Survey Finds States' Ability to Respond to Biological Attacks Rises

October 31st, 2003

AMES, Iowa — Two national surveys show the number of state health department epidemiology employees trained in infectious disease and terrorism preparedness increased significantly after the terrorist attacks of Sept. 11, 2001.

The surveys were conducted by Iowa State University and the Iowa Department of Public Health's Center for Acute Disease Epidemiology. An article outlining the surveys' results is included in the Oct. 31 issue of the Morbidity and Mortality Weekly Report, published by the Centers for Disease Control and Prevention.

"The first survey of state public health epidemiologists was completed the week before the terrorist attacks in 2001," said James Dickson, interim director of the Institute for Food Safety and Security at Iowa State and an animal science professor. "After the terrorist attacks, we decided to conduct a second survey to see how attitudes and the level of preparedness changed." Dickson worked with Patricia Quinlisk, Iowa's epidemiologist, on the research.

The surveys were conducted by Ginger Shipp, an Iowa State microbiology graduate student. Shipp had worked as an intern at the Iowa Department of Public Health, which Dickson said made her uniquely qualified to conduct the two phone surveys.

The surveys showed the number of state health department epidemiology employees in infectious disease epidemiology and terrorism preparedness increased by 131 percent from 2001 to 2003. "Yet there are concerns about the ability of state health departments to hire qualified personnel," Dickson said. "This underscores the need to develop more and diverse training venues for current and future infectious disease epidemiologists."

In Iowa, six new epidemiology employees have been hired, though not all have specific degrees in the field. "Our survey demonstrated that states are hiring people to do epidemiology, but that many have no formal training in it," Quinlisk said. "I believe more emphasis in these academic programs needs to be placed on teaching students about 'shoe leather' or basic health department epidemiology."

Dickson said the deliberate use of anthrax during the terrorist acts of 2001 focused people's attention on the need for government to be prepared to respond to bioterrorism.

"In the year following the events of 9/11, state public health entities received $918 million in new funding to prepare for and respond to bioterrorism, outbreaks of infectious disease and other public health threats and emergencies," he said. "This study suggests this funding was key to increasing the number of epidemiologists and our nation's response capacity."

The study also documents barriers to that response capacity. Those include difficulty finding time for activities such as planning and setting up disease surveillance, the complexities of food security issues, hiring freezes and budget deficits, and finding the time needed for the pre-event smallpox vaccination program.

The article in the Morbidity and Mortality Weekly Report newsletter is on-line at


James Dickson, Animal Science, (515) 294-4733

Patricia Quinlisk, State Epidemiologist, Iowa Department of Public Health, (515) 281-4941

Kevin Teale, Communications Director, Iowa Department of Public Health, (515) 281-6692

Susan Thompson, Communications Service, (515) 294-5616

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