Posted at the request of the Miami-Dade RACES Officer, KA4HLO:
OEM
Subject: THREAT CONDITION INCREASE - Orange
The U.S. Department of Homeland Security has made the decision to raise the national threat level from an Elevated to High risk of terrorist attack or Level Orange. There is concern that terrorist may target the United States when we launch a military campaign against Saddam Hussein.
Agencies should refer to their internal plans and procedures for specific actions related to the increase in the threat condition. As a general rule, the Federal government provides the following suggestions:
“High Condition (Orange). A High Condition is declared when there is a high
risk of terrorist attacks. In addition to the Protective Measures taken in the
previous Threat Conditions, Federal departments and agencies should consider the
following general measures in addition to the agency-specific Protective
Measures that they will develop and implement:
1. Coordinating necessary security efforts with Federal, State, and local law
enforcement agencies or any National Guard or other appropriate armed forces
organizations;
2. Taking additional precautions at public events and possibly considering
alternative venues or even cancellation;
3. Preparing to execute contingency procedures, such as moving to an alternate
site or dispersing their workforce; and
4. Restricting threatened facility access to essential personnel only.”
The Miami-Dade Office of Emergency Management recommends you also consider the following:
Conduct incident planning meeting and if appropriate implement elements of the Comprehensive Emergency Management Plan, the Terrorism Response System annex, and internal plans and procedures.
Maintain routine coordination and communication with law enforcement agencies and the Office of Emergency Management in the event that additional information becomes available.
Advise staff to be especially alert for suspicious persons or activity in or around the campus. Report suspicious activities to a supervisor or the facilities manager.
Ensure operational readiness of your facilities and staff.
Review emergency assignments with staff.
Prepare a response for potential media or public inquiries regarding your
actions.
Lock exterior doors or otherwise restrict access to facilities as appropriate.
Organizational vehicles should be locked at all times if unattended.
Cancellation or changing the venue of public events is not always viable. Consider increasing security staffing, patrols, or security-checks at public events or sites.
Site safety or response plans should be developed if not already in place.
Consider various consequence scenarios and discuss alternate responses.
Posted at the request of the Miami-Dade RACES Officer, KA4HLO
This is an official CDC Health Advisory
Distributed via Health Alert Network
March 15, 2003, 20:45 EDT (8:45 PM EDT)
CDCHAN-000118-03-03-15-ADV-N
Following is information regarding the current WHO investigation of atypical
pneumonia. Included are: a news release from the CDC, interim information and
recommendations for health care providers, and text of a travelers' health alert
card which will be distributed to targeted international travelers returning to
the U.S.
CDC Issues Health Alert About Atypical Pneumonia
Atlanta: In response to reports of increasing numbers of cases of an atypical
pneumonia that the World Health Organization (WHO) has called Severe Acute
Respiratory Syndrome (SARS), the Centers for Disease Control and Prevention (CDC)
today announced several steps to alert US health authorities at local and state
levels.
CDC activated its emergency operations center on Friday, March 14, upon
learning of several cases reported in Canada among travelers recently returned
from Southeast Asia and their family members. The federal public health agency:
· Issued a health alert to hospitals and clinicians on Saturday, March 15.
· Briefed state health officials on Saturday, March 15.
· Is investigating illness among travelers who may have passed through the
United States after having potential exposure to the virus.
· Is preparing health alert cards to give to travelers returning from Southeast
Asia.
· Is preparing guidance to assist public health departments, health care
facilities and clinicians in monitoring and identifying potential cases.
· Deployed eight CDC scientists to assist the WHO in the global investigation.
· Is analyzing specimens to identify a cause for the illness.
CDC has been working with the World Health Organization (WHO) since late
February to investigate and confirm outbreaks of this severe form of pneumonia
in Viet Nam, Hong Kong, and parts of China. No cases have been identified to
date in the United States.
"The emergence of two clusters of this illness on the North American
continent indicates the potential for travelers who have been in the affected
areas of Southeast Asia to have been exposed to this serious syndrome,"
said Dr. Julie L. Gerberding, CDC Director. "The World Health Organization
has been leading a global effort, in which CDC is participating, to understand
the cause of this illness and how to prevent its spread. We do know that it may
progress rapidly and can be fatal. Therefore, we are instituting measures aimed
at identifying potential cases among travelers returning to the United States
and protecting the people with whom they may come into contact."
The WHO issued a global alert about the outbreak on March 12, cautioning that
the severe respiratory illness may spread to hospital staff. No link has been
made between this illness and any known influenza, including the "bird
flu" (A[H5N1]) outbreak reported in Hong Kong on February 19.
# # #
Severe Acute Respiratory Syndrome (SARS)
Interim Information and Recommendations for Health Care Providers
3/15/2003 6:00 pm Eastern Standard Time
The Centers for Disease Control and Prevention (CDC) and the World Health
Organization have received reports of patients with severe acute respiratory
syndrome (SARS) from Canada, China, Hong Kong Special Administrative Region of
China, Indonesia, Philippines, Singapore, Thailand, and Vietnam. The cause of
these illnesses is unknown and is being investigated. Early manifestations in
these patients have included influenza-like symptoms such as fever, myalgias,
headache, sore throat, dry cough , shortness of breath, or difficulty breathing.
In some cases these symptoms are followed by hypoxia, pneumonia, and
occasionally acute respiratory distress requiring mechanical ventilation and
death. Laboratory findings may include thrombocytopenia and leukopenia. Some
close contacts, including healthcare workers, have developed similar illnesses.
In response to these developments, CDC is initiating surveillance for cases of
SARS among recent travelers or their close contacts.
Case Finding
Clinicians should be alert for persons with onset of illness after February 1,
2003 with:
· Fever (>38° C)
AND
· One or more signs or symptoms of respiratory illness including cough,
shortness of breath, difficulty breathing, hypoxia, radiographic findings of
pneumonia, or respiratory distress
AND
One or more of the following:
· History of travel to Hong Kong or Guangdong Province in People's Republic of
China, or Hanoi, Vietnam, within seven days of symptom onset
· Close contact with persons with respiratory illness having the above travel
history. Close contact includes having cared for, having lived with, or having
had direct contact with respiratory secretions and body fluids of a person with
SARS.
Diagnostic Evaluation
Initial diagnostic testing should include chest radiograph, pulse oximetry,
blood cultures, sputum Gram's stain and culture, and testing for viral
respiratory pathogens, notably influenza A and B and respiratory syncytial
virus. Clinicians should save any available clinical specimens (respiratory,
blood, and serum) for additional testing until a specific diagnosis is made.
Clinicians should evaluate persons meeting the above description and, if
indicated, admit them to the hospital. Close contacts and healthcare workers
should seek medical care for symptoms of respiratory illness.
Infection Control
If the patient is admitted to the hospital, clinicians should notify infection
control personnel immediately. Until the etiology and route of transmission are
known, in addition to standard precautions(1), infection control measures for
inpatients should include:
· Airborne precautions (including an isolation room with negative pressure
relative to the surrounding area and use of an N-95 respirator for persons
entering the room)
· Contact precautions (including use of gown and gloves for contact with the
patient or their environment)
Standard precautions routinely include careful attention to hand hygiene.
When caring for patients with SARS, clinicians should wear eye protection for
all patient contact.
To minimize the potential of transmission outside the hospital, case patients
as described above should limit interactions outside the home until the
epidemiology of illness transmission is better understood. Placing a surgical
mask on case patients in ambulatory healthcare settings, during transport, and
during contact with others at home is prudent.
Treatment
Because the etiology of these illnesses has not yet been determined, no specific
treatment recommendations can be made at this time. Empiric therapy should
include coverage for organisms associated with any community-acquired pneumonia
of unclear etiology, including agents with activity against both typical and
atypical respiratory pathogens (2). Treatment choices may be influenced by
severity of the illness. Infectious disease consultation is recommended.
Reporting
Healthcare providers and public health personnel should report cases of SARS as
described above to their state or local health departments.
For more information contact your state or local health department or the CDC
Emergency Operations Center 770-488-7100. Updated information will be available
at http://www.cdc.gov
References
1. Garner JS, Hospital Infection Control Practices Advisory Committee.
Guideline for isolation precautions in hospitals. Infect Control Hosp Epidemiol
1996;17:53-80, and Am J Infect Control 1996;24:24-52. http://www.cdc.gov/ncidod/hip/ISOLAT/Isolat.htm
2. Bartlett JG, Dowell SF, Mandell LA, File Jr, TM, Musher DM, and Fine MJ.
Practice Guidelines for the Management of Community-Acquired Pneumonia in
Adults. Clin Infect Dis 2000;31:347-82. http://www.journals.uchicago.edu/CID/journal/issues/v31n2/000441/000441.web.pdf