KEN SAKAMOTO / KSAKAMOTO@STARBULLETIN.COM Dr. Joel Brown addressed the conference of doctors, nurses and other health care professionals yesterday during a conference on biological warfare at Queen's Medical Center.

Health experts
study bioterrorism

200 doctors, nurses and others
take part in a conference
about biological warfare

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By Diana Leone
dleone@starbulletin.com

Biological terrorism is "the poor man's weapon of mass destruction," Dr. Joel Brown told about 200 doctors, nurses and emergency medical technicians yesterday at a biological warfare conference.

And health care providers --many of whom have never seen a case of anthrax or smallpox themselves -- will be the front lines in the battle against it.

Many biological agents are cheap to produce and readily available for legitimate research uses, Brown said at a packed conference room at Queen's Medical Center.

He said it is believed that Saddam Hussein bought starter cultures for his biological weapons program from a Rockville, Md., firm.

Presenters Dr. Phil Bruno and Dr. Julie Kenner spoke of the symptoms of anthrax and smallpox, spelling out how to differentiate them from other diseases that might be more common, and showed slides of people who had the diseases.

During a break, a group of young doctors serving their internships at Queen's Hospital agreed that the conference was helpful. None of them has ever seen a case of anthrax, much less smallpox.

"Anthrax is so rare that the only physicians who've seen it are in other countries. And smallpox was considered eradicated," said Dr. James H. Ireland.

Brown said that is why he developed curriculum on bioterrorism for medical school students and gives continuing education talks to practicing doctors.

Another presenter, Dr. Patricia Hastings, asked for a show of hands from anyone in the room who had triaged 1,000 or more patients in a mass-casualty situation. Only one hand went up.

Hastings pointed out that after the 1995 sarin gas attack in the Tokyo subway, 9,000 people stormed hospitals seeking treatment.

"Can you imagine what a bad night that would be if you were on shift at Queen's?" she asked.

Salvatore Lanzilotti, Honolulu director of emergency services, said the city is trying to prepare for potential casualties of up to 10 percent of the population -- or 100,000 people -- if a bioterror attack occurred.

With just "250 open beds on any given day" at hospitals, a major attack would trigger a hierarchy of neighborhood assistance centers, triage facilities and field care centers to deal with many of the cases.

Lanzilotti said the city is being proactive, such as testing air at major public events to ensure there is no disease exposure.

He noted that the day after traces of anthrax were detected at the U.S. Supreme Court, the city was called to check out air quality in the federal court building here.

Though no cases of anthrax or other biological weapons have occurred in Hawaii, in an electronic pop quiz at the end of the half-day seminar:

>> Twenty-seven percent of doctors responded that they refused patients' requests to prescribe antibiotics to have on hand in case of a terrorist attack, while 5 percent did prescribe when asked. Sixty-eight percent had not been asked for antibiotics.

>> Of those responding, 23 percent said they are taking antibiotics themselves; 77 percent are not.

Bioterrorism links >> www.queens.org >> www.hml.org/WWW/terror.html >> www.idlinks.com/queensmedctr/bwseminar.htm >> www.bt.cdc.gov >> www.usamriid.army.mil/education/bluebook.html >> www.hopkins-biodefense.org