- The Washington Times - Tuesday, March 4, 2003

RICHMOND Seth Levine's pager is on 24 hours a day, seven days a week. He even sleeps with it next to his bed.
A disease detective on the medical front lines of the war against terrorism, Mr. Levine is alert for a biological attack that he could be one of the first to detect.
A hospital, a doctor, any health care provider could call at any moment with suspicions or a diagnosis of anthrax, smallpox or another killer disease loosed by terrorists intent on mass death.
"We need rapid response for any bioterrorism event," said Mr. Levine, a bioterrorism epidemiologist, who also is trained to recognize chemical or radiological attacks.
Health officials said the September 11 attacks and the ensuing anthrax cases and hoaxes made it obvious that Virginia did not have the human or physical resources to respond to bioterrorism and needed to hire specialists who identify and control communicable diseases.
Mr. Levine, 28, is one of the epidemiologists the state expects to have in each of its 35 health districts. His district covers the suburban county of Henrico and its 267,000 residents.
Twenty-six of the 35 have been hired, Health Department spokeswoman Trina Lee said.
There is a sense of urgency to get them on board as soon as possible, but there are "not a lot of trained and experienced epidemiologists out there," said Diane Woolard, director of disease surveillance and investigation for the department. "Every state is looking for epidemiologists."
Mr. Levine, who holds a bachelor's degree in biology and a master's in public health, checks with institutions such as hospitals, medical laboratories, private physicians, schools, jails and day care centers. He lets authorities there know to call him immediately if any symptoms show up, perhaps a rash and fever indicative of smallpox.
One of his first duties after taking the job last August was to make hospitals in the county aware that he was "a new presence" in the disease reporting chain.
A hospital that detected a disease such as anthrax or smallpox would report to a local health department, which would report to a district health official like Mr. Levine. He would notify a regional health official, who would alert state officials in Richmond.
"It would be very rapid, despite the multiple layers of bureaucracy," Dr. Levine said.
A typical workday for Mr. Levine might include follow-up on patient reports from hospitals, entering reports into a computer database and helping to develop smallpox vaccination plans for health care workers.
Mr. Levine did not receive a smallpox vaccination himself because of a high possibility it could cause an adverse reaction. So, should he have to check for a specific disease, he would be protected only by a medical device resembling a double-ply dust mask, called an N95. "It's sufficient," he said.
Mr. Levine's previous work in public health kept him tied to a desk, but he longed to go where the action is. "This job offered more of an opportunity for field work," he said. "It's an exciting field to be in."
The state also has hired 32 of 35 public health emergency planners to develop hazard preparedness and response plans for local public health districts. They will work with emergency management officials, hospitals and local government and law-enforcement officials. They will also manage locally the national pharmaceutical stockpile of drugs, including the smallpox vaccine.
Complete response plans already have been drafted for widespread influenza and smallpox outbreaks. Specific guidelines have been completed for anthrax, plague and viral hemorrhagic fevers, including physician fact sheets, diagnostic guidance, and treatment and infection control.
The state says it is capable of distributing antibiotics, vaccines and poison gas antidotes throughout the state.
Most of the preparation, including the hiring of the epidemiologists and public health emergency planners, was funded through $23.7 million in federal bioterrorism grants.
"We hope to continuously improve our preparedness," Miss Woolard said, especially by electronic reporting by health providers.
"The more important thing," she said, "is to have good, strong relationships with the medical care community."

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