CDC’s CHEMPACK Program—The Stockpile that may protect you from a chemical attack

It’s a terrifying but plausible scenario. You’re in an enclosed crowded place—perhaps a subway or a mall—and a terrorist organization releases lethal quantities of a nerve agent such as sarin into the air. The gas sends your nervous system into overdrive. You begin having convulsions. EMTs rush to the scene while you go into respiratory failure. If they have nerve agent antidotes with them, you may have a greater chance of living. If they don’t, you may be more likely to die. Will you survive?

Thanks to CDC’s Strategic National Stockpile CHEMPACK program, the answer is more likely to be yes.

CHEMPACKs are deployable containers of nerve agent antidotes that work on a variety of nerve agents and can be used even if the actual agent is unknown. Traditional stockpiling and delivery would take too long because these antidotes need to be administered quickly. CDC’s CHEMPACK team solves this problem by maintaining 1,960 CHEMPACKs strategically placed in more than 1,340 locations in all states, territories, island jurisdictions, and the District of Columbia. Most are located in hospitals or fire stations selected by local authorities to support a rapid hazmat response. More than 90% of the U.S. population is within one hour of a CHEMPACK location, and if hospitals or first responders need them, they can be accessed quickly. The delivery time ranges from within a few minutes to less than 2 hours.

The medications in CHEMPACKs work by treating the symptoms of nerve agent exposure. According to Michael Adams, CHEMPACK fielding and logistics management specialist, “the CHEMPACK formulary consists of three types of drugs: one that treats the excess secretions caused by nerve agents, such as excess saliva, tears, urine, vomiting, and diarrhea; a second one that treats symptoms such as high blood pressure, rapid heart rate, weakness, muscle tremors and paralysis; and a third that treats and can prevent seizures.”

Maintaining CHEMPACKs throughout the nation is challenging, but it is an essential part of the nation’s defenses against terrorism. The CHEMPACK team must coordinate with limited manufacturers to keep the antidote supply chain functioning. CHEMPACK antidotes are regularly tested for potency and are replaced when needed. They must be maintained in ideal locations for quick use by hospitals and first responders. But, having them available is only the first step. Personnel who may use them need to know where they are and must be trained. CDC supports state and local partners as they identify CHEMPACK placement locations and conduct trainings for their responders.

Terrorist nerve agent attacks are not hypothetical. The Aum Shinrikyo group in Japan used sarin gas to attack subway passengers twice: an attack in 1994 killed eight people and a second attack in 1995 killed 12. Experts agree that these attacks were amateurish and a better timed and executed attack could have killed many more people.

CDC’s CHEMPACK team is part of the rarely seen network that protects the people of the United States from unusual threats. You might not have heard much about them, but if you are ever attacked by nerve agents, they may be the reason you survive.

PHPR: Health Security in Action

This post is part of a series designed to profile programs from CDC’s Office of Public Health Preparedness and Response.

The CHEMPACK program is a program run by CDC’s Office of Public Health Preparedness and Response’s (PHPR) Division of Strategic National Stockpile.