Identifying Biological Hazards as They Happen

Simply put, biological hazards are a combination of disease-causing microbes and the body fluids that carry them. Unlike some chemical agents, biological agents are not detectable by human senses. For that reason alone, responders usually must rely on technological means of detection.

There are two main strategies for detection: surveillance; and direct testing. Surveillance analyzes multiple data streams – from hospital emergency rooms, pharmacies, laboratories, and EMS (Emergency Medical Services) units – in an effort to spot disease outbreaks by observing those who are treating the illness. Direct testing fits a number of locations nationally through the use of air sampling gear that collects what is “written on the wind,” so to speak, in an effort to recognize an attack while it is still ongoing. These fixed listening posts almost always have the on-site power and communications channels needed to enable the prompt dissemination of incident information and various related data.

In the ten years since the 9/11 2001 terrorist attacks, the capability to carry out on-scene air testing for biological hazards has both evolved and improved. The new systems and devices now available are small enough and portable enough to be carried by a single responder. Being able to easily transport a system or device into the field – untethered to communications and power supply connections – is an important step forward that allows entry teams to monitor their own risk levels.

The on-scene information now available, or easily obtainable, also allows the medical support staff for these teams to make treatment decisions based on actual exposure data rather than on speculation. Responders and victims also are spared the sometimes harsh side effects of receiving unnecessary medications. In addition, resources that tend to be scarce during a large-scale attack can be preserved for higher-priority applications.

Alarming Facts & Basic Phases 

When an agency is considering the purchase of a biological monitor – or any other type of monitor, for that matter – the agency’s pre-incident plan should include the response that should be expected if the alarm is triggered. This is not as simple as it sounds, and this important operational consideration is often overlooked both during the purchasing process and in the deployment stages of a response. There are, nonetheless, three basic phases of response to a detector alarm: (a) threat removal; (b) immediate treatment; and (c) long-term treatment and monitoring. Following are a few words about each:

Threat Removal – Stopping the Spread:

Having a plan in place for cleaning off and/or otherwise neutralizing any contamination is essential to keep responders and victims from spreading the hazard as they leave the incident site – which is in large part how the harmful effects of biological agent attacks are magnified beyond the scene.

Immediate Treatment – One Among Many: 

Antibiotics help the body fight off infection. However, there are many antibiotics on the market – and, for that reason, knowing the specific biological contaminant at the incident site will help responder teams decide which antibiotic to use. In short, knowing as much specific information as possible about the hazardous agent present may significantly improve the effectiveness of the treatment, not only by providing better results but also by inflicting fewer side effects.

Long-Term Treatment and Monitoring – Tricks of the Trade:

A significant countermeasure against biological attack is knowing and using an effective vaccine. Vaccinations expose responders to a weakened strain of the disease-causing agent, or to the non-lethal cousins of the agent, in order to trick the body’s immune system into building resistance to the disease. The main limitation to using vaccinations effectively is that the agent must be known in advance. For that reason, this strategy is primarily targeted at responders who arrive on the scene after the alarm has sounded and the agent has been confirmed.

The ABCs of Logistics Planning

In either case, the logistics involved should be planned out, well in advance, and should include, as a minimum, the following steps: (a) obtain the medications/vaccines; (b) transport the countermeasure resources to those who need them; and (c) dispense the medications/vaccines. Using a “tool-box” approach enables responders to make a general plan for the distribution of countermeasures that can later be adapted to meet the specific needs of each specific incident.

There are two additional benefits provided by this course of action: First, the long-term monitoring of those who have been exposed allows proper continuing care to be provided against the exposure. Second, such monitoring allows the medical community in general to learn from the incident or event and thereby improve the response preparations for future events.

Advances in detection equipment enable responders to detect biological hazards at an early stage,eally before the contamination has a chance to spread. Using such data – in conjunction with a planned procedure for removing the threat, treating those contaminated, and monitoring the after effects – can help significantly both in reducing the risk of exposure and in stopping additional spread of the agent. Advances in detection technology mean that responding teams no longer need to “blindly” enter the scene of a biological attack.

Joseph Cahill
Joseph Cahill

Joseph Cahill is the director of medicolegal investigations for the Massachusetts Office of the Chief Medical Examiner. He previously served as exercise and training coordinator for the Massachusetts Department of Public Health and as emergency planner in the Westchester County (N.Y.) Office of Emergency Management. He also served for five years as citywide advanced life support (ALS) coordinator for the FDNY – Bureau of EMS. Before that, he was the department’s Division 6 ALS coordinator, covering the South Bronx and Harlem. He also served on the faculty of the Westchester County Community College’s paramedic program and has been a frequent guest lecturer for the U.S. Secret Service, the FDNY EMS Academy, and Montefiore Hospital.



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