Lessons from Tokyo: U.S. Hospitals and Doctors Urged to Prepare for Sarin Gas Attack.

Health/Medical Writers

ATLANTA--(BW HealthWire)--Jan. 23, 2002

American hospitals, doctors, and emergency services providers should heed the lessons of the 1995 Tokyo subway terrorist attack in their preparations for a potential sarin gas release in the United States, according to bioterrorism experts and two Japanese physicians who treated many of the victims in the subway incident.

In exclusive interviews with Bioterror Medical Alert, published by Atlanta-based National Health Information, the two physicians - Sadayoshi Ohbu, MD, and Tetsu Okumura, MD - recall the chaos and the medical response to the attack, propagated by doomsday cult Aum Shinrikyo, which killed 12 people, injured nearly 1,000, and sent more than 5,500 people flooding into Tokyo emergency rooms.

Ohbu, director of neurology at Yokohama Municipal Children's Hospital, says that along with establishing effective triage and decontamination plans, hospitals must be prepared for secondary contamination of health care workers. More than 100 health care personnel became ill at St. Luke's International Hospital in Tokyo, where Ohbu worked at the time and where medical staff received more sarin gas victims than any other facility.

According to Okumura, who was also working in the St. Luke's emergency room at the time of the attack, hospitals should also have in place an emergency staff call-up system, a staff training effort, sufficient supplies of drug antidotes (atropine and pralidoxime), and chemical-resistant suits and masks.

Unfortunately, according to Amy E. Smithson, PhD, author of Ataxia: The Chemical and Biological Terrorism Threat and U.S. Response, many hospitals remain woefully unprepared for a sarin gas attack. Smithson's study took a detailed look at the preparedness of health facilities in 33 major U.S. cities, and found that many were so unprepared to deal with a sarin exposure that the extent of their planning is to lock their doors in the event of an attack.

The in-depth article, which appears in the January 20 issue of Bioterror Medical Alert, also features detailed clinical guidance on the physical effects of sarin and similar nerve agents, proper treatment, and rapid detection.

Other highlights of the January 20 issue include:

-- The latest on the debate over the need for hospitals and other medical
facilities to stockpile potassium iodide, which could prevent thousands of
thyroid cancer cases if taken upon exposure to radiation from a nuclear
facility or a "dirty bomb." The article includes information on dosages and
side effects, as well as information on obtaining supplies of potassium iodide.


-- A study of rescue and recovery workers who responded to the 1988 Piper Alpha
oil rig disaster, which killed 167 men and required nearly three months of
recovery efforts, offers some timely guidance on how to ensure those responding
to a grisly disaster scene don't suffer from debilitating post-traumatic stress
syndromes.

-- In light of the recent anthrax cases, laboratories should be on high alert
for handling biohazardous materials and follow these guidelines for quickly
referring that work to properly equipped state and regional public health
laboratories.

NHI is making Bioterror Medical Alert available on a free trial basis. The four-issue trial, beginning with the current issue, can be requested by calling 800-597-6300, e-mailing a request along with a full physical mailing address to [e-mail], or go to www.nhionline.net/products/bma.htm.