Download 19 Oct 2005

CIVIL DIMENSION
OF SECURITY
186 CDS 05 E
Original: English
NATO Parliamentary Assembly
CHEMICAL, BIOLOGICAL, RADIOLOGICAL, OR
NUCLEAR (CBRN) DETECTION:
A TECHNOLOGICAL OVERVIEW
ADDITIONAL INFORMATION
LORD JOPLING (UNITED KINGDOM)
SPECIAL RAPPORTEUR*
International Secretariat
*
30 September 2005
Until this document has been approved by the Committee on the Civil Dimension of Security,
it represents only the views of the Rapporteur.
Assembly documents are available on its website, http://www.nato-pa.int
186 CDS 05
I.
1
BASIC INFORMATION ON MAJOR BIOTERRORISM AGENTS
Disease
Anthrax
- bacterial infection caused by
the organism Bacillus
anthracis
- 3 forms of human disease:
cutaneous (most common,
95% of cases), inhalation
(rare) and intestinal (very rare)
anthrax
Incubation period
- dependent on the dose and route
of exposure;
- symptoms usually develop within a
week of infection, although it can
take up to several weeks in cases of
inhalational anthrax
- not contagious / no airborne
transmission from person to
person
- mortality rate of up to 20% for
untreated cutaneous anthrax,
higher for inhalation or
intestinal anthrax
Botulism:
-muscle-paralyzing disease
caused by a botulinum toxin
which is a poison produced by
the bacterium Clostridium
botulinum.
- most poisonous substance
known: A single gram of
crystalline toxin, evenly
dispersed and inhaled, would
kill more than 1 million people,
With food borne botulism, symptoms
begin within 2 hours to 8 days. The
three known cases of inhalational
botulism caused symptoms
approximately 72 hours after
exposure.
Type of vaccine
Treatment
Vaccine is protective against
invasive disease. However, it is
primarily given to military personnel
and high risk population. New
generations of anthrax vaccines
(recombinant protective antigen
vaccines) are currently under
development in the US as part of the
BioShield programme and through
US-UK public-private partnerships
Treatment protocols exist for
cases of inhalational and
cutaneous anthrax; if
administered early enough,
treatment can be very effective
In the US, an investigational vaccine
is distributed for high-risk laboratory
workers and by the military to protect
troops, but it is neither
recommended nor available for the
general public due to its scarcity and
effects.
If diagnosed early, food borne
and wound botulism can be
treated with an antitoxin, which
blocks the action of toxin
circulating in the blood. This can
prevent patients from
worsening, but recovery still
takes many weeks, if not
months.
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2
although technical factors
would make such
dissemination difficult.
-not contagious
- dispersion could be airborne
or foodborne
- mortality rate between 5-10%
Plague:
- acute bacterial infection
caused by the organism
Yersinia pestis
-Yersinia pestis used in an
aerosol attack could cause
cases of the pneumonic form
of plague.
- pneumonic plague is
contagious: the bacteria can
spread to others who have
close contact with them.
- mortality rate is over 90% for
untreated pneumonic plague
Smallpox:
- serious, contagious, and
sometimes fatal infectious
disease caused by the variola
virus
- dispersion is likely to be
airborne
- patients are not infectious
until the onset of symptoms,
then most infectious during the
first two weeks of illness; later,
transmission is still possible
One to six days after becoming
infected with the bacteria, people
would develop pneumonic plague.
-a vaccine for plague exists and is
licensed and marketed in Australia.
However it is only licensed for use
against bubonic plague (cutaneous).
A next generation of recombinant
vaccine that would protect against
primary pneumonic plague is under
development, in particular through a
joint programme between the US,
UK and Canada.
To prevent a high risk of death,
antibiotics should be given
within 24 hours of the first
symptoms. Several types of
antibiotics are effective.
They can be administered to
treat infected patients as well as
to prevent contamination to the
patient’s close contacts. With
prompt recognition and
antibiotic treatment, fatal cases
can be reduced to 5-10%.
This incubation period averages
about 12 to 14 days but can range
from 7 to 17 days.
-Vaccine availability
-If given to a person before
exposure to smallpox, the vaccine
can completely protect them.
Vaccination within 3 days after
exposure will prevent or greatly
lessen the severity of smallpox in
most people. Vaccination 4 to 7 days
after exposure likely offers some
protection from disease or may
decrease the severity of disease.
There is no specific treatment
for smallpox disease, and the
only prevention is vaccination.
Some treatment options are
currently being tested on
smallpox animal models and
could lead to human treatment.
- preventive vaccination is not
186 CDS 05
until the rash has disappeared,
but less likely
- disease is fatal in up to 30%
of cases
Hemorrhagic fever:
- group of illnesses that are
caused by several distinct
families of viruses usually
transmitted to humans via
contact with infected animal
reservoirs or arthropod
vectors;
- generally not easily
contagious, except, for some
types of virus (Ebola, Lassa
fever, Marburg, and New
World Arenavirus), through
close contact with infected
patients or contaminated body
fluids
- some viruses cause only mild
illnesses, others cause lifethreatening infections; casefatality rate range from as low
as 0.5% for Omsk
hemorrhagic fever to as high
as 90% for Ebola, subtype
Zaire
3
recommended for the general public,
due, in particular, to proven sideeffects of the vaccine, that have
caused serious reactions in 0.1% of
cases and life-threatening reactions
in a few cases
- new generation of vaccines are
under development
- depends on the type of virus; -Vaccines have been developed for
generally after 2 days and not over yellow fever; they need to be
21 days
administered preventively to be
effective.
- A vaccine for Ebola is currently in
the human trials phase in the US
Patients receive supportive
therapy, but generally speaking,
there is no other treatment or
established cure for VHFs.
Ribavirin, an anti-viral drug, has
proven effective against Lassa
fever, New World Arenavirus
and Rift Valley Fever.
186 CDS 05
- airborne dispersion can
potentially cause serious
morbidity and mortality
Inhalational tularemia :
- zoonosis (infection which can
be spread from animals to
humans), caused by the
bacterium Francisella
tularensis
- 2 types of the bacterium
which can both infect humans:
type A (can be fatal) and type
B (not fatal)
- intentional dispersion would
most likely be airborne,
although foodborne or
waterborne dispersion, or
infection through animals is
possible
- Tularemia is one of the most
infectious pathogenic bacteria
known. It requires inoculation
or inhalation of as few as 10
organisms to cause disease.
Inhalation of F. tularensis
causes an abrupt onset of an
acute, non-specific febrile
illness
- Not contagious / no person to
person transmission
- fatality rate for untreated type
A range from 4% to 30-60%
for more serious cases
4
-Can range from 1 day to 2 weeks,
but symptoms usually develop after
3-5 days
-Illness beginning 1-14 days after
exposure
-Release in a densely populated
area would be expected to result in
an abrupt onset of large numbers of
acute, non-specific febrile illness
beginning 3–5 days later with
pleuropneumonitis developing in a
significant proportion of cases during
the ensuing days and weeks.
In the United States, a live
attenuated vaccine derived from a
virulent F. tularensis biovar
palaearctica (type B) has been used
to protect laboratorians routinely
working with the bacterium. Until
recently, this vaccine was available
as an investigational new drug. It is
currently under review by the Food
and Drug Administration. However,
no vaccine is protective against
airborne infection.
-Available: early antibiotic
therapy is effective
-In a contained casualty setting,
where individual patient
management is possible.
186 CDS 05
II.
5
TIMELINE FOR THE USE OF BIOSENSORS AND SYNDROMIC SURVEILLANCE
IN DETECTING A BIOTERROR ATTACK
In Michael Stoto, “Syndromic Surveillance”, in Issues in Science and Technology online, Spring
2005, available at http://www.issues.org/issues/21.3/stoto.html
III.
RISKIEST MATERIALS FOR RADIOLOGICAL WEAPONS AND THEIR
INDUSTRIAL USE
Americium-241
To detect petroleum deposits and calibrate instruments, and in industrial
gauges.
Californium-252
To detect petroleum deposits
Cesium-137
Used in industrial gauges and to treat diseases, sterilize food and medical
equipment, detect petroleum deposits
Cobalt-60
Used in industrial gauges and to treat diseases, sterilize food and medical
equipment, and detect hidden flaws in structures.
Iridium-192
To detect hidden flaws in structures and treat diseases.
Plutonium-238
To generate low-levels of power
Radium-226
Used in industrial gauges and to produce radon for cancer treatment.
Strontium-90
To generate low-levels of power
In Charles D. Ferguson & William C. Potter (with Amy Sands, Leonard S. Spector, and Fred L.
Wehling), The Four Faces of Nuclear Terrorism (2005), p.8.