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

Physician Preparedness for Acts of Water Terrorism

Augusts 8, 2016 - This CME-MOC opportunity is no longer available.

The website has provided access to free web-based information addressing waterborne disease and the health effects of water pollution and contamination to hundreds of thousands of users since 2002. While we are pleased that this website has been a valuable resource to so many, we have made the decision to shut down the website effective August 12, 2016. If you have any questions, please contact us at
On-line Continuing Medical Education Credits (CME)
and Maintenance of Certification Credits (MOC)
Max. 22.5 Credit Hours
Sponsored By:

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, the medical community, public health agencies, and water utilities now have 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. 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. In addition, public apprehension regarding a terrorist assault on drinking water has also been reinforced by news reports of the arrest of suspects charged with threatening to poison water supplies in the US. As a result, 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.

It should be noted that detection methods for recognizing intentional contamination of a water supply are improving. However, 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 and public health practitioners 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 respond to this critical need and to provide comprehensive resources for healthcare providers and other disaster management professionals faced with recognizing and managing water-related disease in their communities. This Physician On-Line Reference Guide provides free access to more than 550 webpages of clinically relevant information on a “24/7” basis. During a five year period, this medical website has received more than 10 million hits for information from over 350,000 visitors located in 105 countries and 9 regions and territories. More than 425 organizations have highlighted and incorporated this medical website as a waterborne disease medical reference guide and several branches of the US military have utilized this website. In addition, with sponsorship from the American College of Preventive Medicine, a 22.5-hour online Continuing Medical Education (CME) offering has been developed for review of the content of Physician Preparedness for Acts of Water Terrorism: A Physician Online Readiness Guide. American Board of Preventive Medicine (ABPM) diplomates may also earn lifelong learning Maintenance of Certification (MOC) credits by participating in this educational activity. We trust that this on-line medical reference guide will provide you and your community with valuable water disaster resources and preparedness education.

Page last modified on July 2, 2014

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

The American College of Preventive Medicine (ACPM) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

ACPM designates this educational activity for a maximum of 22.5 hours in Category 1 credit toward the American Medical Association (AMA) Physician's Recognition Award (PRA). Each physician should claim only those hours of credit that he or she actually spends in the activity.

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

This website does not host any form of advertisement.

External sites and linkages are not endorsed by the Environmental Protection Agency, Arnot Ogden Medical Center, or the author.

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 - 2016 Patricia L. Meinhardt, MD, MPH, MA. All Rights Reserved.

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