Physician Preparedness for Acts of Water Terrorism
Patricia L. Meinhardt, MD, MPH, MA, Author

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Continuing Medical Education Credit Information

NOTE: The following CME information must be reviewed PRIOR to starting this CME offering.

Physician Preparedness for
Acts of Water Terrorism:

A Physician Online Readiness Guide
On-line CME and MOC Credits
Max. 22.5 Credit Hours

Original Release: 07/15/06
Update: 07/15/09

Principal Faculty
Patricia L. Meinhardt, MD, MPH, MA
Executive Medical Director
Center for Occupational and Environmental Medicine
Arnot Ogden Medical Center
Elmira, New York

Author of Physician Preparedness for Acts of Water Terrorism: A Physician Online Readiness Guide and Recognizing Waterborne Disease and the Health Effects of Water Pollution: A Physician Online Reference Guide accessible at www.WaterHealthConnection.org

“I have no disclosures to make and no commercial support was accepted by me for the development or maintenance of this CME module.”

System Requirements

PC:
Hardware: Pentium III or compatible processor, 256 MB RAM
Operating System: Windows 2000, XP or Vista
Web browser: IE 5.5 or higher/ Netscape 4.7 or higher

Macintosh:

Hardware: G3 500 MHz processor and above, 256 MB RAM
Operating System: Mac OS 10.2 and above
Web browser: Safari 1.2 and above, IE 5.2

Media
Adobe Acrobat Reader may be needed in order to view some documents listed on the website. The software is free and available at www.adobe.com/reader.

Physician Participation
In order to receive CME credits, participants must read each CME chapter and then complete the corresponding post-tests and evaluation forms.

CME Credits
The ACPM designates this educational activity for a maximum of 22.5 hours in Category 1 credits toward the AMA Physician's Recognition Award. CME credit can be earned for the entire course OR for individual sections. Estimated time to complete all available CME chapters is 22.5 hours. The termination date of this CME module is July 15, 2012.

Contact Us
If you have questions regarding CME credits or this process, please contact Jennifer Edwards, Director of Member Services and Development, at jedwards@acpm.org.

If you experience any technical difficulties with this CME module or website, please email us at webmaster@waterhealthconnection.org.

CME/MOC Learning Objectives

Section 1: Purpose of Physician Readiness Guide for Acts of Water Terrorism (Max 3.0 CME/MOC Credit Hours)

Understand the clinical challenges that complicate the recognition and management of water-related diseases resulting from exposure to waterborne Weapons of Mass Destruction (WMD) agents as part of a terrorist assault on water reserves.
Describe the important role of healthcare practitioners as critical "front-line responders" in detecting water-related disease resulting from biological, chemical or radiological terrorism.
Identify the essential need for healthcare providers to act as risk communicators and critical stakeholders in emergency preparedness and response planning for water terrorism.

Section 2: Understanding the Threat of Water Terrorism (Max 1.0 CME/MOC Credit Hours)

Understand the potential vulnerabilities of water systems in the United States to terrorist threats.
List the potential points of contamination in the US water system network that healthcare providers must keep in mind as possible sources of waterborne terrorism when evaluating a suspected case of terrorism-related disease.
Identify the importance of collaborating with local and state public health agencies and community water utilities when faced with recognizing water-related disease from intentional contamination of water.

Section 3: Chemical, Biological, and Radiologic Agent Dispersal and Multiple Exposure Pathways (Max 2.0 CME/MOC Credit Hours)

Recognize the multiple exposure pathways that may be used for dispersal of chemical, biological, and radiologic (CBR) agents during a terrorist attack including waterborne exposure.
Identify several distinguishing features between chemical and biological attacks using epidemiological features, animal indicators, and environmental trends or devices.
Describe the importance of host susceptibility and vulnerable population status during evaluation and management of patients exposed to waterborne CBR agents during terrorist activity that targets water.

Section 4: Detection and Diagnosis of Waterborne Terrorism (Max 3.5 CME/MOC Credit Hours)

Understand the difficulty of monitoring chemical, biological, and radiologic (CBR) agents in water using ONLY environmental detection methods as a means of protecting the public's health.
List the epidemiologic patterns and sentinel clues that may indicate CBR agent exposure and terrorism-related illness in a population resulting from water terrorism or other exposure sources.
Describe the importance of using syndromic surveillance as a critical tool for recognizing terrorism-related disease and intentional contamination of water as part of a terrorist event.

Section 5: Evaluation and Management of Disease Resulting from CBR Agents (Max 2.0 CME/MOC Credit Hours)

Explain the clinical challenges of diagnosing waterborne disease in patients exposed to chemical, biological, and radiologic (CBR) agents dispersed in water.
Describe the importance of communicating, collaborating, and coordinating with public health authorities when evaluating all cases of water-related terrorism in order to protect the public's health.
Understand the risk of indirectly contaminating water reserves subsequent to patient decontamination procedures for exposure to biological, chemical, and radiologic terrorism.

Section 5.1: Evaluation and Management of BIOLOGICAL AGENTS (Max 1.5 CME/MOC Credit Hours)

Explain the clinical difficulties of accurately diagnosing water-related disease resulting from intentional contamination of water with biological agents.
List the bacterial pathogens and parasitic pathogens of public health concern that may be transmissible through water as part of a terrorist assault and the resources available to diagnose and manage these diseases.
Describe the viral, rickettsial, and rickettsial-like pathogens of public health concern that may be transmissible through water as part of a terrorist assault and the resources available to diagnose and manage these diseases.

Section 5.2: Evaluation and Management of BIOLOGICAL TOXINS (Max 2.0 CME/MOC Credit Hours)

Describe the unique characteristics and toxicologic features that make biological toxins attractive biological warfare weapons and effective contaminants in water.
List the bacterial biotoxins and fungal-derived biotoxins (mycotoxins) of public health concern that may be transmissible through water as part of a terrorist assault and the resources available to diagnose and manage resultant disease.
Describe the plant, algae-derived, and marine biotoxins of public health concern that may be transmissible through water as part of a terrorist assault and the resources available to diagnose and manage resultant disease.


Section 5.3: Evaluation and Management of CHEMICAL AGENTS (Max 3.0 CME/MOC Credit Hours)

Describe the unique characteristics and toxicologic features that make chemical warfare agents and routine industrial and agricultural compounds effective contaminants in water.
List the chemical warfare agents including nerve, incapacitating, blood, and vesicant and skin blistering agents of public health concern that may be transmissible through water as part of a terrorist assault and the resources available to diagnose and manage resultant disease.
Describe the industrial and agricultural chemical compounds of public health concern that may be transmissible through water as part of a terrorist assault and the resources available to diagnose and manage resultant disease.

Section 5.4: Evaluation and Management of RADIOLOGIC AGENTS (Max 3.0 CME/MOC Credit Hours)

Describe the unique clinical challenges and public health consequences resulting from a radiologic terrorism attack and the potential for both direct and indirect contamination of water.
List three radiation terrorism threat scenarios and the types of disseminated radioactive materials that would be disseminated in a targeted community that potentially could contaminate water.
Describe the potential exposure pathways resulting from a radiologic terrorism event that may include a waterborne route of exposure and the nuclear agent sources that give rise to each type of exposure.

Section 6: Clinician Role in Risk Communication and Community Readiness (Max 1.5 CME/MOC Credit Hours)

Understand the importance of the clinician's role in local preparedness and community readiness and response for acts of water terrorism.
Recognize the need for a coordinated response to acts of water terrorism that is based upon cooperation among a multidisciplinary team of healthcare providers, public health and water utility practitioners, law enforcement professionals, and community leaders.
Describe the critical role that healthcare providers play as risk communicators in community terrorism preparedness and response plans in order to protect the public's health during and after intentional contamination of water as part of a terrorist event.

Patricia L. Meinhardt, MD, MPH, MA, Author

This website is sponsored by the Arnot Ogden Medical Center. Original funding for this website was
provided by the Environmental Protection Agency.

This website does not host any form of advertisement.

External sites and linkages are not endorsed by the Environmental Protection Agency or Arnot Ogden Medical Center.
This page may be reproduced noncommercially by physicians and other health care professionals to share with one another and their patients.
Any other reproduction is subject to approval.
© 2003 - 2010 Patricia L. Meinhardt, MD, MPH, MA and Arnot Ogden Medical Center. All Rights Reserved.

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