Second Opinion

The terrorist attacks of Sept. 11, 2001, and the subsequent anthrax exposures in New York, Washington and Florida have created a heightened level of concern for future bioterrorism incidents in the United States.

Recognizing the need for enhanced planning and education in Kentucky, the University of Louisville has developed the Center for Deterrence of Biowarfare and Bioterrorism, based in the new School of Public Health/Health Information Sciences.

By establishing and maintaining a repository of expertise, the center brings the collaborative efforts of many disciplines to bear on the issues related to the prevention and detection of, as well as the response to and recovery from, bioterrorism. It also will provide the excellence needed to attract national recognition and significant federal funding.

As the only comprehensive bioterrorism program in the state, the center will develop communication and epidemiological capabilities to aid detection and response to bioterrorism. It already provides effective education for health care providers and conducts research to deter bioterrorism through enhanced medical and public health response capabilities.

The center is interdisciplinary in its approach to research, education, training and service. To augment its medical, public health and scientific expertise, the center includes experts in health care law, bioethics and public safety.

By promoting interaction and collaboration between units of the School of Medicine and the School of Public Health/Health Information Sciences, the center has increased its prospects for external funding for critical research, expanded local and distance learning opportunities, and improved the epidemiological and response capabilities of the region and nation.

UofL is ideally positioned to play a leadership role in the coordination of these efforts for the Commonwealth. First, Louisville is the largest city in Kentucky and hosts a range of events that could be targeted for acts of bioterrorism. Second, the university is located in close proximity to a major military installation, Fort Knox, which would serve a major role in command, control and logistical support in the event of an attack. Third, several UofL faculty hold key positions in organizations that coordinate the national planning for such events.

Ron Atlas, Ph.D., as president of the American Society of Microbiology; Richard Clover, M.D., and Paul McKinney, M.D., as liaison members of the Centers for Disease Control's Advisory Committee on Immunization Practices; and James Snyder, Ph.D., as a colonel in the U.S. Army Reserve with important links to the U.S. Army Medical Research Institute of Infectious Disease, all play key roles in the coordination of the center's planning efforts.

This past summer, the center was awarded $1.5 million in funding from the Centers for Disease Control and Prevention to support its activities. Two major projects are being funded with the grant -- an innovative education program to enhance the ability of health care providers to recognize clinical symptoms related to biothreat agents, and a campaign to expand health informatics capabilities to detect unusual disease activity in a community or regional area.

The educational programs are under the overall direction of McKinney, associate director of the center. Working with McKinney is Gina Wesley, Ph.D., director of the Standardized Patient Program, and Gary Lloyd, M.D., director of the Human Patient Simulation Center.

Standardized patients are professional actors who are trained to simulate the symptoms of various diseases so students and health care providers can improve their diagnostic skills.

Using specialized makeup known as moulage, Wesley and her staff will develop highly realistic lesions for the skin of standardized patients to simulate smallpox and diseases with which it may be confused. Meanwhile, Lloyd and his colleagues use computer-regulated mannequins to create simulations of patients with inhalational anthrax and botulism.

Under the direction of Pete Walton, M.D., the center's associate director, a public health event network will be created to enhance disease surveillance, epidemiology, planning, early recognition, rapid notification and response coordination for possible bioterrorism events.

The center also will act as a conduit through which research, education and consultation bring support to health care agencies, improving the local, regional and national response to epidemic disease and bioterrorism.

The center will accomplish this by:

-- Providing course offerings on bioterrorism response for health providers

-- Providing training for emergency room and laboratory personnel that will enable early detection of an attack

-- Developing training, including distance-education modules, for health providers as first responders to bioterrorism events

-- Developing advanced integrated information systems and communications methods to coordinate responses to bioterrorism events

The center has the goal of making UofL an influential support service to the community, Kentucky and the nation in defense against bioterrorism.

Richard Clover, M.D., is director of UofL's Center for the Deterrence of Biowarfare and Bioterrorism. He also is dean of the School of Public Health/Health Information Sciences. Paul McKinney, M.D., is associate director of the center and the V.V. Cooke chair and professor of medicine and public health at UofL.