Mass Illness and Mass Exposure (Agent)

Mass Illness and Mass Exposure (Agent)

From bug spray to paint fumes and mace to carbon monoxide, there are numerous reasons why large numbers of people may experience similar symptoms.  As an EMS provider, intentional exposures (such as terrorism) and accidental exposures (laced medications, spreading illness, spills, asbestos, etc.) should all be treated suspiciously until proven otherwise.

Common and recent examples of exposure events
  • Nursing home, day care or cruise ship residents sick with a virus
  • 90+ people overdosed on K2 in Connecticut park over 2 days
  • 12 people treated after accidental mace discharge in store in Massachusetts
  • Nearly 30 people treated for opiate exposure at Ohio jail
  • USPS employees had to give up clothing after mercury spill in Norfolk
  • 10 people sent to hospital for fumes from coral in home fish tank in England
  • 5 people critically ill/dead after exposure to nerve gas in England (two separate events)
  • 12 hotel guests sickened by carbon monoxide leak at hotel in Texas


Key points to remember

  • Be aware. Be suspicious.
    • It isn’t “normal” for large numbers of people to suddenly experience symptoms at the same time
    • Do the surroundings match the story? If you get called to a chlorine leak at a swimming pool and see people coughing with watery eyes, that may fit.  If you see those same people at a mall, that is not normal.
    • Is this a high value target?
    • What are the symptoms/signs?
  • Call for help
    • If you are first to arrive or early, make notifications
    • Set a staging area based on size, type, wind, etc.
  • Limit your exposure
    • Apply appropriate PPE
    • Stage at a safe distance
    • Don’t touch unknown substances or known dangerous ones
    • Follow command instructions for staging, entry, etc.
    • Know hot, warm, cold zone areas
    • Don’t become a victim
  • Don’t relocate the incident
    • Corral patients-give them a task, keep them calm, separate sick from not sick
    • Call the nearest hospital as soon as feasible
      • They can prepare for your arrival
      • They might get POV patients before you transport
    • Decon as appropriate and as necessary

What can you do to be more prepared?

As always, be safe, be suspicious, and never stop learning!