Introduction

Good evening ladies and gentlemen. I'm Dr. Steven Wartman, the executive vice president for academic and health affairs, and dean of the school of medicine of the University of Texas Health Science Center here in San Antonio. I'd like to welcome all of you to what should prove to me a most interesting and very, very valuable session tonight. Before I do I would like to acknowledge the hard work and preparation for this that has been done by our associate dean of the school of medicine and professor of psychiatry and Dr. Cervando Martinez. [applause] And his very, very able assistant, Janet Ramon. [applause]

I'm going to welcome now the remote sites around the state that are participating in this and this is an extraordinary list. I think it's probably the most that we've had in any for one of our many medical schools: The Bay area corpus Christi Medical Center, Christus Spahn Memorial Hospital in Corpus Christi, Dimmit County Memorial Hospital,Hill Country Memorial Hospital in Fredricksburg, Laredo Community College, Mercy Health Center in Laredo, Mid Rio Grande Border AHEC in Laredo, South Coastal AHEC in Corpus Christi, Texas A&M University in Corpus Christi, Texas A&M University International in Laredo, United Medical Centers in Eagle Pass, Uvalde Memorial Hospital and Val Verdi Regional Medical Center in Del Rio. Let's welcome all those sites too.

Before I let Dr. Martinez say a few words of welcome, I'd like to give my own remarks at the present time. Who would have thought a few months ago that we would be having this session here today, this evening? Who would have thought it? This might have been one of the furthest things from our minds. Yet here we are tonight. I think it prompts a lot of questions in our minds. Has something very fundamental changed in human beings? Are we different? I think if you examine the history of the human race, you will find throughout history this kind of behavior, but perhaps on a different scale. Surely the 20th century has many examples of this kind behavior. But going back century upon century, there's always that dark side of human behavior that now and again rises up. Has that changed? Are things different? Is it just the technology that has changed? Or is it something much more fundamental? I honestly don't know the answer to that question but it's something that I've been thinking about for quite awhile, at least since September 11. I've talked to a lot of people since that event occurred-people working here at the Health Science Center, people living in San Antonio and around the country. And it is the general feeling that somehow somewhere our lives are different-that they have changed. And some people have said to me that what they do everyday does not seem as important as they did before September 11. And my answer to all of them has been the same-absolutely not. If anything what you are doing today is more important then before September 11. We simply need to carry on with our lives, we simply need to go about our business, to be close to our loved ones, to take care of our jobs, to complete our school, to do whatever it is that we do everyday. It's really never been more important to our way of life. And I urge all of you to have that perspective. I believe it's very, very valuable. So with those remarks, now let me introduce, well, I already introduced Dr. Martinez, to help us with the evening.

[Applause]

Dr. Martinez

I think all Americans realized on Sept. 11 that the horrible events of that day would change our lives forever as Dr. Whartman just said. But few us foresaw that these events-the said loss of life and enormous destruction-would so quickly lead to our present state of dread about further threats. These threats probably perhaps more far-reaching to ours and our loved ones lives and health. It is because of this public anxiety and almost a panic and fear and worry about bioterrorism that we've organized this special session of the mini-medical school. It's purposed is to bring to the public factual information about the scientific and medical aspects of biological threats, such as anthrax, and to share with you your community's state of preparedness or it's lack thereof because we must be realistic and honest with the public to meet these threats. Our belief is an objectively informed and alert public, not a misinformed and panicky one, is the most important component of our nation's security at all times. We are not here tonight to provide you with false reassurances. We always have to live with some anxiety in our lives.

Our knowledge that we're going to present to you tonight is not perfect. And any state of preparedness can always be better. We only want to share with you our current state of information and the state of our community's preparation for any disastrous event. So that you the public and groups represented here tonight and better meet this threat together. With those words about the tone of our world now, let me go now to give you a few, some more mundane information. We're going to have a continuous session. There will be no intermission. So feel free to get up and use the restroom or get a refreshment out in the hallway. In addition, we will be taking questions from the remote sites. You should have received those on your screens already. We have e-mail and fax communication with all the remote sites. I encourage you out there in South Texas to send in questions to the panelists at the proper time or during the course of the session and they will be responded to during the question and answer during after the panelist discussion . With that, let me pass this on to Dr. Ron Stewart, associate professor of surgery, who organized the here panel tonight.

Stewart

Thank you Dr. Martinez. Approximately six weeks ago more than 5,000 people were killed in New York, Washington DC and Pennsylvania. Shortly following that tragedy we were attacked using anthrax through the mail. The initial patient by inhalation anthrax and since that time numerous people have been exposed and a handful of people have developed inhalation anthrax. There are newly reported cases almost daily Time and Newsweek have both run editions with gas masks and Anthrax on the cover. Anthrax and bioterrorism have been the lead stories in the electronic news media. Last week San Antonio police and fire were getting approximately 150 calls per day for suspicious powder. Fortunately all of those were false alarms. It's clear, I think it's certainly clear to all of us, it's certainly clear to me, we're at war and a portion of that war will be fought here in the United States. Given the current events fear is understandable and I think an expected emotion. Fear is understandable, but we can, and we must choose our response to that fear. And I believe there's only two possible responses. Our fear and anxiety can lead us to panic, a destructive and productive response. Or it can lead us to a greater resolve to face and solve these problems. Panic leads to greater fear and weakness. Greater resolve and determination leads to hope and greater confidence. As a surgeon, I can tell that panic should be avoided at all costs. Just as previous generations of Americans have faced grave threats, we must face the threat of biological weapons head on. To do this we first have to understand them, we have to prepare for their potential used and we have to develop constructive solutions. This will make our world a safer place for our children. These are scary times and things may get worse before they get better. But we cannot and should not panic. We owe that to our children and we owe that to the people who have already died. We cannot let them die in vain. So along those lines, we put together a program and a panel of local experts to frankly discuss biologic weapons and prepare us for their potential use. Much of what you learn will be reassuring. Some might be disturbing. Our aim is not to falsely reassure you or is it to falsely alarm you. Our aim is to present the facts as we see them and to allow you to ask questions in a open educational forum. In the end, I think you will feel more comforted than alarmed. These are not mysteries that are poorly understood. In confidence I can say we have the world's best biologists and medical scientists far superior than our current adversary's capability. The current risk of acquiring an infection from biologic agent used as a weapon is far less than the risk that each of you took when you drove your car here tonight. And finally, in the event of a real or potential bio-terrorist event, there is a very good local plan in place, which aims first to prevent such an attack. Second, recognize such an outbreak. And third, affectively treat any patients created by such a weapon.

We have a really great panel. And I would classify this panel as a collection of heroes and experts. You may think that preparation has just started, but almost all of the people on the panel have been working on it for at least four or five years. They've done behind the scenes work to prepare our community to face this threat. It takes a lot of self discipline and determination to do that when the threat is uncertain.

But I'd like to take a few minutes and introduce them. To my left is Jan Patterson. Dr. Patterson is professor of medicine from the division of infectious disease, she's head of infection control at University Hospital, and the hospital epidemiologist. Dr. Patterson tonight will give a overview of biologic weapons along with a short listing of the potential agents.

To her left is Dr. Fernando Guerra, director of health at the San Antonio Metropolitan Health District one of the leading health districts in the country. Dr. Guerra will give his view from the public health response and is the lead agency with respect to any biologic event.

Immediately to Dr. Guerra's left is Dr. Chuck Bauer. Dr. Bauer is the is chair of the emergency preparedness committee of the Bexar County Medical Society and the Greater San Antonio Hospital Council. Dr. Bauer probably has done more than any physician locally to educate physicians and health care workers about biological and chemical terrorism and has been doing that for approximately five years.

To Dr. Bauer's left is Dr. Don Morse. Dr. Morse is the public health administrator and the liaison for emergency preparedness of the San Antonio Metropolitan Health District. Dr. Morse has worked closely with the city, fire, EMS and hospitals to develop the bioterrorism plan.

Immediately to Dr. Morse's left is Dr. Rasa Selenas. Dr. Selenas is director of homeland security of the Office of Applied Solutions in Operational Medicine. Dr. Selenas behind the scenes has been a huge asset to our local community. I can't state it strongly enough how much she's been a help by using the military's expertise to help us prepare for the current events.

To her left is Dr. LaDona Farinacci. Dr. Farinacci is assistant professor of research at the South Texas Interprevention Research Center at the Health Science Center. Dr. Farinacci is an expert in personal preparedness and we'll get her perspective concerning what you can do as an individual to help you prepare for what is unlikely but possible event.

To Dr. Farinacci's left is Chief Mike Miller. Chief Miller is the city of San Antonio's fire chief and emergency management coordinator. The weight of basically putting together some of these plans has fallen on Chief Miller and he has done an excellent job with respect to developing these plans. Oftentimes with frustrating road blocks to try and break down. He's a real hero in fire and EMS.

To his left is Leni Kirkman. Ms. Kirkman is Corporate Communications Manager for the University Health System. She's been a very busy little bee over the past several weeks with respect to answering questions and basically put in place a structure to get constructive answers to many peoples' questions.

With that I'd like to introduce Dr. Patterson. She will give the opening lecture.