Download Naturally-Emerging Infectious Disease Threats: Agents, Impacts

UNCLASSIFIED
Emerging Infectious Disease Threats:
Agents, Impacts, and Considerations
22 July, 2009
R. Todd Reilly, Ph.D.
Department of Homeland Security
Office of Intelligence and Analysis
Booz | Allen | Hamilton
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Health and the I&A Mission
“Homeland health security” is the protection of the health of the U.S.
population, food supply, agriculture, and environment; reducing
vulnerabilities of the U.S. public health, agricultural, food, and
medical infrastructures; and sustaining homeland security operations
during significant health events.
Mission: The I&A Health Team produces all-source threat and risk
analysis on human health, agriculture, and food security for DHS
components, Federal, State, and local government agencies, and the
private sector. We assess Homeland implications of foreign health
issues—to include foreign policy and socio-economic issues—on
Homeland security operations and policy and the effect on critical
infrastructure.
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Health Threats and Issues of
Concern
Threats to U.S. health interests includes accidental, intentional, or
naturally-occurring actions/events that would negatively impact the health of
U.S. persons, animals, and/or plants, to include catastrophic health events that
result in casualties such that local/regional emergency response and health
care systems are overwhelmed.
Homeland health threats include, but are not limited to, infectious
disease or environmental threats to human, animal, and plant health and
hazardous imports such as contaminated food, animal feed, and
counterfeit pharmaceuticals.
Homeland health issues of concern include, but are not limited to,
disease translocation to the Western hemisphere, vulnerability of the U.S.
healthcare system and ability to respond to CBRN events, and medical
CBRN defense.
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Health Issues Crosscut DHS’ Mission
HOMELAND SECURITY
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Preparedness &
Emergency
Response
Critical
Infrastructure
Border Security
Immigration
Health Security and Intelligence
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Defining Emerging Threats
Naturally-emerging or Purposeful release?
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Defining the Nexus:
(an important connection
between the parts of a system or
a group of things)
Biotechnology
Discovery
Biothreat
Agent/Strategy
Biothreat Spectrum
Chronic Emerging
Disease Disease
Misuse of
Dual-Use
Technology
Bioterrorism
Biowarfare
INTENT!
Clinical
Research
Basic
Biological
Sciences
Counterterrorism
Biosecurity
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Counterterrorism
Counterproliferation
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Defining Emerging Threats
What agents should be considered?
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CDC/APHIS Select Agent List
Toxins
Bacteriotoxins
Human and zoonotic pathogens
1. Botulinum toxins
2. Clostridium perfringens toxins
3. Staphylococcal enterotoxins
4. Shigatoxins
Viruses
1. Crimean–Congo haemorrhagic fever virus
2. Eastern equine encephalitis virus
3. Ebola virus
4. Sin Nombre virus
5. Junin virus
6. Lassa fever virus
7. Machupo virus
8. Marburg virus
9. Rift Valley fever virus
10. Tick-borne encephalitis virus
11. Variola major virus (smallpox virus)
12. Venezuelan equine encephalitis virus
13. Western equine encephalitis virus
14. Yellow fever virus
15. Monkeypox virus
Bacteria
1. Bacillus anthracis
2. Brucella melitensis
3. Brucella suis
4. Burkholderia mallei
5. Burkholderia pseudomallei
6. Francisella tularensis
7. Yersinia pestis
8. Coxiella burnetii
9. Rickettsia prowazekii
10. Rickettsia rickettsii
Protozoa
1. Naegleria fowleri
Phycotoxins
1. Anatoxins
2. Ciguatoxins
3. Saxitoxins
Mycotoxins
1. Trichothecene toxins
Phytotoxins
1. Abrin
2. Ricin
Zootoxins
1. Bungarotoxins
Plant pathogens
Animal pathogens
1. African swine fever virus
2. African horse sickness virus
3. Bluetongue virus
4. Foot-and-mouth disease virus
5. Newcastle disease virus
6. Rinderpest virus
Peronosclerospora philippinensis
(Peronosclerospora sacchari)
Phoma glycinicola
(formerly Pyrenochaeta glycines)
Ralstonia solanacearum race 3, biovar 2
Rathayibacter toxicus
Sclerophthora rayssiae var zeae ・
Synchytrium endobioticum
Xanthomonas oryzae
Xylella fastidiosa
(citrus variegated chlorosis strain)
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Defining Emerging Threats
How is that threat measured?
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Threat of Importation
• Infected human traveler
• Infected imported animal, animal product,
animal feed
• Contaminated surfaces
• “Stowaways”
• “Natural” importation
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Threat of Sustained Transmission
• Population susceptibility; Healthcare
• Disease-specific traits (transmissibility,
mechanism of infection)
• Presence of life cycle members (vectors,
hosts reservoirs)
• Environmental conditions
• Descent with modification
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Defining Emerging Threats
How is impact defined and quantified?
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Assessing Impact
• Health impact
– Attack rate; morbidity and mortality
– Emergency response capacity, preparedness
• Social and Security impact
– Disruptions to transportation, food supply,
utility, and other critical infrastructure
– Large population movements; border security
• Economic impact
– Spending for response, recovery, prevention
– Effects on trade/commerce (how calculated)
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Defining Emerging Threats
How are different disease threats prioritized?
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Examples
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Influenza (not just the dz)
Ebola virus
West Nile Virus
Malaria
Foot and Mouth Disease Virus
Stem Rust (Ug99)
Factoring in changes
– Threat factors and countermeasures
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Questions and Further Discussion
An ounce of (forethought) …
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