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U.S. Department of Health and Human Services



Botulinum toxin poses a credible biological threat because of its extreme potency and lethality, ease of production, and ability to cause significant human morbidity and mortality. An intentional event involving this toxin could cause significant casualties in military or civilian settings, and disrupt political, economic, and social infrastructures in the United States (U.S.). The purpose of this Botulinum Food Contamination Playbook is to provide guidance to the Secretary and the Assistant Secretary for Preparedness and Response, U.S. Department of Health and Human Services’ (HHS) decision making processes in response to a terrorist food attack with botulinum toxin in a single metropolitan area. An intentional release of botulinum toxin will require prompt ESF #8 action and intervention to protect the general population. This playbook will outline key options and actions to aid the Secretary in leading public health and medical response efforts during a time of national crisis. It will also provide the Assistant Secretary for Preparedness and Response (ASPR) a resource document to assist in coordinating HHS and ESF #8 response activities.

Playbook Structure

The seven major sections of the intentional botulinum food contamination playbook are:

  • Scenario
  • Concept of Operations
  • Actions and Issues
  • Decision Papers*
  • Briefing Papers*
  • Essential Elements of Information (EEIs)
  • Pre-Scripted Sub-Tasks (PSSTs)

The botulinum intentional food contamination playbook is prepared in accordance with the National Response Framework and Homeland Security Presidential Directives (HSPD), emergency declarations, and the National Preparedness Guidelines 1 . Additionally a list of acronyms is provided for your use at the end of the document. The following definitions of each category are provided below to acquaint planners with the context of the playbook:

  • Scenario: The botulinum intentional food contamination attack scenario is an account or synopsis of a projected series of events and situations. Scenario development is used in preparedness and response planning within HHS in an effort to set the conditions for conventional thought on how the department would approach, plan for, and test strategies against uncertain future developments. The purpose of the botulinum intentional food contamination attack scenario is to help understand how events might unfold and to provide realistic assumptions for planning purposes. This scenario should not be used to forecast future events, but rather is offered as a plausible account for possible future events leading toward a botulinum intentional food contamination attack.

  • Concept of Operations (CONOPs): This CONOPs evolved from a vision of actions and events and is a description of how a set of capabilities may be deployed and subsequently employed to achieve desired objectives or a particular end state for a botulinum intentional food contamination attack. It takes into account the steps and procedures that may be found in federal and SLTT response plans for a botulinum intentional food contamination attack. The CONOPS also incorporates the synchronized activities and capabilities under consideration and adds the resource management details of who may allocate resources, and where resources may be applied to achieve desired mitigating outcomes. This CONOPS does not describe how to conduct preparedness activities, but serves as a discussion point for federal and SLTT planners to use as a baseline for a coordinated preparedness effort.

  • Actions and Issues: Refers to the actions and issues associated within each of the three phases of the botulinum intentional food contamination attack, further segmented by functional activity. The functional activities include; Planning and Coordination, Surveillance, Antitoxin, and Ventilator Utilization Policies, Healthcare/Emergency Response, and Communications/Outreach. The actions steps and issues are the essence of the playbook. They not only outline the steps necessary to achieve interagency coordination, but they also identify lead and supporting government agency responsibilities.

  • Essential Elements of Information (EEIs): EEIs are critical items of information required to accurately respond to circumstances surrounding natural or manmade disasters. They provide decision makers at all levels of authority insight into how and where resources should be applied to achieve maximum benefit to the general population in easing suffering or protecting infrastructure. In this playbook, information requirements are derived as they relate to the preparedness and response activities for a botulinum food contamination attack.

  • Pre-Scripted Sub-Tasks (PSSTs): PSSTs are defined as coordinated critical tasks that must be performed by other departments and/or agencies in the federal government, namely those with responsibility to support ESF #8 activities. They identify expected capabilities, drafted in clear language for the purpose of developing and gaining rapid mission assignment approval. ESF #8 federal partners include: the Departments of; Agriculture (USDA), Defense (DOD), Energy (DOE), Homeland Security (DHS), Interior DOI), Justice (DOJ), Labor (DOL), State (DOS), Transportation (DOT), Veterans Affairs (VA), and agencies including Environmental Protection Agency (EPA), General Services Administration GSA), U.S. Agency for International Development (USAID), U.S. Postal Service (USPS), and the American Red Cross (ARC).

* Decision Papers (Tab 6) and Briefing Papers (Tab 7) have been redacted from this publication.
1US Department of Homeland Security (September 2007)

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  • This page last reviewed: March 20, 2012