Threats,Impacts & Preparedness Of
• “...the intentional release of an
infectious particle, be it a
virus or bacterium,
from the confines of a
laboratory or medical
practice must be formally
condemned as an irresponsible
threat against the whole human
Threats (silent threats)
• Threat To Economy
• Threat To Wildlife and
• Psycho-social Factors During
• Threat To Population Size
Key elements of the threat
The who (the actor),
The what (the agent),
The where (the target),
How (the mode of attack).
THREAT TO ECONOMY
• The terrorists have an option to use exotic organisms to
spread disease in animals and plants.
• Animals Disease
• Imagine somebody spread:
• Foot and Mouth disease
• Rinderpest (infectious,viral)
• Glanders (contagious,bacterial)
• Swine fever (contagious disease of pigs and wild boar)
• Fowl plague
• Rabies and so on.
THREAT TO ECONOMY (continued)
• Similarly Plant Diseases
• Rice blast (Fungal disease)
• Late blight of potato (A Serious Disease of Potatoes and Tomatoes)
• Black Rust (fungal disease)
• Maize Rust and so on would destroy all the crops and shatter the
economy of the country.
• Eg:-Irish Potato Famine
In 1940 due to potato blast half a million people died of starvation and
half a million people migrated. It took one century for the country’s
economy to recover.
• Highly pathogenic avian influenza, Hong Kong
• The outbreak of highly pathogenic avian influenza (HPAI) type A (H5N1) in
live market chickens in Hong Kong resulted in 6 million deaths and killing
of 1.4 million birds.
Threat To Wildlife & Biodiversity
• Wildlife populations are more vulnerable to biological
terrorist attacks than are domesticated species.
• Access to free-ranging wildlife is unrestricted, chances
of a perpetrator being noticed are very low, and
wildlife disease surveillance activities are minimal in
• Bioterrorist easily spread bioweapons to wild life,due
to which extinction of species occurs.
• Due to extinction of species threat to biodiversity also
• As wild animals and plants are the key elements for
food,medicines,industries and other things.Nonavailability of these things cause much problems to
particular country being attacked.
Is distance between human and
urban wildlife necessary?
The close proximity
between humans & urban
wildlife provides a “bridge”
for the delivery of
infectious disease that
easily could be exploited
because of inadequate
disease surveillance and
monitoring of these
Psycho-social Factors during
Anger at Terrorist/Government
Panic ( anxiety )
Magical thinking about microbes
Fear of invisible agents and contagion
Loss of faith in social institutions
Attribution of arousal symptoms to infection
MANAGEMENT OF PEOPLE WITH
• Care of health workers.
• Confidence building by the medical workers.
• Critical incidence stress management (CISM) for rescue
• Dealing with emotional and psychological problems while
dealing with the dead.
• Care of emergency workers, medical and paramedical workers
• Critical incidence of stress debriefing(CSID)
Threat To Population Size &
• Due to lethal bioweapons,death rate increases
and population size of particular area
• Along with targting,other organism also
affected by bioterrorism.
Regulating environmental and agricultural conditions to
Limiting access to certain biological agents.
Improving intelligence to uncover plans for biological or
Health care provider training and education to improve
Enhanced surveillance & epidemiology to detect
improved laboratory capabilities
establishment of response plans,
regular drills or exercises of those plans
regional and interagency coordination and
medical capacity for decontamination, immunization,
Most of these capacities has dual use
For natural and bioterroric attacks
PREPARATION FOR BIOTERRORISM
• Familiarize medical staff with BT agents
• Incorporate into Disaster Planning
• Decontamination & Infection Control
• Communications with key agencies
• Laboratory, CDC, Police, FBI, etc.
• Contacts to obtain stockpiled supplies: antibiotics,
immune sera, vaccines, etc.
• Security preparations
• Nature of Bioterroric Weapons:
Biological weapons are
contagious,virulent,robust,difficult to detect
Public should be warn of invisible enemies
Medical professionalist back to school
Is this the real thing?
Indications of a bioweapon attack
• A rapidly increasing disease incidence (e.g., within hours or
days) in a normally healthy population.
• An unusual increase in the number of people
seeking care, especially with fever, respiratory,
or gastrointestinal complaints
• The rapid outbreak of any disease
that is not indigenous to the local
area (i.e., vector-borne illness)
• Large numbers of casualties
concentrated in a certain area
or with wind direction.
• Lower attack rates among people who have
been indoors, especially in areas with filtered
air or closed ventilation systems, compared
with people who have been outdoors
• Clusters of patients arriving from a single
Even a single case may be a signal
Caused by an uncommon agent
Unusual for region, age group or season
Fulminant(sudden) disease in otherwise healthy patient
Similar genetic type of agent from distinct source
Unusual, atypical, genetically engineered, or
Atypical aerosol, food, or water transmission
Concurrent animal disease
• Biosurveillance is the science of real-time
disease outbreak detection”.
• Made its debut in 1999. This collects data
from labs,hospitals, and environmental
studies in order to detect bioterror attacks as
early as possible.
• Detection system
• RODS (Real-Time Outbreak Disease
Detecting the existence of a threat
• Electronic Chips
• Tiny electronic chips that would contain living nerve cells to warn of
the presence of bacterial toxins (identification of broad range
• Fiber-optic tubes lined with antibodies coupled to light-emitting
molecules (identification of specific pathogens, such as anthrax,
• Ultraviolet Avalanche Photodiodes(New research )
• Ultraviolet avalanche photodiodes offer the high gain, reliability and
robustness needed to detect anthrax and other bioterrorism agents
in the air.
• biodetectors molecular identification
WHAT WE NEED TO
PREPARE FOR BIOTERRORISM
• More trained epidemiologists
to speed detection
• Increased laboratory capacity
• Health Alert Network
• SPECIAL PROBLEMS WITH BIOTERRORISM
• Specialized labs needed
• for some agents
• • Risks to laboratory workers
• • Limited resources
• • Communication
WHAT TO DO IF YOU SUSPECT A
• Hospital Infection Control
• Isolation: Smallpox,
• Hospital Administration
• Local Public Health
HOW CAN HOSPITALS PREPARE?
• Familiarize medical staff and lab with bioterrorist
threat and agents
• • Incorporate BT planning into disaster planning
• • Infection control
• • Notification procedures and contact numbers
• • Daily surveillance and reporting
• • Security preparations
• • Media
• • Personal Protective Equipment (PPE)
Role of Clinicians & Labs
Be prepared to diagnose and treat BT diseases
Keep alert to unusual disease patterns
Use reportable disease system to alert
Health officials of a potential problem
Get involved in disaster planning process
Labs should work on
advanced detection systems to detect
identify at-risk areas, and to
give proper Treatment
• Forensic teams
• work hard to identify biological agents,
• their origins and effects
Factors contribute to the emergence and re-
emergence of infectious diseases
1. Unprecedented worldwide population growth draining the natural
2. Overcrowding in cities with poor sanitation.
3. Rapid and increased international travel.
4. Increased international trade in animals and food products.
5. Mass distribution of food and unhygienic food preparation practices
6. Increased exposure of humans to disease vectors and reservoirs in
7. Man-made changes to the environment and climatic changes which
have a direct impact on the population of insect vectors and animal
8. Misuse of antibiotics leading to the evolution of resistant microbes.
What is being done?
National Pharmaceutical Stockpile Program (NPSP) -- This resource of
medical supplies can be sent anywhere in the country within 12 hours of a
The Health Alert Network (HAN) – this organizations is developing a national
communication system on the Internet.
Health department lab preparedness -- The CDC is working with other
officials to ensure that all state health departments are equipped to test
The Association for Professionals in Infection Control and Epidemiology, Inc.
(APIC) has worked with the CDC to develop the Bioterrorism Readiness Plan
Integrated Disease Surveillance Project (IDSP), a decentralized and state-based
surveillance program, was introduced in November 2004 in India.
rural and urban
• There is incorporation of International Health Agencies (WHO, CDC, etc.).
• Its major components include
integration and decentralization of surveillance activities,
• strengthening of public health laboratories
human resource development
• Use of information technology for
collection, collation, compilation, analysis, and dissemination of data.
• The threat of bioterrorism is real. To prepare
for it, we must educate our health care team,
incorporate bioterrorism preparedness into
disaster plans, and support cooperation and
communication between the public health
department and hospitals