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Introduction to Bioterrorism

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1763 French & Indian War During the Pontiac Rebellion in New England , ... St. Louis Metropolitan Area. Most Likely Agents. Potentially thousands ... – PowerPoint PPT presentation

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Title: Introduction to Bioterrorism


1
Introduction to Bioterrorism
  • Bioterrorism Epidemiology
  • Module 2
  • Missouri Department of Health
  • and Senior Services

2
Bioterrorism is the single most dangerous threat
to U.S. national security in the foreseeable
future.
3
The one that scares me to death, perhaps even
more so than tactical nuclear weapons, and the
one we have the least capability against is
biological weapons.
Colin Powell
4
The emerging security threats to the United
States, its friends and allies, and even to
Russia, now come from rogue states, terrorist
groups and other adversaries seeking weapons of
mass destruction, and the means to deliver them.
George W. Bush
5
Today one man can make war. A lucky bio buffoon
could kill 400,000 people. Joshua Le
derberg
6
Earliest Attempts at Biological Warfare
  • 400 BC Scythian archers used arrows dipped in
    blood and manure
  • 300 BC Persian, Greek, and Roman literature
    provide examples of using animal cadavers to
    contaminate water supplies
  • 190 BC Hannibal hurled venomous snakes onto
    enemy ships of King Eumenes

7
Continuing Attempts at Biological Warfare
  • 1155 Battle of Tortona Barbarossa put dead
    bodies in enemy water supplies
  • 1346 Siege of Caffa - Mongols catapulted bodies
    of plague victims over the city walls
  • 1718 Reval, Estonia - Russians tried the same
    tactic against Sweden

8
Early Use of Smallpox in Biological Warfare
  • 1763 French Indian War During the Pontiac
    Rebellion in New England , British forces gave
    smallpox inoculated blankets to Native Americans

9
Era of Modern Microbiology
  • 1915-18 World War I German BW Program
  • Developed anthrax, glanders, cholera, and wheat
    fungus as weapons .
  • 1932-1945 World War II Japanese BW Program
  • Operated a secret facility (Unit 731) testing BW
    agents on Chinese prisoners

10
Biological Warfare to the Present
  • 1942-1957 U.K. BW Program
  • 1942-1969 U.S. BW Program
  • 1920-1990 U.S.S.R. BW Program
  • 1985 2003 Iraqs BW Program
  • Today At least 17 nations are thought to have a
    offensive BW Programs

11
Iraqs Biological Weapons Program
12
in the Soviets view, the best biological agents
were those for which there was no prevention and
no cure. For those agents for which vaccines or
treatment existed, antibiotic-resistant or
immuno-suppressive variants were to be developed.
Ken Alibek
13
Why is there an increased interest in
bioterrorism?
14
Availability of Seed Cultures
  • 453 worldwide repositories in 67 nations
  • 54 will sell and ship anthrax
  • 18 will sell and ship plague
  • International black-market sales

15
Early Recognition of a Bioterrorist Attack
  • Most doctors have never seen a case of anthrax or
    smallpox
  • It could be days before a bioterrorist attack was
    recognized
  • Training for physicians in the recognition of
    diseases associated with bioterrorism is limited

16
Changing Goals of Terrorism
  • Historically
  • Low Casualty, High Visibility
  • Today
  • Mass Casualties

17
Sources of Terrorism
  • State-Sponsored Programs
  • Former Soviet Iraqi Biological Programs
  • Ideological Extremists
  • Anti-Government, Militia
  • Religious Extremists
  • Aum Shinrikyo
  • Al Qaeda
  • Hamas
  • Lone Wolves

18
Foreign Terrorist Organizations
  • Abu Nidal Organization
  • Abu Sayyaf Group
  • Armed Islamic Group
  • Aum Shinrikyo
  • Gamaa -Islamiyya
  • Hamas
  • Harakat Ul-Ansar
  • Hizballah
  • Japanese Red Army
  • Al-Jihad
  • Kach
  • Kahane Chi
  • Khmer Rouge
  • Kurdistan Workers Party
  • Liberation Tigers of Tamil Eelam
  • Manuel Rodriguez Patriotic Front
  • Mujahedin-E-Khalq Organization
  • National Liberation Army
  • Palestine Islamic Jihad Shiqaqi
  • Palestine Liberation Front
  • Revolutionary Armed Forces of Columbia
  • Revolutionary Organization 17 November
  • Revolutionary Peoples Liberation Party
  • Shining Path
  • Tupac Amaru Revolutionary Movement

19
Osama bin Laden
  • Indicted as the architect of U.S. embassy
    bombings in Kenya and Tanzania that killed more
    than 200 people, he has declared a holy war
    against all Americans and is the prime suspect
    for masterminding the September 11 bombing of the
    world trade center.

20
Hostility toward America is a religious duty,
and we hope to be awarded for it by GodI am
confident that Muslims will be able to end the
legend of the so-called superpower that is
America.
Osama bin Laden
21
Domestic Groups
Aryan Nation members Larry Wayne Harris, left,
and William Job Leavitt are led from court in Las
Vegas, where they were charged with conspiring to
possess anthrax for use as a weapon. (Marsh
Starks/Reuters)
Timothy McVeigh (above) conspired with Terry
Nichols, a member of the far-right Michigan
Militia, to build the bomb that destroyed the
Alfred P. Murrah Federal Building in Oklahoma
City killing 168 people. (AP)
22
Religious Terrorists
Shoko Asahara led the 10,000 member strong Aum
Shinrikyo cult that killed 12 and left thousands
ill after a nerve gas attack on the Tokyo subway.
(AP Photo)
Ramzi Yousef was convicted of masterminding the
1993 World Trade Center bombing that left six
dead and 1,000 wounded. (AP Photo)
23
Advantages to Biological Agent Use
  • Inexpensive / relatively easy to produce
  • Cost (1970 Study - Cost of 50 casualties over a
    one sq/km area)
  • Conventional weapons - 2,000
  • Nuclear - 800
  • Chemical - 600
  • Anthrax - 1

24
Common Characteristics
  • Can be a liquid or powder
  • Can be successfully dispersed as aerosol
  • Can be aerosolized from a line source or point
    source
  • Must take account of weather conditions
    inversions are important for effective outdoor
    aerosol delivery
  • Can be delivered orally through food or water
    contamination

25
Point Source Release
2.27 Kilo (5 lb) Anthrax Release over St. Louis
  • Anthrax Model
  • Single point release
  • 38.6283 N / 90.1937 W
  • Altitude 200 meters
  • NE corner of Bell Building
  • Total mass of Inventory 5.67 Kg
  • Total mass expelled 2.27 Kg
  • Surface Moisture Normal
  • Surface Type Urban
  • Particle Size 4.85 to 5.12 microns
  • Date 8 Nov 2000
  • Historical Weather Models
  • Employed
  • Fixed winds used 12 mph
  • streams

Population Affected (Census Point Data)
Computed Against HPACANTH _at_ 5.50 hrs
DEATHS 62,503
26
St. Louis Metropolitan Area
  • Plume Model
  • Anthrax
  • 500 kg
  • Dissemination Efficiency 60
  • Historical Weather Data
  • NOTE This is an exaggerated quantity designed to
    display a line source release

27
St. Louis Metropolitan Area
  • Plume Model
  • Anthrax
  • 500 kg
  • Dissemination Efficiency 60
  • Historical Weather Data
  • NOTE This is an exaggerated quantity designed to
    display a line source release

28
St. Louis Metropolitan Area
  • Plume Model
  • Anthrax
  • 500 kg
  • Dissemination Efficiency 60
  • Historical Weather Data
  • NOTE This is an exaggerated quantity designed to
    display a line source release

29
St. Louis Metropolitan Area
  • Plume Model
  • Anthrax
  • 500 kg
  • Dissemination Efficiency 60
  • Historical Weather Data
  • NOTE This is an exaggerated quantity designed to
    display a line source release

30
St. Louis Metropolitan Area
  • Plume Model
  • Anthrax
  • 500 kg
  • Dissemination Efficiency 60
  • Historical Weather Data
  • NOTE This is an exaggerated quantity designed to
    display a line source release

31
St. Louis Metropolitan Area
  • Plume Model
  • Anthrax
  • 500 kg
  • Dissemination Efficiency 60
  • Historical Weather Data
  • NOTE This is an exaggerated quantity designed to
    display a line source release

32
St. Louis Metropolitan Area
  • Plume Model
  • Anthrax
  • 500 kg
  • Dissemination Efficiency 60
  • Historical Weather Data
  • NOTE This is an exaggerated quantity designed to
    display a line source release

33
St. Louis Metropolitan Area
  • Plume Model
  • Anthrax
  • 500 kg
  • Dissemination Efficiency 60
  • Historical Weather Data
  • NOTE This is an exaggerated quantity designed to
    display a line source release

34
St. Louis Metropolitan Area
  • Plume Model
  • Anthrax
  • 500 kg
  • Dissemination Efficiency 60
  • Historical Weather Data
  • NOTE This is an exaggerated quantity designed to
    display a line source release

35
St. Louis Metropolitan Area
  • Plume Model
  • Anthrax
  • 500 kg
  • Dissemination Efficiency 60
  • Historical Weather Data
  • NOTE This is an exaggerated quantity designed to
    display a line source release

36
St. Louis Metropolitan Area
  • Plume Model
  • Anthrax
  • 500 kg
  • Dissemination Efficiency 60
  • Historical Weather Data
  • NOTE This is an exaggerated quantity designed to
    display a line source release

37
St. Louis Metropolitan Area
  • Plume Model
  • Anthrax
  • 500 kg
  • Dissemination Efficiency 60
  • Historical Weather Data
  • NOTE This is an exaggerated quantity designed to
    display a line source release

38
St. Louis Metropolitan Area
  • Plume Model
  • Anthrax
  • 500 kg
  • Dissemination Efficiency 60
  • Historical Weather Data
  • NOTE This is an exaggerated quantity designed to
    display a line source release

39
St. Louis Metropolitan Area
  • Plume Model
  • Anthrax
  • 500 kg
  • Dissemination Efficiency 60
  • Historical Weather Data
  • NOTE This is an exaggerated quantity designed to
    display a line source release

40
Most Likely Agents
  • Potentially thousands
  • NATO NBC Handbook narrows the list to 31 agents
  • USAMRIID Criteria narrows the list to 6 primary
    agents of concern based on
  • Availability
  • Ease of Production
  • Lethality
  • Stability (Deliverability)
  • Infectivity

41
Most Likely Agents
  • Category 1 Anthrax Smallpox
  • Category 2 Plague Tularemia
  • Category 3 Botulism Toxin Viral
    Hemorrhagic Fever

42
Other Possible Agents
  • c. burnetti (Q Fever)
  • brucella spp. (Brucellosis)
  • burkholderia mallei (Glanders)
  • burkholderia pseudomallei (Melsosdosis)
  • alphaviruses (Viral Encephalitis)
  • rickettsia prowazekii (Typhus)
  • Toxins (Ricin)
  • Staph Enterotoxin B
  • chlamydia psittaci (Psittacosis)

43
Toxin Lethality
  • Agent LD50 Source
  • Sarin (GB) 100 Chemical Agent
  • Soman (GD) 64 Chemical Agent
  • VX 15 Chemical Agent
  • Ricin 3.0 Castor Bean
  • Botulinum 0.001 Bacterium

44
2000-2001 Bioterrorism Survey
  • 20,000 Surveys Mailed Prior to September 11
    Bombing of World Trade Center and Follow-up
    survey after September 11th
  • Physicians (AMA)
  • Public Health (NACCHO)

45
Bioterrorism Risk Perceptions
46
Bioterrorism Risk Perceptions
47
Bioterrorism Risk Perceptions
48
Bioterrorism Risk Perceptions
49
Case I - The Threat Alone
  • 1997, Bnai Brith Offices, Washington, DC
  • Mail room worker spotted a leaking package
    containing a petri dish marked antrax
    (misspelled)
  • Many agencies got involved
  • Office workers were paraded through decon in
    front of CNN cameras
  • There was nothing on the plate.
  • The terrorists shut down Washington, DC during
    Friday rush hour, armed only with an empty dish

50
Case II - Failing to Report
  • Saturday, in March 1997, Sun Harbor Airport,
    Phoenix, Arizona
  • 737 arrives from Acapulco, 50 on board
    w/diarrhea
  • EMS contacted plane stops on tarmac offloading
    25 passengers to ambulances 6 patients admitted
  • County Health Officer learned of the event on the
    radio the following Monday
  • Public Health had no names and no stool samples
  • The aircraft had been cleaned, reloaded and
    continued to Detroit the same day

51
Case III Bioterrorism Attack
  • Several grams of highly processed anthrax spores
  • Poor selection of delivery device
  • Numerous cases of exposure and five deaths
  • Millions of dollars in damages
  • Nationwide increase in anxiety over possible
    bioterrorist attacks
  • No arrests

52
Case IV - Raising Suspicion
  • September 1984, The Dales, Oregon
  • Religious cult put Salmonella bacteria in the
    salad bars of ten restaurants
  • More than 750 people became sick
  • It required over a year to determine that the
    outbreak was intentional

53
Types of Bioterrorist Attacks
  • Attacks not requiring epidemiological methods to
    detect
  • Attacks requiring epidemiological methods to
    detect
  • Attacks requiring epidemiological methods to
    detect early
  • Attacks requiring epidemiological methods to
    manage

54
Attacks Not Requiring Epidemiological Methods to
Detect
  • Diagnosis of a disease that has been eradicated
    (smallpox)
  • Disease with very low probability of occurrence
    (inhalational anthrax, primary pneumonic plague)
  • Large scale outbreak occurring over a short time
    in a limited geographical area

55
Attacks Requiring Epidemiological Methods to
Detect
  • Small scale outbreak
  • Outbreak occurring over a long time period
  • Outbreak occurring in multiple geographical
    areas
  • Outbreak of a difficult to diagnose disease or a
    disease that naturally occurs.
  • Outbreak with low mortality rates

56
Attacks Requiring Epidemiological Methods to
Detect Early
  • Diseases difficult to diagnose clinically and
    requiring several days for laboratory confirmation

57
Attacks Requiring Epidemiological Methods to
Manage
  • Diseases transmittable person-to-person
  • Diseases from outdoor releases of an agent over a
    wide geographical area

58
Point Source Release
2.27 Kilo (5 lb) Anthrax Release over St. Louis
  • Anthrax Model
  • Single point release
  • 38.6283 N / 90.1937 W
  • Altitude 200 meters
  • NE corner of Bell Building
  • Total mass of Inventory 5.67 Kg
  • Total mass expelled 2.27 Kg
  • Surface Moisture Normal
  • Surface Type Urban
  • Particle Size 4.85 to 5.12 microns
  • Date 8 Nov 2000
  • Historical Weather Models
  • Employed
  • Fixed winds used 12 mph
  • streams

Population Affected (Census Point Data)
Computed Against HPACANTH _at_ 5.50 hrs
DEATHS 62,503
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