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----- Original Message ----- From: "Nicol Mark (RBT) Mid Cheshire Tr" Subject: Re: Anthrax > I have since found www.phls.co.uk to > be invaluable and have printed off the chapters on anthrax, botulism, plague > and smallpox (as medline search highlighted these to be the most likely > agents biologically). I have emailed the department of health indicating > that notification of this significant resource would help in earlier > preparations. I'm sure the Department of Health will be intrigued that you have told them about the PHLS! Seriously though, I agree that information has not cascaded down properly. The Chief Medical Officer did however issue guidelines on 11th October, http://www.doh.gov.uk/cmo/cmo01_13.htm which clearly indicated that the PHLS website would be the official source of government information on the subject, http://www.phls.co.uk/facts/deliberate_releases.htm (I suppose we have been aware of these a little earlier than most as we are a regional ID centre and the national VHF centre). As far as possible exposure to a suspicious agent goes, these should not be dealt with in an A&E department. This is a police and public health matter and such cases should not get through your doors! They should be isolated, ideally where the exposure has occurred, the police then informed together with CDSC, who will advise on the need for chemoprophylaxis or vaccination. Conversely any patients who present with suggestive symptoms should be promptly referred to your local ID team. Adrian Fogarty Royal Free Hospital