Bioterrorism and Food Safety Gregory Evans, PhD, MPH JAPHI ANNUAL CONFERENCE October 28, 2004

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Bioterrorism and Food SafetyGregory Evans, PhD,
MPHJAPHI ANNUAL CONFERENCEOctober 28, 2004
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Subway riders injured in Aum Shinrikyo Sarin gas
attack, Tokyo, March 20, 1995. (AP Photo/Chikumo
Chiaki )
http//www.terrorismanswers.com/groups/aumshinriky
o.html
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Anthrax Spores
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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
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The Quranic Concept of War
Terror struck into the hearts of the enemies is
not only a means, it is the end in itself. Once a
condition of terror into the opponents heart is
obtained hardly anything is left to be achieved.
It is the point where the means and the end meet
and merge. Terror is not a means of imposing
decision upon the enemy it is the decision we
wish to impose upon him.
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Courtesy of the US Department of State
http//www.state.gov/s/ct/rls/pgtrpt/2001/html/102
37.htm
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Courtesy of the US Department of State
http//www.state.gov/s/ct/rls/pgtrpt/2001/
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Religiously Motivated Terrorism
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Courtesy of The Federal Bureau of Investigation
http//www.fbi.gov/terrorinfo/terrorism.htm
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Why an Increasing Risk of Bioterrorism
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Changing Goals of Terrorism
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Advantages to Biological Agent Use
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Most Likely Agents
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Most Likely Agents

• Category 1 Anthrax Smallpox
• Category 2 Plague Tularemia
• Category 3 Botulism Toxin Viral
  Hemorrhagic Fever

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Likely Bioterrorism Agents

• Category B
• 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)
• Other Foodborne agents
• Other Waterborne agents

Source Centers for Disease Control and
Prevention, Critical Biological Agents for Public
Health Preparedness, 1999
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Some Examples of Bioterrorism Involving Food
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Outbreak of Shigella dysenteriae Type 2

• Dallas, Texas A large Medical Center
• 29 Oct 1 Nov 96 12 Laboratory workers
  experienced severe gastrointestinal illness
• All had eaten pastries left in their breakroom
  between the night and morning shifts on October
  29th 1996

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Shigella dysenteriae Type 2

• Rare organism
• Also known as Schmitz bacillus
• Does not produce Shiga toxin
• Much less severe infection than Type 1
• Initial symptoms Nausea, abdominal discomfort,
  and bloating. Followed approximately 24hrs later
  by diarrhea
• Infection confirmed with positive stool culture
  for S dysenteriae

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Lessons from Dallas Outbreak of S dysenteriae
Type 2

• Covert contamination of food items is one of the
  most uncomplicated forms of bioterrorism
• Better lab security is needed
• Control access to laboratory stock cultures
• Lock storage freezers
• Maintain documentation of every individual
  gaining access

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Other FoodborneBioterrorism Incidents

• 1960s Several Japanese outbreaks of typhoid and
  dysentery traced to research biologist
  intentionally contaminating food items
• 1970 4 Canadian students were ill after
  consuming food contaminated with embryonated
  Ascaris suum ova, a large ringworm infecting
  pigs.
• 1984 In Oregon, more than 750 people became ill
  after being exposed to Salmonella from
  contaminated salad bars.

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Salad Bar Contamination

• September 1984, The Dalles, Oregon
• 10 salad bars contaminated with Salmonella
  bacteria
• More than 750 people became sick
• Officials slow to identify the outbreak as
  deliberate
• We really lost our innocence over this. We
  weren't suspicious enough." Michael Skeels of the
  Oregon State Public Health Laboratory in
  Portland.

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Food Supply Vulnerability

• January 2003, Michigan
• Four families (18 people) experienced acute
  illness
• Burning of the mouth, nausea, vomiting, dizziness
• Recall of 1,700 pounds of beef
• 148 more illnesses reported following recall
• Four hospitalized, no fatalities
• February 12, 2003, supermarket employee indicted
• Poisoned 200 pounds of meat with Black Leaf 40
  insecticide, primary ingredient is nicotine

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Failing to Report

• Saturday, in March 1997
• Sun Harbor Airport, Phoenix, Arizona
• 737 arrives from Acapulco, 50 on board
  w/diarrhea
• Plane offloads 25 passengers to ambulances
• 6 patients admitted to local hospital
• County Health Officer learned of the event
  listening to the radio (NPR) the following Monday
• Public Health had no names and no stool samples
• The aircraft was cleaned, reloaded and continued
  to Detroit the same day

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Steps in Food Safety and Security

• Identify the hazards
• Assess the risk
• Analyze risk control measures
• Make control decisions
• Implement risk controls
• Supervise and review

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Identify the Hazards

• Conduct review of each activity in food
  production process
• Concentrate on where people have access to the
  process
• Food can be contaminated with biological and
  chemical agents at all points in process

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Assess the Risk

• Risk level severity can go from catastrophic to
  negligible
• Risk level probability can go from frequent to
  unlikely

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Examples of Hazards

• Trucks not secured
• Little security in hiring personnel
• Water to clean products could be contaminated
• Facilities not secured

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Risk Control Measures

• Put up security cameras
• Put guard on doors
• Provide warning devices on doors
• Lock doors and use panic bars to open
• Put new hires under close supervision for first
  90 days
• Do background checks on employees

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Make Risk Control Decisions

• Determine which risks are the most severe
• Determine which risk are the most probable

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Implement Risk Control Decisions

• Put control measures in budget
• Train personnel on new procedures
• Develop incentives for employees and management
  to implement control measures

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Supervise and Review

• Monitor effectiveness of controls
• Provide frequent feedback to employees and
  management

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2000-2001 Bioterrorism Survey
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Bioterrorism Risk Perceptions
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Bioterrorism Risk Perceptions
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Bioterrorism Risk Perceptions
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Bioterrorism Risk Perceptions
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Questions?

• www.bioterrorism.slu.edu www.emerginginfections.sl
  u.edu

www.cfsan.fda.gov