Bioterror expert spends day mulling ‘horrible scenarios’

Dr. Joel Ackelsberg spends his days worrying about safety in the face of a bioterrorist attack. He’s not paranoid — well, maybe a little — but it’s his job.

As bioterror surveillance coordinator and medical epidemiologist in the New York City Department of Health and Mental Hygiene’s Bureau of Communicable Diseases, he is tagged with responsibility for emergency preparedness, from investigating incidents and controlling their impact to coordinating with law enforcement and other city agencies.

It means drawing up plans and continually analyzing them for flaws to fix and gaps to close.

Over the years, he acknowledged in a telephone interview on a recent Monday morning, “I’ve worked on these really horrible scenarios.”

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Hired in 2000, his job changed dramatically after Sept. 11, 2001.

“Within 24 hours of 9/11, we sent alerts to the entire health-care community to be on the lookout for things like anthrax.” That’s because they were worried that there could be a second attack, and that it might be biological.

When the anthrax attack materialized that October, he led one of the teams investigating the cases, interviewing coworkers, chasing down leads. Although it turned out to be unrelated to 9/11, it was just the sort of thing his office prepares for.

And he’s learned over the years that his skills can quickly be applied to any kind of infectious disease outbreak, whether an influenza pandemic or SARS. But the primary focus remains bioterror, and the threats have grown since 9/11. “There are probably a lot more people out there who would like to attack us if they could,” he said.

Ackelsberg lives in Montclair with his wife and their three children — a 14-year old and nine-year-old twins who were born in the midst of the anthrax investigation, cutting short his paternity leave. He is a member of Bnai Keshet, the Reconstructionist synagogue in Montclair, where he will speak about his work at a program Friday evening, March 25.

Biodefense investments

One of the biggest challenges of Ackelsberg’s job, he said, is “figuring out what the genuine threats are and separating those from the many other claims that are out there.”

How likely are we to face a bioterror threat in the near future?

“That’s a tough one to answer. All I can say is that it’s impossible to know. The world certainly is more dangerous than it was 10 years ago. But I also know a lot of smart people who’ve been working on these issues and we are better at doing emergency public health than we were 10 years ago.”

But he dug into the New York City budget shortfall without prompting.

“When we have decreasing resources, funding for programs needs to be cut and there are very painful decisions to be made: Should we spend our resources to prepare for low probability, high consequence incidents? Or instead should we spend our money on what we routinely do — because high probability public health risks require ongoing investment — things like immunizations, sexually transmitted diseases, tobacco elimination? There is not an endless pool of resources.”

Luckily, he pointed out, “I’m at the program level, not the one making those tough strategic decisions.”

Still, Ackelsberg’s is the kind of job that has stress written all over it. He copes by deploying a sense of dark humor that emerges almost immediately in conversation.

“I’ve learned to appreciate the little things in life a lot more — hanging out with my kids, reading the parsha of the week,” he said. “We all have our ways of trying to make the world a better place. It’s great when we can do it professionally.”

Becoming a bioterror expert is not what Ackelsberg set out to do when he left home in Cranford for college. He took a circuitous route to medical school, but once there, it wasn’t long before he fell for infectious diseases, which led to a fellowship with the Centers for Disease Control’s Epidemic Intelligence Service, learning how to respond to and investigate infectious disease outbreaks.

Along the way, he also picked up a master’s degree in public health. When he graduated from medical school, a colleague invited him to join a team establishing New York City’s first dedicated center on bioterror preparedness.

“There was a lot going on in the 1990s,” he said, including the Oklahoma City bombing, the sarin gas attack on the Tokyo subway, and Saddam Hussein’s threat to use chemical warfare in the Gulf war.

There was also a worry, with the breakup of the Soviet Union, that materials and expertise for developing biological weapons might be available to those who might want to use them.

“There was a concern that we might actually be targeted,” he said.

What he’s learned since 9/11 is that despite counterexamples like the anthrax used in 2001, it is “pretty tough” to make high-quality biological agents. More important, he said, since 9/11, “significant investments have been made into biodefense.”

But the risks are ever present, and he has no plans to quit anytime soon.