Something in the Air

Agencies work out the kinks in their new bioterrorism network.

In October 2003, while Houston residents were preparing for the usual Halloween antics, homeland security and public health officials were just plain spooked. For three tense weeks they feared America's fourth-largest city had been a target of biological terrorism.

Biosurveillance monitors belonging to a hush-hush national network had detected suspicious organisms in Houston's air. Two filtering machines captured three tiny fragments of the bacterium that causes tularemia, a respiratory ailment known as rabbit fever. Hospitals were on alert for patients complaining of sudden fever, chills, head and muscle aches, joint pain, diarrhea, dry cough and worse symptoms associated with the disease. Tularemia occurs naturally in mice, squirrels, rabbits and similar small mammals. It can be fatal to humans if not treated with antibiotics.

People can get tularemia through insect bites, or by handling infected animal carcasses, eating contaminated meat, or inhaling the organisms. The disease isn't contagious, but it is highly infectious. As few as 10 F. tularensis bacteria can cause tularemia, rating it a spot on the Centers for Disease Control and Prevention's "Category A" list of the six most likely bioterrorism agents.

The Houston incident marked the first reported positive result from the federally funded and locally operated BioWatch network. Earlier in 2003, the Environmental Protection Agency had helped implement the system quickly and quietly in a number of cities to look for early indicators that people, animals and plants have been exposed to biological agents. The idea is to detect a release within 36 hours, which the government says is time enough to provide effective treatment for those exposed.

It took three weeks of testing and field investigations to determine that the air monitors had detected naturally occurring background levels of tularemia and action wasn't required. In the interim, confusion mounted over which agency would continue routine air sampling, what constituted a tularemia case and even whether the test results had been positive. It became clear that Houston lacked an adequate plan to collect information, assess risk to public health and identify an appropriate response. That lack of "consequence management planning" was EPA's fault, a recent internal audit found.

BioWatch was spearheaded by the Homeland Security Department with the help of EPA, which established cooperative agreements, procured monitors and worked with state and local organizations to set up systems for collecting samples. EPA operates, maintains and oversees the labor-intensive network for DHS. Aerosol monitors draw in air and pass it through filters that must be collected at least once a day. State and local agencies deliver the filters for analysis to BioWatch facilities operated by CDC and located in federal, state or local public health laboratories. The intent is to provide coverage for 80 percent of the population in select cities. DHS won't name the cities publicly, but congressional testimony indicates that the network has spread from Washington and New York to at least 29 other locales.

In a March report, EPA Inspector General Nikki Tinsley concluded that the agency was shirking its duties of network operation, maintenance and oversight. "The failure of EPA to completely fulfill its responsibilities raises uncertainty about the ability of the BioWatch program to detect a biological attack," Tinsley wrote. She recommended a comprehensive assessment of the program, which relies on the expertise of the Defense Department, FBI and two Energy Department national laboratories, in addition to DHS, EPA and CDC.

The inspector general said EPA failed to ensure that BioWatch monitors were optimally deployed and secure when it was helping to set up the network. As a result, some monitors were not installed according to EPA guidelines. The audit noted that EPA developed standard operating procedures for BioWatch sampling, but did not provide guidance consistently to state and local agencies that collect the samples. In February 2004, four months after the Houston incident, the federal partners provided each BioWatch city with consequence management planning templates. But one year later, local plans still were incomplete, according to the March 23 IG report.

EPA has begun addressing the criticisms through its regional offices. The agency defended itself in a written response, saying rising security concerns made it necessary to deploy monitors on extremely tight schedules. EPA said the government has upgraded the network substantially since it was established. The improvements-including more monitors and quality assurance activities-"effectively resolve the concerns raised by EPA's inspector general," the statement said.

As of February 2005, officials wrote, EPA has worked with every BioWatch city to ensure that all monitoring equipment is secure and functioning properly. The statement said EPA will help local governments with response planning if they request it, and DHS will focus on developing full planning guidance in 2005.

The BioWatch program costs $1 million to install and $1 million annually to operate in each city. In 2005, the Homeland Security Department budget included a $65 million increase to enhance current monitoring activities. DHS plans to increase the number of monitors from 10 or 15 in some cities to as many as 50. Coverage would reach beyond EPA's existing monitoring networks to include subways and other facilities.

Keeping Watch

BioWatch is supposed to discover a biological agent release within 36 hours of first exposure. Capital and operational expenses for the air monitoring network have totaled more than $200 million over three years.

Source: EPA