College Mobilizes To Prepare Members, Labs
The College, at the request of the Centers
for Disease Control and Prevention, has sent a CDC alert on anthrax
protocols to all its members and thousands of clinical laboratories,
and continues work internally and with other groups to respond to the growing
threat of bioterrorism.
Last Friday, the College mobilized to distribute the alert to about
30,000 clinical laboratories and all 16,000 CAP members after receiving
the CDC request for assistance only hours earlier.
College staff and CDC officials had been discussing possible CDC participation
in a ASCP/CAP Joint Annual Meeting program on bioterrorism (see story
below) when the agency asked for the College's help to distribute the
alert. The request came about noon Friday, even as the CDC and other federal
agencies were responding to reports of possible anthrax exposure at NBC
headquarters in New York City. News of the NBC anthrax case added urgency
to the CDC decision to notify laboratories of the anthrax protocols.
The College's Officers, who were attending a meeting of the CAP Finance
Committee in New York at the time, quickly assembled for a conference
call with staff and authorized the mass distribution of the alert. The
College then worked with the CDC to craft the language of the alert, which
asks labs to familiarize themselves with the protocols and the procedures
to follow if they believe they have a case or isolate. After language
for the alert was made final, College staff responded quickly to distribute
it by e-mail and fax.
The College has in recent weeks discussed laboratory preparedness with
federal officials, including Scott Lillibridge, MD, a special assistant
to Health and Human Services Secretary Tommy Thompson and Stephen Morse,
PhD, director of the CDC's Laboratory Response Network (LRN). The alert
asks laboratories to use the LRN if they have a suspect agent. The LRN
comprises more than 80 state and local public health and military laboratories
with protocols and reagents that allow them to rapidly identify Bacillus
Bioterrorism Measures Win Quick Endorsements
Last Friday, the College's Council on Government and Professional
Affairs endorsed two legislative efforts in the U.S. Senate aimed
at responding to the threat of bioterrorism.
The Council, meeting via conference call, agreed to support "The
Biological and Chemical Weapons Preparedness Act of 2001" (S.
1468), introduced Oct. 3 by Sens. John Edwards, D-N.C., and Chuck
Hagel, R-Neb., and an effort by Sens. Edward Kennedy, D-Mass., and
Bill Frist, R-Tenn., to secure funding for the Public Health and Emergencies
106-505), which became law last year.
The Edwards-Hagel bill includes provisions that specifically address
laboratory readiness, hospital preparedness and health care workforce
training. Rep. Richard Burr, R-N.C., has introduced a companion bill
in the House, H.R. 4964. The legislation highlights the need to boost
funding for "hospitals, laboratories, clinics, information networks,
and other necessary elements to ensure the provision of public health
services in the event of a bioterrorism attack." It earmarks
$1.65 billion for various programs and directs the Secretary of Health
and Human Services to allot funds to each state through block grants
for various goals. Of specific interest to pathologists, are goals
related to building a nationwide laboratory response system and the
education and training of health care workers, which would include
The Kennedy-Frist effort would provide $1.4 million in fiscal 2002
funding for readiness and medical personnel training programs already
established under the Public Health and Emergencies Act. Although
the act became law in November 2000 and authorizes various programs
to improve the nation’s overall preparedness against bioterrorist
attacks, those programs can't start until Congress appropriates money
CAP Collaborates With Government,
Offering assistance and experience, the College is reaching
out to both government policymakers and professional groups as the nation—and
laboratories—respond to the growing threat of biological and chemical
This week, the College will provide testimony for a Senate hearing on
bioterrorism. The hearing, scheduled for 10 a.m. Thursday, will be held
by the Senate's Health, Education, Labor & Pensions (HELP) Committee,
chaired by Sen. Kennedy, and will focus on how the federal government
can fight against and prepare for terrorist attacks involving biological
The College also will continue working with the Centers for Disease
Control and Prevention on laboratory preparedness and is expected to
meet with Health and Human Services Secretary Tommy Thompson to discuss
On the private-sector side, CAP staff met recently with a representative
of the American Society for Microbiology (ASM) to address issues of common interest related
to laboratory preparedness. Of particular interest is the College's
ability to promptly disseminate Level A laboratory protocols now being
revised by the CDC, the ASM and the Association
of Public Health Laboratories. These protocols describe the specific
tests the microbiology Level A laboratory should perform to rule out
a suspected organism or refer it to another laboratory.
The protocols are designed to assist clinical microbiology laboratories
with information and techniques for micro-organisms that might be suspected
as bioterrorist agents. The protocols for level A clinical laboratories
offer standardized, practical methods to aid laboratories in ruling
out critical agents or referring specimens to level B and C public health
laboratories for confirmation. The procedures focus on anthrax, tularemia,
plague, brucellosis, botulism and unknown viruses. When the protocols
are made final, they will replace the CDC Level A Protocols currently
In another collaborative effort, the College is coordinating a December
audioconference on bioterrorism with the American
Association for Clinical Chemistry and the American
Society for Clinical Laboratory Science. The conference, titled
"What Every Laboratory Needs to Know About Chemical and Bioterrorism,"
is scheduled from 1 to 2:30 p.m., Dec. 12, and will be moderated by
K. Michael Park, PhD, director of Core Laboratory Operations, the University
Hospitals, Oklahoma City, Okla. Scheduled speakers include Jane R. Willis,
PhD, with the CDC's National
Laboratory Training Network; and Jimmie L. Valentine, PhD, professor
of pediatrics and pharmacology at the University of Arkansas for Medical
Sciences, Little Rock.
CSA to Review Programs With Eye Toward Preparedness
The CAP Council on Scientific Affairs has indicated its commitment
to review the College's laboratory accreditation and proficiency testing
programs in the context of preparedness for biological or chemical
CAP leaders believe the College's long-standing role as a leader in
ensuring high-quality laboratory services now carries over to the
effort to prepare laboratories for handling possible cases of anthrax
and other biological agents terrorists might use here and abroad.
To that end, CSA and Commission on Laboratory Accreditation members,
in a special conference call last week, committed to review how the
Program can educate pathologists and laboratories about the Centers
for Disease Control and Prevention's Laboratory Response Network and
ensure laboratories have systems to protect personnel from exposure
to biological agents. They also discussed whether CAP checklists should
be modified to address bioterrorism preparedness and the feasibility
of proficiency testing for biological or chemical agents likely to
be used in a terrorist attack.
No decisions have been made to modify existing programs; the CSA will
continue to assess the situation.
CAP Assembles Bioterrorism Experts for Annual
The College, through programs at the upcoming ASCP/CAP Joint Annual Meeting
and later this year, is placing a high priority on educating pathologists
and laboratories about how to prepare for biological and chemical attacks.
The College has arranged to have leading authorities on responding to
biological and chemical threats speak during a special program at the
Joint Annual Meeting in Philadelphia. The program, "Government Affairs:
Issues and Answers—Bioterrorism," will be Saturday, Oct. 20,
from 8:30 a.m. to noon, at the Pennsylvania Convention Center, Room 113BC,
Level 100. CAP Secretary-Treasurer Jared N. Schwartz, MD, PhD, will moderate
the program and speak about his experience working with samples from the
recent anthrax contamination incident in Florida.
Also scheduled to speak at the program are:
- Stephen Morse, PhD, director of the CDC's Laboratory Response Network
(LRN). Dr. Morse, who will deliver his remarks by way of a video link,
has been working with the College over the past several weeks to alert
laboratories to CDC anthrax protocols and take other measures to prepare
laboratories for biological threats.
- Amy E. Smithson, PhD, a senior associate at the Henry L. Stimson
Center. Smithson directs the 8-year-old center's Chemical and Biological
Weapons Nonproliferation Project, which serves as an information clearinghouse,
watchdog and problem-solver regarding chemical and biological weapons
- Judith F. English, president of the Association for Professionals
in Infection Control and Epidemiology (APIC). English, who chaired the
APIC's Bioterrorism Task Force, co-authored a 1999 report titled "Bioterrorism
Readiness Plan: A Template for Healthcare Facilities."
Also Saturday: A special free program, "Responding
to Disaster—Lessons Learned," will be presented from 8 to 9:30
p.m. in Room 201 of the convention center. Scheduled speakers include
Susan D. Roseff, MD, of Virginia Commonwealth University, Richmond, Va.;
Kim A. Collins, MD, of the Medical University of South Carolina, Charleston;
and Capt. Glenn N. Wagner, DO, Armed Forces Institute of Pathology, Washington,
D.C. Lee H. Hilborne, MD, of the UCLA Medical Center, Los Angeles, will
moderate. The program will focus on how laboratories, pathologists and
technologists can respond to media inquiries and how they can prepare
for potential future terrorist assaults and similar events.
College Talking Points on Bioterrorism
The College soon will make available Talking Points on bioterrorism to
help members respond to inquiries by the media and others.
The CAP Council on Public Affairs and College staff are now developing
the Talking Points document, which is expected to be available soon on
the College's Web site, in an area set aside for CAP Spokesperson information.
Existing CAP documents that can help pathologists work with the media
include "Presenting Yourself on Television" and "Tips on
Successful Interviews." A question-and-answer document on anthrax
also is in the works.
Further help for pathologists will be available this weekend at the ASCP/CAP
Joint Annual Meeting in Philadelphia, during a program on responding to
media inquiries (see story above). And members may use the College's "Hometown
Interviews" program at the meeting to serve as expert sources of
information for their local media.
CDC Utilizes SNOMED for Infectious Disease Reporting
College review of SNOMED® International, used for the electronic
reporting of infectious diseases to the Centers for Disease Control and
Prevention, shows that the latest release includes coverage of bioterrorism
In relation to the recent outbreaks, SNOMED® can be used for bioterrorism
preparedness. Early detection can be enhanced if the laboratory continually
tracks and monitors infectious organisms, diseases, signs and symptoms.
A SNOMED-enabled system can make this process more efficient.
The reporting to CDC of more than 50 infectious illnesses, including anthrax,
is required. All of these reportable conditions are coded in SNOMED®
3.5 and SNOMED® RT (Reference Terminology). SNOMED-encoded data captured
by pathologists through laboratory information systems provides a timely
and reliable source of records that can be quickly forwarded to the CDC
or other health care agencies. The CDC offers prepaid SNOMED® RT licenses
for laboratories willing to electronically report infectious diseases.
For more details, call Peggy LaJoie at (847) 832-7248.
Editor: Carl Graziano
202-354-7118 • 202-354-7155 (fax) •