View stunning SlideShares in full-screen with the new iOS app!Introducing SlideShare for AndroidExplore all your favorite topics in the SlideShare appGet the SlideShare app to Save for Later — even offline
View stunning SlideShares in full-screen with the new Android app!View stunning SlideShares in full-screen with the new iOS app!
BIOTERRORISM AND VETERINARY PUBLIC HEALTH Dr. Shahnawaz ahmad I.V.R.I Div. Of Surgery
Definition of Bioterrorism Bioterrorism is the threat of use of biological agents by individuals or groups motivated by political, religious, ecological, social or for other ideological objectives to inculcate fear or cause illness or death in order to achieve their objectives (Carus 1998).
According to the United States Centers for Disease Control and Prevention (CDC) a bioterrorism attack is the deliberate release of viruses, bacteria or other germs (agents) or toxins used to cause illness or death in people, animals or plants .
1932-45, Manchuria: Japanese military physicians infected 10,000 prisoners with biological agents ( B. anthracis, N. meningitidis, Y. pestis, V. cholerae ) – 11 Chinese cities attacked via food/water contamination, spraying via aircraft
The Japanese army used Chinese prisoners to test bioweapons.
Reported cases of bioterrorism World war II – Polish resistance organizations used biological agents against German forces 1952 – Mau Mau, an independence movement in Kenya, used a plant toxin to poison livestock 1966 – Dr. M. Suzuki, a Japanese physician, infected health care providers and patients with S. typhi
1981 – Dark harvest groups got anthrax contaminated soil from Gruinard Island and damped it on Porton Down. 1984 – Rajaneesh in Portland, Oregon (USA) used S. thphimurium to contaminate restaurants salad bars 1995 – AUM Shinrikyo used sarin nerve gas in the Tokyo subway in Japan. 2001 - Anthrax contaminated mails sent to various people in USA
Casualties Incident Number of cases Number of deaths Polish resistance Not reported 200 Germans Mau Mau Not reported 33 head of cattle Dark Harvest None None Rajaneesh 751 (45 Hospitalized No deaths AUM Shrinkyo 5500 (641 seen at SJIH on day I & 349 following week 106 hospitalized at SLIH, 12 deaths ( 2 at SLIH) Dr. Suzuki 200 4 deaths Anthrax (USA) 22 4 deaths
Motive for Bioterrorism Incident Motive Polish resistance Resistance against foreign occupation Mau Mau Resistance against colonialism Dark Harvest Send a political message Rajneesh Win a local election by incapacitating the non-Rajneeshees voters AUM Shrinkyo Seize control of Japan through mass murder causing fear and apprehension Dr. Suzuki Revenge for unfair treatment he received at the medical training Anthrax (USA) Inculcate fear
THREAT TO ECONOMY The terrorists have an option to use exotic organisms to spread disease in animals and plants. Imagine somebody spread Foot and Mouth disease, Glanders, VEE, Rinderpest, Brucellosis, Swine fever, Fowl plague, Rabies and so on.
Place contaminated clothes in impervious bag, wear PPE
Decontaminate environmental surfaces with EPA approved
germicidal agent or 0.5% bleach (1:10 dilution)
Bioterrorism agents: Laboratory risk Agent BSL Laboratory Risk B. anthracis 2 low Y. pestis 2 medium F. tularensis 2/3 high Brucella spp . 2/3 high Botulinum toxin 2 medium Smallpox 4 high Viral Hemorrhagic fever 4 high
INHALATION ANTHRAX, US Prominent superior mediastinum, ?small left pleural effusion B. ANTHRACIS : PERIPHERAL BLOOD SMEAR
Cutaneous Anthrax, US 7 mo male infant hospitalized with 2 day history of swelling left arm and weeping lesion at left elbow. Patient had been at his mother’s office at a TV network. Biopsies yielded B. anthracis.
Direct contact with infected tissue and body fluids or contaminated objects
Probably aerosol inhalation
Borio, et al JAMA consensus statement 2002 Maculopapular Rash in Marburg Disease Ocular Manifestations in Bolivian Hemorrhagic Fever
Psychological and Social Factors during bioterrorism
Magical thinking about microbes
Fear of invisible agents Fear of contagion
Anger at Terrorist/Government
11. Loss of faith in social institutions
12. Attribution of arousal symptoms to infection
MANAGEMENT OF PEOPLE WITH PSYCHOLOGICAL PROBLEMS
care of health workers
Critical incidence stress management (CISM) for rescue workers
Prevention of public fleeing
Confidence building by the medical workers
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)
8.Prevention of group panic 9. Avoidance of emotion based responses (Knee jerk quarantine) 10. Effective risk communication 11. Control of symptoms secondary to hyper arousal 12. Reassurance 13. Management of anger fear (Diazepam and other anxiolytic drugs) 14. Provision of respite as required 15. Social support of the community
New diseases have also appeared within the developed nations including United States. Some of these include:
New variant of Creutzfeldt -Jakob disease
West-Nile virus disease
Hantavirus pulmonary syndrome (HPS)
Multi-drug resistant TB,
Antibiotic resistant staphylococcal, enterococcal and pneumococcal infections
Diarrhoeal diseases caused by the parasite Cryptosporidium parvum and then certain strains of Escherichia coli bacteria.
Factors contribute to the emergence and re-emergence of infectious diseases 1. Unprecedented worldwide population growth draining the natu ral resources 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 nature 7. Man-made changes to the environment and climatic changes which have a direct impact on the population of insect vectors and animal reservoirs. 7. Misuse of antibiotics leading to the evolution of resistant microbes.
Impact of biological agents on national economies
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.