American Medical Association (AP, 2003b), the Agency for Healthcare Research and Quality, the Association of Professionals in Infection Control, and from a number of university-based centers that study bioterrorism and disaster preparedness (e.g., the Centers for Public Health Preparedness).

In addition to the efforts of public health agencies, accreditation systems could be used to further the engagement of hospitals and health care organizations in bioterrorism and overall public health preparedness. In the area of accreditation, the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) has been integrating bioterrorism and smallpox components into the requirements for emergency preparedness. The committee urges CDC to work with all health care accrediting bodies (JCAHO, National Commission for Quality Assurance, and American Accreditation HealthCare Commission [URAC]) to encourage the incorporation of emergency preparedness standards (i.e., for developing, implementing, and exercising plans for responding to a potential bioterrorist attack including, but not limited to, smallpox) into requirements for the accreditation of hospitals and health care organizations.

The Role of Public and Media Communication in Smallpox Preparedness

Public communication is an essential component of public health and smallpox preparedness. As detailed in the CDC guidance issued May 2, 2003, health departments should have communication plans in place and channels of communication tested to prepare for the possibility of an attack (CDC, 2003b). However, as with other aspects of preparedness, risk communication should be focused on all possible threats, including, but not limited to, smallpox. Public health officials and spokespersons should be familiar with all potential bioterror agents and also should have a clear understanding of other major threats to the public health.

Practicing good communication would suggest that before a potential event and the intense sense of crisis it would create, public health authorities communicate to the public about what preparations are being made (e.g., rapidly accessible vaccine and other pharmaceutical stocks, mass vaccination or point of distribution sites), and about the availability of prepared key responders in their jurisdiction. Having information about what is in place and what will be done before a crisis occurs will help to ease the public’s fears and concerns. This includes communicating about the smallpox vaccine, its risks and benefits, its availability, and plans for its rapid distribution when needed, as noted above.

The media would play a vital role in a potential bioterrorist event; journalists and other media specialists should be included in scenarios and exercises (DiGiovanni et al., 2003). This will help educate the media about the nature of infectious agents, the capacity of the public health and health



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