A detailed exploration of leadership problems that can develop during public health crises such as the anthrax attacks, SARS, and Mad Cow disease.An imminent threat to the public health, such as the swine flu outbreak, is no time for a muddled chain of command and contradictory decision making. Who's In Charge? Leadership during Epidemics, Bioterror Attacks, and Other Public Health Crises explores the crucial relationships between political leaders, public health officials, journalists, and others to see why leadership confusion develops.Who's In Charge? begins by looking at the overarching issues of leadership, public health administration, and the threats of bioterrorism. It then examines five recent emergencies-the 2001 anthrax attacks and 1993 cryptosporidium outbreak in the United States, the 2003 SARS outbreak in Toronto, the 2001 foot-and-mouth disease crisis, and the decade-long battle against Mad Cow Disease in the U.K. A perfect text for schools in public health, or as a reference for elected officials at every level of government, the book shows how each event developed step-by-step to pinpoint specific leadership issues. Engaging and absorbing, the work presents official reports, medical literature, first-person accounts from officials and journalists, and discussions of the role of law enforcement and the military during health care emergencies.

A comprehensive index organized by disease and by individuals involved in emergency response

PrefaceAcknowledgments1. Understanding LeadershipAn Overview of LeadershipStudying Public Health LeadershipPolitical Leaders and BureaucratsDefining Leadership2. The Long March to Improving the Public's HealthInfectious Disease EpidemicsVaccines: A Fortunate CoincidenceAn Unfortunate Side Effect of HospitalsEarly Public Health Epidemics in the Newly Formed United StatesSweeping Social Changes in EuropeThe Father of EpidemiologyCrossing Borders: European Influences on Early American Public Health EffortsAwakenings: A Long-Awaited BreakthroughThe Germ Theory of DiseaseThe Civil War and the Changing Face of U.S. Public HealthPostwar Public Health DevelopmentsThe Beginnings of International HealthPandemic Influenza in the Early 20th CenturyThe Beginnings of the World Health OrganizationThe HIV/AIDS PandemicPublic Health Past, Present, and Future3. Microbes as WeaponsBiowarfare and Bioterrorism through the AgesAdvances in the 20th CenturyThe Role of the United StatesThe Role of the Soviet UnionTerrorist Acts by Groups and IndividualsEmerging Concerns4. Rising to the OccasionPolitical Leadership during Infectious Disease CrisesAnthrax Attack, Fall 2001, Hamilton Township, New JerseyMayor Glen D. Gilmore, Hamilton Township, New JerseyCryptosporidium Outbreak, Spring 1993, Milwaukee, WisconsinMayor John Norquist, Milwaukee, WisconsinSevere Acute Respiratory Syndrome (SARS), Spring 2003, Toronto, CanadaDeputy Mayor Case Ootes, Toronto, CanadaConclusion5. Success Favors the Prepared Public Health LeaderAnthrax Attacks in New Jersey, Florida, Maryland, and New YorkNew JerseyFloridaMarylandNew York CityCryptosporidium in Milwaukee, WisconsinSARS in Toronto, CanadaConclusion6. Confronting UncertaintyThe 1976-77 Swine Flu DilemmaThe 1997 Avian Flu DilemmaThe 2009 Swine Flu DilemmaLeaders' Responses to Disease ThreatsInformation Required for Decision MakingConclusion7. Part I: The Vital Link between Animal and Human HealthThe Impact of Animal Health CrisesBovine Spongiform Encephalopathy (BSE)Views of the CrisisConclusionPart II: The Vital Link between Animal and Human HealthThe Foot-and-Mouth Disease CrisisViews of the CrisisSumming UpConclusion8. Reaching the MassesRisk Assessment, Perception, and CommunicationSmallpox Outbreak in New York City, 1947The Changing MediaFrom the Media PerspectiveAnthrax Outbreak in New Jersey, 2001Cryptosporidium Outbreak in Wisconsin, 1993SARS Outbreak in Toronto, 2003Conclusion9. All Hands on DeckWorst Case ScenariosLegal Challenges of Public Health and BioterrorismImproving PreparednessA Better ModelExperts' AdvicePublic Health and Emergency ManagementWho's in Charge?Epidemics and Bioterrorist Attacks: Leadership ChallengesPublic Health, the Military, and the National GuardConclusion10. ConclusionCritical Need: Prepared Elected OfficialsRelationships between LeadersWhen Science Does Not Have the AnswersThe Public Communication Roles of Different LeadersLegal and Organizational Structures and Crisis LeadershipTraining Elected OfficialsNotesIndex