Juneau residents may feel far removed from recent anthrax scares on the East Coast but public officials are warning that the city is not immune from terrorist attacks and should craft a response strategy.
A terrorist could target a cruise ship or mail anthrax to Juneau because it's the state capital, cautioned a spokesman with the U.S. Coast Guard at a conference on biological and chemical warfare this week.
Or a person infected with a contagious and deadly disease elsewhere could unwittingly spread the ailment here, said Dr. Bernard Jilly, director of the state Section of Laboratories and a former bioterrorism expert for the Centers for Disease Control.
"You can be exposed in New York, come to Juneau and expose all your friends and neighbors," Jilly, speaking of a hypothetical incident, said to a crowd on Wednesday at Bartlett Regional Hospital. "And there will be an outbreak in Juneau."
If a biological or chemical attack happened here, it's unclear who would be in charge of Juneau's emergency response, according to public officials at the two-day conference attended by more than 100 health-care workers and emergency responders.
A Coast Guard spokesman wrapped up the session with a recommendation that city officials form a work group with federal and state agencies to map out a strategy.
"Who's in charge in Juneau?" asked Rick Janelle of the Coast Guard. "I'm not really sure we know the answer to that one."
Juneau City Manager Dave Palmer said the city is not sure what resources would be available in case of a terrorism incident here. He left the conference saying he would contact the governor's office to discuss setting up a work group with city, state and federal officials.
Juneau Police Chief Mel Personett said the city does not have a specialized team to handle hazardous substances. Officers who respond now do not have proper equipment and have had only four hours training, he said.
"We have a minimal response at this point," Personett said.
The workshop was organized by the state Department of Health and Social Services as a crash course on terrorism for people on the front line trying to learn how to respond to America's newest threat.
Dr. Robert Urata said he attended the conference primarily to learn how to diagnose and treat patients infected with anthrax a disease most doctors have never encountered.
"I know how to treat pneumonia and most of the common bacteria that affects us on an everyday basis, but this is all new," Urata of Valley Medical Care said.
The state has found no evidence of anthrax in Alaska to date, but Urata and other doctors at the workshop said a few patients have come to them with fears of infection and some have asked for nasal swabs to test for anthrax exposure.
Jilly, of the state health lab, advised physicians not to do the swabs unless authorized by the lab because the swabs can test negative even if a person has inhaled the deadly spores. He also told emergency workers not to hose down people who might have been exposed to anthrax.
He said a Fairbanks hazardous materials team recently hosed down a woman who was fearful she had picked up anthrax spores on a trip to Florida. The team took the woman outside in frigid temperatures, stripped her naked, turned the hose on her, then put her in a protective suit and dispatched her to a hotel. None of it was necessary, he said.
"You don't have to hose them down," said Jilly, noting a hosing doesn't help people who inhale the bacterium, and people with spores on their skin can simply take a shower and wash their clothes.
Dr. Sharon Fisher was more worried about smallpox than anthrax, which is treated with antibiotics.
"I think smallpox is a scarier thing than anthrax because it's not treatable," said Fisher, a local family practitioner.
"This is the one that scares the bejeebers out of me," said Jilly, noting recently declassified information shows that North Korea has smallpox in its military arsenal.
Infected patients have a 1-in-3 chance of dying from smallpox, which was eradicated in the wild 20 years ago, Jilly said. The highly contagious disease is preventable with vaccines but the United States has only 15 million doses, said Jilly, adding that it's unclear how many of the doses still are viable. A pharmaceuticals company is producing more vaccines, but they won't be available probably until 2005, he said.
The first visible manifestations of smallpox include lesions, which first appear on the face, then spread to the arms and lower body. Health-care workers must quarantine smallpox patients and learn to distinguish the virus from chicken pox, a similar but treatable disease, Jilly said.
Urata, the doctor, questioned whether Juneau's hospital had emergency response plans in place for a terrorist attack, which would require different procedures than trauma incidents such as earthquakes or landslides.
"I'm not sure we have anything in writing for chemical or biological" attacks, said Urata, who serves on the hospital board.
The city also does not have a plan to respond to a terrorist attack, and recent anthrax scares underscored the need to identify who is in charge, according to people at the meeting.
Police responded to an anthrax scare at the downtown post office but later questioned whether they had jurisdiction in the Federal Building, said Sandi Hicks of the post office.
And the state flew in a trooper from Ketchikan to respond to an anthrax scare in a state office in Juneau, said City Manager Palmer.
Kathy Dye can be reached at firstname.lastname@example.org.