Bioterrorism

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Bioterrorism

• UW- Eau Claire
• ENPH 210- Introduction to Environmental Health
• Sarah Arneson
• Todd Dennis
• Pamela Dohm
• Heather Rapala
• Daniel Rehberger
• Laura Suppes
• Kevin Wang

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Definition

• Bioterrorism is terrorism using germ warfare, an
  intentional human release of a naturally-occurring
  or human-modified toxin or biological agent

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Case study

• Sitting in an office opening up a piece of mail
• Few weeks later you start to feel sick
• You find out that you have anthrax
• Course of antibiotics, mainly doxycycline
• Everyone who was in your office is now sick
• An act of bio terrorism

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Brief overview

• We will be covering 6 different topics.
• FAQ
• Past and present cases
• Types of agents that are used and the effects
  that these agents have on the human body
• How to prevent and protect yourself from bio
  terrorism
• Organizations that are trying to protect us from
  bio terrorism and how much money it is costing
  us

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Frequently Asked Questions
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FAQ

• What is the likelihood of a large-scale attack on
  the United States?
• likelihood of a large-scale attack is low.
• Not easy to spread a biologic agent that could
  infect lots people.
• While a major attack could be devastating,
  preparations will minimize casualties.

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FAQ

• Is the U.S. health system prepared for an act of
  bioterrorism?
• Centers for Disease Control and Prevention, the
  Public Health Service, Cook County Public Health
  Office conduct surveillance for a bioterrorist
  event.
• Federal, state, and local authorities are working
  with physicians, hospitals, and the
  pharmaceutical industry to provide
• information and communication systems and ensure
  the availability and rapid deployment of
  life-saving pharmaceuticals, vaccines, and
  antidotes

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FAQ

• Should I be immunized against anthrax?
• The anthrax vaccine is only available to military
  personnel and those who might come in contact
  with natural anthrax in their work (special-risk
  groups such as goat-hair mill or goatskin
  workers, wool or tannery workers, laboratory
  workers).
• Physicians do not have this vaccine and cannot
  obtain it.
• The anthrax vaccine is only recommended for
  people between 18 and 65 years of age.

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FAQ

• Should I be immunized against smallpox?
• The last naturally occurring case of smallpox in
  the world occurred in 1977.
• The vaccine is not generally available to the
  public.
• 12 to 15 million doses of vaccine remaining in
  the United States.
• no treatment for the disease, vaccine provides
  protection and serves to stop spread of the
  disease.

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FAQ

• Should I ask my doctor for antibiotics to have on
  hand in case of a bioterrorist attack?
• No. Indiscriminant use of antibiotics could be
  harmful, particularly for pregnant women and
  children.
• Keeping a supply of antibiotics on hand poses an
  additional problem because they have a limited
  shelf life and will lose potency over time

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FAQ

• What is the "National Pharmaceutical Stockpile"
  that health officials talk about on the news?
• This is a large reserve of antibiotics, chemical
  antidotes, and other medical supplies set aside
  for emergencies.
• CDC can move stockpiled material to affected
  areas in the United States within 1 to 2 hours of
  notification from a states Governor.

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FAQ

• Who do I contact regarding a possible exposure?
• If you believe you have been exposed to an
  infectious bioagent or if you develop symptoms
  that you believe might be associated with such an
  exposure, immediately contact a physician.

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FAQ

• What can I do to protect my family and myself?
• Although there is little that you as an
  individual can do in advance to protect yourself
  from a bioterrorist attack.
• Government agencies, health care institutions,
  and public health agencies can and are doing more
  to improve capacity to protect the public
  following a bioterrorist attack.
• We can all educate ourselves about this issue,
  make family preparations for a disaster, and find
  out ahead of time what our local communities
  suggest we do.

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History of Biological Weapon Use(BC- 1986)
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• RYE ERGOT
• Used as early as 6th century B.C.
• Used by Assyrians against enemies (Israelites) to
  poison wells
• The plant is infected by the fungus Claviceps
  Purpurea
• Symptoms include convulsions, gangrenous
  extremities,
• madness and death.

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• Animal Cadavers
• 300 BC
• Romans and Greeks used dead animals to
  contaminate wells of their enemies and other
  water sources

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• Snake Venom
• 190 BC
• Hannibal at the battle of Eurymedon conquered
  King Eumerus II of Pergamon
• Hannibal used poisonous snakes by putting them
  into enemy ships

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• Human Cadavers
• 12th Century AD
• Battle of Toptona
• Barbossa used the bodies of dead soldiers to
  poison enemy wells
• Also, Romans, Greeks and Persians dipped arrows
  into decomposing corpses to contaminate the arrow
  tips

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• Plague
• 1346- breakout of plague in Tartar Army during
  the Seige of Kaffa
• Tartar soldiers threw plagued corpses over the
  walls of Kaffa and infected the city causing
  surrender
• Infected Kaffans may have contributed to the
  cause of the Black Death Pandemic
• Spread through transmission of flea to human host
• The plague bacilli invades the lymph nodes
  causing inflammation, which was what buboes
  were named after

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• Small Pox
• 1753
• Beginnings of the French and Indian War
  (1754-1763)
• Fort Pitt- Pennsylvania Frontier
• General Amherst
• The disease was spread by the British peace
  gesture of offering blankets infected with
  smallpox to Native Americans who were loyal to
  the French
• Ottowan Chief- Pontiac
• The fight during which the smallpox outbreak took
  place was named Pontiacs Rebellion
• 1796
• British soldiers infected the Continental Army
  with smallpox

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• Robert Koch
• 1870
• first person to discover that microorganisms
  cause infectious disease
• Does so by injecting mice with anthrax spores
• Mice contract the disease

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• First Vaccines
• 1882
• Louis Pasteur
• Development of the first successful vaccine
• Prevents Anthrax in animals

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• Glanders--B- Mallei
• 1915
• Germans use the agent Glanders to infect allied
  countries livestock
• Symptoms include fever, rigors, sweats,
  headache, chest pain, and is almost always fatal
  without treatment

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• Use of biological agents by the Japanese
• 1937
• Unit 731 in present day Sun Yang China, a base
  made for the construction of bombs containing
  deadly biological agents
• The base was disguised as an Epidemic Prevention
  and Water Supply Unit
• The base included 3 crematoriums and 2 secret
  prisons
• It was the largest weapons of mass destruction
  center in the world
• Various microorganisms were used on Chinese
  prisoners

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• Anthrax inhalation methods were found to be one
  of them, as well as the use of Plague, Cholera,
  Gas Gangrene, Brucellosis, Tularemia, and
  Glanders
• Symptoms for Anthrax include mild fever, muscle
  aches, sore throat, malaise and after a few days,
  they may progress into difficulty breathing and
  shock
• Inhalation anthrax is usually fatal
• Cholera Vibrio cholerae is the bacterium which
  causes the disease in the intestinal track
• It is a diarrheal illness
• The disease itself is acute with little or no
  symptoms

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• Gas Gangrene caused by Clostridium Perfringens
  bacterium
• Symptoms include pain and swelling around
  injury, fever, blisters filled with red fluid,
  increased heart rate
• Caused by the infection of wounds
• Brucellosis from the genus Brucella
• Symptoms include sweating, weight loss, fatigue,
  headache, abdominal pain
• Not a deadly disease but is highly contagious and
  can incapacitate a person for weeks
• Tularemia caused by the bacteria Francisella
  tularensis
• Symptoms include enlarged lymph nodes, sweating,
  headache, muscle pain, weight loss
• Not very lethal, but also will incapacitate a
  person for a long period of time

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• A testimonial from a Japanese scientist who
  worked on the base stated in a documentary done
  years later
• "I cut him open from the chest to the stomach and
  he screamed terribly and his face was all twisted
  in agony. He made this unimaginable sound, he was
  screaming so horribly. But then finally he
  stopped. This was all in a day's work for the
  surgeons, but it really left an impression on me
  because it was my first time."
• The surgeon soon learned, as stated in the text,
  that he was subjected to this operation because
  the man had been purposely infected with the
  plague, and was there for scientific observation

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• Plague Infested Fleas
• 1940
• Epidemic in China and Manchuria
• Source of plague came from Japanese planes, which
  reportedly dropped containers full of plague
  infested fleas over cities

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• We know today that in 1945 the Japanese had plans
  to use biological warfare on the U.S.
• The Japanese military developed long-distance
  traveling balloons
• The balloons contained biological agents such as
  the ones used on Unit 751, and could reach U.S.
  shores
• Kamikaze planes were also planned to crash into
  San Diego in 1945 while carrying plague infested
  fleas

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• Anthrax - British Military
• 1942
• Guinard Islands
• Off the coast of Scotland, British military
  tested Anthrax spores by dumping the spores from
  planes
• The Bomblet used was created at the Crane Naval
  Air Station in Southern Indiana in 1941
• The experiment killed all of the sheep on the
  island within 72 hours
• In 1986, the Island was so contaminated, it had
  to be disinfected
• To disinfect, Formaldehyde and sea water were
  used
• The island is now officially decontaminated

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• Anthrax- United States Military
• 1942
• Camp Detrick
• U.S. begins their biological weapons construction
• 5,000 bombs filled with anthrax spores are made

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• U.S. development of vaccines
• 1953
• The first mass development of vaccines to
  specifically protect U.S. troops against
  biological warfare
• Other countermeasures, along with vaccines were
  developed as well

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• Executive order to stop weapon production
• 1969
• Richard Nixon signs an executive order to stop
  all biological weapon production as well as
  research
• 1971-1972
• All biological weapons in the U.S. are destroyed

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• Biological Weapons Convention
• 1972
• Prohibition of the stockpiling of biological
  weapons for offensive purposes
• Signed by many countries including the U.S., the
  former Soviet Union, and Iraq

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• Accidental release of Anthrax spores
• 1979
• Sverdlovsk, Russia
• Accidental release of airborne Anthrax spores
• 66 confirmed deaths
• Studies indicated that the spores contained 4
  different strains of anthrax

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• Salmonella
• 1984
• The Rajneeshee cult contaminated a salad bar in
  Oregon
• attempting to influence a local election by
  incapacitating voters
• Symptoms include stomach cramping, bloody
  diarrhea and nausea
• The fatality rate is small for this disease

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Bioterrorist Attacks 1986-Present
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Aum Shinrikyo

• The first bioterrorist attack on U.S. soil was
  not noticed by many. Almost a decade later
  another cult created a large amount of media
  attention.
• In 1995, the Aum Shinrikyo cult of Japan released
  sarin gas in the Tokyo subway. The attack killed
  12 and injured thousands.
• The religious group also attempted to spray
  botulisim and anthrax in Tokyo ten times from
  1993 to 1995.
• The failure of the attacks is blamed on
  insufficient particle size and a non-virulent
  strain of anthrax.

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Disgruntled Hospital Worker

• In October 1996, 12 lab hospital workers became
  sick after eating some free doughnuts and
  muffins.
• Upon analysis of the sick workers Shigella
  dysenteries type 2 was found in their stool.
  Analysis of an uneaten muffin contained the same
  strain.
• A lab technician later admitted to committing the
  crime and also similarly caused her boyfriend to
  become sick with infected food.

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Insurance Fraud in Japan

• Another attack on peoples food occurred at a
  summer festival in Japan in 1998. At the event
  67 people ate curry rice and later became sick.
• At first cyanide poisoning was suspected but
  later it was discovered to be arsenic added to
  the rice. Four people died from the attack.
• It is believed that Masumi and Kenji Hayashi
  carried out the poisoning but Kenji has never
  admitted guilt for the event. Kenji was a
  termite exterminator which would have given him
  access to arsenic.
• While the mass-poisoning in Wakayama instilled
  terror in the population, the intent was
  allegedly to perpetrate insurance fraud, which
  Masumi had done in the past.

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Anthrax Letters

• In the fall of 2001, letters containing anthrax
  spores were mailed to many prominent people in
  the U.S.
• Tom Brokaw, Senator Tom Daschle, and the offices
  of the New York Post were among those who were
  targeted.
• According to the CDC 23 people were infected and
  five died.

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• Types of Biological Agents

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AIDS

• Stands for Acquired Immunodeficiency Syndrome
• Viral disease caused by HIV, Human
  Immunodeficiency Virus
• Attacks bodys immune system and leaves it
  vulnerable to other infections and diseases
• Currently no cure, but there are many drug
  treatment options
• AIDS is becoming a threat to national security
  around the world but especially in Sub-Saharan
  Africa where the disease evolved
• AIDS can be transmitted only through sexual
  intercourse with an infected person, contact with
  contaminated blood, transmission from an infected
  mother to her child before or during birth or
  during breastfeeding

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AIDS

• Symptoms start out as flu-like with nausea,
  fever, sore throat, and headache which last
  around 4 weeks, after that time has passed the
  body starts to battle the HIV and the person can
  enter a symptom free period of ten or more years
• AIDS could be used for a bio-terrorist weapon
  because there is no current cure
• AIDS has a huge impact on the communities that it
  thrives in which leads to undermining government
  relations such as has what has happened in some
  parts in Africa where AIDS is virtually
  uncontrolled

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Anthrax

• caused by Bacillus Anthracis, a bacterium that
  forms spores.
• Spore is a cell that is dormant but may come to
  life with the right conditions
• Three types of anthrax
• -Skin (cutaneous)
• -Lungs (inhalation)
• -Digestive (gastrointestinal)
• not known to spread from person to person
• infection from infected animals, handling
  products or infected meat, of breathing anthrax
  spores
• Classified as a Category A agent by the Centers
  for Disease Control and Prevention which means
  that
• -It poses the greatest possible threat for a
  bad effect on public health
• -Spreads across a large area and needs public
  awareness
• -Needs a great deal of planning to protect the
  publics health

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Anthrax

• Symptoms include
• Cutaneous- small sore develops into a blister
  then develops into a skin ulcer with a black area
  in the center. (These sores do not usually hurt)
• Gastrointestinal- nausea, loss of appetite,
  bloody diarrheas, fever, stomach pain
• Inhalation- cold and flu-like symptoms, sore
  throat, fever, cough, shortness of breath, muscle
  aches
• Symptoms appear around 7 days after contact for
  all 3 types inhalation can take a week to 42
  days to appear

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Anthrax

• Treatment is 60 days of antibiotics
• The CDC is preparing for an anthrax bio-terrorist
  attack by
• -Planning the response to an attack
• -Training emergency response teams
• -Educate health care providers
• -Educate general public
• -Develop national electronic database to
  track potential cases of anthrax
• -Making sure there are enough supplies in
  case of an attack

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Plague

• Caused by bacterium Yersinia Pestis
• Yersinia Pestis is easily destroyed by sunlight
  and drying but it can still live up to an hour in
  the air
• 3 kinds of plague
• Pneumonic- Y. pestis infects the lungs, spreads
  from person to person through the air, and
  requires direct or close contact with an ill
  animal or human to transmit.
• Bubonic- most common type, caught when an
  infected flea bites a person, develops swollen
  tender lymph glands, fever, headache, chills, and
  weakness, does not spread from person to person.
• Septicemic- When plague bacteria multiply in the
  blood, it can be a combination of pneumonic and
  bubonic plague or it can occur by itself.
  Symptoms include fever, chills, abdominal pain,
  shock, bleeding into the skin and organs, does
  not spread from person to person.

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Plague

• Treatment- antibiotics given within 24 hours of
  the first symptoms, antibiotics include
  streptomycin, gentamicin, tetracycline, and
  chloramphenicol. Currently there is no plague
  vaccine.
• Plague could be used in an aerosol attack in
  which people would develop symptoms 1-6 days
  after exposure.
• Plague occurs naturally in the world. The World
  Heath Organization reports 1000-3000 worldwide
  occurrences every year, most are bubonic,
  outbreaks are readily controlled by standard
  public health responses and measures.

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Q Fever

• Zoonotic disease caused by Coxiella Burnetii
• Organisms are excreted in milk, urine, and feces
  of infected animals
• Organisms are resistant to heat, drying, and
  common disinfectants
• Organisms survive for long periods in the
  environment, making them ideal for a
  bio-terrorist weapon
• Only about half of the people infected show
  symptoms which include high fever, headache, sore
  throat, chills, sweats, nausea, vomiting,
  abdominal pain, and chest pain

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Q Fever

• Only 1-2 of people infected with acute Q fever
  die
• Most patients are ill 2-3 weeks after exposure
• Treatment includes antibiotics which are most
  effective the first 3 days of illness
• Q Fever is ideal for bio-terrorism because it is
  highly infectious, very resistant to heat and
  drying and can become airborne and inhaled by
  humans

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Salmonellosis

• Infection caused by bacteria salmonella
• Develop diarrhea, fever, abdominal cramps
• Symptoms usually last 4-7 days and people usually
  recover without treatment
• Caught by eating foods contaminated with animal
  feces
• Prevention includes not eating raw or uncooked
  eggs, poultry, and meat and washing your hands
  before handling foods

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Shigellosis

• Caused by bacteria Shiglla
• People infected develop diarrhea, fever, and
  stomach cramps which start 1-2 days after
  exposure
• shigellosis usually clears up in 5-7 days
• Treatment for shigellosis is through antibiotics
• Transmitted from person to person usually through
  fecal-oral transmission, eating contaminated
  foods, and drinking or swimming in contaminated
  water
• Prevention includes washing your hands and not
  swimming in contaminated waters
• 18,000 cases are reported annually in the United
  States
• Effective for bio-terrorism because it is easy to
  transmit from person to person

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Botulism

• is a rare but serious paralytic illness caused
  by a nerve toxin that is produced by the
  bacterium Clostridium botulinum.
• There are three main kinds of botulism.
• Food borne botulism is caused by eating foods
  that contain the botulism toxin.
• Wound botulism is caused by toxin produced from a
  wound infected with Clostridium botulinum.
• Infant botulism is caused by consuming the spores
  of the botulinum bacteria, which then grow in the
  intestines and release toxin.
• All forms of botulism can be fatal and are
  considered medical emergencies. Food borne
  botulism can be especially dangerous because many
  people can be poisoned by eating a contaminated
  food.

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Brucellosis

• is an infectious disease caused by the bacteria
  of the genus Brucella.
• These bacteria are primarily passed among
  animals, and they cause disease in many different
  vertebrates.
• Various Brucella species affect sheep, goats,
  cattle, deer, elk, pigs, dogs, and several other
  animals.
• Humans become infected by coming in contact with
  animals or animal products that are contaminated
  with these bacteria.
• In humans brucellosis can cause a range of
  symptoms that are similar to the flu and may
  include fever, sweats, headaches, back pains, and
  physical weakness.
• Severe infections of the central nervous systems
  or lining of the heart may occur.
• Brucellosis can also cause long-lasting or
  chronic symptoms that include recurrent fevers,
  joint pain, and fatigue.

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Marburg Hemorrhagic Fever

• rare, severe type of hemorrhagic fever which
  affects both humans and non-human primates.
• Caused by a genetically unique zoonotic (that is,
  animal-borne) RNA virus of the filovirus family,
  its recognition led to the creation of this virus
  family.
• The four species of Ebola virus are the only
  other known members of the filovirus family

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Ricin

• Ricin is a poison that can be made from the waste
  left over from processing castor beans.
• It can be in the form of a powder, a mist, or a
  pellet, or it can be dissolved in water or weak
  acid.
• Ricin is a stable substance. For example, it is
  not affected much by extreme conditions such as
  very hot or very cold temperatures.
• Ricin works by getting inside the cells of a
  persons body and preventing the cells from
  making the proteins they need. Without the
  proteins, cells die. Eventually this is harmful
  to the whole body, and death may occur.
• Effects of ricin poisoning depend on whether
  ricin was inhaled, ingested, or injected.

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Ricin

• Inhalation Within a few hours of inhaling
  significant amounts of ricin, the likely symptoms
  would be respiratory distress (difficulty
  breathing), fever, cough, nausea, and tightness
  in the chest.
• Heavy sweating may follow as well as fluid
  building up in the lungs (pulmonary edema).
• This would make breathing even more difficult,
  and the skin might turn blue.
• Excess fluid in the lungs would be diagnosed by
  x-ray or by listening to the chest with a
  stethoscope.
• Finally, low blood pressure and respiratory
  failure may occur, leading to death.
• In cases of known exposure to ricin, people
  having respiratory symptoms that started within
  12 hours of inhaling ricin should seek medical
  care.

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Ricin

• Ingestion If someone swallows a significant
  amount of ricin, he or she would develop vomiting
  and diarrhea that may become bloody. Severe
  dehydration may be the result, followed by low
  blood pressure.
• Other signs or symptoms may include
  hallucinations, seizures, and blood in the urine.
  
• Within several days, the persons liver, spleen,
  and kidneys might stop working, and the person
  could die.
• Skin and eye exposure Ricin in the powder or
  mist form can cause redness and pain of the skin
  and the eyes.
• Death from ricin poisoning could take place
  within 36 to 72 hours of exposure, depending on
  the route of exposure (inhalation, ingestion, or
  injection) and the dose received.
• If death has not occurred in 3 to 5 days, the
  victim usually recovers.

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Smallpox

• is a serious, contagious, and sometimes fatal
  infectious disease.
• There is no specific treatment for smallpox
  disease, and the only prevention is vaccination.
• The name smallpox is derived from the Latin word
  for spotted and refers to the raised bumps that
  appear on the face and body of an infected
  person.
• There are two clinical forms of smallpox.
• Variola major is the severe and most common form
  of smallpox, with a more extensive rash and
  higher fever.
• There are four types of variola major smallpox
• ordinary (the most frequent type, accounting for
  90 or more of cases)
• modified (mild and occurring in previously
  vaccinated persons)
• flat and hemorrhagic (both rare and very
  severe).
• Historically, variola major has an overall
  fatality rate of about 30 however, flat and
  hemorrhagic smallpox usually are fatal.

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Smallpox

• Variola minor is a less common presentation of
  smallpox, and a much less severe disease, with
  death rates historically of 1 or less.
• Except for laboratory stockpiles, the variola
  virus has been eliminated. However, in the
  aftermath of the events of September and October,
  2001, there is heightened concern that the
  variola virus might be used as an agent of
  bioterrorism.
• Generally, direct and fairly prolonged
  face-to-face contact is required to spread
  smallpox from one person to another.
• Smallpox also can be spread through direct
  contact with infected bodily fluids or
  contaminated objects such as bedding or clothing.
  
• Rarely, smallpox has been spread by virus carried
  in the air in enclosed settings such as
  buildings, buses, and trains.
• Humans are the only natural hosts of variola.
• Smallpox is not known to be transmitted by
  insects or animals.

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Tularemia

• Potentially serious illness that occurs naturally
  in the United States.
• It is caused by the bacterium Francisella
  tularensis found in animals (especially rodents,
  rabbits, and hares).
• Symptoms of tularemia could include sudden
  fever, chills, headaches, diarrhea, muscle aches,
  joint pain, dry cough, and progressive weakness.
  
• People can also catch pneumonia and develop chest
  pain, bloody sputum and can have trouble
  breathing and even sometimes stop breathing.
• Other symptoms of tularemia depend on how a
  person was exposed to the tularemia bacteria.
  These symptoms can include ulcers on the skin or
  mouth, swollen and painful lymph glands, swollen
  and painful eyes, and a sore throat.
• Symptoms usually appear 3 to 5 days after
  exposure to the bacteria, but can take as long as
  14 days

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Tularemia

• People can get tularemia many different ways
• being bitten by an infected tick, deerfly or
  other insect
• handling infected animal carcasses
• eating or drinking contaminated food or water
• breathing in the bacteria, F. tularensis
• Tularemia is not known to be spread from person
  to person.
• People who have been exposed to the tularemia
  bacteria should be treated as soon as possible.
• The disease can be fatal if it is not treated
  with the right antibiotics.

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Protection and Prevention
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Water Storage

• Store at least one gallon per person and pet per
  day.
• Store at least a three-day supply of water for
  each member of your family
• Store in a cool, dark place in your home, each
  vehicle and your workplace.
• Change stored water every six months.

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Water Sources

• Water sources in your home
• your hot-water tank
• pipes and faucets
• ice cubes
• Water sources outside your home
• Rainwater
• Streams and rivers
• Ponds and lakes
• Natural springs

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Food Storage

• Store enough food for two weeks.
• Store foods that require no refrigeration,
  preparation or cooking .
• Include vitamin, mineral and protein supplements.
  
• Eat salt-free crackers, whole grain cereals and
  canned foods with high liquid content if your
  water supplies are low.
• If there's a power outage, eat food in the
  refrigerator first, then from the freezer, and
  finally from stored supplies.

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Supplies

• .
• Kitchen Supplies (manual can opener, plastic
  baggies, knife)
• Battery-powered radio or television
• Extra batteries
• Flashlights
• First aid kit
• Change of clothing and footwear for each person
• Blankets or sleeping bags
• Sanitation and hygiene items (soap/shampoo, hand
  sanitizer, bleach)
• Entertainment (magazines, books, games)
• Matches in a waterproof container
• Paper and Pencil

51, 52, 53, 54
72
Shelter

• Bring everyone indoors
• Choose interior room with few windows or doors
• If a chemical has been released, choose a room
  above ground level, because some chemicals are
  heavier than air and may seep below ground. If
  there are radioactive particles in the air, you
  should choose an interior room or basement.
• Lock doors and windows and close curtains
• Turn off fans, heating, air conditioning
• Seal any openings with duct tape/plastic sheeting
• Listen to radio/TV
• Stay off phone (but keep near by)

51, 52, 53, 54
73
Treatment

• ThyroSafe Tablets (potassium iodide) as a
  thyroid-blocking agent for use in radiation
  emergencies.
• ATNAA (atropine/pralidoxime) autoinjector to
  treat nerve gas intoxication. .
• Reactive Skin Decontamination Lotion for use by
  the military to remove or neutralize chemical
  warfare agents and T-2 fungal toxin from the skin.

51, 52, 53, 54
74
Treatment/Prevention

• Smallpox can be prevented through vaccination
  (Dryvax)
• The treatment for all types of anthrax is
  antibiotics. The antibiotics approved by the FDA
  are Cipro (ciprofloxacin), drugs in the
  tetracycline class such as doxycycline, and some
  drugs in the penicillin class such as procaine
  penicillin G there is also a vaccine.
• Antibiotics such as streptomycin, doxycycline,
  and other drugs in the tetracycline class are
  used to treat plague.

51, 52, 53, 54
75
Government Prevention

• The Centers for Disease Control and Prevention
  (CDC) is the U.S. government agency responsible
  for controlling the spread of disease.
• State and local health departments have emergency
  preparedness and response plans.
• Quarantine (have been exposed to a contagious
  disease but who may or may not get sick) and
  isolation (known to have a contagious disease)
  control the spread of disease.

51, 52, 53, 54
76
Government prevention

• Public Health Security and Bioterrorism
  Preparedness and Response Act of 2002
• Amended Section 319 of the Public Health Service
  Act to increase protections associated with
  public health.
• The Act requires the Secretary of Health and
  Human Services (HHS), along with Federal
  department and agency officials, to launch a
  combined effort on preparedness for acts of
  bioterrorism.

51, 52, 53, 54, 55
77
Organizations and Costs
78
Organizations and Costs

• September 11th it was proposed that within the
  next 5 years 3.2 billion dollars should be set
  aside and used against bio terrorism. (Adams,
  2001)
• Quote

56
79
Organizations and Costs

• December of 2001 the house passed a bill that
  allowed 2.9 billion dollars for bio terrorism,
  less than 7 days later the senate passed the
  same bill only adding 300 million dollars more
• Quote from Tommy Thompson

57
80
Organizations and Costs

• The CDC, Health and Human Services
• the money that they used in 2002 was used for
  vaccines and other pharmaceutical to prepare for
  a possible bio-terror attack, and for the
  response to the limited anthrax assault that
  occurred. (Adams, 2002)
• In 2003 the BioWatch Initiative was started by
  US HSD.
• Quote

57, 58
81
The main goal

• CDC, FDA, and our government is making sure that
  all of us are more aware of the threat of bio
  terrorism
• Stockpiling drugs and medical equipment is
  currently occurring
• Making laws tougher against those that use or
  even possess the possible agents

82
Summary

• Bioterriorism is a real
• However it is hard to spread the biological
  agents
• There are a lot of different agents and a lot of
  different treatments
• You can protect yourself and your family
• Agencies are spending lots of money to protect us

83
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