More bioterrorism education needed

More bioterrorism education needed

Newsdesk Tragic death of Leonid Stratchounski Russian Chemotherapy Society Leonid Stratchounski, a pioneering academic physician-scientist in antim...

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Newsdesk

Tragic death of Leonid Stratchounski

Russian Chemotherapy Society

Leonid Stratchounski, a pioneering academic physician-scientist in antimicrobial chemotherapy and member of The Lancet Infectious Diseases editorial board, died on June 7, 2005. For a number of years, he had worked tirelessly to bring Russia into the modern era of antimicrobial chemotherapy and to establish a hub of antimicrobial research in the country. He died, aged 52 years, after being attacked in a Moscow hotel. Having graduated from Smolensk State Medical Institute in Russia in 1976, he began his scientific career in 1978 as an assistant professor at their Department of Paediatrics. By 1986, he was head of the Department of Clinical Pharmacology, and was awarded a Doctor of Sciences degree in clinical pharmacology and antimicrobial chemotherapy in 1993. In 1999, he founded the Institute of Antimicrobial Chemotherapy in Smolensk. In 2000, he was appointed

head of the Scientific Centre of the Ministry of Health of the Russian Federation of Monitoring Antimicrobial Resistance. “By the force of his intellect, energy, and determination, Stratchounski brought Russia into the modern age of antimicrobial chemotherapy”, says Roman Kozlov (Institute of Antimicrobial Chemotherapy, Smolensk State Medical Academy). He engaged Smolensk Medical Academy’s most talented graduates to develop a successful academic enterprise. He also developed important collaborations with microbiologists, pharmacologists, and the infectious disease community throughout Russia and internationally. In 1997, he founded the Russian Interregional Association for Clinical Microbiology and Antimicrobial Chemotherapy (IACMAC). Among IACMAC’s several important achievements was its journal, Clinical Microbiology and Antimicrobial Chemo-

therapy, which translated foreign articles and guidelines into Russian. Stratchounski’s aim in founding the Institute of Antimicrobial Chemotherapy in Smolensk was to improve Russia’s scientific research into clinical microbiology and antimicrobial chemotherapy. “He imparted enthusiasm, integrity, and a unique global vision to science and humanity. Leonid’s death is an enormous loss to the scientific community”, says Anibal Sosa (Alliance for the Prudent Use of Antibiotics). Part of Stratchounski’s vision was to bring together all of the talent he had assembled into a state-of-the-art facility for research and training. Although he was not able to see the plans through to their completion, the IACMAC—which will serve as a centre for education and research into antibiotics—will represent a fitting memorial to Stratchounski and his legacy.

Rosie Taylor

More bioterrorism education needed More needs to be done to educate US physicians about the infections caused by agents that might be used in bioterrorism attacks, say researchers at Johns Hopkins School of Medicine (Baltimore, MD, USA). “When we tested the ability of physicians during their pre-certification clinical training to diagnose and manage such infections, they did pretty badly”, says senior author Stephen Sisson. However, participation in a teaching module greatly improved test scores (Arch Intern Med 2005; 165: 2002–06). “The US Centers for Disease Control has identified the agents most likely to be used in a bioterrorism attack on the USA”, explains Sisson, “but many of these agents cause diseases that overlap clinically with common disorders. In the 2001 anthrax attacks, several of 678

the early patients were sent home with the wrong diagnosis so we wondered just how good US physicians are at differentiating between, say, smallpox and chickenpox”. In 2003–04, the researchers tested the ability of 631 physicians at 30 internal medicine residency programmes to diagnose and manage cases of smallpox, anthrax, botulism, and plague. The participants then completed a teaching module and a second test. Correct diagnosis of these four diseases in the pre-education test averaged 46·8%; post-education scores averaged 79·0%. For management, scores increased from 25·4% to 79·1%. “There was no effect of year of training on pre-test scores”, notes Sisson, indicating a lack of education about bioterrorism agents during clinical

training. “However, our results show that such training would be very useful”. All medical housestaff at Johns Hopkins now complete an annual module on bioterrorism. Luciana Borio, a senior associate at the Center for Biosecurity at the University of Pittsburgh Medical Center (Baltimore, MD, USA) agrees that clinicians should have some basic familiarity with the diseases that might be used by bioterrorists. But, she says, because even now not all US physicians believe there is a threat from bioterrorism, the educational focus should be on explaining how this threat and that of emerging infections will affect public health instead of teaching them specific details about each organism.

Jane Bradbury

http://infection.thelancet.com Vol 5 November 2005