Abstract
Protocols for mass antibiotic prophylaxis against anthrax were under development in New York City beginning in early 1999. This groundwork allowed the city’s Department of Health to rapidly respond in 2001 to six situations in which cases were identified or anthrax spores were found. The key aspects of planning and lessons learned from each of these mass prophylaxis operations are reviewed. Antibiotic distribution was facilitated by limiting medical histories to issues relevant to prescribing prophylactic antibiotic therapy, formatting medical records to facilitate rapid decision making, and separating each component activity into discrete work stations. Successful implementation of mass prophylaxis operations was characterized by clarity of mission and eligibility criteria, well-defined lines of authority and responsibilities, effective communication, collaboration among city agencies (including law enforcement), and coordination of staffing and supplies. This model can be adapted for future planning needs including possible attacks with other bioterrorism agents, such as smallpox.
Highlights
Protocols for mass antibiotic prophylaxis against anthrax were under development in New York City beginning in early 1999
The goal of the plan was to have the ability to provide mass antibiotic prophylaxis to 8 million New Yorkers over a 48-hour period—in the worst-case scenario of a large-scale bioterrorism attack—without impinging upon the capacity of local medical facilities to respond to the needs of persons affected by the biological agent
On October 12, 2001, the department began collecting nasal swabs and distributing prophylactic antibiotics to persons working at the media company who might have been exposed to a letter implicated in the index case
Summary
An Ounce of Prevention Is a Ton of Work: Mass Antibiotic Prophylaxis for Anthrax, New York City, 2001. As part of national bioterrorism preparedness efforts, New York City began actively developing protocols for the distribution of mass antibiotic prophylaxis against anthrax in early 1999. These efforts were led by the Mayor’s Office of Emergency Management, in close collaboration with the New York City Department of Health (DOH). On October 12, 2001, the department began collecting nasal swabs and distributing prophylactic antibiotics to persons working at the media company who might have been exposed to a letter implicated in the index case Included in this effort were those working on the same floor as the index patient. Within hours of the Mayor’s public announcement of this case, DOH and the Office of Emergency Management
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