At the top of the Northern Kentucky bioterrorism preparedness shopping list: an epidemiologist.

        The region has had to react to several anthrax scares without an epidemiologist — a physician who tracks outbreaks of disease.

        As auditors at federal agencies urge increased speed and vigilance in preparing for terrorist threats, Kentucky is still figuring out how its portion of the state's $15.7 million in federal grants to fight bioterrorism will be used.

        “There's a lot of money coming down from the federal office of security to make sure the local level is ready in case the worst happens,” said Dr. Gary Crum, public health director for the Northern Kentucky Independent District.

        “We're still trying to figure out how to spend the money locally.”

        Kentucky is receiving part of $918 million allotted to the states after Sept. 11.

        Kentucky's bioterrorism funding amount was finally approved and formally announced only a few weeks ago.

        The Kentucky Centers for Disease Control and Prevention will receive $13.9 million of the $15.7 million to upgrade state and local public health preparedness for bioterrorism, other outbreaks of infectious disease and other public health emergencies.

        Dr. Steve Englender, director of the Department of Epidemiology and Health Planning for the state Department for Public Health, said there are 55 health departments serving Kentucky's 120 counties and only two or three epidemiologists in the state at the local level.

        “We will work with our local health departments on a regional level,” he said.

        “What this means for Northern Kentucky and Kentucky as a whole is more epidemiological capacity to the health departments. We would anticipate Northern Kentucky to get an epidemiologist as a result of this.”

        Dr. Crum agrees that epidemiology is an important issue. “We have some nurses who serve as epidemiologists doing things like studying disease outbreaks,” he said. “We need more epidemiological expertise and we need more basic bioterrorism training locally for our staff.”

        Northern Kentucky, as part of the Greater Cincinnati metro area, has benefited from the epidemiological expertise of physicians based in Ohio.

        As a result of federal emphasis on domestic terrorism since 1996, the City of Cincinnati and Hamilton County have been receiving federal equipment grants, training programs and medical response programs offered to 150 major metropolitan areas.

        When one anthrax contamination scare shut down the Internal Revenue Service processing center in Covington this fall, the suspicious envelope was flown by helicopter to Columbus for analysis. Results, within a few hours, showed no danger.

        The Centers for Disease Control and Prevention divides its work plan for states into six focus areas:

        • Preparedness planning and readiness assessment;

        • Surveillance and epidemiology capacity;

        • Laboratory capacity-biologic agents;

        • Health alert network/communications and information technology;

        • Risk communication and health information dissemination;

        • Education and training.

        “Even though the focus is to prepare, it will also upgrade the local health systems in general,” said Gwenda Bond of the Cabinent for Health Services.

        “We're going to increase the ability of the health departments to be able to communicate with each other and the state,” she added. “We'll teach the health department staff to communicate with the media and the population.”

        The plan includes health departments being linked to the Internet, text messaging and having satellite phones in case a cell tower goes out.

        “This plan leaves Kentucky more prepared at any level to deal with any type of bioterroristic attack,” said Ms. Bond, specifically citing anthrax attacks, infectious diseases like smallpox, chemical agents and disasters at a nuclear power plant.

        The remaining $1.8 million is intended to improve hospital preparedness throughout the state. This is being administered through the Kentucky Health Resources and Services Administration.

        “The hospital grant is a lot smaller, so that's not going to be as intense of a program,” said Ms. Bond.

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