Exercise Mission

The Beleaguered Bus Exercises were conducted to test the skills and capacity of rural county emergency response personnel in responding to a epidemiological threat. Participants in the exercises included:

• Capital Area Chapter of the American Red Cross
• County Health Departments
• County Emergency Management Departments
• County Emergency Medical Services Agencies
• County Sheriff's Offices
• Rural Community Hospitals

Exercise Overview

For several days in June, 20 to 30 Disaster Services Volunteers from the Capital Area Chapter of the American Red Cross played the part of returning missionaries as a charter bus traveled to Franklin, Gadsden, Hamilton, Jefferson, Lafayette, Liberty, Madison and Wakulla Counties in rural North Florida.

The Capital Area Chapter also provided Mass Care (feeding) support for the exercise participants on a daily basis from ERV # 1074.

Exercise Report	Format
Beleaguered Bus Exercise Report	Power Point

Exercise Backgrounder

1994 From August 20 through October 18, there was an outbreak of bubonic and pneumonic plague in India. The World Health Organization reported a total of 693 cases, with 56 deaths, were reported in five (5) Indian states: Maharashtra 488 cases, Gujarat 77 cases, Karnataka 46 cases, Uttar Pradesh 10 cases and Madhya Pradesh 4 cases and from a federal district of New Delhi 68 cases.

Present Day In May 2004, a religious group calling themselves the Modern Missionary Movement left their rural county church to work for six weeks in small villages around the city of Bangalore, India. The Mission work included staffing small clinics and constructing schools and chapels. During their stay, four (4) isolated cases of pneumonic plague were reported in neighboring villages. Although none had been reported in the villages where the missionaries were working, they were sufficiently alarmed by these events to hastily cut their work short and they scrambled for seats on an outgoing flight from New Delhi to London and from London to Orlando. Through a telephone call to the pastor of their county church, they arranged for a chartered bus to return them to home from Orlando.

On the flight back to the states several missionaries began to feel ill - malaise, mild fever and chills. They fought through the symptoms because they all wanted to get home. They arrived in Orlando and met the bus. Some of the missionaries with medical training began to worry about their friends and urged them to get help in Orlando, but those affected fought the suggestion. "I'll see a doctor when I get home, my family will take care of me," they responded.

The bus began rolling through the Florida countryside back to their home county. One of the passengers went into cough spasms that racked her body; her fever was clearly elevated. To the distress of all of her friends she began coughing up blood.

The medically-trained missionaries demanded that the bus driver stop the bus immediately and call in a 911 medical emergency. He pulled over and did just that.

Thus the Beleaguered Bus Exercises Begin!

	Franklin County Deputies from the Franklin County Sheriff's Office secure the perimeter surrounding the bus after it arrives in Apalachicola.
	Staff from the Franklin County Health Department confer with a deputy from the Franklin County Sheriff's Office as the determine what to do next..
	The Nursing Director from the Franklin County Health Department call for support and notifies the State of Florida Department of Health of the situation.
	EMS, Law Enforcement and the Health Department discus an incident action plan.
	One of the missionaries has been transported to Weems Hospital in Apalachicola for observation and isolation.
	Staff from Weems Hospital and Franklin County Health Department review their findings.
	Gadsden County After the charter bus pulls into Quincy, the missionaries (black shirt) are transported to Gadsden Memorial Hospital for observation and possible isolation or quarantine.
	Liberty County As the charter bus arrives in Bristol, it is diverted to the football field at the Liberty County High School.
	With Liberty County not having a local hospital, the Liberty County Health Department makes the decision to use the high school gym as a medical evaluation center.
	In a panic one of the missionaries tries to run for safety.
	Missionaries are screened while still on the bus by EMT / Paramedics from the Liberty County Emergency Medical Services Agency.
	Liberty County Health Department staff begin to work out a plan.
	Several of the critically ill missionaries are prepared for transportation to Tallahassee Memorial Hospital.
	Another missionary panics and tries to flee the area but is stopped by a Liberty County Sheriff's Office deputy.
	THE BUS PREPARES TO TRAVEL TO ANOTHER COUNTY!