Biological Agents -- Description

Q: What are biological agents?
A: Biological agents are live organisms or their poisons used by terrorists to cause illness or death in humans. Several biological organisms are suitable for weapon adaptation by terrorists. These biological agents are classified in three groups:

• Bacteria
  
• Viruses
  
• Toxins
  

Q: What is bioterrorism?
A: Bioterrorism or biological warfare is the intentional use of organisms to harm or kill people. Biological agents can also be used to harm plants, crops and animals in order to disrupt an economy.

Q: How harmful are biological agents?
A: Some are deadly, especially if there is a delay in recognition of the cause of illness and a delay in starting appropriate therapy. Other agents cause illness without death.

Q: Have biological weapons been used before?
A: Yes, biological pathogens have been used for biological warfare and terrorism. Both the U.S. and the Soviet Union prior to the closing of their biological weapons programs developed the potential for delivery of biological weapons and viable agents. The anthrax cases in 2001 were the result of a bioterrorist attack.

Q: Why are biological agents effective as weapons?
A: Biological agents are effective as weapons because:

• Biological agents can kill or disable humans.
  
• Biological agents can severely harm a nation's economy when plants or animals are affected.
  
• Some biological agents can be adapted for easy and large-scale dispersal as aerosols or airborne particles.
  
• Biological agents may be difficult to detect. Biological agents cause illness that can be delayed by days or weeks, complicating recognition and treatment.
  
• Biological weapons have extreme destructive potential that can be concentrated in a small and unremarkable package such as an envelope. Biological weapons are also difficult to trace to a source.
  

Q: How many biological agents can be used as weapons?
A: The list of potential agents that could be used as weapons is long. However, only a handful of biological agents are believed to have the ability to paralyze a large city or region of the country and cause high numbers of deaths, wide-scale panic and massive disruption of commerce.

Some biological agents considered by health authorities to have bioterrorism potential are:

• Bacteria that cause anthrax, brucellosis, cholera, glanders, plague, Q fever or tularemia.
  
• Viruses that cause arboviral encephalitis, Ebola virus hemorrhagic fever, Lassa fever, Marburg virus disease or smallpox.
  
• Toxins including botulinum, ricin, mycotoxins or staphylococcal enterotoxins.
  

Q: Is it easy for terrorists to get biological agents?
A: It is possible to obtain biological organisms, but not easy. It is extremely difficult to change a biological organism to make it a "weapons grade" agent. It is thought that it would take the resources of an established government or state to accomplish this.

Transmission
Q: How can biological agents be spread?
A: People could be exposed to bacteria, viruses or toxins through fine airborne particles (aerosol), contaminated food and water or person-to-person contact.

Q: How do biological agents enter the body?
A: Biological agents are infectious through one or more of the following exposure mechanisms:

• The respiratory tract (inhalation).
  
• Eating or drinking (ingestion).
  
• Contact with mucous membranes, eyes, or skin that is not intact.
  

Symptoms
Q: How will I know if I've been exposed to a biological weapon?
A: You will most likely not know you have been exposed unless the terrorist issues a threat or claims responsibility.

• Authorities may not realize that the illness is the result of a biological agent being used as a weapon unless it is a very unusual agent or many people are sick with the same thing. It is important to keep abreast of local health alerts because an alert may be the first indication of exposure to a biological weapon.
  
• Biological agents are difficult to identify, and not everyone who is exposed or infected gets sick. Some agents will have unique symptoms and will need to be diagnosed and treated by a medical professional. If an outbreak is identified in a geographical area in which you live, work or have spent time, you should suspect exposure and contact your local health provider or health department.
  

Response
Q: What should I do if someone threatens a terrorist action?
A: If you receive a threat:

• Get as much information from the caller as possible.
  
• Keep the caller on the line and document everything that is said.
  
• Immediately notify police and building management.
  

After you've been notified of a threat:

• Do not touch any suspicious packages.
  
• Clear the area and notify the police immediately.
  
• Avoid standing in front of windows or other potentially hazardous areas.
  
• Do not block sidewalks or streets to be used by emergency officials.
  

Q: I've noticed suspicious activity at the house next door. People come and go carrying packages and lately they've been wearing medical masks. Should I report what is going on?
A: Report any suspicious activity to local law enforcement authorities. If you suspect a crime is being, or is about to be committed, call 911. If the activity simply appears suspicious, call the police non-emergency number and be prepared to describe the activity in detail.

Q: What should I do if I find a suspicious substance?
A: Report any suspicious substance to local authorities.

• Don't touch or try to clean up the substance.
  
• Alert others in the area.
  
• Leave the room and close the door, or section off the area to prevent others from entering. If possible, turn off the ventilation system.
  
• Remove any contaminated clothing and place in sealed bags. Wash your hands and exposed body surfaces well with soap and water.
  
• Report the substance to local law enforcement authorities and building management, if applicable. Seek additional assistance for exposed or potentially exposed people.
  

Q: What should I do if I receive suspicious mail?
A: If you receive suspicious mail:

• Do not shake or empty the contents of a suspicious package or envelope. Do not carry the package or envelope, show it to others or allow others to examine it.
  
• Put the package or envelope on a stable surface; do not sniff, touch, taste, or look closely at it or any contents that may have spilled.
  
• Alert others in the area about the suspicious package or envelope.
  
• Leave the area, close any doors and prevent others from entering the area. If possible, shut off the ventilation system.
  
• Remove and bag any contaminated clothing. Wash hands with soap and water to prevent spreading potentially infectious material to face or skin. Seek additional instructions for exposed or potentially exposed persons.
  
• If at work, notify a supervisor, security officer or law enforcement official about the suspicious package or letter. If at home, contact your local law enforcement agency.
  
• If possible, create a list of persons who were in the room or area when this suspicious letter or package was recognized and a list of persons who also may have handled this package or letter. Give the list to both the local public health authorities and law enforcement officials.
  

Q: If I'm in a contaminated area, what should I do?
A: If you believe a biological agent has contaminated a room:

• Alert others nearby and leave the area immediately, covering your mouth and nose with a tissue, handkerchief or piece of clothing.
  
• Close the door or section off the area to prevent others from entering. Turn off fans or ventilation units if possible.
  
• Immediately remove contaminated clothing and thoroughly rinse your eyes and exposed skin thoroughly with water. Do not touch the clothing again or allow others to go near it.
  
• Summon nearby emergency help.
  

Q: What if I think there has been a biological release and no one else seems to know about it?
A: If you think you have been exposed to a biological agent or if you see something that you think may be dangerous, immediately call your local police.

Q: Can terrorists put biological agents in my drinking water?
A: Contamination of water supplies by chemical, biological or radiological agents is a possibility, but is not considered a great risk, due to protective measures already in place.

• The federal experts at the EPA, Centers for Disease Control and Prevention (CDC) and the Department of the Army find that it takes very large amounts of a contaminant to threaten the safety of a water system.
  
• It is difficult for someone to introduce the quantities needed to contaminate a system without being detected.
  
• The treatment system already in place for treating drinking water before it comes out of the tap will, in most cases, remove the immediate threat to public health.
  

Medical treatment
Q: Is there any treatment for disease outbreaks that could occur following a bioterrorist attack?
A: Treatment for exposure to a biological weapon depends on the agent used and would be determined by your local health care providers. If you suspect you have been exposed to a biological agent contact your health care provider or emergency medical personnel.

If it is determined that there is an outbreak in your locality, listen to advice given by local officials on your Emergency Response System (EAS) radio or television station to determine what steps you need to take, or contact your health care provider.

Q: What should I do if I am in a biological weapon's range?
A: Listen to your local Emergency Alert System (EAS) radio or television station to determine what steps you need to take to protect you and your family.

• Emergency services may be overwhelmed. Only call 911 about life threatening emergencies.
  
• People who are exposed to a biological agent may need to receive medical attention. Follow the recommendation of local emergency officials or your health care provider.
  

Protective actions
Q: Can I get vaccinated to protect myself from diseases such as smallpox?
A: Vaccines for any of the potential agents such as anthrax, smallpox or plague are not currently available to the public or recommended. Check with your physician, health care provider or local health department in the event of an actual event for any changes in these recommendations.

Q: What can I do to prepare for biological warfare?
A: The most important protective measure is early detection of disease. Early detection is the key to minimizing worsening of illness in affected persons. You should stay informed and alert for local public health announcements concerning dangers.

Q: I'm still very anxious, isn't there anything I can do?
A: You might feel less anxious if you take small precautionary steps such as:

• Developing a disaster supplies kit and plan.
  
• Creating an emergency communications plan.
  
• Staying informed by paying attention to local news and announcements from the local public health department.
  

Q: Should I keep a lot of food on hand in case there is a biological attack?
A: Although it doesn't hurt to keep a supply of nonperishable food and water on hand, there are very few biological agents for which remaining in your home will be safer than going outside. Follow the advice of your local health officials.

Q: How do I keep my stockpiled food and water from getting contaminated by biological agents?
A: Store food and water in sealed containers.

Q: Should I keep a supply of antibiotics on hand in the event there is a biological attack?
A: No. It is not recommended to stockpile antibiotics for several reasons:

• Each organism requires a certain antibiotic. If a doctor hasn't diagnosed your condition, the antibiotic you take may not be the right one to eliminate the organism causing the infection.
  
• Only those who have been exposed to the agent should take antibiotics and sometimes they are only prescribed once you are actually sick. Antibiotics should only be taken on the advice of health authorities.
  
• Individuals may have serious adverse reactions to antibiotics.
  
• Some organisms do not respond to antibiotics.
  
• Some antibiotics have limited shelf life.
  
• Organisms can become resistant to antibiotics if they are not taken properly or are taken when they are not needed. This will cause the antibiotics to not be useful when they are needed.
  

Q: Should I buy a gas mask to protect me if there's a biological attack?
A: We view the purchase of escape hoods, gas masks and similar equipment a matter of personal choice. If you wish, you may search the Internet for gas masks and escape hoods, or check the Yellow Pages under Safety Equipment and Clothing.

Escape hoods, gas masks and similar equipment are difficult to use properly and have numerous limitations. Escape hoods are made of plastic and have a special filter. They must be put on in a clean environment and taken off promptly after the wearer has gone through a contaminated area.

Gas masks must be fitted to each individual and they must contain the proper filter in order to be effective. With the large number of potential chemical agents, it is impossible to know in advance which filter should be used. With some chemicals, gas masks would be totally ineffective.

Depending on how contaminated the air is, the hood or mask could stop working in less than 20 minutes. Batteries in powered air units typically expire in a few hours.

For the general population, we recommend standard protective actions of sheltering in place or evacuation. You can find guidance about sheltering in place or evacuation on the Virginia Department of Emergency Management Web site. (That Web address is www.vaemergency.com.) Or, call your local emergency management office or the American Red Cross chapter.

Tune in to the radio or television station where you normally get your news for information on what actions to take. Where you are in relation to the site of an incident will affect how you should respond. Listen carefully.

Q: What about biological agents?
A: A common facemask - the N95 dust mask - will provide protection against such agents as anthrax. These masks are inexpensive and readily available at hardware stores.

Q: Can I survive a biological attack if I seal the windows and doors in my home?
A: Most attacks occur without warning. Unless you seal your windows and doors permanently, you cannot prevent contamination. It would also depend on the agent and how it was dispersed. Some biological agents may spread person-to-person so sealing the home would not be necessary.

Emergency water supply
Q: How will I know if I shouldn't drink my water?
A: Your water supplier is required by law to notify you if your water doesn't meet EPA or state standards or if there is a waterborne disease emergency. They will notify you by newspaper, mail, radio, TV or hand delivery.

• The notice will describe any precautions you need to take, such as boiling your water.
  
• If there is an attack on a local water system, the drinking water utility will activate its emergency response plan with local law enforcement and state emergency officials. These plans provide for shutting down the system, notifying the public of emergency steps to take and an alternative source of water, if needed.
  

Q: How do I find out what water can be used following a disaster, if I don't have any stored?
A: Listen to your Emergency Alert System (EAS) radio or television station for the latest information and instruction. In the event an attack affects a local water system, your drinking water utility will activate its existing emergency response plan with local and state emergency officials. Emergency plans have provisions for shutting down water systems, notifying the public of emergency steps to take and an alternative source of water they can use, if needed.

Q: If I haven't stockpiled water and I can't access any local information about water sources, what water could I use following a disaster?
A: Take the following steps:

• If you need to find water outside your home, you can use several sources:
  
• Rainwater.
  
• Streams, rivers and other bodies of moving water.
  
• Ponds and lakes.
  
• Natural springs.
  

Treat water before drinking it. Avoid water with floating material, an odor or dark color. Use saltwater only if you distill it first. Do not drink floodwater.

Q: If I'm sheltering or trapped in my home or work place, what water sources can I use?
A: If you are caught without a supply of clean water, you can use water from your hot water tank, pipes and ice cubes. As a last resort, you can use water in the reservoir tank of your toilet (not the toilet bowl).

• Shut off the incoming water valve if there are reports of broken water or sewage lines to keep contaminated water from entering your water system.
  
• To use the water in your pipes, let air into the plumbing by turning on the faucet in your house at the highest level. A small amount of water will trickle out. Then obtain water from the lowest faucet in the house.
  
• To use the water in your hot-water tank, be sure the electricity or gas is turned off and open the drain at the bottom of the tank. Start the water flowing by turning off the water intake valve and turning on a hot-water faucet. Do not turn on the gas or electricity when the tank is empty.
  

Q: If I have to disinfect my water, what should I do?
A: Listen to your Emergency Alert System (EAS) radio or television station for the latest local information and instruction. In times of extreme crisis, local health departments may urge consumers to follow additional measures. When local public health department information differs from any general advice being given, the local information should prevail.

If you are told to disinfect your water:

• Any water to be used for drinking, cooking, making any prepared drink or brushing teeth should be properly disinfected.
  
• Do not drink water with floating material, an odor or dark color. Examine the physical condition of the water. Disinfectants are less effective in cloudy water.
  
• Filter murky or colored water through clean cloths or allow it to settle, and draw off the clear water to be disinfected.
  
• Either boil or chemically treat small quantities of your water to kill potential microorganisms. Boiling is the best method to ensure water is bacterially safe to drink. Vigorous boiling for 1 minute will kill most disease-causing microorganisms. Certain chemicals such as household bleach and iodine, if applied with care at the correct concentrations can also make most water free from harmful or disease-causing organisms.
  
• Use saltwater for drinking only if you distill it first.
  

Q: How should I boil water that is unsafe to drink?
A: Treat it like this:

• Before treating, let any suspended particles settle to the bottom, or strain them through layers of paper towel or clean cloth.
  
• Bring water to a rolling boil for 1 minute.
  
• Let the water cool before drinking.
  
• Boiled water tastes better if you put oxygen back into it by pouring the water back and forth between two clean containers. This will also improve the taste of stored water.
  

Q: How do I chemically disinfect my water?
A: When boiling is not practical, you can use certain chemicals to disinfect your water. The two chemicals commonly used are chlorine and iodine. (These chemicals do not effectively kill several microorganisms found in surface water. Boiling is a better alternative when surface, rather than well water, is used.)

Chlorine bleach
You can use common household liquid bleach to kill microorganisms. Use only regular household liquid bleach. Do not use scented bleaches, color safe bleaches or bleaches with added cleaners.

Follow the directions given on your liquid bleach label. If there are no directions, add 1/8 tsp. or 8 drops (double this amount for cloudy or colored water) of bleach per gallon of water, stir and let stand for 30 minutes.

If the water does not have a slight bleach odor, repeat the dosage and let stand another 30 minutes. If the treated water has too strong a chlorine taste, leave it exposed to the air for a few hour or pour it from one clean container to another several times.

Chlorine tablets
Chlorine tablets can be purchased in commercially prepared form that contains the necessary dosage for drinking water disinfection.

These should be used as stated in the package instructions. When instructions are not available, use one tablet for each quart of water.

Tincture of iodine
Common household iodine from the medicine chest or first aid kit may be used to disinfect water.

Add five drops of 2 percent United States Pharmacopeia (USP) tincture of iodine to each quart of clear water (for cloudy water, add 10 drops).

Let the solution stand for at least 30 minutes before drinking.

Iodine tablets
Commercially prepared iodine tablets containing the necessary dosage for drinking water disinfection can be purchased to disinfect water.

Use as directed on the package. When instructions are not available, use one tablet for each quart of water to be purified.

Q: I've been told that to drink salt water I need to distill it. How do I distill water?
A: Distillation removes microbes that resist boiling and chemicals. It also removes heavy metals, salts and most other chemicals. Distillation involves boiling water and collecting vapor, which condenses back to water. The condensed vapor will not include salt and other impurities.

To distill:

• You will need a pot with a secure lid. Fill the pot halfway with water.
  
• Secure a cup to the pot's lid so that the cup will hang right side up when the lid is upside-down. Put the lid on upside down (make sure the cup is not dangling into the water).
  
• Boil the water for 20 minutes.
  

The water that drips from the lid into the cup is distilled.

Q: Do I need to keep a supply of water on hand for use during an emergency? How do I store the water?
A: You may want to keep a fresh supply of stored water in your house for emergencies. Having an ample supply of clean water is a top priority in an emergency. If disaster strikes your community, you might not have access to water for days, or even weeks.

A normally active person needs to drink at least 2 quarts of water each day. Hot environments can double that amount. Children, nursing mothers and ill people need even more. You can minimize the amount of water your body needs by reducing activity and staying cool. You will also need water for food preparation and hygiene.

• Store a total of a least one-gallon per person, per day. Rotate water every 6 months.
  
• Store water in thoroughly washed plastic (preferably), glass, fiberglass or enamel-lined metal containers. Never use a container that has held toxic substances. Plastic containers, such as soft drink bottles are best. You can also purchase food-grade plastic buckets or drums.
  
• Seal water containers tightly, label them and store in a cool, dark place.
  

Q: How should I treat water before storing it?
A: Only your local public health agency should make recommendations about whether your local water can be safely stored, for how long, and how to treat it. Check with your local health department prior to an emergency for local water storage tips. After a disaster listen to your local Emergency Alert System (EAS) radio or television station for updated information and instruction.

Q: Is bottled water safer from a biological attack than the water from my tap?
A: Bottled water is not necessarily safer from a terrorist attack than your tap water. In most cases, bottled water comes from a water source just like water from your tap. Tap water is protected at the drinking water facility through local security measures while the safety of bottled water depends on security and emergency response plans at the bottling plant.

Protecting pets
Q: Can my pet get diseases from biological agents?
A: Yes and no, depending on the agent. Pets are susceptible to some of the same diseases humans contract. Check with your veterinarian for specific disease information.

Q: Are there vaccinations my pets can get for protection from biological agents?
A: There are some vaccines available for pets for specific diseases. Check with your veterinarian for vaccination and treatment information.

Evacuation
Q: If I'm asked to evacuate, what should I do?
A: Authorities may decide to evacuate an area for your protection. If you are asked to evacuate, listen to your Emergency Alert System (EAS) station for detailed information.

• Make sure the evacuation order applies to you.
  
• Find out if you need to evacuate immediately or if you have time to pack some essentials.
  
• Find out where you need to go and what route to take.
  
• Do not use your telephone, as the lines should be kept open for life-threatening situations.
  

Q: If I'm told to leave my home or office immediately? What should I take with me?
A: If you are told to evacuate immediately:

• Check on neighbors or coworkers to make sure they have been notified, and offer help to those with disabilities or other special needs. If you need a ride, ask a neighbor or coworker. If no one is available to help you, listen to your local Emergency Alert System (EAS) radio or television station for further instructions.
  
• Locate and keep your disaster supplies kit with you. (See also workplace disaster supplies kit.) Make sure you have an adequate supply of water. Wear protective clothing, such as long-sleeved shirts, long pants, sturdy shoes, hats, gloves and eyeglasses.
  
• Use travel routes specified by local authorities. Don't use shortcuts because certain areas may be impassable or dangerous.
  
• Continue to listen to you local EAS station for information and instruction.
  

You can do the following, only if you are sure you have extra time:

• Call your family contact to tell them where you are going and when you expect to arrive.
  
• Provide for your pets. Pets are not permitted in public shelters.
  
• Gather a change of clothing for each family member, personal items such as toothbrushes and eyeglasses, and items for your baby such as formula and diapers.
  
• Shut off water and electricity before leaving, if instructed to do so. Leave natural gas service ON, unless local officials advise otherwise. Lock your doors and windows.
  

Q: Are there any special precautions I should take while I'm driving to the shelter?
A: Follow these precautions:

• Don't take shortcuts because a shortcut may put you in the path of danger. For your safety, follow the exact route you are told to take.
  
• Take only one car to the evacuation site.
  
• Close your car windows and air vents and turn off the heater or air conditioner.
  
• If possible, continue to listen to your Emergency Alert System (EAS) radio or television station for updated information.
  

Q: If a terrorist attack occurs during the day my children will most likely be in school, how will I be able to take care of them?
A: In an emergency, your children may be sheltered in place or evacuated from school. Do not go to the school. School personnel are trained to handle emergencies.

• Do not call your child's school. You could tie up a phone line that is needed for emergency communications.
  
• For further information, listen to local emergency radio and TV stations to learn when and where you can pick up your children.
  
• You can check with your children's schools prior to an emergency to see what protective plans they have in place.
  

Q: Are there any bomb shelters I can go to if there is an emergency?
A: There is no listing of bomb shelters or civil defense shelters in any community in Virginia. After 1970, most of the existing shelters were either closed or not replaced. There may be private shelters in office buildings, churches, schools or houses, but they are not listed.

There are numerous guidelines available for building "safe rooms" traditionally used for protection against tornadoes and hurricanes. These plans are available on the FEMA web site at www.fema.gov/mit//saferoom. Some books on the subject were also printed in the 1980s by FEMA and there are a number of plans available from private businesses and nonprofit groups. These can be accessed on the Internet using a search engine of your choice.

Q: I don't know of any evacuation procedure set up for my area. How can I find out if we have one?
A: Check with your local emergency management office. A list of local emergency numbers appears in Appendix A.

Q: I'm in a wheelchair, I don't drive and I live alone. What should I do if we're told to evacuate?
A: Check with your local emergency management office to find out about special needs notification procedures. A list of local emergency numbers appears in Appendix A.

Sheltering in place
Q: What does "shelter in place" mean?
A: "Shelter in place" means to stay indoors – in homes, schools, businesses or public buildings during an emergency. Sheltering in place may be used when there is little time to react to an incident – where it would be more dangerous to be outside attempting to evacuate than to remain where you are.

Q: If I'm told to "shelter in place" what should I do?
A: "Shelter in place" may be one of the basic instructions given during an emergency. This is a precaution aimed to keep you safe while remaining in your home or other location. If you are told to shelter in place:

• Stay in a building or other shelter. If you are outdoors, go inside immediately. If there are contaminants, you can provide a minimal amount of protection by covering your mouth and nose with a cloth or other material such as newspaper. If you have to gather up family members, protect your body as much as possible.
  
• If possible, bring your pets indoors, but do not put yourself at risk for your pets.
  
• Locate and keep your disaster supplies kit with you. Make sure your radio is working and that you have an adequate supply of fresh water.
  
• Close all windows. Turn off all fans, heating and air conditioning systems. Close the fireplace damper.
  
• Go to an aboveground room (not the basement) with the fewest windows and doors. Take your family disaster supplies kit with you.
  
• Wet some towels and jam them in the crack under the doors. Use duct tape to seal around doors, windows, exhaust fans and vents. Use plastic garbage bags to cover windows, outlets and heat registers. (See the question below.)
  
• If you are told there is danger of explosion, cover the windows with shades or blinds and stay clear of them.
  
• Stay in the room and listen to your Emergency Alert System (EAS) radio and television station for information and instruction or until you are told all is safe.

Q: Should I use duct tape and plastic sheeting to seal my home?
A: Authorities may ask you to tape and seal an interior room with duct tape and plastic. These items should be included in your disaster supplies kit. You will not only need to seal the windows and doors but also the cracks and openings in the walls, floors and ceilings, light fixtures, fans, plumbing, electrical outlets, door handles and even locks. Also shut down all air-handling units.

Preparing a safe room is one positive step you can take to protect your family, but it is important to remember that sealing a room is only a temporary protective measure. You would have to seal the room as tightly as possible to prevent even small quantities of the chemical from seeping into the room. If the agent cannot cross the barrier, however, oxygen will not be able to penetrate it either. Be aware that you will run out of oxygen if you stay in a sealed room too long.

Awareness and notification
Q: Will authorities notify me if biological weapons are used?
A: Yes, in the event of a public health emergency, local and state health departments will inform you about any actions you need to take. As soon as the circumstances are understood, these officials will call news conferences to convey accurate information and instructions. Additional news conferences will be called as frequently as possible with updated information. In a genuine disaster, the Emergency Alert System (EAS) would be used to give instructions.

Q: How will I be notified if biological weapons are used?
A: In the event of a major emergency, authorities will get your attention in at least one of several ways. There will be announcements over your local Emergency Alert System (EAS) radio or television station, a siren could sound, you may be called by telephone, emergency personnel may drive by and give instructions over a loudspeaker, or officials could come to your door. You can check with local authorities prior to a disaster to see what notification methods they would use.

Q: If I listen to the local EAS station what kind of information will I get about a biological agent release?
A: You could be told:

• The type of health hazard.
  
• The area affected.
  
• How to protect yourself.
  
• Evacuation routes, if necessary.
  
• Shelter locations, if necessary.
  
• Type and location of medical facilities.
  
• Phone numbers to call if extra help is needed.
  

Q: Should I call 911 for information following a biological attack?
A: Dial 911 or EMS numbers only for a life-threatening emergency.

Listen to your Emergency Alert System (EAS) radio or television station for the latest information.

Emergency supplies
Q: What emergency supplies should I keep on hand in case there's a terrorist attack?
A: Keep these supplies on hand:

• A three-day supply of water (1 gallon per person per day).
  
• Food that won't spoil.
  
• One change of clothing and footwear per person, and two blankets or a sleeping bag per person.
  
• A first aid kit that includes any family prescription medications.
  
• Emergency tools.
  
• A battery-powered radio, flashlights and plenty of extra batteries for each. An extra bulb for the flashlight.
  
• Cash, traveler's checks, credit cards and important family documents in a waterproof container. An extra set of car keys.
  
• Sanitation supplies.
  
• Special items necessary for infants, elderly or disabled family members.
  

(NOTE: See disaster kit tips)

Community readiness
Q: Are hospitals in my area prepared to handle a biological emergency and its demands for health care?
A: The preparedness level in hospitals depends on the agent used in an attack. Because a sudden surge in patients could overwhelm an individual hospital's resources, hospitals collaborate with other hospitals in their area to respond effectively to an attack on a citywide or regional basis.

Hospitals are required to maintain disaster response plans and to practice applying them as part of their accreditation process. In an emergency, local medical care capacity will be supplemented with federal resources. Most hospitals in Virginia have been modifying their disaster response plans to prepare for a bioterrorist event.

Q: Does every community have an adequate emergency response system? How quickly can it be implemented?
Q: The emergency response system varies from community to community on the basis of each community's needs and resources. Some emergency system components can be implemented very quickly, while others may take longer. (NOTE: Provide local emergency numbers if available).

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