Pediatricians’ conference in San Francisco addresses bioterrorism

By Ritu Bhatnagar The Associated Press
Tuesday October 23, 2001

SAN FRANCISCO — Pediatricians are urging officials to take steps to protect children against bioterrorism, saying they are especially vulnerable to its effects. 

The American Academy of Pediatrics’ annual conference this weekend offered panels addressing how to treat infants and children if they become infected with a bioterrorist agent. 

“They live closer to the ground, so aerosol agents with heavy particles will affect them more,” said Dr. Frederick Henretig, one of the speakers at a panel Sunday. “Their skin is thinner and they can be affected developmentally.” 

The doctors noted the recent anthrax infection of a 7-month-old baby in New York. The infant is the child of an ABC employee and had been in the network’s offices, where authorities believe the baby may have contracted the disease. 

“We know that children are much more vulnerable to a chemical exposure,” said Dr. Steve Berman, president of the academy. “There’s been talk about decontamination or special uniforms or equipment, but what if those don’t fit children or don’t allow children to be cared for? 

“If we embark on smallpox vaccine or anthrax vaccine, what happens if there are complication rates for children or aren’t as effective for them? It is absolutely critical that people with pediatric specialties are involved in disaster planning,” he said. 

Berman quickly pointed out that there is no need for parents or pediatricians to become overly alarmed, creating panic. 

Other sessions, part of a disaster-related series, focused on psychological concerns, such as how to talk to children about crisis and loss. 

Doctors from around the world attended the conference, fearing that anthrax and other types of bioterrorism could affect their countries. 

“I attended a similar conference in Chicago last week and am understanding how important it is to create a network of colleagues around the world to get better prepared,” said Dr. Sally McCarthy, an emergency physician from Australia. 

Some doctors noted that bioterrorism agents are typically easy and cheap for terrorists to obtain, even though it’s often difficult to weaponize such materials. 

“Any of you with two semesters of microbiology can go out and grow this stuff yourself,” said Dr. Theodore Cieslack. 

Cieslack said another problem that could arise in a crisis situation is a lack of facilities or equipment to treat many people. 

“Botulism, as of 2000, is survivable. But you have to put the patient on a ventilator for seven months after infection,” he said. “Imagine what would happen if 10,000 people are infected at the same time and there aren’t enough ventilators?” 

Cieslack said he considered the most harmful agents to be anthrax, smallpox and the plague, because very few samples are needed to produce illness or death on a large scale. 

Doctors said diagnosing smallpox in children can be particularly difficult since the early stages of the rash can easily be confused with chicken pox. 

“It’s tough to suspect that you’re dealing with something sinister,” Cieslack said. “One saving grace that smallpox has is that it has a long incubation period — 12 days — so you can immunize within a couple of days of infection.” 


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