Download Bioterrorism Notes

Bioterrorism
Biological Agents of Warfare and
Terrorism
Bioterrorism:
• Use of bacteria, viruses or toxins against
humans, animals or plants in an attempt to
cause harm and to create fear
• Mass production, stockpiling and use of
biological weapons, was outlawed by the
1972 Biological Weapons Convention (BWC)
Outline:
• What is Bioterrorism?
– Brief history
– 2001 Bioterrorist anthrax attack
• Identifying Bioterrorism
• Bioterrorism Agents in Research
– CDC categories
• Agroterrorism
• Are we ready?
• Conclusions
• 590 BC: water supply tainted with toxic plant
• 5th BC: Spears and arrows tipped with poisons,
snake venom, or animal feces
• 14th century Middle Ages: Plague corpses
forced into enemy quarters
• 1700s: Smallpox to Indians??
http://www.nativeweb.org/pages/legal/amherst/34_40_305_fn.jpeg
Biosecurity Incidents:
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1984: Rajneeshee religious cult grew Salmonella typhimurium in their own lab
(from ATCC) and put in a salad bar in Oregon. Hoping to prevent voters from voting
so their candidate would win
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751 illnesses
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1995: Larry Harris, microbiologist, ordered 3 vials of Yersinia pestis (plague) from
the American Type Culture Collection. 1998 arrested for anthrax.
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1995: Diane Thompson, Lab tech, removed Shigella dysenteriae Type 2 from the
hospital’s collection and infected coworkers by sprinkling it on donuts. 12 illnesses20 years in prison.
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2003: Professor Thomas Butler, 30 vials of Yersinia pestis missing from
lab and were never recovered. 2 years in prison
http://news.bbc.co.uk/hi/english/static/in_depth/world/2001/anthrax/biological.stm
4 Oregon Restaurants hit with salmonella
Larry Harris- microbiologist obtained
vials of Yersinia pestis
Anthrax 2001
• Anthrax victim –October 16th 2001, postal worker 47 male
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Flu-like symptoms on October 16th
Day 5: Fainted in church, continued to work
Day 6: Nausea, vomiting, abdominal pain drove to ER, and later released
Day 7: Back to ER with nausea, vomiting, and lightheadedness
– Suspected anthrax due to 2 other postal workers diagnosis and antibiotics administered
– Diagnosis confirmed 24 hours later
• 5 hours after admission irregular heart rate followed by cardiac
arrest
• Diagnosis: Chest X-ray and Gram + bacilli (blood culture after 11
hours)
• 7 letters mailed, 22 cases, 11 inhalation, 30,000 people
were placed on antibiotics; 5 fatalities
• Bruce Ivins- suspect (microbiologist)
Identifying a Bioterrorist Event
Epidemiology of a Bioterrorist Attack:
• Similar to natural epidemic
– Certain features should raise alarms and investigation
Bioterrorist Attack
1.Lg # of cases at same time with same symptoms
2.Illness in humans and animals concurrently
3.Lg # of unexplained deaths (middle age)
4.Single case of uncommon organism
5.Unusual seasonal pattern
6.Illness fails to respond to usual treatment
http://aleksandreia.wordpress.com/2009/10/06/christ-stopped-at-e-coli/
Encounter w/Biological Weapon:
• Modes of Transmittance:
• Aerosilized: most feared (anthrax, smallpox)airborne
• Food/water: botulism, diarrheal agents
• Person to person: smallpox, influenza
• Animal/Insect vectors: ebola, plague, lassa fever
http://faculty.vetmed.ucdavis.edu/faculty/bbchomel/WHO_Zoonoses/Spanish/tr.html
http://lightmeetsdark.files.wordpress.com/2010/11/disease.png
http://www.cidd.psu.edu/research/synopses/social-contact-network-disease-transmission/image/image_view_fullscreen
• *Of the 1461 diseases now recognized in
humans, it is estimated that a full 60% are
caused by multi-host pathogens that affect
several species
Why biological weapons?
"Advantages" of biological weapons:
Relatively inexpensive
Easier to conceal than conventional weapons
Potential to cause widespread panic
“Disadvantages” of biological weapons:
Not easy to obtain
May "backfire" on those using them
Potentially traceable
to original source by DNA
typing
U.S. purely from flight paths
Characteristics:
• Ideal agent:
– Accessibility
– Durability
– Infectiousness/mortality
– Communicability
– Mass production
http://www.aguntherphotography.com/usa/interesting-sights/titan-missile-air/hazmat-suits.html
• CDC has developed categories of perceived
threats to national security
CDC Categories:
• Category A (ex. Anthrax , Botulism, Plague
Smallpox)
– Most dangerous, highest research priority
• easily disseminated or transmitted person-person
• High mortality
• Potential for major health impact
CDC Categories:
• Category B (Salmonella species, Ricin toxin,
cholera)
– Are moderately easy to disseminate
– High morbidity and low mortality
CDC Categories:
• Category C (Multidrug resistant pathogens,
influenza)
– Less of an immediate threat but may be
genetically engineered (lethal, drug resistant)
• Readily available
• Easily produced and disseminated
• Potential for high morbidity and mortality
•Biosafety level (BSL) is the level of biocontainment precautions required (1-4)
•4 is level working with most dangerous agents
Bioweapons Research
• Important to understand how to:
– Detect/diagnose
– Treat/prevent (Vaccines)
– Decontaminate
– Provide the source for an outbreak??
• Anthrax-laden needle, genetically altered microbe injected
Infectious Disease Research Centers
Agroterrorism:
• Agroterrorism:" The intentional introduction of
biological agents against the agricultural industries with the
intent of producing fear, creating economic loses and
undermining the stability of government ”
• Perfect target?
SART: state agricultural response team
Targets of Agroterrorism:
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Animal/plants
Trucks/RR
Water supply
Farm Workers
Produce
Grain Elevators
Ships
Restaurants
Grocery Stores
What would be the effects of an
agroterrorism attack?
• One way is to cause direct disease and harm
to the human population
– Eating contaminated food
• Second way is to wipe out a crop
– Economic effect
Progress:
• Smallpox:
– Dryvax; MVA; antiviral drugs
• Anthrax:
– rPA; antitoxins
• Botulinum:
– Vaccine; antitoxins
• Ebola:
– Effective in trials
http://en.wikipedia.org/wiki/File:Dryvax.jpg
Conclusions
• Threat horizon is broad and rapidly changing
• Recognized pathogens may not be the only priority, as newly
engineered non-pathogens can be engineered
• Best defense will be to maintain a scientific edge
http://textbookofbacteriology.net/themicrobialworld/bactresanti.html
June 6th 2012: Drug-Resistant Gonorrhea: WHO Agrees It’s An Emergency
Anthrax Research
Hela cells
ATP
Anthrax
Edema
Toxin
cAMP
ELISA