Hawaii boosts
bioterror program

$8.4 million in federal funds will
be used to increase staff,
train and upgrade facilities

By Diana Leone

The state Health Department has been quietly making plans to greatly expand its Bioterrorism Preparedness Program to combat attacks using anthrax, smallpox or other biological agents.

With the influx of $8.4 million from the federal government, the program will:

>> Increase full-time staff from six to 30, plus have the ability to borrow staff from other Health Department divisions for planning and crisis situations.

>> Invest $2 million in laboratory upgrades.

>> Offer training for medical workers on recognizing the symptoms of biological agents and how to deal with patients who have them.

"I was so excited. At first I thought that it wouldn't happen," said Rebecca Sciulli, bioterrorism microbiologist and coordinator, who gets to increase her staff from herself and a clerk to nine microbiologists and molecular biologists.

"Almost everything I requested for the laboratory was approved -- close to $2 million for personnel, equipment and supplies," Sciulli said.

In addition, $300,000 of state capital improvement money will build a new "Biosafety Level 3" laboratory to provide more protection to lab workers dealing with extremely hazardous substances.

"It used to be I was only person in the lab with two or three (trained) volunteers during an event," Sciulli said. "With the new positions, we'll have 24-7 coverage."

Dr. Paul Effler, chief of the Communicable Disease Division and its Epidemiology Branch, is now also the state executive director for bioterrorism preparedness.

Effler said the work breaks down into several major categories:

>> Planning: Coordinating with Civil Defense, the Red Cross, the counties, hospitals and emergency personnel.

>> Surveillance and response: Detecting a bioterrorism event by tracking symptoms and diagnoses at all the state's hospitals and major health clinics, then acting to protect the public.

>> Lab capacity: Improving the state lab to detect bioterror hazards and having it primed to respond to an event.

>> Communication: Improving the information that flows into the Health Department from hospitals and clinics, and informing the media and the public about what's going on and what to do if there is a biochemical event.

>> Training: Helping health care workers at clinics and hospitals recognize potential biochemical agents by their symptoms.

"Unlike bombs, etc., a bioterrorism event is likely to be detected by increments," Effler said, as surveillance specialists review data from hospitals.

State Emergency Medical Services Chief Donna Maiava said the surveillance will be so detailed that a worker could review statistics and notice that 20 patients picked up and taken to 12 different hospitals exhibited the same symptoms.

Planned staff additions will include five surveillance and response positions -- three for Oahu and two for neighbor islands.

In addition to lab positions, there will be computer, analyst and clerical jobs.

Others already involved in bioterrorism preparedness, who are not part of the expansion, include Dr. James Marzolf, who is leading a team developing a response to smallpox threats; and Dr. Paul Kitsutani, assigned to Hawaii by the Centers for Disease Control.

Maiava and Toby Clairmont of the Healthcare Association of Hawaii recently returned from a workshop in Washington, D.C., regarding bioterrorism emergencies. Before they left, both said they expected to exchange ideas with their peers in other states.

Bioterrorism project manager Bart Aronoff, a 16-year Health Department veteran, called the bioterrorism preparedness team a "very exciting group of people."

"The potential of this program is to make improvements in Hawaii's public health system beyond the need for preparation for bioterrorism, if there's never a need for that here," Aronoff said.

If bioterrorism never happens here, much of the work the team does will be helpful in case of a nonterrorist disease outbreak, he said.

"Whether it's smallpox or other possible diseases, or even the outbreak of a new strain of influenza, there are many logistic problems" when you're dealing with a large number of sick people, Aronoff said. "In a sense, there's no precedent."

For more information about the Department of Health's Bioterrorism Preparedness Program or applications, e-mail

E-mail to City Desk


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