August 24, 2006 InfoGram

This InfoGram will be distributed weekly to provide members of the Emergency Services Sector with information concerning the protection of their critical infrastructures. For further information, contact the Emergency Management and Response - Information Sharing and Analysis Center (EMR-ISAC) at (301) 447-1325 or by email at emr-isac@fema.dhs.gov.

Mass Psychogenic Illness

According to an April 2000 article by Timothy Jones, M.D., an epidemiologist with the Tennessee Department of Health, Mass Psychogenic Illness (MPI) occurs "when a group of people start feeling sick at the same time even though there is no physical or environmental reason for them to be sick." It is characterized by symptoms, which appear among a group of persons "with shared beliefs regarding those symptoms, that suggest organic illness but have no identifiable environmental cause and little clinical or laboratory evidence of disease."

MPI, also referred to as mass hysteria, is not an uncommon social phenomenon among otherwise healthy individuals. Many outbreaks of MPI start with an environmental "trigger," such as a bad odor, a suspicious-looking substance or something else (e.g., food and water) that makes people believe they have been exposed to a germ or poison. "Outbreaks are often enhanced by a vigorous emergency response and substantial media attention."

When an environmental trigger makes a group of people believe they have been exposed to something dangerous, many of them may begin to exhibit signs of sickness at the same time. They might experience headache, dizziness, faintness, weakness or a choking feeling. Their signs of sickness are not imagined; they really do have headaches or dizziness, etc. In some cases, one person gets sick and then other people in the group also start feeling sick. "People who feel sick in an MPI outbreak genuinely believe it is possible that they have been exposed to something harmful." However, the symptoms are actually caused by the stress or anxiety resulting from the irrational belief.

The Emergency Management and Response - Information Sharing and Analysis Center (EMR-ISAC) cautions that mass psychogenic illness can potentially degrade the continuity and response-ability of Emergency Services Sector (ESS) departments and agencies. Emergency personnel responding to incidents involving suspected contagions can experience elevated stress, get "caught up" in the situation, and develop the same reported symptoms of illness.

MPI among first responders can seriously impede performance of duties, significantly diminish organizational efficiency, and threaten mission accomplishment. Hence, the EMR-ISAC believes it is reasonable to consider MPI a possible critical infrastructure protection issue.

To terminate an outbreak of MPI, Dr. Jones advises that authorities take the following actions: promptly label the illness as MPI; get people away from where it started; medically examine the stricken followed by doctor assurances that the victim does not have a dangerous illness; and deliver general reassurances throughout the community that the illness was benign and without long-term effects. Dr. Jones further recommends that emergency services providers take the free one-hour online course.

Integrated Physical Security

The Emergency Management and Response - Information Sharing and Analysis Center (EMR-ISAC) understands the necessity for Emergency Services Sector (ESS) organizations to guarantee survivability, continuity, and response-ability by protecting their physical assets (i.e., critical infrastructure) from degradation or destruction. Therefore, recognizing the value of a comprehensive physical security plan for ESS departments and agencies, the EMR-ISAC reviewed The Integrated Physical Security Handbook published by the Homeland Defense Journal.

Physical security specialists often assert that the goal of implementing a quality physical security plan is "achieving sensible and sustainable security" for the buildings and people they contain. The EMR-ISAC contends a secure department or protected facility is a safer one that appropriately elevates personnel well-being and mission success. Apart from the legal and liability issues, it makes good sense to protect the facilities containing the individuals on whom you depend for their knowledge, skills, and abilities.

The following is a process to acquire a truly integrated plan that was modified for ESS leaders, owners, and operators from the steps offered in The Integrated Physical Security Handbook:

• Determine what constitutes a model secure facility given organizational core functions, critical infrastructures, personnel realities, threats, vulnerabilities, and mitigation measures.
• Decide which physical entities must be protected, and identify the threats to and vulnerabilities of those assets.
• Resolve which internal and external resources or options are best to mitigate identified threats and eliminate existing vulnerabilities.
• Prepare the plan to logically and concisely capture steps 1 to 3 above, and include the responsibilities of all those who must execute the requirements of the document.
• Implement the plan with training sessions, quality assurance provisions, feedback and evaluation opportunities, on-the-spot corrections, and no less than annual revisions.

A Proactive Approach to a Serious Personnel Threat

The Emergency Management and Response - Information Sharing and Analysis Center (EMR-ISAC) often examines how to protect Emergency Services Sector (ESS) personnel from natural and man-made hazards. Recently, the EMR-ISAC observed annual statistics indicating that more responder Line-of-Duty Deaths (LODDs) are caused by heart attacks and heart disease than other hazards.

Regardless of the type of hazard, it is the work itself that endangers first responders. Intense periods of demanding and strenuous activity often under the weight of protective clothing and breathing apparatus, and in extreme weather or fluctuating ambient conditions place great stress on all responders. Coupling pre-existing heart problems (e.g., arteriosclerosis), hypertension, or poor overall physical health (e.g., excess weight, lack of exercise, smoking, etc.) with extreme overexertion are usually casual factors in nearly half of annual LODDs. This is a serious threat to the most important of all critical infrastructures - personnel.

Given responders' devotion to their duties, colleagues, departments, agencies, and communities, the EMR-ISAC believes ESS personnel should be receptive to challenging the status quo regarding this leading cause of job-related fatalities. The National Volunteer Fire Council (NVFC) established a Website, Healthy-Firefighter.org, to help all responders understand their personal risk factors and provide tools and resources to reduce the number of responder deaths from heart attack. By visiting this website, users can take advantage of "heart-healthy" tools, view success stories, learn more about nutrition and healthy recipes, and stay up to date on relevant news.

The U.S. Fire Administration initiated a partnership with the NVFC to study issues related to responder occupational safety and health in the volunteer segment of the sector and to develop programs and strategies to reduce on-duty fatalities. Particular attention is being given to such volunteer-distinct health and safety issues as rural operations, wide age range of volunteers, distance from training facilities, declining number of volunteers, and antiquated equipment. Visit the USFA Website for additional information.

DHS and FBI Create Virtual Library

What constitutes a "workplace" varies by occupation or industry, but for the Emergency Services Sector (ESS), workplaces can include stations, training centers, airports, even Emergency Operations Centers. Whatever the physical form of the emergency workplace, it must, as part of the sector's physical infrastructure, be protected.

The Department of Homeland Security and the Federal Bureau of Investigation recently launched Protect Your Workplace, a campaign that includes a virtual library of downloadable documents.

The Emergency Management and Response - Information Sharing and Analysis Center (EMR-ISAC) reviewed the materials in the online library to assess their relevance to emergency responders, and found that many offer practical, precise CIP information. Categories of information include continuity of operations, emergency planning and supplies, medical emergencies, drill and exercises, and discussion guidelines for whether to "stay or go" in an emergency or disaster situation. A section on the costs of developing a disaster protection and business continuity plan features a bulleted list of recommendations divided by "no cost," less than $500, and more than $500. Brief case summaries of named businesses share outcomes of their disaster planning.

Available to print or download are "Ready Business" posters and brochures, a supply checklist, and sample emergency plan, as well as physical and cyber security guidance. The virtual library is a repository of planning information, which includes protecting the critical infrastructure of responder organizations. An added benefit is that the materials are a ready-to-use resource for National Preparedness Month, 1-30 September 2006.