With the appearance of new and rare diseases in recent years and the continuing threat of bioterrorism, the importance of disseminating accurate information to physicians and involving clinicians in the early stages of outbreak response cannot be overstated, the nation's top public health official says.
"The two messages that really stick out in my mind are the need for communication and the importance of clinicians," says Julie Gerberding, M.D., director of the Centers for Disease Control and Prevention.
Gerberding, who addressed the AMA's annual conference in Chicago on Wednesday morning, notes that, for the first time in CDC history, a team of clinicians accompanied the epidemiology field team sent out to investigate early human cases of West Nile virus last year.
Having physicians present during the initial stages of identifying a public health emergency can help officials get the word out to local medical professionals who will treat affected patients and be crucial in containing an outbreak, according to Gerberding.
"One thing about clinicians, they like to be educated by peers, naturally," Gerberding says. "We can send CDC clinicians to outbreaks, but it's also important to have front-line clinicians involved."
Gerberding drew applause from AMA delegates when she said there should be no distinction between the public health system that identifies and plots response to diseases and the healthcare system that treats affected patients.
Consultations with physicians last summer to study lessons learned from the 2001 anthrax attacks on the East Coast convinced CDC officials that practitioners want a simple fact sheet to help with understanding and diagnosing epidemic conditions, Gerberding says. Accordingly, the CDC produced and disseminated 1.5 million one-page fact sheets on severe acute respiratory syndrome this year and published a similar form for the current monkeypox outbreak.
Most importantly, according to Gerberding, public health officials got the word out fast. On March 14, the CDC activated its emergency operations center in Atlanta, just two days after the World Health Organization issued its first SARS alert from China.
To date, there have been no deaths in the United States attributed to SARS.
"The lesson learned from anthrax is that we couldn't wait until we dotted every I and crossed every T," Gerberding says. "It's bold action that matters most. You can't sit around in committees" debating a response to mysterious, communicable diseases like SARS.
"The new normal is emerging infectious diseases and emerging infectious diseases that are transmitted rapidly," says Gerberding.