Emergency Preparedness and
Incident Command System

Regional Public Health Bioterrorism Exercise,
October 2004 (BTX 04)

Executive Summary of BTX 04

In October, 2004, Metro Portland, Oregon's Clackamas, Multnomah, and Washington County health departments collaborated with public and private organizations throughout the tri-County region to conduct a major bioterrorism exercise . Its purpose was to exercise and evaluate the region's epidemiological investigatory capabilities, regional coordination and communications during a major event, and our use of Incident Command System and the draft Regional Public Health Emergency Response Plan. On October 4, the communicable disease staffs of the three Counties were alerted of unusual and related cases in several emergency rooms. Department executives were notified and they activated the Regional Plan. October 5-6 exercises tested the command post operations of the health departments, 10 hospitals, local emergency management agencies, and the Federal Bureau of Investigation. Most participants activated operation centers and their incident management teams. The large size of the contagious disease event forced participants to contend with resource shortages. A number of organizations instituted a formal planning cycle leading to creation of Incident Action Plans (IAP). The scenario called for many mass vaccination clinic operations.

On October 13, a field exercise of one mass prophylaxis field distribution site tested the Mass Prophylaxis Clinic Tab of the Regional Public Health Emergency Response Plan. Held at Reynolds Middle School in Fairview, the clinic was staffed by public health workers from the three counties as well as the Health Reserve Corps volunteers. Most staff did not know each other until the just-in-time training an hour before operations began. A novel aspect of the clinic was the use of a fun and fictitious disease so as to not alarm the middle school ‘patients’ or the community. The exercise confirmed that the clinical model presented in a Mass Clinic Tab of the Regional Response Plan could exceed its design capacity of three hundred patients per hour during two hours of operation. Click on the following links to exercise documents, elements of the Regional Plan, and two videos of the clinic operation.

• Mass Clinic Incident Action Plan (PDF ~435K)


• Mass Clinic Summary and Evaluation BTX 04 (PDF ~277K)


• Documentary Video of Mass Clinic - 10 minutes (wmv ~24MB)


• BTX04 Time lapse of Mass Clinic - compresses 2 hour duration into 4 minutes (wmv ~8MB)


• Photos of Mass Clinic


• Summary Evaluation of Command Post Exercise from Regional Perspective (PDF ~147K)


• Draft Regional Plan’s Chapter 2, Response Operations (PDF ~161K)


• Draft Regional Plan’s Tab B, Mass Vaccination Clinic (PDF ~461K)

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Page updated March 06, 2008