May 9, 2005
In January of this year a tabletop exercise named “Atlantic Storm” was held that simulating a smallpox bioterrorism attack that quickly caused many casualties in multiple nations and included Turkey, Western Europe, and North America. This heuristically valuable exercise brought together high-level political, emergency preparedness, and public health officials from many nations and organizations.
Given the state of the H5N1 avian influenza outbreaks in Asia involving multiple species of animals, and humans over the past 18 months, it would be valuable to begin a series of international tabletop exercises to catalyze further global preparedness for pandemic influenza. The first such exercise could be called “Pacific Storm”.
The critical issue is to initiate such global exercises, even if another name is chosen, lest the risk not be recognized of pandemic influenza spreading first in a direction other than across the Pacific, or beginning in a part of the world other than the Pacific. Involvement by nations from all continents would be essential given that the next influenza pandemic will involve all continents from the public health, economic, and political perspectives.
This series of international pandemic influenza tabletop exercise would build on the foundation established by the extensive preparedness work already done by the World Health Organization, the FAO/OIE, and the multiple nations in Asia where H5N1 outbreaks in animals have been documented. First-hand experience and “lessons learned” from H5N1 infection of humans in Hong Kong in 1997, and more recently in Vietnam, Thailand, and Cambodia should also be emphasized.
Ongoing work in Europe should also be integrated into global preparedness exercises, such as the April 2005 European Commission proposals to prevent avian influenza epidemics. Moreover, the US Institute of Medicine (IOM) multidisciplinary symposium updating pandemic influenza research April 4-5, 2005 provided key information on antiviral and vaccine development against H5N1 and related candidate pandemic influenza viruses that could be included in the initial “Pacific Storm” exercise.
Daniel R. Lucey, MD, MPH
Director, Center for Biologic Counterterrorism and Emerging Diseases
Washington Hospital Center
Adjunct Professor of Microbiology and Immunology
Georgetown University School of Medicine