Influence of Words as Determinants of U.S. International and Domestic Health Policy: Part I, The

Journal of Allied Health, Fall 2005 by Elwood, Thomas W

Apart from the harm intended by terrorists, there exists the risk of exposure to infectious disease that may result by accident from the sources designed to prevent such occurrences. Recently, the College of American Pathologists and three or four other organizations that are responsible for testing the proficiency of laboratories around the world inadvertently sent out proficiency testing panels that contained the H2N2 influenza A virus. Proficiency testing is the way to assure that laboratories have the kinds of quality measures in place that would allow them to be able to identify a novel virus accurately.

This virus was associated with the Asian flu pandemic in 1957 (H2N2 virus), which killed 70,000 persons in the United States alone and is one that has not been seen here for a long time. The last known date when this particular strain of virus was circulating was 1968, so anyone born after that year would not have had any exposure and would presumably be completely susceptible. The virus was distributed to approximately 4,000 or more laboratories, with the earliest release date believed to be September 10, 2004. Panels were sent to 18 countries, including the United States and Canada. As of early May 2005, no deaths had been reported, but the incident caused alarm in public health agencies in all the countries where the testing panels were sent.

The Need for Cooperation at All Levels

According to a 2004 report on protecting the public's health in the age of bioterrorism, it was noted that a lack of consensus on communication between local, state, and federal efforts and the absence of standardized national performance accountability measures threaten to imperil future readiness initiatives.7 An inability to place our own house in order speaks to the difficulty of achieving meaningful coordination with other countries where readiness to deal with health calamities may be at even lower levels.

Increased global alliances are needed that are based on accurate diagnostics, epidemiology studies, rapid communications, and swift provision of health care services in the form of vaccines, medicines, and transport of patients to appropriate clinical facilities. Clearly, the United States has a role to play in seeing to it that such functions are carried out satisfactorily.

The United States and its allies are pressing the WHO to take the lead in bioterrorism investigations. Other nations, especially poorer ones, are concerned that a greater presence by that agency would involve it in questions of national security and would compromise their political neutrality. Because there already is reluctance by some countries to report disease and permit WHO access because of repercussions on trade and tourism, the addition of security issues may only worsen the situation. An effort to resolve the impasse was scheduled for mid-May 2005.8

Allied Health Is Part of the Solution

Allied health professionals such as clinical laboratory science personnel, emergency medical service workers, and respiratory therapists will be involved in the diagnosis and treatment of victims of both naturally occurring and human acts of bioterrorism. According to the Centers for Disease Control and Prevention, "clinical laboratory personnel will most likely be the first ones to perform preliminary testing on clinical specimens from patients who have been intentionally exposed [to biological, chemical, or radiological terrorism] . . . and will play a critical role in facilitating rapid identification of [the hazardous substance].9