Anticipating Anthrax: New Tools Designed to Enhance Long-Term Medical Countermeasure Distribution

NACCHO in coordination with the the Association of State and Territorial Health Officials (ASTHO) and the Centers for Disease Control and Prevention (CDC) recently released two complimentary resources to bolster emergency planning and response following an anthrax event. The primary document, developed by the CDC, outlines response protocol following a large-scale aerosolized anthrax emergency for federal medical countermeasure (MCM) staff. More specifically, the guidance includes expanded 10-day anthrax guidance, provides information on requesting, receiving, and dispensing follow-up MCMs (50-day courses of antibiotics, anthrax vaccine, and anthrax treatment MCMs), and additional MCM planning guidance for state and local health department planners. The CDC guidance document is posted in their On-TRAC Portal via the “MCM Hot Topics” section (click here for more information on how to access the On-TRAC Portal).

Subsequently, NACCHO and ASTHO collaborated to release a complimentary resource, titled “Extended Medical Countermeasure Distribution and Dispensing Considerations for an Anthrax Incident,” targeting MCM staff at the state and local level. The NACCHO/ASTHO document features information on a range of relevant MCM distribution and dispensing topics, including a descriptive overview, relevant assumptions, promising practices, steps to implementation, opportunities for state and local health departments, critical points for plan improvement, and additional resources for each topic. Together, the CDC and NACCHO/ASTHO guidance documents offer state and local health department planners an array of tools and promising practices that can directly enhance their agency’s capacity to develop and support an effective anthrax response.

The development of the document was implemented through an inter-agency NACCHO/ASTHO workgroup, composed of more than 30 MCM subject matter experts representing both state and local health departments. Together the workgroup conducted a needs assessment, selected document topics, developed a template for document sections, drafted sections, engaged federal partners in the document review and development, and jointly finalized the document. The version of the NACCHO/ASTHO document that is being released contains the most up-to-date information that was available as of May, 2017.

The following resources on long-term MCM planning are also available on the NACCHO Toolbox:

In addition to using these resources, NACCHO encourages state and local health department planners to share tools and guidance for long-term MCM resources used within their own jurisdictions via the NACCHO Toolbox. For additional information on the Extended Medical Countermeasure Distribution and Dispensing Considerations for an Anthrax Incident document, please contact NACCHO Preparedness team members, Raymond Puerini ( or Neyling Fajardo (

About Raymond Puerini

Raymond Puerini, MPH, is a Senior Program Analyst on the Environmental Health, Pandemic Preparedness, and Catastrophic Response team at NACCHO. His work includes sharing best practices for the distribution and dispensing of medical countermeasures and developing policy and guidance to support strategic national stockpile responses. Twitter: @Are_You_Ray_Dy

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