Bioterrorism Preparedness

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Bioterrorism Preparedness

• Daniel W. Saylak, D.O., FACOFP
• Senior Medical Officer
• Texas-1 Disaster Medical Team
• National Disaster Medical Service

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The United States of America Responds to
Disasters at Numerous Levels
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Combination Civilian/Military Agencies
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Disaster Preparedness
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Bioterrorism

• Does the TV series 24 represent the threats?

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A University of Arizona researcher has created a
method and map that shows the relative level of
threat of bioterrorism in 132 major cities in the
United States. The map displays the level of risk
based critical industries, ports, railroads,
population, natural environment and other
factors.
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What is Bioterrorism?

• The history of bioterrorism goes back as far
  as human warfare, in which there have always been
  efforts to use germs and disease as weapons. In
  the late 20th century, violent non-state actors
  began seeking to acquire or develop biological
  agents to use in attacks on civilians. The
  reported risk has led the U.S. government to
  expend immense resources for biodefense in the
  early part of the 21st century.

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Class A Biological Diseases

• Bioterrorism refers to the intentional release of
  toxic biological agents to harm and terrorize
  civilians, in the name of a political or other
  cause. The U.S. Center for Disease Control has
  classified the viruses, bacteria and toxins that
  could be used in an attack. Category A Biological
  Diseases are those most likely to do the most
  damage. They include
• Anthrax (Bacillus anthracis)
• Botulism (Clostridium botulinum toxin)
• The Plague (Yersinia pestis)
• Smallpox (Variola major)
• Tularemia (Francisella tularensis)
• Hemorrhagic fever, due to Ebola Virus or Marburg
  Virus

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A Brief History of Bioterrorism

• Sixth Century B.C.One of the earliest
  reported uses of bioterrorism. Assyrians poison
  enemy wells with rye ergot, a fungus that causes
  convulsions if ingested.1346Plague breaks out
  in the Tartar army during its siege of Kaffa (at
  present-day Feodosia in Crimea). Attackers hurl
  the corpses of plague victims over the city
  walls, causing an epidemic that forces the city
  to surrender. Some infected Kaffa residents who
  left the city may have inadvertently started the
  Black Death pandemic. 1754During the French
  and Indian wars, it's suspected British forces
  distribute smallpox-laden blankets to native
  American Indians who were loyal to the French.
  1870German scientist Robert Koch proves that
  microorganisms cause infectious diseases by
  injecting anthrax spores into mice. The mice
  contract the disease.1882In France, Louis
  Pasteur develops the first successful vaccine to
  prevent anthrax in animals.

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Bioterrorism 1900 - 2009

• This century biological and chemical warfare has
  reached new heights of ingenuity.1910-20 On
  April 22, 1915, the Germans used poison gas for
  the first time at Ypres in Belgium. By 1918, one
  in four shells on the western front was a gas
  shell, and its use resulting in more than one
  million casualties and more than 100,000
  deaths.1930-40 Japan reportedly used plague and
  other bacteria in the war against China in the
  1930s and 1940s.1983-88 More recently, there is
  evidence Iraq used chemical weapons extensively
  during the Iran-Iraq war between 1983 and 1988
  and subsequently against the Kurds.The threat
  now that most countries have agreed to destroy
  military stockpiles of chemical and biological
  weapons, the biggest remaining threat is
  terrorism.1984 In 1984, a safe house belonging
  to the German Red Army Faction, a militant group,
  was reportedly uncovered in Paris, France.1993
  The bomb that damaged the World Trade Center in
  New York in 1993 reportedly also contained
  cyanide, but the chemical apparently evaporated
  in the explosion.1994 In 1994 two members of a
  religious cult in Oregon successfully used
  salmonella to poison the salad bars of local
  restaurants in an attempt to affect the outcome
  of local elections. More than 700 people were
  believed to be affected, though none were
  apparently killed, and the reason for the
  outbreak was not uncovered for a year.1995 The
  series of Sarin gas attacks made on the Tokyo
  subway system by a cult in March 1995 that killed
  a dozen people and injured thousands brought the
  use of chemical and biological weapons to
  international attention. Inside the safe house an
  improvised laboratory was said to have been found
  containing flasks of deadly botulism toxin.

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Pulling In The Reins

• Although several countries are suspected to
  retain some chemical or biological weapons
  capabilities, nearly all have formally agreed to
  renounce their military use.Even as early as
  ancient times, the Greeks and Romans condemned
  the use of poison as a violation of the rules of
  war, though they continued to use it.1925 After
  World War I, the Geneva Protocol of 1925 outlawed
  the use of both chemical and biological weapons
  in war, but countries were unable to agree on a
  treaty to ban stockpiles.1956 In 1956 Marshal
  Zhukov announced to the Soviet Congress that
  chemical and biological warfare weapons would be
  used as weapons of mass destruction in future
  warsThis caused the US to renew its own
  programs, but in 1969, US President Nixon ordered
  the termination of all research on biological
  warfare and the disarmament of all such
  weapons.This outlawed the production,
  stockpiling and use of biological weapons. In
  July 1995, however, Iraq admitted that it had
  tried to build up stocks of biological weapons
  after UN inspectors found large amounts of
  anthrax, botulinum and other toxins.1993 In
  January 1993 a ban on the production, stockpiling
  and use of chemical weapons - The Chemical
  Weapons Convention was signed by 130 countries.
  Iraq has yet to sign this ban, however, and of
  the 165 countries which have now signed, 62 have
  yet to ratify the agreement. The current Gulf
  crisis stems from UN Security Council resolution
  687, which calls for the elimination of Iraq's
  weapons of mass destruction.1975 The Biological
  and Toxin Weapons Convention (BWC), which
  prohibits the acquisition of biological materials
  for hostile purposes and armed conflict, entered
  into force in 1975 and now has the participation
  of 140 nations (158 nations have signed the BWC,
  but only 140 of these have also ratified it).
  However, there is no monitoring mechanism
  associated with the BWC.

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So How do we prepare?

• Awareness
• Development of Contingency Plans
• Focus on Class A Agents
• Avoidance of High Risk Areas
• Use of mass inoculations
• Rapid delivery of pharmaceuticals
• Tested at 2009 Presidential Inauguration

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Class A Agents
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Be Prepared

• Boy Scout Motto