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Transcript
GIS in a context of Bioterrorism
Maria Styblińska
University of Silesia
Institute of Informatics
Deaths in Angola
Deadly Powder
Bioterrorism and Biowarfare
Bioterrorism (BT) and biowarfare (BW) are the
intentional or the alleged use of infectious
biological agents as: viruses, bacteria, fungi,
toxins or germs to cause illness and produce
death or disease in humans, animals or
plants.
Bioterrorism or Biowarfare
•Micro organisms or their toxins
•Intentionally produce sickness or death
•Target people, plants, animals
Anthrax – Bacillus anthracis;
Lymth tissue
Biological Diseases/Agents Listing
Category A
• Anthrax (Bacillus anthracis)
• Botulism (Clostridium botulinum toxin)
• Plague (Yersinia pestis)
• Smallpox (variola major)
• Tularemia (Francisella tularensis)
• Viral hemorrhagic fevers (filoviruses [e.g. Ebola, Marburg]
• and arenaviruses [e.g. Lassa, Machupo])
Category B
• Brucellosis (Brucella species)
• Epsilon toxin of Clostridium perfringens
• Food safety threats (Salmonella species, Escherichia coli, Shigella)
• Glanders (Burkholderia mallei)
• Melioidosis (Burkholderia pseudomallei)
• Psittacosis (Chlamydia psittaci)
• Q fever (Coxiella burnetii)
• Ricin toxin from Ricinus communis (castor beans)
• Staphylococcal enterotoxin B
• Typhus fever (Rickettsia prowazekii)
• Viral encephalitis (alphaviruses [Venezuelan equine
•encephalitis, eastern equine encephalitis, western equine
•encephalitis])
• Water safety threats (Vibrio cholerae, Cryptosporidium
parvum)
Category C
Emerging infectious disease threats such as
Nipah virus and hantavirus
Category Descriptions
Category A Diseases/Agents :
High-priority agents include organisms
that pose a risk to national security because they
can be easily disseminated or transmitted from person to
person;
result in high mortality rates and have the potential for
major public health impact;
might cause public panic and social disruption; and
require special action for public health preparedness.
Category B Diseases/Agents
Second highest priority agents include those that are
moderately easy to disseminate;
result in moderate morbidity rates and low mortality
rates; and require specific enhancements of CDC's
diagnostic capacity and enhanced disease surveillance.
Category C Diseases/Agents
Third highest priority agents include emerging
pathogens that could be engineered for mass
dissemination in the future because of availability; ease of
production and dissemination; and potential for high
morbidity and mortality rates and major health impact.
The threat of terrorists using biological
warfare agents has received increased attention
in recent years.
The most distinguishing feature separating
BW terrorism from conventional terrorism is the
extraordinarily larger number of casualties that
could follow a major terrorist attack involving
biological agents.
Rather, the most likely BW terrorist tactic
will be to release BW agents anthrax spores,
botulinum toxin, ricin, smallpox or other deadly
agents into the air as a biological aerosol, a stable
cloud of suspended microscopic droplets of
bacterial or virus particles.
Since BW agents are invisible, odorless, and
tasteless, no one would know that a terrorist
attack is under way.
The aerosol release of BW agents could be
accomplished in several ways, including using
low-flying airplanes, crop dusters, or trucks
equipped with spray tanks and releasing the BW
agent upwind of populated areas;
leaving aerosol canisters filled with the BW
agent and timing devices in subways, airports,
air-conditioning/heating systems in buildings, or
other crowded places; or directly contaminating
bulk food supplies in restaurants, supermarkets,
or other places with a BW agents.
Bioterrorist attacks can be, at least in theory, executed at
several levels:
1.The strategic level, which can cover large populations or
geographic areas. This may also be directed against crops
and livestock resulting in famine or economic disruption.
1.The tactical level, which is a more directed attack. These
are usually limited by the incubation times. They are most
effective against a fixed position, e.g.is the intentional
contamination of a salad bar at a restaurant in The Dallas, Oregon”82
1.The terrorist approach, which doesn't have to make
anybody ill. This may be easy to deliver and difficult to
detect, e.g. in Washington D.C. the downtown area was grid locked
because somebody sent a petrie dish labeled "anthrax," into rush hour
traffic.
Clues to a biological attack.
1.Large unexplained epidemic with similarly acute patients
with an unusual epidemic curve.
2.More severe case of disease than usual with higher
mortality, refractory to treatment and usually with
respiratory manifestations.
3.Multiple diseases in the same patient.
4.Unusual geographic, seasonal, or patient distribution.
5.Suspicious transmission pattern.
6.Unusual genetic or molecular patterns.
7.Multiple simultaneous epidemics.
8.Unusual clinical presentation.
9.Unexplained animal deaths.
10.Direct evidence of biowarfare munitions.
Comparative Cost: $/km2
•Smart bombs: $80,000
•Explosive: $10,000
•Nuclear: $4,000
•Chemical: $300
•Biologic: $5
(Stanford,personal comm,1988)
DEATHS:
•1 KT H-BOMB
•.6M - 2M
•100 Kg ATX
•1M - 3M
(IDSA, 2001)
MASS EFFECT:
•"Subnational attacks using genetically engineered
organisms are inevitable"
•"Biologic agents now join nuclear agents"
(Stansfield Turner, CIA, 2001)
History: Corpses + Catapults
•600 BC: Assyrians -- Ergot
•300 BC: Greeks -- Wells
•1346: Tartars -- Plague
•1500: Pissaro -- Smallpox
•1710: Russia/Sweden -- Plague
History: Specific Disease Application
•1763 Amherst -- Bouquet
•1915 Germany
•Cholera -- Italy
•Plague -- Russia
•Glanders, Anthrax -- Rumania, Syria
•1925 Geneva Convention
History: Modern Era
•1937: Japan -- Many
•1943: US -- Bacteria, virus
•1945: Japan -- Generators
•1969: US -- Stops efforts
•1970: Russia -- Bio-preparat
Biologic Arms Race
Yes
Maybe
Iraq
India
Iran
Pakistan
Libya
Israel
Russia
Saudi Arabia
Syria
Afganistan
How GIS can be used for phases
of Bioterrorism planning and
response
The benefits of infectious disease surveillance
are as follows:
•To detect trend in disease occurrence
•Detect epidemics
•Provide estimates of morbidity and mortality
•Stimulate epidemiologic research
•Identify risk factor for disease
•Assess the effectiveness of disease controls
•Improve clinical practice
•Improve resource allocation
GIS has been used for many “after
event” analyses
Objective is to create dynamic “real
time” information systems that allow
greater access to the data for decision
making and problem characterization
GIS and Events
Characteristics of an event
starts locally, spreads by water, air, vector, or contact
• Event is a spatial problem: geographic space (2-3D) and
social space
• GIS has tools for geographic and (to limited degree)
social space:
• visualization, summary, management of attribute
and spatial data
• hydrological and network modeling
• population models/simulation
• weather models/simulation
Using GIS to turn Data into Information
Data Management, Visualization,
Analysis/Modeling, Scenario Management
Preparedness Detection/Surveillance, Response,
Communication
What is required for GIS?
• Mandate and management support
• Spatially enabled data sets:
• topographic and environmental data provide the
spatial context
• demographic data provide the social context
• health data provide the health context
• Trained staff
• Software to visualize, manage, and analyze the data
sets
• Hardware to store,
GIS issue
• Security/Privacy of health data
• legislation and privacy laws
• GIS architectures
• stand-alone vs. networked
• Analysis
• mapping units
• statistics
• error
• Metadata
Hypothetical application of GIS
A disease surveillance report at the onset and peak of a
bioterrorism event plots cases, street networks, community facilities,
administrative boundaries.
Predominance of cases in low population density
areas
Examples of GIS applications:
CDC BT Scenario - Traffic management
Early Warning Outbreak Recognition System
Department of Defense, USA
GIS System ESSENCE - Electronic Surveillance
System for Early Notification of Communitybased Epidemics, Washington, D.C.
International Biological Warfare
Agreements:
 The Geneva Protocol of 1925
 1972 the Biological Weapons Convention
"No return address"
Thinking About the Unthinkable
• Kahn H.:Thinking About the Unthinkable.
London, England: Weidenfeld & Nicolson; 1962.
REFERENCES:
Biological Terrorism Introduction, Center for the Study of Bioterrorism and Emerging Infections,
Saint Loius University School of Public Health
2. 2. Carter A, Deutch J, Zellcow P.: Catastrophic terrorism., Foreign Affair., 1998; 77:80-95
3.
3. Public Health Emergency Preparedness and Response; Centers for Disease Control and Prevention;
US Department of Health and Human Services; http://www.bt.cdc.gov/Agent/Agentlist.asp
4.
4. Working Group on Civilian Biodefense, USA
5.
5. Bioterrorism: Alert and Response; University of Washington, School of Public Health and
Community Medicine; http://www.hscer.washington.edu/em_inf/bio/bio2.html
6. 6. Meselson M, Guillemin J, Hugh-Jones M, Langmuir A, Popova I, Shelokov A, et al.: The Sverdlovsk
anthrax outbreak of 1979. Science 1994;266:1202-8
7.
7. Investigation of bioterrorism – related anthrax: Connecticut, 2001. MMWR Morb Mortal Wkly
Raport, 2001;50:1077-1079.
8.
8. Simnott J.: Bioterrorism, Lecture and Presentation, University of South Florida College of Medicine;
http://www.medinfo.ufl.edu
9.
9. Stanford, personal comments, 1988
10. 10. Fiedler R, Hughes T, Garcia M,:GIS Mapping and Use of Spatial Data in a BioTerrorism Scenario,
cientific Technologies Corporation
11. 11. Styblińska M.:.Internet GIS Application in Health Care and Medical Information, GIS Polonia 2001,
p. 268-276, Zagreb 2001.
12. 12. Bioterrorism GIS Can Help Fight the New Threat; website GeaoWorld; geoplace.com The
Authorative Resources for Spatial Information http://www.geoplace.com/gw/2002/0207/0207bio2
1.
1.
13.
Northwest Center for Public Health Practice at the University of Washington School of
Public Health and Community Medicine;
http://healthlinks.washington.edu/nwcphp/niphp/gis.html
14.
Mitchell JT, Everly GS.Critical Incident Stress Debriefing: An Operations Manual for
the Prevention of Traumatic Stress Among Emergency Services and Disaster Workers;
2nd ed rev. Ellicott City, Md: Chevron Publishing Corp; 1995, 1996.
15.
Popovich M., Fiedler R., Fiedler S. Massee J: Bioterrorism GIS Can Help Fight the
New Threat; website GeaoWorld; geoplace.com The Authorative Resources for Spatial
Information http://www.geoplace.com/gw/2002/0207/0207bio2
16.
US Congress, Office of Technology Assessment.; Proliferation of Weapons of Mass
Destruction: Assessing the Risks.; Washington, DC: Office of Technology Assessment;
August 1993. Document OTA ISC 559
17.
Kahn H.: Thinking About the Unthinkable.: Weidenfeld & Nicolson, London, England
1962; 1962