psychological impacts of attack, 171
see also Office of Emergency Preparedness
Department of Justice, 17
Department of Veterans Affairs, 26, 250
Detection and measurement of agents, 3, 5-6, 18-19, 24, 26-27, 103, 185, 188, 190
acoustic, 53, 55, 57, 58, 59, 84, 256-257
aerosols and vapors, 44, 45, 47-51, 56, 86-87, 88-89, 226, 227
biological agents, 66-71, 78-96, 234-238, 255
chemical agents, 5-6, 43-64, 226-231, 256-257
computer tools, 8, 58, 73-74, 76-77, 175-176, 177-178
cost factors, 6, 46, 47-51, 57, 59, 63, 64, 87, 96, 183
cyanide, 5, 44, 55, 60, 63-64, 128
DoD, general, 46, 58, 90, 94, 232, 255, 256
emergency response personnel, 43, 44-45, 57, 59, 64, 190
environmental, 6, 86-95, 178, 190, 226, 229, 230, 231, 234, 255
fluorescence techniques, 72, 81, 82, 84, 85, 90, 92, 93-95, 236, 238
inventory of resources, 226-231, 234-238, 255-257
local authorities preparedness, 56-57
military personnel vs civilians, 13
nerve agents, 5, 44, 47-51, 53, 55, 56, 58, 60-62, 226-231
paper detectors, 45, 54, 55, 57, 226, 228
point detection, 91-95
powered air purifying respirators, 37
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research recommendations, 6, 57-59, 64, 95-96, 125, 190
sampling technology, 88-95
signal processing technologies, 52-55 (passim), 58, 80, 82, 83, 85, 90, 159
stand-off detection, 90-91
vesicants, 5, 45, 55, 60, 62-63, 229
see also Assays; Chromatography; Clinical diagnoses; Covert exposures of population; Miniature technology; Spectroscopy
Dexamethasone, 124
DHHS, see Department of Health and Human Services
Diagnosis, see Clinical diagnoses
Diazepam, 113, 115, 117, 121, 241
Dichloroformoxime, see Phosgene
Dicobalt ethylene diamine tetraacetic acid, 127, 128, 163, 192
4-Dimethylaminophenol, 128
Disaster Medical Assistance Teams, 25-26, 167
Disaster Response Network, 171
5,5'-dithio-bis (2-nitrobenzoic acid), 61
Dizocilpine, 120
DNA, see Deoxyribonucleic acid
Domestic Preparedness Program (U.S. Army), 45, 57, 168
DRN, see Disaster Response Network
Drugs, antibiotics, 9, 10-11, 31, 69, 92, 96, 133-164 (passim), 191, 244-249, 259
emergency response personnel, 150, 155, 157
FDA, 131, 132, 139, 146, 147, 149, 153, 157, 161
see also Vaccines; specific drugs
Drugs, antidotes/antitoxins, 4, 9, 10-11, 110-131 (passim), 149, 155, 160-161, 162-163, 191, 192, 241-243, 258-259
cyanide, 10, 125-127, 128-129, 163, 191, 192, 241, 259
emergency response personnel, 112-119 (passim), 121, 126, 129, 152, 160-161
hospitals, 111, 117, 121, 125, 130
vesicants, 9, 10, 123-125, 158, 162, 164, 191, 192, 242-243, 259 topical skin protectants, 123, 124, 156-158, 242
see also specific drugs
Drugs, general, 1, 4, 9-11, 24, 110-164
administration methods, 10, 115, 121-122, 123, 135, 142, 162, 193
central nervous system, 113, 114, 115, 117, 118, 121, 137, 169
cost factors, 111, 116, 131, 133, 135, 154
funding, 140-141, 153, 160, 258
investigational new drugs, 110, 111-112, 131, 132, 139, 146, 147, 149, 153, 156, 188, 258, 259
legislation, 18
military personnel vs civilian, 13
nerve agents, 9, 10, 113-122, 162, 191, 192, 241-242, 259
prophylactic, 111, 115, 116-120, 121, 124, 129, 134; see also Vaccines
regulatory approval, 28; see also Food and Drug Administration
research recommendations, 9, 10-11, 111, 121-122, 126-127, 136, 143-144, 146, 148, 152, 153, 154, 158, 161-164, 191-193
seizures and anticonvulsants, 9, 11, 63, 113, 114, 115, 121, 122, 125, 144, 162, 191, 192
side effects, 115, 116, 121, 128, 131, 142, 150
see also Vaccines; specific drugs
DSWA, see Defense Special Weapons Agency
E
Eastern equine encephalomyelitis, 144, 145, 246, 258
Ebola virus, 16, 132, 133, 146, 147, 148, 258, 263
Edgewood Research, Development and Engineering Center (U.S. Army), 86, 95
EDI, see Emerging Infectious Disease Initiative
EDTA, see Dicobalt ethylene diamine tetraacetic acid
Education and training, 7, 71, 77, 106, 190, 193
children, 39
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clinical diagnosis, 3, 66, 75-76, 175-176, 178, 191, 193, 194
computer tools, 3, 174-183, 191, 193, 194
decontamination and triage, 108
Domestic Preparedness Program (U.S. Army), 45, 57, 168
hazardous substances emergency events surveillance system, 66, 75
legislation on, 18
local response plans, 25, 39, 77, 173, 190
preemptive systems, 22
psychological effects, 11-12, 71, 168, 170-172, 173
standards, 36
EEE, see Eastern equine encephalomyelitis
EIS, see Epidemic Intelligence Service
Electrochemical sensors, 46, 52, 83, 256-257
Electrotechnologies, decontamination, 107
ELISA, see Enzyme-linked immunosorbent assay
Emergency Medical Service, 112
Emergency response personnel, 23, 25, 185
computer tools, 174-175, 176-177, 183
detection and measurement, 43, 44-45, 57, 59, 64, 190
drugs, antibodies, 150, 155, 157
drugs, antidotes/antitoxins, 112-119 (passim), 121, 126, 129, 152, 160-161
Hazmat teams, 4, 5, 6, 8, 23, 25, 36, 43, 44-45, 57, 59, 64, 65, 75, 93, 99, 100, 101, 104-105, 112-115 (passim), 121, 152, 166, 190
Metropolitan Medical Strike Teams, 25, 28, 55-57, 59, 76, 100, 105, 114, 168, 188
protective equipment, 35-36, 41, 42, 108
psychological impacts, 166, 167-168, 170-171, 173, 176, 193
Emerging Infections: Microbial Threats to Health, 74
Emerging Infections Program (CDC), 7, 67-69
Emerging Infectious Disease Initiative, 257
EMS, see Emergency Medical Service
Environmental Protection Agency, 17, 35, 170, 173, 180, 230, 256
Enzyme-linked immunosorbent assay (ELISA), 61, 62, 72
Epidemic Intelligence Service, 70
Epidemiological approaches, 11, 26, 66, 70, 189, 190-191
CDC, 7, 26, 66-69, 73-74, 190-191
computer tools, 175-176
inventory of resources, 232, 245, 257
recommendations, 7
state-level, 4
see also Centers for Disease Control and Prevention; Covert exposure of population
ERDEC, see Edgewood Research, Development and Engineering Center
Eyes
mustard, 122-123
protection, 4, 36, 41, 106, 147
F
Fab, see Antibody fragments
FABS, see Force-amplified biological sensor
FDA, see Food and Drug Administration
Federal Bureau of Investigation, 17-18, 236
Federal Emergency Management Agency, 11, 17, 18, 25, 27, 102, 167, 170
Federal government role, general, 3, 4, 33
see also Funding; Legislation; specific departments and agencies
Federation of American Scientists, 71
FEMA, see Federal Emergency Management Agency
Fiber-optic evanescent wave guide, 85, 94
Fingerprinting/gene sequencing, 74, 77, 95-96, 191, 235
First responders, see Emergency response personnel
Flame photometry, 52
Fluorescence techniques, 72, 81, 82, 84, 85, 90, 92, 93-95, 236, 238
Food and Drug Administration, 28, 188, 232, 237, 255
biologic agent drug treatments, 131, 132, 139, 146, 147, 149, 153, 157, 161
cyanide drug treatments, 129
investigational new drugs, 110, 111-112, 131, 132, 139, 146, 147, 149, 153, 156, 188, 258, 259
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nerve agent antidotes, 113, 116, 118
new drug applications, 156, 158
vaccines, 131, 132, 146, 147, 153
vesicant drug treatment, 123, 124
Food contamination, 2, 12, 22, 67, 68, 194, 237
see also Botulism; Brucellosis; Crop contamination
Force-amplified biological sensor, 84
Fourier transform infrared spectrometry (FTIR), 55, 58
FOWG, see Fiber-optic evanescent wave guide
covert exposure preparedness, 7, 67
psychological treatment, 167, 170
see also Research recommendations
G
GA, see Tabun
Gas chromatography, 54, 62-63, 86, 226, 227, 228
Gas chromatography mass spectrometry (GC/MS), 6, 61, 86, 190
Gas chromatography tandem mass spectrometry (GC-MTMS), 61, 62
GB, see Sarin
GD, see Soman
DNA, 74, 77, 80-81, 82, 92, 122, 136, 141, 146, 159, 160, 234, 235, 236, 237, 246
gene sequencing/fingerprinting, 74, 77, 95-96, 191, 235
genetic engineering of pathogens, 21
pathogen gene mapping, 18
reverse transcriptase, 92
RNA, 74, 77, 80, 81, 92, 122, 144, 145-146, 159, 160, 234
see also Immunoassays
Gentamicin, 139
Global Emerging Infections Surveillance and Response System, 69, 232, 257
Global Infectious Disease and Epidemiology Network, 76, 175, 232, 257
Global NBC Emergency Response Technology Program, 38
Global Public Health Intelligence Network, 69
Global Surveillance Program, 69
Gloves, 4, 35, 36, 41, 98, 102, 106, 147
G nerve agents, 47-51, 56, 58, 62, 115, 231, 261
see also Sarin; Soman; Tabun
Gulf War, see Persian Gulf War
H
Hantaan virus, 147
Hazardous materials, general, 4, 5-6, 18-19, 27-28
Hazardous substances emergency events surveillance system, 66, 75
Hazard prediction and assessment capability, 180
Hazmat teams, 4, 5, 6, 8, 23, 25, 36, 43, 44-45, 57, 59, 64, 65, 75, 93, 99, 100, 101, 104-105, 112-115 (passim), 121, 152, 166, 190
HD, see Sulfur mustard
Hemorrhagic viruses, 21, 41, 72, 76, 146-148, 245
see also specific diseases
Heparin promethazine, 124, 243
High-efficiency particle respirators, 41, 42
High-performance liquid chromatography, 86
HIV, see Human immunodeficiency virus
Hospitals, 5, 26, 28, 185, 187
communication with law enforcement authorities, 30-31
decontamination facilities/procedures, 5, 6, 8, 100-106
drugs, antidotes, 111, 117, 121, 125, 130
personal protective equipment, 4, 5, 34, 36, 42, 106, 147
quarantine, 147
see also Medical personnel
HPLC, see High-performance liquid chromatography
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I
Immunoassays, 5, 61, 62, 72, 80-85, 87, 92-93, 229, 234-235, 237, 238
Impingers and bubblers, 89-90
Improved Chemical Agent Point Detection System, 58
IMS, see Ion mobility spectrometry
IND, see Investigational new drugs
Information requirements, see Communications; Education and training; Intelligence, information
Infrared spectroscopy, 53, 226
Intelligence, information, 3-4, 21, 24, 28, 29-33, 41, 121, 158, 174-175, 183, 187, 189
medical personnel involvement, 3-4, 21, 24, 28, 29-33
International perspectives
covert exposure recognition, 69
treaties, 16
see also Japan, Tokyo subway incident; Persian Gulf War
Investigational new drugs, 110, 111-112, 131, 132, 139, 146, 147, 149, 153, 156, 188, 258, 259
Ion mobility spectrometry, 46, 56, 57, 58, 59
Ipratropium bromide, 117, 121, 122
Israel
Gulf War, 39
personal protective equipment, 38, 39, 40, 222
U.S./Israel Agreement on Cooperative Research and Development Concerning Counter-Terrorism, 38
J
Japan, Tokyo subway incident, 30-31, 44, 75, 102, 166, 169
Joint Chemical Agent Detector (JCAD), 58
Joint Chemical Biological Agent Water Monitor (JCBAWM), 58
Joint Commission on Accreditation of Healthcare Organizations (JCAHO), 4, 36, 101
Joint Service Lightweight Integrated Suit Technology (JLIST), 38
Joint Service Lightweight Standoff Chemical Agent Detector (JSLSCAD), 58
Joint Vaccine Acquisition Program, 133, 143
L
LANL, see Los Alamos National Laboratory
Lassa fever, 146, 147, 246, 259, 263
Law enforcement authorities and personnel, 3, 23, 30-31
medical personnel liaison with, 30-31
protective equipment, 35-36
see also Emergency response personnel
Lawrence Livermore National Laboratory, 93, 180, 240, 253
Legislation, 16-18, 67, 68, 168
see also specific laws
Lewisite, 47-50, 122, 123, 231, 243, 261
Ligand-based probes, 82-83, 84, 93-94, 237, 256
LLNL, see Lawrence Livermore National Laboratory
Local Firefighter and Emergency Services Training Act of 1996, 17
Local preparedness and response, 3, 4, 22-23, 27-28, 172, 187, 190
CDC funding, 7
covert exposure recognition, 65, 67-68, 70-71, 77
decontamination, 105
detection and measurement, 56-57
education and training, 25, 39, 77, 173, 190
poison control centers, 74-75, 76
see also Emergency response personnel; Hospitals; Urban areas
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M
Masks, filtering, 4, 35-41 (passim), 98, 102, 116, 147, 222
Mass spectrometry, 54, 63, 85-86, 94, 229, 231, 234, 238, 256
computer tools, 174-175
covert exposure recognition, 6-7, 66, 67, 68
decontamination facilities/procedures, 5, 6, 8, 100-103, 106
detection and measurement, 43, 59
intelligence, information, 3-4, 21, 24, 28, 29-33
law enforcement, communication with, 30-31
military, 26
personal protective equipment, 4, 5, 19, 34, 35-36, 41, 42, 100, 103, 106, 108, 147
psychological effects of attack, 168, 170-172, 173
see also Emergency response personnel; Hospitals; Public health officials; Triage procedures
Memantine, 120
Mental illness, see Psychological effects
Methanesulfonate salt of pralidoxime, 118
Methemoglobin, 21, 127, 128, 163, 192
Metropolitan Medical Strike Teams, 25, 28, 55-57, 59, 76, 100, 105, 114, 168, 188
Midazolam, 117
Mine Safety and Health Administration, 35
Miniature technology
biological agent detectors, 93, 94, 178, 234
chemical agent detectors, 6, 64, 95, 178, 190, 226, 229, 230, 231, 255
MMST, see Metropolitan Medical Strike Teams
Monitoring systems, see Detection and measurement of agents
Monocolonal antibodies, 10, 61, 62, 81, 82, 119, 122, 144, 149, 151, 152, 157, 158, 162, 192, 242
Monoisonitrosoacetone, 118
Mustard agents, see Sulfur mustard
Myasthenia gravis, 115
Mycotoxins, 11, 21, 76, 154, 156, 157-158, 193, 247-248, 258
N
N-acetylcysteine, 124, 127, 192, 242
NAME, see Nitroarginine methylester
National Aeronautics and Space Administration, 38, 84, 255, 256
National Atmospheric Release and Advisory Center, 180-181
National Center for Infectious Diseases, 73
National Coordinator for Security, Infrastructure Protection, and Counter-Terrorism, 18
National Counterterrorism Plan, 25
National Disaster Medical System, 11, 25-26, 28, 167, 188
National Fire Protection Association, 35
National Infrastructure Protection Center, 18
National Institute for Occupational Safety and Health, 34-35, 37
National Institute of Allergy and Infectious Diseases, 148
National Institutes of Health, 140-141, 147-148, 153
National Notifiable Disease Surveillance System, 7, 66-67
National Oceanic and Atmospheric Administration, 180
see also Vomiting
Naval Medical Research Institute, 26, 87, 93
Naval Research Laboratory, 91
NDMS, see National Disaster Medical System
Nerve agents, general
committee's list of, 2, 21, 261
decontamination, 102, 113, 114
detection and measurement, 5, 44, 47-51, 53, 55, 56, 58, 60-62, 226-231
drug treatment, 9, 10, 113-122, 162, 191, 192, 241-242, 259
personal protective equipment, 4, 36, 37
psychological vs neurological impacts, 169
symptoms, 60-62, 113; see also Seizures and anticonvulsants
see also Central nervous system; G nerve agents; specific agents
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NFPA, see National Fire Protection Association
NIAID, see National Institute of Allergy and Infectious Diseases
Nicotine hydroxamic acid methiodide, 118, 242
NIH, see National Institutes of Health
NIOSH, see National Institute for Occupational Safety and Health
NIPAC, see National Infrastructure Protection Center
Nitric oxide synthase inhibitor, 124, 243
Nitroarginine methylester, 124
NMRI, see Naval Medical Research Institute
NOAA, see National Oceanic and Atmospheric Administration
NRL, see Naval Research Laboratory
Nuclear Regulatory Commission, 171
O
Oak Ridge National Laboratory, 94, 95
Occupational Safety and Health Administration, 188
exposure standards, 56
personal protective equipment, 4, 35, 42, 188
Office of Emergency Preparedness (OEP), 25, 171
role in report at hand, 1, 18, 19
Officials, see Law enforcement authorities and personnel; Public health officials
Optical transduction, 84-85
Organophosphates, 60, 61-62, 115, 116, 118, 119
OSHA, see Occupational Safety and Health Administration
P
Paper detectors, 45, 54, 55, 57, 226, 228
PAPR, see Powered air purifying respirators
Para-aminoheptanophenone (PAHP), 129, 241
Para-aminooctanoylphenone (PAOF), 128, 241
Para-aminopropiophenone (PAPP), 128, 241
PBBs, see Polybrominated biphenyls
PCBs, see Polychlorinated biphenyls
PCR, see Polymerase chain reaction
PDDs, see Presidential Decision Directives
Persian Gulf War, 39, 112, 115, 166
Personal protective equipment, 1, 3, 4-5, 18-19, 24, 34-42, 158, 189
Battle Dress Overgarment, 38, 224
clothing, 4, 13, 34, 35, 38, 41, 223-225
cost factors, 39
defined, 34
emergency response personnel, 35-36, 41, 42, 108
general public, 4, 34, 39, 40, 41, 42, 222-225
gloves, 4, 35, 36, 41, 98, 102, 106, 147
hospitals, 4, 5, 34, 36, 42, 106, 147
inventory of available products, 222-225
levels of protection, 35, 36, 37, 40
masks, 4, 35-41 (passim), 98, 102, 116, 147, 222
medical personnel, 4, 5, 19, 34, 35-36, 41, 42, 100, 103, 106, 108, 147
regulatory approval of, 4, 28, 189
research recommendations, 5, 42, 189
shelters vs, 39
skin, 35, 37, 38, 41; see also Topical skin protectants; "gowns" supra
splash protection, 35, 37; see also "gowns" supra
types of, 34-35
see also Respirators; Shelters, protective
Pharmacological therapy, see Vaccines; terms beginning "Drugs …"
Phosgene, 5, 10, 21, 44, 47-48, 63, 122, 123, 127, 130, 163, 192, 242, 259
Photoacoustic infrared spectroscopy (PIRS), 53
Photo ionization detectors (PIDs), 53
pH paper, 45
PHS, see Public Health Service
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Plague, 9, 11, 21, 72, 132, 137-139, 147, 163, 193, 246
Planning Guidance for the Chemical Stockpile Emergency Preparedness Program, 101
Point detection, 91-95
Poison control centers, 74-75, 76, 111, 125
Polybrominated biphenyls, 98
Polychlorinated biphenyls, 98
Polymerase chain reaction, 27, 72, 82, 92-93, 136, 229, 231, 232
Post traumatic stress disorder, 9, 11, 165-166, 169, 173
Powered air purifying respirators, 4, 37-38
PPE, see Personal protective equipment
Pralidoxime chloride (2-PAM), 113, 114-115, 116, 117, 118, 121, 242
see also Intelligence, information
Presidential Decision Directives, 17, 18, 33
Pressure-demand supplied air respirator, 35
Probe technologies, 80-83, 84, 85-86
Program for Monitoring Emerging Diseases (ProMED), 71, 175, 232
Prophylactic drugs, 111, 115, 116-120, 121, 124, 129, 134
see also Vaccines
Protective equipment, see Personal protective equipment; Shelters, protective
Psychological effects, 3, 9, 11-12, 24, 71, 165-173, 193
community-wide, 172
decontamination procedures, 9, 102, 105, 107, 108, 109, 191
education and training, 11-12, 71, 168, 170-172, 173
emergency response personnel, 166, 167-168, 170-171, 173, 176, 193
inventory of resources, 250-251, 259
medical personnel, 168, 170-172, 173
neurological vs, nerve agents, 169
post traumatic stress disorder, 9, 11, 165-166, 169-170
professional training, 170-172, 193
research recommendations, 11-12, 170, 172-173
standard operating procedures, 11, 12, 192
testing guidelines, 35
PTSD, see Post traumatic stress disorder
Public health officials, 12, 22, 32, 33, 176, 193
Disaster Medical Assistance Teams, 25-26, 167
Metropolitan Medical Strike Teams, 25, 28, 55-57, 59, 76, 100, 105, 114, 168, 188
Q
Q fever, 11, 21, 72, 140-141, 163, 193, 246, 258
Quarantine, 147
3-quinuclidinyl benzilate, 117
R
Raman spectroscopy, 54
Rapid assessment and initial detection (RAID) teams, 27
Recombinant vaccines, 10, 149, 151, 152, 162, 192
Regional-level preparedness and response, 25-26
poison control centers, 74-75, 76
Regulatory issues, 28, 42, 189
see also Environmental Protection Agency; Food and Drug Administration; Occupational Safety and Health Administration; Standards
Research recommendations, 41, 189-194
committee approach, general, 1-2, 3, 18-19
communications and intelligence, 4, 32, 34, 189, 190-191
computer applications, 12, 182-183, 193-194
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decontamination and triage, 8-9, 102-104, 105, 108-109, 191
detection and measurement techniques, 6, 57-59, 64, 95-96, 125, 190
drugs, vaccines, and other therapeutics, 9, 10-11, 111, 121-122, 126-127, 136, 143-144, 146, 148, 152, 153, 154, 158, 161-164, 191-193
improper use, 39
pathogen gene mapping, 18
personal protective equipment, 5, 42, 189
psychological effects, 11-12, 170, 172-173
Respirators, 4, 5, 35, 37-42 (passim), 127
civilian equipment, 4, 5, 34, 39, 40, 41, 189
inventory of available products, 222-225
powered air purifying respirators, 4, 37-38
self-contained breathing apparatus, 35, 37, 40, 41, 42
Respiratory agents, 4, 60, 63, 261
phosgene, 5, 10, 21, 44, 47-48, 63, 122, 123, 127, 130, 163, 192, 242, 259
Respiratory effects of agents, 40, 107, 113, 125, 134, 145, 152, 153
Reverse transcriptase, 92
Ribonucleic acid, 74, 77, 80, 81, 92, 122, 144, 145-146, 159, 160, 234
Ricin, 11, 21, 153-154, 155, 164, 193, 247, 258
Rift Valley fever, 146
Riot control, see Crowd control
RNA, see Ribonucleic acid
S
Sampling devies
bubblers/impingers, 89-90
cyclone samplers, 89
viable particle-size impactors, 88
virtual impactors, 89
cyclosarin, 61
Tokyo subway incident, 30-31, 44, 75, 102, 166, 169
SBIR, see Small business innovative research
SCBA, see Self-contained breathing apparatus
SDA, see Strand displacement amplification
SEB, see Staphylococcal enterotoxin B
Second-order Closure Integrated Puff (SciPUFF), 180
Seizures and anticonvulsants, 9, 11, 63, 113, 114, 115, 117, 121, 122, 125, 144-145, 162, 191, 192
Selectively permeable membrane technology, 40
Self-contained breathing apparatus, 35, 37, 40, 41, 42
Sentinel Surveillance Networks, 68
SFM, see Swept frequency acoustic interferometry detector
Shelters, protective, 39, 41, 42, 105
Shipboard Automatic Lightweight Standoff Chemical Agent Detector, 58
Showering, decontamination, 8, 98, 99, 100, 104, 109, 122, 191
Side effects, 115, 116, 121, 128, 131, 142, 150
Signal processing technologies, 52-55 (passim), 58, 80, 82, 83, 85, 90, 159
Skin, 52
blister agents, 48, 52, 53, 54, 55, 58
decontamination, 100, 106 showering, 8, 98, 99, 100, 104, 109, 122, 191
mycotoxins, 156
personal protective equipment, 35, 37, 38, 41
topical skin protectants, 123, 124, 156-158, 242
see also Vesicants
Small business innovative research, 20, 254
Smallpox, 9, 10, 21, 41, 72, 131, 133, 141-144, 148, 162, 191, 192, 247, 258
Sodium nitrite, 125
Special Operations Forces Nonintrusive Detector, 58
chemical biological mass spectrometers, 94
Fourier transform infrared spectrometry, 55, 58
gas chromatography mass spectrometry, 6, 61, 86, 190
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gas chromatography tandem mass spectrometry, 61, 62
ion mobility spectrometry, 46, 56, 57, 58, 59
mass spectrometry, 54, 63, 85-86, 94, 229, 231, 234, 238, 256
photoacoustic infrared spectroscopy, 53
raman spectroscopy, 54
see also Gowns
Standard operating procedures, 19, 24, 64, 185, 190
decontamination, 8, 19, 24, 98-103, 105, 108-109, 191
hazardous materials plans, general, 5, 6, 8
military vs civilian, 13, 186-187
psychological effects, 11, 12, 192
see also Triage procedures
Standards
detection and measurement, 44, 64
drugs, antidote administration, 114
medical personnel protection, 4, 5
protective equipment, 4, 35, 36, 37, 42, 188, 189
testing, 5, 35, 37, 39, 42, 189
see also Regulatory issues
Stand-off detection, 90-91
Staphylococcal enterotoxin B, 11, 21, 152-153, 160-161, 163, 193, 247
State-level preparedness and response, 3-4, 25, 27, 189
children, 39
covert exposure, surveillance, 7, 65, 67-68, 70-71, 77
Strand displacement amplification, 92
Substance Abuse and Mental Health Services Administration, 167
Sulfur mustard, 5, 21, 37, 47-51, 52, 62, 65, 122-123, 124
eyes, 122-123
Surface acoustic wave sensors, 53
Swept Frequency Acoustic Interferometry detector, 58
Symptoms, see Clinical diagnoses; Side effects
T
Tabun, 52
TAS, see Transcription-Based Amplification System
TDG, see Thiodiglycol
Thermoelectric conductivity, 52
Thienylcyclohexlpiperidine, 120
T-2 mycotoxins, 11, 21, 76, 154, 156, 157-158, 164, 193, 247-248, 258
Tokyo subway incident, 30-31, 33, 44, 75, 102, 166, 169
Topical skin protectants, 123, 124, 156-158, 242
Training, see Education and training
Transcription-Based Amplification System, 92
Transducer technologies, 80, 83-86, 256
Transportation systems, contamination, 12, 58, 194
Tokyo subway incident, 30-31, 33, 44, 75, 102, 166, 169
Triage procedures, 3, 8-9, 19, 24, 97, 102, 103, 107-109, 126, 185, 191
TSP, see Topical skin protectants
Tularemia, 21, 72, 139-140, 248, 258
U
UAV, see Unmanned aerial vehicles
Ultraviolet radiation, 107, 238
Unconventional Pathogen Countermeasures, 158
United States Policy on Counterterrorism (PDD-39), 17-18
Unmanned aerial vehicles, 91, 236
Up-converting phosphor technology, 85
Domestic Preparedness Program (U.S. Army), 45, 57, 168
Emerging Infections Program, 68
Metropolitan Medical Strike Teams, 25, 28, 55-57, 59, 76, 100, 105, 114, 168, 188
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U.S. Army, 37, 45, 57, 86, 96, 102, 168, 225
U.S. Army Chemical Biological Defense Command, 26-27
U.S. Army Medical Research Institute of Chemical Defense (USAMRICD), 26, 82, 241, 242, 247
U.S. Army Medical Research Institute of Infectious Diseases (USAMRIID), 26, 87, 93, 94, 141, 145, 147-148, 153, 154, 238, 239, 245, 246, 247-248
U.S./Israel Agreement on Cooperative Research and Development Concerning Counter-Terrorism, 38
U.S. Marine Corps, 26, 86, 240
U.S. Navy, see terms beginning ''Naval"
V
VA, see Department of Veterans Affairs
Vaccines, 3, 9-11, 19, 111, 131-143 (passim), 145, 146, 149, 150-151, 153, 154, 157-159, 162-164, 191, 192
DoD, general, 133, 134, 136, 143, 146, 154
inventory of resources, 244-249
legislation on, 18
military personnel vs civilian, 13, 187
recombinant vaccines, 10, 149, 151, 152, 162, 192
Vapors, see Aerosols and vapors
Venezuelan equine encephalomyelitis (VEE), 144, 145, 146, 248
detection and measurement, 5, 45, 55, 60, 62-63, 229
drug treatment, 9, 10, 123-125, 158, 162, 164, 191, 192, 242-243, 259
topical skin protectants, 123, 124, 156-158, 242
Lewisite, 47-50, 122, 123, 231, 243, 261
list of, 261
sulfur mustard, 5, 21, 37, 47-51, 52, 62, 65, 122-123, 124
see also Blister agents
Veterinary medicine, 72, 73, 111, 116
Viable particle-size impactors, 88
Viral encephalitides, 9, 10, 21, 72, 144-146, 163, 192, 246
see also specific diseases
Viral hemorrhagic fevers, 21, 41, 72, 76, 146-148, 163, 245
see also specific diseases
Virtual impactors, 89
Vomiting, 113, 138, 141, 152, 153, 156
VX nerve agent, 52, 56, 58, 115, 231, 261
W
Wally Wise Guy program, 39
Water contamination, 2, 12, 22, 58, 67, 91, 194, 228, 237
Western equine encephalomyelitis (WEE) 132, 144, 145, 146, 249, 258
World Health Organization, 69, 141, 232
World Wide Web, 20, 250-251, 254, 259
X
X-rays, 107