Weaponized Bioagents

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Weaponized Bioagents

• YSU Agents of Mass Casualty

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Agent Classification

• Military
• Foundations may be foreign
• May have practical roots
• Civilian
• CDC Classification

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Military C

• C Class
• Chemical Classes
• C01 to C24
• Biological Classes
• C25 to C29

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Chemical Agents

• Sub-Codes Examples C01
• GA
• GB
• GD
• GF

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Military Classes - Bioagents

• C24 Anti-Personnel
• C25 Anti-Personnel/Vector
• C26 Anti-Personnel/Ingestion
• C27 Anti-Animal
• C28 Anti-Plant
• C29 - Simulants

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CDC EM Classification

• Category A Weaponized or Available
• Variola virus
• Bacillus anthracis
• Yersinia pestis
• Botulinum toxin
• Francisella tularensis
• Filoviruses Arenaviruses

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CDC EM Classification

• Category B Lower Virulence/Possible Agents
• Coxiella burnetii
• Brucellae
• Burkholderia mallei
• Alphaviruses
• Ricin
• SEB
• Foods Agents E. coli 0157H7, Salmonellae
• Water Threat Vibrio cholera, Cryptosporidium

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CDC EM Classification

• Category C
• Any other emerging pathogen or biological toxin
  that might be a threat.

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Anthrax B. anthracis

• 12 hrs-5 days (except delay)
• Inhalation flu-like, fluid in lungs, severe
  difficulty breathing, broadening mediastinum
• Not Contagious Aerosol or powder
• Treat With Antibiotics
• Military Vaccine
• 30 Mortality (untreated may be higher)

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Botulinum Toxin

• Affects in 12 hours to 3 days
• Flu-like symptoms, difficulty speaking,
  swallowing, drooping eyelids, paralysis
• Antitoxin available (not reversible damage)
• No commercial vaccine
• Probably disseminated in liquid droplets or on
  food.

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Cholera V. cholera

• 12 hours to 5 days
• Severe diarrhea, vomiting and weakness, leg
  cramps and fluid loss.
• Not contagious disseminated in food or water.
• Treatable with antibiotics high fluids
• Newer vaccines not available in U.S. Old vaccine
  low effectiveness, short-lived

12
Glanders B. mallei

• 1-14 days
• Fever and headache, muscle tightness, chest pain,
  tearing and light sensitivity
• Not highly contagious aerosol diss.
• Treatable with antibiotics
• Very few historical cases, up to 50 mortality
  possible.
• No vaccine

13
Plague Y. pestis

• 1-6 days
• Flu-like, lymph node pain (buboes),
  blood-streaked sputum, septic shock
• Aerosol or food pneumonic transmissible
• Treatable with antibiotics time is critical
• Vaccine, once available did not prevent pneumonic
  form. Discontinued in 1999.

14
Q-Fever C. burnetii

• 2-3 weeks
• High fever, throbbing headache, sweating,
  auditory and visual hallucinations, hepatitis
• Aerosol or food dissemination, not very
  transmissible
• Low mortality, most recover without treatment.
• Vaccine not available to general public

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Smallpox V. major

• 10-14 days
• High fever, aches, rash starts in face and arms
  (then trunk unlike chickenpox)
• Aerosol or person-to-person. Contagious stage
  comes with symptoms.
• Vaccination 3-5 days after exposure may avoid or
  lessen disease.
• No treatment (supportive therapy only)

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Tularemia F. tularensis

• 1-14 days in nature (3-5 in a deliberate act)
• Flu-like lethargy. Swollen lymph nodes in
  systemic infections, red, sore eyes, pneumonia
• Disseminated as aerosol or on food no human to
  human
• Antibiotics. Some weaponized strains may be abx.
  resistant.

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Mortality

• 1970 World Health Organization
• Assumed 50 kg of dried agent
• Disseminated on a 2 km line
• Upwind of a population of 500,000

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Results
Agent Distance Carried (km) Fatalities Casualties (Total)
VEE 1 400 35,000
Typhus 5 9,500 35,000
Brucellosis 10 19,000 85,000
Plague 10 500 100,000
Q-Fever gt20 150 125,000
Tularemia gt20 30,000 125,000
Anthrax gtgt20 95,000 125,000
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Other Concerns

• Residential backflow protectors
• Food QC
• Availability of viral hemorrhagic fevers
• Soviet brain drain

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Soviet Bioweapons - Rating

• Smallpox
• Plague
• Anthrax
• VEE
• Tularemia
• Q-Fever
• Marburg virus

Others include the flu virus, glanders and
epidemic typhus.
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Detection

• Rapid Dx Assays
• Military
• Botulinum, SEB, SEA-C-D
• Dengue Fever, Q-Fever, Plague, Tularemia, Typhus,
  West Nile
• Civilian
• SMART Tickets
• DNA Techniques

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Decon
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ER Decon

• Isolate small areas to 100 ft or more
• Note weather, population, density and time of day
• For airborne cloud shelter-in-place
• Field Detection Not Recommended
• PPE
• General rule Level A Latex may not be fully
  protective

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ER Decon

• Remove clothing (aerosol or powder)
• Double bag
• Wash w/soap water
• 10 bleach wash (10-15 minutes)
• Rinse solutions should be retained if possible

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ER Decon

• Careful of reaerosolization
• Treat all items as Haz-Waste
• Note airflow around patients (bioaerosols)
• Always try to decon at site if possible

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NPS or SNS

• Future module will address
• Located at secret locations around the nation (12
  hour deployment on gov. req.)
• Enough to treat, perhaps hundreds of thousands
  (depending on disease)

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Antibiotics

• May be classified
• By spectrum
• Method of administration
• Activity (bacteriacide vs. bacteriastat)
• Chemical structure
• Useful because those in the same class will show
  similar side-effects, action, toxicity etc.

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Antibiotics

• Penicillins
• Cephalosporins
• Fluoroquinolones
• Tetracyclines
• Aminoglycosides

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Antibiotics

• Penicillins
• Oldest
• Similar in chemistry to cephalosporins
• Bacteriacidal
• Natural penicillins (G) (methycillin)
• Aminopenicillins (Amoxil) broader may require
  penicillinase inhibitor

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Antibiotics

• Cephalosporins
• Bacteriacidal
• May show similar allergic problems to pen.
• 1st, 2nd and 3rd generation
• 3rd generation cross blood-brain barrier
• Work on anaerobes

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Antibiotics

• Fluoroquinolones
• Synthetic
• Reach deep tissues
• Bacteriacidal
• Cipro, Penetrex, Floxin, Trovan

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Antibiotics

• Tetracyclines
• Derrived from strep bacteria
• Bacteriostatic
• Effective against rickettsia parasites
• Macrolides
• Emycin, Z-pak, Clarithromycin
• Effective to penetrate lung tissue
• Spectrum similar to penicillins