What if a bomb went off in a downtown building simultaneously injuring hundreds of people? What if a group of government employees reported to the emergency department with suspected anthrax exposure?

When disaster strikes, the public health system shifts into emergency mode. Wayne State University faculty members are making sure future doctors and other health professions students are prepared for such emergencies and follow a planned response. A multidisciplinary team from WSU has been awarded a $300,000 grant from the Department of Health and Human Services to develop a terrorism, disaster and public health emergency curriculum.

When faced with the threat of bioterrorism or a public health scare, there are three things doctors need to know immediately, said Suzanne White, M.D., project director and professor of emergency medicine and pediatrics:

• Is it contagious and can it harm me?
• Where do I call for reliable information?
• What bigger response will go on around me and what's my involvement with law enforcement and public health officials?

"Detroit is high risk for terrorism with a density of vulnerable populations," Dr. White said. "How many students in pharmacy, nursing and medicine go untrained? Yet we look to health care professionals to take the lead when a disaster happens. Recognizing that WSU has a history of expertise in developing competencies for emergency and disaster medicine, we are filling a training gap with a five-module training program."

The undergraduate curriculum focuses on recognition of possible terrorist or public health threats. It emphasizes: basic principles of disaster medicine; bioterrorism and biological agents; mental health and risk communication; nuclear and explosive threats; and chemical agents. These themes are taught throughout the undergraduate medical curriculum by microbiologists, pharmacists, crisis communication experts, radiation researchers, and rescue operations teams.

"Preparation will never be wasted," said Dr. Matt Jackson, project co-director and assistant dean for basic science education. "It's not a matter of if something happens. It's a matter of when. There was heightened awareness of disaster readiness after 9/11, but this applies to non-terrorist issues too: the power outage in Detroit a couple summers ago, tornadoes and floods, large-scale fires, chemical spills, SARS, avian flu, infant abductions and security threats. All of these events fit into a larger public health structure. The recent tsunami, earthquakes and hurricanes in the world provide tremendous examples of the health care system being overrun. Physicians need to be trained to respond."

"The core pieces of information health care workers need are recognition, reporting and response," said Dr. Sharon Popp, assistant director of clinical curriculum development. "We want students to understand the importance of working together with the local health department, law enforcement agencies and emergency management teams, so they are not treating affected patients in isolation."

The curriculum, to be integrated into the curriculum for medicine, and shared with the colleges of nursing, allied health and social work, highlights the importance of the field of public health. "That specialty alone has added 25 years to our life expectancy, through advances in polio, vaccinations, and simple reporting of trends," Dr. White said. "Physician educators need to know that this specialty is critical and the role they play in disaster medicine is critical."

While other schools and hospitals offer sporadic training seminars and disaster drills, this is the most comprehensive, curriculum-based training of its kind. WSU was one of two medical schools to receive funding this round from the U.S. Health Resources and Services Administration for disaster medicine training. The other was Duke. WSU modules are being developed and will be implemented into the curriculum beginning in January.