BIOLOGICAL TERRORISM AND SECURITY

EMD545b

Lecture #9

Biological TerrorismIntentional or threatened release of viruses, bacteria, fungi or toxins derived from living organisms to produce disease or death in humans, animals, or plants

Outline• Historical events

• Potential agents of bioterrorism

• Means of delivery

• Monitoring and detection

• Hazardous materials/emergency response

• Security issues

• Suspicious materials

• Discussion and comments

Historical Events

6th Cent. BC: Rye ergot, plant toxins

1300’s: Plague-infected corpses catapulted into defenders during Siege of Kaffa

1500’s: Strategic value of smallpox-laden blankets during Spanish conquest of Central and

South America

1700-1800’s: Smallpox-laden blankets repeatedly traded to North American Indians

More Recent Events WW II: Japan’s Unit 731

1940’s-1969: US offensive use research

1972: Biological Weapons Convention Treaty

1978: Assassination by KGB using ricin

1979-1982: “Yellow-rain” by Soviet Army in Afghanistan

1979: Accidental Soviet anthrax release at bioweapons facility in Sverdlovsk - ca. 80 cases, 60+ deaths

Most Recent Events

1984: Purposeful Salmonella contamination of food by Oregon religious cult - 700+ cases

1995: Sarin released in Tokyo subway religious cult

12 deaths, thousands exposed

1998: Vengeful use of radiolabeled saxitoxin stolen from Brown University laboratory

2001-2002: Anthrax distribution in/on US Mail

1995 Tokyo Subway Sarin Release by Aum Shinrikyo

Why BioWeapons?

• Fear and hysteria

• Overwhelm medical resources

• Can be lethal or cause severe incapacitation

• Delayed effects (but acute from toxins)

• Relatively easy to obtain, produce, and use

• Potential for secondary infections

• Multiple routes for exposure

• Compared to chemical and nuclear materials:– Very difficult to detect in field

The Perfect BW

• Highly pathogenic/toxic

• Highly infectious

• Incapacitation may be preferable to lethality

• Symptoms confused with non-BW diseases

• Transmissible by desired route of exposure

• Stable for packaging and delivery

• Easily harvested, selected, or created

• Vaccination/treatment only available to aggressor

Epidemiology of BW Attack

• Case chronology differences from natural epidemics

• Observations of signs/symptoms likely most sensitive surveillance means

• Reportable symptoms and diseases

Time

Factors for Disease Transmission

• Presence of pathogenic organism • Viable • Infectious dose (minimum [ ] and qty)• Susceptible host• Effective route of exposure

Potential Agents of Bioterrorism

• Bacterial agents• Viral Agents• Biological/biologically-derived toxins• Recombinant organisms

Bacterial Agents

• Single cell microscopic organisms typically with diameter 0.5 - 1.0 um

• Capable of causing disease by infection and/or producing toxins

• Spore forms often very

stable in environment

Anthrax• Bacillus anthracis (spore former)

• Cutaneous, inhalational, and ingestion forms

• Common among livestock and livestock product workers

• Spore-form very stable

• Flu-like illness, respiratory failure, shock, meningitis

• Highest CFR from inhalation (90-100%)

• Antibiotic treatment must

be early to be effective

• Vaccine available

Plague

• Yersinia pestis

• Transmitted by flea bites or aerosol droplets

• Wild rodents are natural reservoir

• Bubonic and pneumonic forms (“black death”)

• Swollen lymph nodes, rapid progressive pneumonia

• High case fatality rates

• Vaccine and antibiotic

therapies available

Tularemia

• Francisella tularensis (“rabbit fever”)• All routes of exposure, including vector• Low infectious dose• Fever, chills, headache, weight loss, pneumonia• Moderate case fatality rate untreated• Vaccine and antibiotic therapies

Brucellosis

• Brucella spp. (abortus, melitensis, ovix, others)• Zoonotic, primarily from infected mammals and

contaminated milk/other dairy products• Highly infectious by aerosolization• Variable symptoms, but many “flu-like”

Viral Agents

• Very small particles (ca. 0.02 - 0.2 um diameter)

• Not truly “living”

• Outer shell and DNA or RNA, but no organelles for metabolism or reproduction

• Rely exclusively upon host

cells - “parasites”

• Typically very short lived

outside of host or vector

Smallpox• Variola major

• Highly contagious by aerosols

• Moderately high case fatality rate (~30%)

• Incapacitating malaise, fever, vomiting, lesions and pustules

• WHO initiative claims eradication (except for stored specimens in US and Russia)

• Quarantine essential

• Vaccine available

Viral Equine Encephalites

• Venezuelan, Western, and Eastern

• Vector & aerosol transmission (vector primary in nature)

• Fever, headache, malaise, nausea/vomiting, neurological damage from encephalitis

• Highly incapacitating, high lethality

(CFR for EEE 50 - 75%)

• Experimental vaccines

• Palliative care only

Viral Hemorrhagic Fevers• e.g., Marburg, Ebola, Congo-Crimean

• BL4 agents

• Poorly understood, difficult to work with

• Arthropod vectors, contact, possible aerosol routes

• Natural epidemics with severe consequences - marked by fever, malaise, headache, internal hemorrhaging, multi-organ failure

• Seriously incapacitating

• Very high CFRs: 25 - 90%

• Palliative care only

Biological Toxins

• Any toxic substance or compound produced by an animal, plant, or microorganism

• Typically high MW proteins or toxic chemicals

• Hazardous by most routes of exposure - contact facilitated by dermal penetrants like DMSO

• Range of effects from tissue necrosis to nervous system interruption

• Most are readily inactivated by heat, steam, or common chemicals

Comparative Toxicity

Agent LD50 (ug/kg) Source

Botulinum toxin 0.001 Bacterium

Tetanus toxin 0.002 Bacterium

Diptheria toxin 0.10 Bacterium

Ricin 3 Plant (Castor bean)

a-Conotoxin 5 Cone snail

Saxitoxin 10 Marine dinoflagellate

Sarin 100 Chemical/nerve agent

T-2 toxin 1,210 Fungal mycotoxin

Delivery and Release

• Acquisition/production in sufficient quantity/concentration to achieve desired outcome

• Stability under storage conditions • Packaging • Actual delivery and release• Exposure

Routes of Exposure

• Airborne - inhalational

• Food/water supplies - ingestion

• Contact - dermal

• Vector - percutaneous

Sources of BW Agents

• Field, clinical, and veterinary samples

• Type culture collections

• Commercial distributors

• Foreign laboratories and suppliers

• Museums and universities

• Genetically engineered (rDNA) or selected

Monitoring and Detection• Comparison vs. chemical, explosive, and radioactive

• Medical signs and symptoms - healthcare providers become first line of surveillance

• Laboratory analysis– Antibody titers

– Cultures

– DNA fingerprinting

• Field tests

• Future/emerging methods (GC/MS, semi-conductors)

HAZWOPER

• OSHA standard (29 CFR Part 1910.120)• “Hazardous waste operations and emergency

response”• Comprehensive requirements for written safety

programs, training, protective equipment, field exercises, medical surveillance, and at least annual re-certifications

HAZWOPER/Emergency Response

• First responders• Incident commander and IC system• Site/scene health and safety officer• Technician-level responders• Potential crime scene investigation issues• Other specialists as-needed

HAZWOPER/Emergency Response

• All-hazards approach – Biological, chemical, and radiological

• Site/perimeter controls• Work zones• Decontamination systems

Knowledge and Information • Incident/facility information • Eyewitnesses critical• On-going process• Monitoring and predictions where possible• Weather and local environmental factors

HAZMAT Ensemble Levels

D Safety shoes and glasses/goggles, work gloves, and work clothing

C Above plus more enclosing garments, and air purifying respirator

B Above plus even more enclosing garments, and upgrading of respiratory protection to self-contained breathing apparatus (SCBA)

A Fully encapsulating garments, SCBA

Low

High

HAZMAT Ensembles

A

BC

D

Key Selection Factors for Protective Clothing

• Contaminants and concentration• Consequences of equipment failure• Permeation/penetration resistance• Anticipated duration of use• Exposure type (e.g., incidental contact, immersion)

• Anticipated work activities (e.g., dexterity, tactility)

• Cost, size, availability, manufacturer’s differences

Personal Protective Equipment • Low on controls hierarchy• Advantages• Disadvantages

– No one ensemble

– Selection criteria

– Training

– Formal “fitting” process

– Maintenance and inspection

– Periodic review

Medical Interventions

• e.g., pre-exposure immunizations, blocker administration, and immediate post-exposure treatment

• Excellent protection but for only very limited suite of exposures

• Duration of protection highly variable• Potential contraindications of treatment• Timing of administration critical

Biosecurity Issues• “Select Agents” transfer rule • Revisions now include “possession”• Basic requirements:

– Registration of entity and individuals possessing, using, storing, etc. “select” biological agents and toxins

– Inventory controls

– Physical security of storage and use

– Periodic inspections

– Emergency procedures and notifications

– Individual background/security clearances

Related Security Issues

• Building perimeter controls and access• Public vs. non-public areas • Mechanical equipment and HVAC intakes

– Collateral benefits of modern filtered HVAC systems

• Identify and report strangers/suspicious persons

Suspicious Materials

• Mail, packages, objects

• Return address, condition, and appearance (leaking, discoloration, odor, etc)

• Expected or unexpected? Verify source if possible.

• Follow recommended procedures.

???

Sources for More Information

• US Government:

Occupational Safety and Health Administration

Nuclear Regulatory Commission

National Institute for Occupational Safety and Health

Centers for Disease Control and Prevention

Federal Emergency Management Agency

Federal Bureau of Investigation/Department of Justice

• Advisory Groups:

American Biological Safety Association

American Industrial Hygiene Association

American and International Red Cross

Discussion and Comments