Download BIOTERRORISM: - South Carolina Area Health Education

BIOTERRORISM: SOUTH
CAROLINA AT RISK
OBJECTIVES



To understand the concept of terrorism
To understand the rationale for the use
of biological agents as terrorist weapons
To describe the characteristics of those
biologic agents thought to be the choice
of terrorists

Bioterrorism is one form of terrorism.
Terrorism is defined as the unlawful use
of force or violence against persons or
property to intimidate or coerce a
government or civilian population in the
furtherance of political or social
objectives.

Terrorists use weapons of mass
destruction. These are destructive
devices which include bombs, missiles,
poison chemicals, disease organisms,
radiation or radioactivity at levels
dangerous to human life.



The 9/11 Commission Report stated
referring to the terrorist threat……
………..we are not safe
Time is not on our side…………..

Biologic agents are likely to be used by
terrorists as weapons because:





They are capable of damaging populations,
economies, and food supplies
Certain agents are inexpensive to make
They can be directed at a small group of people or
an entire population
They can be used to attack people, economies
and food supplies
They cause fear, panic and social disruption
Characteristics of biological agents that
could be used as bioterrorist agents






They have a wide range of effects
They are obtained from nature
They are easily made by relatively
unsophisticated methods
They are invisible to the senses
Their effects may be delayed
They can produce mass casualties
DIFFERENCES BETWEEN A
BIOLOGICAL ATTACK AND A
NATURAL OCCURENCE




A biological terrorist attack may mimic a
large scale naturally occurring disease
outbreak. There are differences. A
biological attack:
Results from a deliberate act
Will be treated as a crime scene
May not be immediately recognized
BIOLOGICAL ATTACK VS. NATURAL
OCCURRENCE






May be preceded by verbal or written threats
from a terrorist group
May find abandoned spray devices may be
found
Claims by a terrorist group to have released a
biologic agent
May result in contamination of critical facilities
May expand rapidly from different source cases
Will cause widespread public panic
ROUTES OF ENTRY INTO
THE HUMAN BODY



Ingestion
Dermal penetration
Inhalation
AEROSOL INHALATION

The use of aerosols is an efficient way
to affect the maximum number of
people with a single attack.
BIOWEAPONS RECENT
HISTORY




Bioweapons have a long history. Recent
uses include:
U.S, Canada, Great Britain, Japan, and the
U.S.S.R experiment with anthrax during
World War II (W.W.II)
In 1991, Iraq threatens use of bioweapons
against U. S. troops in Persian Gulf war
Post W.W.II , NATO and the Warsaw Pact
nations had bioweapons programs
BIOWEAPONS RECENT
HISTORY



In 1969, U. S. unilateral decision to
destroy bioweapons
In 1972, Bioweapons Convention
created in which U. S. and U. S. S. R.
were signatories
Possible/probable active offensive
bioweapons programs in N. Korea, Iran,
China, Egypt, Algeria, India, Pakistan,
Syria, Israel
BIOWEAPONS RECENT
HISTORY


In 1986, Bhagwan cult poisons Oregon
salad bars with salmonella-715 people
sick
In 1995, Aryan Nation orders plague
bacteria from supply house in Maryland
and Minnesota Patriots Council
members convicted for planning ricin
use in assassination attempt
BIOLOGICAL AGENTS





There are several types of agents.
They are classified as:
Bacteria
Rickettsia
Viruses
Biotoxins
BACTERIA


Single celled organisms
capable of causing
disease. These agents,
grown on culture to
produce large
quantities, can be
modified or
“weaponized” for
greater destruction
Produces inflamation in
tissues and/or toxins






EXAMPLES
ANTHRAX
SMALL POX
PLAGUE
TYPHOID
CHOLERA
TULAREMIA
RICKETTSIA



Vector borne (ticks,
lice, mosquitos)
parasitic form of
bacteria
Diseases are difficult
to treat
Variants exist
worldwide
EXAMPLES
 TYPHUS
 ROCKY MT.
SPOTTED FEVER
 Q FEVER
 INDIA TICK FEVER
 MEDITERANEAN
TICK FEVER
VIRUSES




Smaller than
bacteria
RNA or DNA in a
protein coat
Use living cells to
reproduce
Not affected by
antibiotics





EXAMPLES
EBOLA
LASSA FEVER
INFLUENZA
VIRAL HEPATITIS
VIRAL
HEMORRHAGIC
FEVERS
BIOTOXINS




Are poisonous byproducts of bacteria,
fungi, marine
animals or plants
Do not replicate in
the host
Are not
communicable
Highly toxic when
delivered as an
aerosol
EXAMPLES



BOTULINUM
STAPHLOCCOCAL
ENTEROTOXIN B
RICIN
Biological Agents most likely
to be used in a terrorist attack



Bacteria - anthrax, plague, tularemia
Virus - small pox, viral hemorrhagic
fever
Biotoxin - botulism
ANTHRAX


Infectious agent: Bacillus anthracis –
gram +, spore forming bacteria
May enter the body from skin
(cutaneous), digestive system or by
inhalation (most likely route to be used
by terrorists)
ANTHRAX






Symptoms: itching, lesions, fever, fatigue,
non-productive cough, respiratory failure and
hemodynamic collapse
Transmission: none person to person except
with cutaneous
Incubation period: 1 to 6 days
Mortality: 5 to 20% percutaneous, 80 to 90%
inhalation
Treatment: antibiotics
Prevention: vaccine
PLAGUE




In nature, fleas living on rodents spread
infection to humans. As a bioterrorist weapon
– inhalation of aerosol leads to pneumonia,
sepsis and infections of bodily organs
Infectious agent: Yersinia pestis – a gram
neg., non-motile bacillus
May be bubonic ( infection of lymph nodes) or
pneumonic (infection of lungs)or septicemic
Symptoms: cough with bloody sputum, fever,
chill, shortness of breath
PLAGUE





Transmission: may occur person to
person by respiratory droplet inhalation
Incubation period: 2 to 3 days
Mortality: 50 to 60%
Treatment: antibiotics
Prevention: vaccine ineffective against
aerosol exposure
TULAREMIA


A zoonotic, bacterial infection caused by
Francisella tularensis, a gram negative
coccobacillus
In nature, bacteria is commonly found
in ticks living on rabbits and transmitted
by handling the animal or by tick bite.
Inhalation of aerosol leads to
pneumonia and sepsis
TULAREMIA






Symptoms:sudden and influenza-like with
fever,chills, headache and nausea
Transmission: not usually person to person
Incubation period:3 to 5 days(range 1 to 14)
Mortality:low unless untreated
Treatment:antibiotics if early, vaccine available
Prevention: in nature, avoid tick bites and using
gloves when handling infected animals
BOTULISM


Infectious agent: Clostridium botulinum
– a spore forming, anaerobic bacillus
In nature, may be food borne, wound, or
intestinal. As a bioterrorist weapon,
ingestion or inhalation leads to
production of the neurotoxin and
resulting flaccid paralysis
BOTULISM






Symptom: fatigue, weakness, blurred vision,
difficulty in swallowing and speaking, descending
muscle paralysis and respiratory failure
Transmission: none person to person
Incubation period: 12 to 72 hours
Mortality: most lethal compound per weight
Treatment: antitoxins, respiratory support
Prevention: vaccine available for types A and B
SMALL POX




Infectious agent: Variola virus - Orthopox virus
Declared eradicated in 1980, but stockpiles may
exist
Not naturally acquired. It can be disseminated
as and inhaled as an aerosol
Symptoms: Fever, muscular rigidity, headaches,
and vomiting. Severe cases experience
prostration and hemorrhage into skin and
mucous membranes
SMALL POX






Rash appears after about three weeks;
progresses from macules (initial skin lesions) to
papules to pustular vesicles, to scabs
Transmission: may occur person to person by
respiratory droplets or skin inoculation. Highly
contagious when rash appears
Incubation period: 10 to 12 days
Mortality: less than 1% in the minor form and 20
to50 % in the major form
Treatment: supportive
Prevention: vaccine
VIRAL HEMORRHAGIC
FEVERS



These are highly infectious viral illnesses caused by
the Filoviruses (Ebola and Marburg), Arenaviruses
(Lassa fever), Bunyaviruses (Congo hemorragic
fever and Hantaviral disease), and Flaviviruses
Symptoms: vary from one type to the next. They
include: sudden onset of fever, muscle aches,
headache, followed by vomiting, diarrhea, and rash
and internal bleeding
Complications: In severe forms, multiorgan failure
occurs, primarily due to hemorrhagic and pulmonary
complications
VIRAL HEMORRAGIC
FEVERS







Mode of transmission: handling infected wild
animals, but may be used as an aerosol bioterrorist
weapon
Incubation period: 2 to 21 days
Reservoir: gorillas and chimpanzees
Transmission: some may be spread person to
person by contact with body secretions
Mortality: Ebola rates have reached 90% but vary
Treatment: supportive
Prevention: Avoid contact with infected monkeys or
other animal hosts


Will we be ready?
Let’s look at how South Carolina
responds in the next section