Physician Preparedness for Acts of Water Terrorism

On-line Continuing Medical Education Credits (CME) - Max. 22.5 Credit Hours
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Physician On-Line Readiness Guide:

Until recently, contamination of water with biological, chemical or radiologic agents generally resulted from natural, industrial or unintentional man-made accidents. Unfortunately, recent terrorist activity in the US has forced the medical community, public health agencies, and water utilities to consider the possibility of intentional contamination of US water supplies as part of an organized effort to disrupt and damage important elements of our national infrastructure. In his 2002 State of the Union Address, President Bush noted that confiscated Al Qaeda documents included detailed maps of several US municipal drinking water systems. Apprehension regarding a terrorist assault on drinking water has also been reinforced by news reports and recent arrests of suspects charged with threatening to poison water supplies in the US. In addition, the National Academy of Sciences reported to Congress that water supply system contamination and disruption should be considered a possible terrorist threat in the U.S. As a result of these reports, there continues to be concern that water may represent a potential target for terrorist activity and that deliberate contamination of water is a potential public health threat.

Although detection methods for recognizing intentional contamination of a water supply are improving, the most likely initial indication that a water contamination event has occurred in a community will be a change in disease trends and illness patterns. Practicing healthcare providers are likely to be the first to observe these unusual illness patterns and must understand their critical role as "front-line responders" in detecting water-related disease resulting from biological, chemical or radiological terrorism. Healthcare practitioners provide an “early detection system” for possible exposure to weapons of mass destruction -- since humans continue to remain the most sensitive and often the only “detector” of a covert terrorist attack on our population. Early recognition, accurate diagnosis, and conscientious case reporting by community healthcare providers of suspected waterborne disease cases -- no matter what their clinical specialty -- will be critical to maintaining water security and safety and to protecting the nation’s public health in the future.

Although it is not realistic to believe that healthcare providers can prevent the first cases of illness resulting from intentional acts of water terrorism, we could play a critical role in minimizing the impact of such an event by practicing medicine with a heightened level of suspicion that such an attack could occur in our community. With prompt diagnosis, proper management, and collaboration with public health and water authorities, prepared healthcare professionals may make the difference between a controlled response to an act of water terrorism versus a public health crisis.

A coordinated and effective response to acts of water terrorism will depend upon cooperation among a multidisciplinary team of healthcare providers, public health and water utility practitioners, law enforcement professionals and community leaders in order to mitigate the potential impact of an intentional contamination event. In order to respond to a potential act of waterborne terrorism, healthcare providers must have access to immediately accessible and constantly updated information. The primary purpose of this Physician Readiness for Acts of Water Terrorism guide is to address this critical need and provide healthcare practitioners with streamlined access to resources that will help guide them through the recognition, management and prevention of water-related disease resulting from intentional acts of water terrorism.