Disaster Preparedness in Biocontainment Animal Research Facilities ...

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Disaster Preparedness in Biocontainment Animal Research Facilities: Developing and Implementing an Incident Response Plan (IRP)

James R. Swearengen, Karen J. Vargas, Mallory K. Tate, and N.S. Linde

Abstract

Introduction

Preparing for the wide variety of disasters that can occur is challenging for any animal research facility, but the level of concern for human and animal health rises significantly when infectious agents and toxins are part of the scenario. Federal regulations provide detailed requirements for the development of an incident response plan (IRP) when select agents and toxins (SATs) are used. In addition to the usual issues associated with disaster planning, the IRP must address concerns associated with the potential theft, loss, or release of SATs that may affect both institutional personnel and the surrounding community. The level of detail in the IRP and the intensity of training should be appropriate for the level of risk involved. Regulations describe certain basic requirements but do not address the risks of SAT-exposed animals, which have been the subject of additional guidance to help implement regulatory requirements. A 2008 joint publication of the Centers for Disease Control and Prevention and the Animal and Plant Health Inspection Service describes scenarios in which SAT-exposed animals are handled in the same manner as the agent or toxin itself for the purpose of reporting a SAT theft, loss, or release. Events that resulted from the impact of Hurricane Ike at the University of Texas Medical Branch in Galveston provide a valuable opportunity to evaluate the effectiveness of the federal regulations and to build on lessons learned from this disaster. These lessons can help to supplement the regulatory requirements and improve the safety and security of handling both SATs and animals exposed to them during and after an emergency situation.

he need to consider research animals in the development of an institution’s incident response plan (IRP1) has been stressed by a number of organizations and publications (AVMA 2008; NRC 1996; Vogelweid 1998). The passage in 2002 of federal regulations that mandate specific requirements for possessing or using certain high-risk infectious agents and toxins, called select agents and toxins (SATs1), significantly expanded regulatory oversight of infectious disease research (CFR 2002a,b; Gonder 2005). These regulations provide a relatively detailed list of items that must be incorporated in an IRP, but they do not address animals that have been exposed to SATs. This lack of regulatory language specifically addressing animals does not, however, alleviate an institution’s responsibility to take into account SAT-exposed animals and to design the IRP to protect their security and health, the health of the public, and the environment in the event of a disaster. The Centers for Disease Control and Prevention (CDC) and the Animal and Plant Health Inspection Service (APHIS) are the lead agencies for implementing the SAT regulations for the Departments of Health and Human Services (DHHS) and Agriculture (USDA), respectively. Both lead agencies have provided basic guidelines on the development of IRPs for programs that stock or use SATs. To assist facility managers with meeting regulatory mandates, the CDC has published guidance on the development of security measures and IRPs for laboratories that work with SATs, stressing the importance of site-specific risk assessments (analyses of the likelihood of such a disaster and resulting damage) (MMWR 2002). Much like the regulations themselves, this document focuses mostly on physical security to prevent the loss or theft of SATs, but does offer some considerations for the development of an IRP with regard to animal facilities. A joint APHIS/CDC (2007) incident response inspection checklist also is available for use by agency inspectors who conduct SAT program audits; the checklist simply mirrors the requirements outlined in the regulations, but it can be a useful tool for institutions to verify that all the necessary components of an IRP are in place. In addition to the specific regulatory requirements, it is important to bear in mind that biocontainment facilities are subject to disaster-related challenges that can affect the

Key Words: biocontainment; disaster planning; emergency; evacuation; hurricane; incident response plan (IRP); power outage; select agent or toxin (SAT) James R. Swearengen, DVM, was a senior director at the Association for Assessment and Accreditation of Laboratory Animal Care (AAALAC) International (at the time of this writing) and is now Comparative Medicine Veterinarian for the National Biodefense Analysis and Countermeasures Center, both in Frederick, Maryland. Karen J. Vargas, DVM, MS, is Associate Director; Mallory K. Tate, DVM, is Senior Biocontainment Veterinarian; and N.S. (Seth) Linde, LATG, is the Animal Biosafety Level 3/4 Manager, all at the Animal Resources Center of the University of Texas Medical Branch in Galveston. Address correspondence and reprint requests to Dr. James R. Swearengen, National Biodefense Analysis and Countermeasures Center, 110 Thomas Johnson Drive, Suite 200, Frederick, MD 21702 or email [email protected].

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1Abbreviations

used in this article: IRP, incident response plan; SAT, select agent or toxin; UTMB, University of Texas Medical Branch

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entire campus (e.g., loss of emergency generator power, water and sewage issues, loss of normal supply routes, escaped animals, and transportation difficulties for people and animals) and the IRP should account for these as well.

Requirements and Recommendations for Incident Response Plans Any entity that is required to register under the CDC/APHIS select agent program must develop and implement a written IRP. Although, as mentioned above, the regulations do not explicitly address animals exposed to SATs, such animals are subject to the same handling requirements as a SAT for the purposes of reporting a theft, loss, or release (APHIS/ CDC 2008). For example, the inability to account for a SATinfected animal is reportable as a SAT loss to the lead agency and other appropriate federal, state, and local agencies; and, as with SATs themselves, access to SAT-exposed animals is restricted, which can impede IRP implementation. In the following sections we discuss particular factors to consider in the preparation of an IRP.

Parties Involved in IRP Development The safe, secure operation of a biocontainment facility that uses SATs requires a wide variety of professional and technical personnel. According to CDC guidance (MMWR 2002), the emergency planning process should include the SAT responsible official and representatives of administrators, scientific directors, investigators, laboratory workers, facility maintenance staff, safety officers, and security officials. We also recommend the inclusion of animal facility managers, veterinarians, and animal care staff in the planning process, and consideration of the involvement of the institutional animal care and use committee (IACUC) in the review and approval of applicable portions of the plan. As a legally mandated agent of the research facility, the IACUC has responsibility for the oversight of all activities involving animals (CFR 2002c). Finally, development of the IRP must be coordinated with organizationwide plans.

Risk Assessment The development of an IRP requires considerable forethought and should include a thorough risk assessment and evaluation of all animal areas for security and safety (MMWR 2002). The plan must address natural (e.g., tornadoes, hurricanes, earthquakes, floods), man-made (e.g., bomb threats, intrusions, suspicious packages), and mechanical (e.g., power outages, gas leaks, ventilation failures) threats and include measures to manage the hazards associated with each SAT and to prevent their theft, loss, or release. Each emergency situation identified during the risk assessment process must be addressed in the context of each SAT present and how it is used in the facility. While the types Volume 51, Number 2

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of in vitro laboratory activities tend to be relatively constant among research programs, the activities and risks in animal facilities can vary widely depending on the animal models in use. For example, knowledge of the pathogenesis of the SAT in the different models can be very important in deciding what actions may be necessary in an emergency situation. Other factors, such as primary containment housing systems for animals, can reduce the risk of exposure of personnel to aerosolized hazards (Chosewood and Wilson 2007) and may be a consideration when determining responses to certain types of emergency situations. With the introduction of any new animal models and safety-related equipment, the IRP should be reviewed for possible updating.

Coordination with Local Agencies An integral part of the IRP is coordination with local agencies such as health, fire, and police departments (Wingfield et al. 2010 also discuss local, state, and federal resources). Coordination and outreach with these agencies are critical processes that will not only expedite communication and assistance during an emergency but also help build solid relationships with the local community. Tours of the laboratories and animal facilities—if possible, before SATs are brought on-site—can help to familiarize police and fire department personnel with the layout and facilitate the development of emergency response procedures (e.g., for dealing with unauthorized intruders and for emergency evacuation of personnel from containment areas). These respected members of the local community can also attest to the transparency of the program and help to build an open and trusting relationship. Of course, these types of activities must always involve a balance between transparency and security and ensure that emergency responders understand the importance of confidentiality and the security of the SATs.

Communication and Training The backbone of an effective IRP is the ability to communicate through well-defined channels, and SAT regulations require the establishment of well-defined roles for responsible personnel, lines of authority, training, and routes and modes of communication. But, although effective communication during an emergency requires clearly articulated expectations of all involved and explicit training in the behaviors expected, data collected over the last few decades have shown that most assumptions in disaster planning may not be valid (Auf der Heide 2006). In particular, plan developers often do not take into consideration how people and organizations are likely to act but rather assume that they will change their behavior to conform to the plan (Quarantelli 1985). Evidence has shown that in a hazardous material disaster, affected staff are likely to bypass on-site triage, first aid, and decontamination in favor of going directly to a hospital or clinic (Auf der Heide 2006). Thus if an explosion in a 121

biocontainment facility required the immediate evacuation and treatment of injured personnel, an IRP might provide for a designated area for potentially contaminated personnel to congregate for decontamination and for injured personnel to be triaged and decontaminated before transport to local treatment facilities by emergency responders. But without adequate training and immediate communication and response, it is likely that many people with nondebilitating injuries would react instinctively, bypass the decontamination process, and transport themselves, and others, directly to a health care facility, thus risking contamination of their colleagues and other patients at the clinic. Such liabilities underscore the importance of thoughtful, evidence-based communication and ongoing training.

Postdisaster Arrangements for SAT-Exposed Animals Immediate rescue, first aid, and emergency medical treatment of personnel are priorities after a disaster that results in significant damage to the physical structure. In the absence of regulatory requirements for consideration of SAT-exposed animals, we recommend that the IRP delineate measures for dealing with injured and escaped animals according to the APHIS/ CDC (2008) guidance, which considers the infected animals equal to the actual agent or toxin itself. The plan should include the designation of personnel and their responsibilities, a decision process and criteria for determining entry into the affected area, and a list of personal protective equipment (PPE) and emergency supplies (e.g., capture devices, pharmaceuticals, medical kits) along with their locations. These measures should be closely coordinated with all emergency responder groups, who should also have emergency contact information for the reporting of injured or escaped animals. SAT-exposed animals that cannot be accounted for pose a risk to site security and control and require the submission of an APHIS/CDC Report of Theft, Loss, or Release of Select Agents and Toxins. In light of the seriousness of risks related to SATs or SAT-exposed animals, we recommend adaptation of the federal regulatory criteria for postdisaster security of SATs. Thus the IRP should • • • • • • •

be disaster specific, set forth procedures to ensure that the animals are kept secure, describe how the animals will be secured, identify who is responsible for securing the animals, identify who is responsible for maintaining security, explain procedures to verify that no animals escaped, and identify whom to contact should an escape occur.

Accomplishing these security tasks and providing for the care of injured animals in a potentially contaminated environment requires a significant level of training, expertise, and security clearance for access to areas where SATs are maintained. An institution’s attending veterinarian and 122

veterinary technicians are arguably the only personnel qualified to perform these duties and therefore should be intimately involved in the development of the IRP and their duties and responsibilities clearly described. Federal law requires each animal research facility to have an attending veterinarian but allows for others (e.g., a research technician or investigator) to perform daily observations to assess the animals’ health and well-being (CFR 2002c). This system can be very effective as long as there is direct and frequent communication with the attending veterinarian. A disaster that involves SATs, however, presents special challenges. While it is not federal law, the Guide for the Care and Use of Laboratory Animals (the Guide; NRC 1996) is the required standard for institutions that either receive research funds from the National Institutes of Health (NIH) or are accredited by the Association for the Assessment and Accreditation of Laboratory Animal Care International. The Guide calls for adequate veterinary care and access to all animals for evaluation of their health and well-being. Implementation of this provision also ensures that personnel with the appropriate clearances, expertise, and experience are available to access animals housed in SAT restricted areas when a disaster occurs.

Evacuation IRPs must include procedures for emergency evacuation of humans and certainly should include consideration of the disposition of research animals during an evacuation. For humans, these procedures must be tailored for the type of emergency and clearly indicate the type of evacuation (e.g., for a building, the surrounding area, or a geographic area), exit routes, safe distances, places of refuge, and postevent decontamination. For animals, some circumstances may allow for the evacuation of those housed in conventional animal facilities, but for those in a biocontainment envelope there should be clearly established procedures for either euthanizing or securing them in their primary enclosures. If the latter, a secondary security device, such as a padlock, may be advisable for large animal cages in containment areas to deter animal escapes if the integrity of the primary enclosure is damaged.

Decontamination The IRP must define procedures to ensure that SAT storage and use areas are safe to enter after a disaster. Decontamination cannot proceed until the disposition of the animals still housed in those areas is determined with input from the veterinary care staff. The IRP should therefore clarify the need for involving the attending veterinarian and veterinary care staff in these determinations.

Test Runs and IRP Updates It can be very easy to become lulled into a false sense of security in an area where there is a constant seasonal threat ILAR Journal

of natural disasters (e.g., hurricanes, tornadoes, wildfires). Multiple “false alarms” may decrease the intensity of preparation for the next incident, but regular training and drills should help to prevent complacency.2 Drills are a very valuable tool not only for training personnel but also for evaluating the effectiveness of the IRP, which must be considered a living document, reviewed on an annual basis, and revised as new information becomes available or changes in the program occur. Drills or exercises must be conducted annually to evaluate the effectiveness of the plan, and when gaps are identified in an IRP test run the plan must be revised accordingly. Some programs conduct walk-through drills with emergency response teams and practice specific components of the plan (e.g., those governing animal-related issues; Vogelweid 1998). Tabletop exercises3 can also be particularly useful in identifying weaknesses and gaps in an IRP. For example, one author participated in an IRP tabletop exercise that dealt with a bomb threat. After all employees had evacuated the building, the director of the institute released them to go home. Although an animal response team had been identified for certain emergency situations, there was no provision in the IRP for the team to remain in the event of a bomb threat. Trying to call back individuals that had already left the premises would have been difficult at best and would certainly have resulted in unnecessary delays in addressing animal-related issues after an explosion. This important gap in the IRP was resolved with the identification of an animal response team to remain in the designated safe area during a bomb threat for more timely action if needed.

The UTMB Experience: Lessons Learned At the beginning of every hurricane season, the University of Texas Medical Branch (UTMB1) IRP and the Animal Resource Center Weather Disaster Plan are subject to review and reevaluation. Response systems undergo repeated testing, primarily with regard to the predisaster staging of supplies and equipment, as well as provisions for staff who are to remain on-site. The years 2005-2008 saw a heightened level of hurricane activity in the Gulf of Mexico and along the Texas-Louisiana Gulf Coasts. Hurricane Ike in September 2008 was the first major test of the hurricane procedures in the UTMB IRP— and of the staff’s endurance, ingenuity, organization, and teamwork. It soon became apparent that some of the support systems presumed to be functional were not and that predisaster training and drills are of critical importance. As a re2However,

for those who work in a biocontainment environment, it is important to know when a fire alarm is real or a drill. 3According to FEMA, “a tabletop exercise simulates an emergency situation in an informal, stress-free environment. The participants—usually people on a decision-making level—gather around a table to discuss general problems and procedures in the context of an emergency scenario. The focus is on training and familiarization with roles, procedures, or responsibilities” (http:// training.fema.gov/).

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sult of that experience, hurricane preparedness systems for UTMB and the Galveston National Laboratory (GNL) have significantly improved. In the fall of 2008, the GNL had not yet opened for housing animals but its biocontainment facilities were being used for the collection and storage of SATs for future use. This arrangement made it possible to test facility systems and response plans under extreme conditions before the placement of animals and use of SATs in the GNL. Other campus buildings with biosafety level 2 and 3 laboratories and animal housing all underwent prestorm preparatory measures, including the euthanasia of some animals, shutdown and decontamination of laboratories, securing of hazardous agents, and autoclaving of infectious materials.

Backup Power It is imperative to consider the placement of emergency generators: they cannot be useful if they are located in areas subject to flooding. State and local historical information on flood plains and storm surges can be useful for identifying safe areas for the location of emergency generators. Drills should include scenarios in which there is no power available for an extended period—planning for a power outage of only 3 to 4 days is inadequate for major disasters, which may result in a loss of power (and other infrastructure challenges) for weeks and even months. For functional generators, plans should be in place for moving bulk supplies of fuel. The physical plant staff should be the central point of contact for coordinating orders for repair supplies, contract services, equipment, and other materials. Identification of breaker box locations and the posting of this information on equipment before a disaster will provide essential information for first responders and contractors who need to prioritize power restoration. During the recovery phase, physical plant personnel should conduct a campuswide damage assessment and identify critical needs for repairs, additional power or air conditioning, and debris removal. Because emergency generators may not be able to maintain all the freezers, it may be necessary to keep additional stores of liquid nitrogen and holding tanks rated for highrisk disasters both for backup and for the possible storage of tissue samples involving SATs. Emergency planners should also evaluate potential dry ice needs and coordinate quantities and delivery locations with suppliers. Freezers on emergency power may run on circuits involving more than one laboratory, and the overloading of those circuits may thus affect equipment in several laboratories, so it may be helpful to place freezers on casters to facilitate movement to other areas as needed to balance electrical loads.

Communication The IRP should include a clear designation of lines of communication at all levels among both biocontainment facility staff and relevant campus authorities (e.g., upper administration, 123

physical plant, and security personnel). There should also be a tracking system for employees, construction contractors, consultants, and others who come back to campus immediately after the disaster, and security personnel should have lists of approved staff for specific areas on campus and even within a building if appropriate (the subject of personnel access after a disaster is further developed in the next section). It is never a good idea to depend on a single mode of communication; rather, multiple types of communication systems should be available. Walkie-talkies and cell phones, along with ample battery supplies or even solar-powered equipment, are useful options, and their operation should be checked routinely. It is critical to ensure that staff are thoroughly trained on the communication devices to be used during and after the disaster. Other communication concerns include the inability to contact relief teams, inaccurate or insufficient phone tree information, and the lack of a central area or point person for personnel who report to work in the days after a disaster. Frequent, timely communication with staff is of vital importance after a disaster. Daily updates on progress and on changes in procedures or lines of reporting support not only effective communication but also morale.

Team Roles and Responsibilities The roles and responsibilities of all biocontainment staff should be clearly defined and personnel drilled on their assigned duties. If procedures require external animal care support staff, their roles, responsibilities, and lines of authority should be clearly defined as well. The UTMB animal biocontainment facilities are served by three teams: •





The Emergency Animal Care (EAC) team consists of designated primary responders to disasters that specifically affect animal care. Its members, responsible for providing animal care during the disaster, are a veterinarian and three animal health technicians, all with approval for unescorted access to SATs as well as extensive training and experience working with animals in a biocontainment environment. The Animal Treatment team succeeds the EAC team to provide triage and specialized veterinary support to sick or injured laboratory animals after the disaster. Its composition is the same as that of the EAC team (but with different members). The Animal Recovery and Relocation (ARR) team is responsible for coordinating the logistics for maintaining animals in place during a disaster; its responsibilities include preparing emergency kits, conducting an inventory of the animal population, and rescuing, reclaiming, and/or recovering laboratory animals after a disaster. The ARR team is composed of one veterinarian and four animal health technicians with experience in biocontainment.

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These three teams must work closely together to accomplish their missions. Personnel need to meet with their designated teams before any disaster and plan to return to work as soon as possible afterward. They should therefore be considered essential personnel for reporting purposes (Goodwin and Donaho 2010 also stress this point). The designation of a team of research staff as initial responders for each department will facilitate the prompt identification of critical damage specific to each laboratory. These teams should have the authority to make decisions about the handling of sensitive materials or damaged equipment, and one individual in each department should be responsible for decisions about the disposition of study animals in that department. Such arrangements can reduce the frustration of trying to contact individual investigators when communications are seriously compromised.

Supplies, Staging, and Other Logistics The IRP should address asset protection and documentation. It is important to maintain and regularly update inventories of consumables and supplies that must be replaced and to photograph supplies and equipment relevant to each specific area or laboratory. Backup data should be available for documents such as equipment operation and maintenance manuals and vendor information, with copies in off-site locations. Security requirements should be considered for photos and data involving SATs. The staging of equipment and supplies is another key planning consideration. Staging areas require risk assessment to identify risk factors such as possible water surge levels, for example, in the event of a hurricane. Because staged supplies may not last the entire postdisaster recovery period, it may also be necessary to establish staging areas for contractors (e.g., facilities, electrical, construction) that will arrive after the storm. If space is available, it is best to plan for staging supplies and equipment on each floor of a building. In the event of power outages and the loss of elevator use, response teams may not be able to move supplies from lower to upper floors, and it could take several months (e.g., after a storm of the magnitude of Hurricane Ike) for elevator service to resume. Designated staff must determine whether the supplies and equipment necessary to support specific projects are on hand and will be adequate to sustain animals during and after a disaster (items such as disposable caging and gel packs may reduce the need for postdisaster support functions). The following questions provide useful guidelines: • • • •

Are anesthesia/euthanasia stations set up in several different areas, according to animal facility need? Are compressed gas cylinders secured, full, and equipped with properly working regulators? Are emergency kits stocked and ready to provide clinical support, or euthanasia if required? If the decision is made to maintain certain groups of animals rather than to euthanize them, will adequate ILAR Journal

project-related materials be available after the disaster to avoid invalidation of the study? Such determinations require close communication and coordination with research staff. It can also be useful to contact facilities in surrounding areas for possible housing space, freezer storage, feed and bedding supplies, and cage cleaning services if needed. Formal, prearranged agreements with other facilities and with vendors can alleviate many postdisaster animal support issues. If animals are moved to other areas or facilities, their up-to-date records must accompany them. Adequate supplies of personal protective equipment should be staged in areas where it may be needed after a disaster. Planners should bear in mind that enhanced PPE may be necessary for dealing with animals in all areas after a disaster, not just biocontainment areas. Examples of enhanced PPE include powered air-purifying respirators instead of surgical masks, rubber boots instead of shoe covers, waterresistant jumpsuits instead of cloth scrubs, and heavy-duty rubber gloves in addition to latex or nitrile gloves. Basic services (e.g., hand washing stations, portable toilets, food prep facilities) should be available for first responders throughout the campus. Hand wash and shower stations are especially critical for personnel working in biocontainment areas.

Command and Control The IRP should clearly indicate who will be responsible for determining that it is safe to reenter laboratories and animal housing areas. Security policies should be in place for data and equipment in areas where first responders may have unsupervised, unlimited access. If video surveillance is no longer functional in SAT storage areas, the IRP should include arrangements for escorting or otherwise monitoring responders in the facility. Security checkpoints may require increased staffing and/or changes in location. The lines of authority should also be well defined for time-sensitive decisions about SAT-exposed animals, whose disposition before a hurricane (or other forecasted disaster) must be clearly specified. The criteria for euthanizing animals in such circumstances are complex, involving a variety of factors that may include the level of biocontainment, risk of escape, expected amount of time before care can be resumed, and the ability to provide food and water for an extended period. Generally, the decision to euthanize must be made even when the impending disaster is at a distance such that its path could alter. Waiting until there is a high probability of knowing the exact path and timing of a disaster is too late, although the necessity of an early decision point means that there is a risk of euthanizing animals for a storm that alters its path and is no longer a threat. But a delay in the decision can cause serious problems, such as inadequate staffing if personnel leave before they are notified of the need to stay, a large number of animals to euthanize and process out of the biocontainment facility, and/or a large quantity Volume 51, Number 2

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of caging, equipment, and animal housing areas to be decontaminated, all within a short period of time. Incinerator shutdown times also affect these decisions as animal carcasses must be moved to incinerators in a timely manner. The decision timeline and IRP should factor in the time necessary for processing carcasses and for moving essential equipment and supplies out of biocontainment areas. In addition to defining the criteria and timing for euthanasia, the plan should both identify personnel with the authority to approve euthanasia of selected animals and establish a reasonable timeline for initiating and completing the required procedures. Documentation is critical as an inability to account for any SAT-infected animal results in the requirement to file a SAT loss report.

After the Disaster Staff should be prepared to respond to inspections from agencies such as the CDC and USDA shortly after a major disaster. Agency representatives will seek to determine whether an IRP was in place and was implemented as written, and, if variations occurred, how they are being addressed and documented. For accurate assessment of losses after a disaster and for reporting to insurance companies and the Federal Emergency Management Authority, animal inventories must be current and animal losses documented; the latter may include animals euthanized in preparation for a disaster as well as losses resulting from the disaster itself. The IACUC can be a great help in assisting with postdisaster animal activities and should begin functioning on-site as soon as possible. The animal care and use program may consider establishing a smaller committee that includes the minimum required members of an IACUC, per USDA and NIH Office of Laboratory Animal Welfare requirements, to allow animal issues to be addressed as quickly as possible. Institutions must also maintain awareness of community concerns and should provide information during recovery operations. Updates from an institution’s public relations office can significantly reduce the impact of erroneous news reports, such as inaccurate stories of escaped animals. In the event of a widespread disaster, it will be necessary to make allowances for employees who may have undergone personal crises, such as damage to their homes, displacement, or the loss of loved ones. Such severe emotional and psychological stresses may disrupt employees’ normal functioning. The availability of mental health professionals to provide for the emotional well-being of staff is extremely important.

Conclusion As an increasing number of institutions have endured major weather and other disasters, they have learned the strengths and weaknesses of their IRPs. So, too, UTMB’s campus and animal care disaster preparedness teams continuously review and refine plans in preparation for another hurricane of the 125

magnitude of Ike, which dramatically altered their views of risk assessment. The simple questions of “What worked?” and “What didn’t work?” are very effective tools in these efforts. It is essential to continually evaluate disaster scenarios and responses and to enhance training with drills for specific areas and response teams. Periodic assessment of checklists and training should also be part of IRP review activities. Locations for emergency equipment and lines of responsibility for maintaining and checking equipment will change, and the IRP and drills must incorporate these changes. Two rules of thumb underlie the continual refinement of the UTMB IRP:

chlorine dioxide generators, and paraformaldehyde) for biocontainment areas. Two critical lessons from the UTMB experiences were the importance of (1) multiple backup plans in the IRP for essential services and supplies for the animal facilities and (2) communication for the successful provision of veterinary care and protection of both institutional personnel and the community. UTMB is very fortunate to have a wonderful cadre of dedicated personnel that adapted in tough situations and provided excellent veterinary care and husbandry under extreme conditions.

Acknowledgments • •

“Err on the side of caution,” and “Plan on the worst-case scenario—every time.”

For the institution’s animal facilities, these guidelines have translated into the development of alternatives for aspects of the IRP that were not effective. For example, emergency generators had been located in an area that flooded during the storm, so there was no power for the animal facilities. Another big limiting factor for responding to the disaster was that personnel had to wait almost 3 hours at security checkpoints to get to work, and when they arrived they found limited accommodations for staying on-site. Not least, the lack of things normally considered routine (e.g., getting to work, usable restrooms, communication) can greatly compound problems in the wake of a disaster. In response to these experiences, UTMB has improved its IRP with the following changes: • • • •



• •

use of portable generators that operate on marine batteries for biocontainment facilities; installation of a commercially produced bag watering system to maintain a larger supply of water for animals that remain in the facility; maintenance of emergency medical/veterinary supplies in a secure location—possibly a climate-controlled storage unit—away from the facility; designation of places to sleep, eat, and perform personal hygiene for members of the veterinary response teams (e.g., in tents or shelters with sufficient water, first aid, and showering facilities); establishment of a veterinary care command center for all veterinary teams to report to the animal care director and hold scheduled meetings every morning and afternoon; arrangements for emergency euthanasia of animals; and maintenance of an adequate supply of room decontamination equipment (e.g., vaporized hydrogen peroxide,

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The authors acknowledge all the dedicated individuals who have faithfully responded to disasters at their facilities as well as those who provided both material and emotional support to help them through the difficult times.

References APHIS/CDC [Animal and Plant Health Inspection Service/Centers for Disease Control and Prevention]. 2007. Incident Response Inspection Checklist. Available online (www.selectagents.gov/Checklists.html), accessed September 3, 2009. APHIS/CDC. 2008. Select Agents and Toxins Theft, Loss and Release Information Document. Available online (www.selectagents.gov/ TheftLossRelease.html), accessed September 3, 2009. AVMA [American Veterinary Medical Association]. 2008. The AVMA Emergency Preparedness and Response Guide. Schaumburg, IL. Auf der Heide E. 2006. The importance of evidence-based disaster planning. Ann Emerg Med 47:34-49. CFR [Code of Federal Regulations]. 2002a. Title 42, Part 73. Possession, Use and Transfer of Select Agents and Toxins. Washington: Office of the Federal Register. December 13. CFR. 2002b. Title 7, Part 331; and Title 9, Part 121. Agricultural Bioterrorism Protection Act of 2002: Possession, Use, and Transfer of Biological Agents and Toxins. Washington: Office of the Federal Register. December 13. CFR. 2002c. Title 9, Parts 1-4. Animal Welfare Regulations. Washington: Office of the Federal Register. January 1. Chosewood LC, Wilson DE, eds. 2007. Biosafety in Microbiological and Biomedical Laboratories, 5th ed. Washington: US DHHS. Gonder JC. 2005. Select agent regulations. ILAR J 46:4-7. Goodwin BS Jr, Donaho JC. 2010. Tropical storm and hurricane recovery and preparedness strategies. ILAR J 51:104-119. MMWR. 2002. Laboratory security and emergency response guidance for laboratories working with select agents. MMWR 51(RR-19):1-6. NRC [National Research Council]. 1996. Guide for the Care and Use of Laboratory Animals. Washington: National Academy Press. Quarantelli EL. 1985. Organizational behavior in disasters and implications for disaster planning, Report series 18. Newark, DE: Disaster Research Center, University of Delaware. Vogelweid CM. 1998. Developing emergency management plans for university laboratory animal programs and facilities. Contemp Top Lab Anim 37:52-56. Wingfield WE, Rollin BE, Bowen RA. 2010. You have a disaster plan but are you really prepared? ILAR J 51:164-170.

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