This document summarizes a presentation on bioterrorism. It begins with defining bioterrorism as the intentional release of pathogens to harm people, livestock or crops. It then provides a brief history of bioterrorism from ancient times to modern examples. It classifies biological agents into categories A, B and C based on their ability to cause harm. It discusses the challenges of bioterrorism for public health and strategies for preparedness, including surveillance, communication and stockpiling medical resources.
Bioterrorism is using living organsims as weapons of mass destruction or to cause panic in population. it has existed since ancient times and yet pose a potential future threat. this compilation is not exhaustive and contains references at the end for further reading
Bioterrorism is using living organsims as weapons of mass destruction or to cause panic in population. it has existed since ancient times and yet pose a potential future threat. this compilation is not exhaustive and contains references at the end for further reading
This presentation focuses on a short history of bioterrorism, description, its advantages and disadvantages and organisms incorporated into weapons are also shown here.
Introduction to bioterrorism , history of bioterrorism, key features of biological agents used as bioweapons, biological agents and effects, bioterrorism agents, effects of biological attacks, COVID-19 used as bioweapon , technology at work, preventive measures.
biological weapons, an weapons which can kill many and that also by means of biology this may refer as silent killer as being describe in many science fiction movies like resident evil etc
“Microbial forensics” has been defined as “a scientific discipline dedicated to analyzing evidence
from a bioterrorism act, biocrime, or inadvertent microorganism/toxin release for attribution
purposes” (Budowle et al., 2003). This emerging discipline is still in the early stages of
development and faces substantial scientific challenges to provide a robust suite of technologies
for identifying the source of a biological threat agent and attributing a biothreat act to a particular
person or group. The unlawful use of biological agents poses substantial dangers to individuals,
public health, the environment, the economies of nations, and global peace. It also is likely that
scientific, political, and media-based controversy will surround any investigation of the alleged
use of a biological agent, and can be expected to affect significantly the role that scientific
information or evidence can play. For these reasons, building awareness of and capacity in
microbial forensics can assist in our understanding of what may have occurred during a biothreat
event, and international collaborations that engage the broader scientific and policy-making
communities are likely to strengthen our microbial forensics capabilities. One goal would be to
create a shared technical understanding of the possibilities—and limitations—of the scientific
bases for microbial forensics analysis._ NCBI
A biological attack, or bioterrorism, is the intentional release of viruses, bacteria, or other germs that can sicken or kill people, livestock, or crops. Bacillus anthracis, the bacteria that causes anthrax, is one of the most likely agents to be used in a biological attack.
This presentation focuses on a short history of bioterrorism, description, its advantages and disadvantages and organisms incorporated into weapons are also shown here.
Introduction to bioterrorism , history of bioterrorism, key features of biological agents used as bioweapons, biological agents and effects, bioterrorism agents, effects of biological attacks, COVID-19 used as bioweapon , technology at work, preventive measures.
biological weapons, an weapons which can kill many and that also by means of biology this may refer as silent killer as being describe in many science fiction movies like resident evil etc
“Microbial forensics” has been defined as “a scientific discipline dedicated to analyzing evidence
from a bioterrorism act, biocrime, or inadvertent microorganism/toxin release for attribution
purposes” (Budowle et al., 2003). This emerging discipline is still in the early stages of
development and faces substantial scientific challenges to provide a robust suite of technologies
for identifying the source of a biological threat agent and attributing a biothreat act to a particular
person or group. The unlawful use of biological agents poses substantial dangers to individuals,
public health, the environment, the economies of nations, and global peace. It also is likely that
scientific, political, and media-based controversy will surround any investigation of the alleged
use of a biological agent, and can be expected to affect significantly the role that scientific
information or evidence can play. For these reasons, building awareness of and capacity in
microbial forensics can assist in our understanding of what may have occurred during a biothreat
event, and international collaborations that engage the broader scientific and policy-making
communities are likely to strengthen our microbial forensics capabilities. One goal would be to
create a shared technical understanding of the possibilities—and limitations—of the scientific
bases for microbial forensics analysis._ NCBI
A biological attack, or bioterrorism, is the intentional release of viruses, bacteria, or other germs that can sicken or kill people, livestock, or crops. Bacillus anthracis, the bacteria that causes anthrax, is one of the most likely agents to be used in a biological attack.
Major agents and their characteristics which has beenChandrani Goswami
Biological weapon, also called germ weapon
“Any of a number of disease-producing agents such as bacteria, viruses, rickettsia, fungi, toxins, or other biological agents that may be utilized as weapons against humans, animals, or plants”.
Bioterrorism
Introduction
Bioterrorism is the intentional or threatened use of viruses, bacteria, fungi, or toxins from living organisms to produce death or disease in humans, animals or plants to accomplish political or social objectives. Agents of bioterrorism can be altered or mutated in such a way soas to increase their virulence and ability to cause disease. They can be engineered to resist current medications. They can be spread through air, food, water, fomites, or through infected hosts (including humans, animals, insects, and other reservoirs)
Defecation
Normal defecation begins with movement in the left colon, moving stool toward the anus. When stool reaches the rectum, the distention causes relaxation of the internal sphincter and an awareness of the need to defecate. At the time of defecation, the external sphincter relaxes, and abdominal muscles contract, increasing intrarectal pressure and forcing the stool out
The Valsalva maneuver exerts pressure to expel faeces through a voluntary contraction of the abdominal muscles while maintaining forced expiration against a closed airway. Patients with cardiovascular disease, glaucoma, increased intracranial pressure, or a new surgical wound are at greater risk for cardiac dysrhythmias and elevated blood pressure with the Valsalva maneuver and need to avoid straining to pass the stool.
Normal defecation is painless, resulting in passage of soft, formed stool
CONSTIPATION
Constipation is a symptom, not a disease. Improper diet, reduced fluid intake, lack of exercise, and certain medications can cause constipation. For example, patients receiving opiates for pain after surgery often require a stool softener or laxative to prevent constipation. The signs of constipation include infrequent bowel movements (less than every 3 days), difficulty passing stools, excessive straining, inability to defecate at will, and hard feaces
IMPACTION
Fecal impaction results from unrelieved constipation. It is a collection of hardened feces wedged in the rectum that a person cannot expel. In cases of severe impaction the mass extends up into the sigmoid colon.
DIARRHEA
Diarrhea is an increase in the number of stools and the passage of liquid, unformed feces. It is associated with disorders affecting digestion, absorption, and secretion in the GI tract. Intestinal contents pass through the small and large intestine too quickly to allow for the usual absorption of fluid and nutrients. Irritation within the colon results in increased mucus secretion. As a result, feces become watery, and the patient is unable to control the urge to defecate. Normally an anal bag is safe and effective in long-term treatment of patients with fecal incontinence at home, in hospice, or in the hospital. Fecal incontinence is expensive and a potentially dangerous condition in terms of contamination and risk of skin ulceration
HEMORRHOIDS
Hemorrhoids are dilated, engorged veins in the lining of the rectum. They are either external or internal.
FLATULENCE
As gas accumulates in the lumen of the intestines, the bowel wall stretches and distends (flatulence). It is a common cause of abdominal fullness, pain, and cramping. Normally intestinal gas escapes through the mouth (belching) or the anus (passing of flatus)
FECAL INCONTINENCE
Fecal incontinence is the inability to control passage of feces and gas from the anus. Incontinence harms a patient’s body image
PREPARATION AND GIVING OF LAXATIVESACCORDING TO POTTER AND PERRY,
An enema is the instillation of a solution into the rectum and sig
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Stewardship is the act of taking good care of something.
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
WHO launched the Global Antimicrobial Resistance and Use Surveillance System (GLASS) in 2015 to fill knowledge gaps and inform strategies at all levels.
ACCORDING TO apic.org,
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
ACCORDING TO pewtrusts.org,
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According to WHO,
Antimicrobial stewardship is a systematic approach to educate and support health care professionals to follow evidence-based guidelines for prescribing and administering antimicrobials
In 1996, John McGowan and Dale Gerding first applied the term antimicrobial stewardship, where they suggested a causal association between antimicrobial agent use and resistance. They also focused on the urgency of large-scale controlled trials of antimicrobial-use regulation employing sophisticated epidemiologic methods, molecular typing, and precise resistance mechanism analysis.
Antimicrobial Stewardship(AMS) refers to the optimal selection, dosing, and duration of antimicrobial treatment resulting in the best clinical outcome with minimal side effects to the patients and minimal impact on subsequent resistance.
According to the 2019 report, in the US, more than 2.8 million antibiotic-resistant infections occur each year, and more than 35000 people die. In addition to this, it also mentioned that 223,900 cases of Clostridoides difficile occurred in 2017, of which 12800 people died. The report did not include viruses or parasites
VISION
Being proactive
Supporting optimal animal and human health
Exploring ways to reduce overall use of antimicrobials
Using the drugs that prevent and treat disease by killing microscopic organisms in a responsible way
GOAL
to prevent the generation and spread of antimicrobial resistance (AMR). Doing so will preserve the effectiveness of these drugs in animals and humans for years to come.
being to preserve human and animal health and the effectiveness of antimicrobial medications.
to implement a multidisciplinary approach in assembling a stewardship team to include an infectious disease physician, a clinical pharmacist with infectious diseases training, infection preventionist, and a close collaboration with the staff in the clinical microbiology laboratory
to prevent antimicrobial overuse, misuse and abuse.
to minimize the developme
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2. Plan of presentation
• Definition
• History of bioterrorism
• Features of bioweapons
• Classification of bio-warfare agents
• BT and public health
• Challenges
• Anti BT preparedness.
• References
3. Definition
• Intentional release of viruses, bacteria, fungi, or other
germs that can sicken or kill people, livestock or
crops.
Centers for Disease Control and Prevention (CDC)
4. HISTORY
Ancient:
• 184 BC: in a naval battle between Hannibal and king
Eumenes II of Pergomon, former hurled earthen pots
filled with poisonous snake.
•6th
century BC:
– the poisoning of water supplies in the with the
fungus Calviceps purpurea (rye ergot) by the
Assyrians.
– Siege of Krissa: Solon, poisoned water supply with
hellebore.
5. Medieval age:
• 1346 AD: Siege of Kaffa- hurling of the dead bodies
of plague victims over the walls of the city of Kaffa
by the Tartar army.
• 1422 AD: The battle of Karlstein- catapulted plague
stricken soldiers and 2000 cartloads of excreta.
• 15th
century: Pizzarro gifted the native Americans
clothing infested with smallpox virus.
• 1760: Sir Jeffery Amherst distributed smallpox
infested blankets and handkerchief to native Indians
during France and India war.
Microsoft
PowerPoint 97-2003 Slide Show
6. Modern age
• 1924 AD: Germany weaponised anthrax and
Pseudomonas mallei (glanders), and used them on
cattles, horses etc.
• 1932 AD: Japanese invaded Manchuria under Shiro
Ishii. Established a lab there by the name of “Unit-
731” where they tested for the lethality of
bioweapons on Chinese prisoners for war.
• They also dropped plague infested fleas over China
leading to several deaths.
7. • 1979: The accidental release of spores into the
atmosphere from a Soviet Union bioweapons
facility in Sverdlosk
• 1993 AD: The release of anthrax spores by the
Aum Shrinrikyo cult in Tokyo in 1993.
8. Key Features of Biologic Agents Used as
Bioweapons
• Highly infectious.
• Aerosolized
• Readily grown and produced
• Stable on storage
• Resistant to climate change.
• Resistant to conventional antibiotics and treatment.
11. Viral agents
•Viral encephalitis
– alphaviruses (e.g., Venezuelan, eastern, and
western equine encephalitis)
Toxins
•Ricin toxin from Ricinus communis (castor beans)
•Staphylococcal enterotoxin B
Category C agents
•Peolple lacks immunity.
•Could be genetically engineered for mass destruction
•SARS, Nipah and hanta virus.
12. Bioterrorism and public health
• Early detection through surveillance/ rapid
assessment of reports
• Mobilize laboratory
• Rapid confirmation of agent, site, initial at-risk
population, prophylaxis and/or treatment
• Alert medical community, ER team, labs
• Implement disease specific plans (e.g. Smallpox)
• Determine resource needs and possible quarantine
• Coordinate with partner agencies
(local/state/national/international)
13. Continued…..
• Closely monitor communication network for new
information
• Provide, accurate, timely information to public
• Continue epidemiologic investigation to refine at risk
population
• Assess environmental contamination
• Provide or coordinate testing/ prophylaxis/ treatment
to at-risk population
• Access biological stockpiles as necessary
14. Global Outbreak Alert and Response
Network :GOARN
• Head quarter: Geneva
• There are 200 technical institution worldwide that
respond to acute public health events.
• Objectives:
1. Provides international public health resources to
control outbreak and public health emergencies.
2. Networking international resources to save lives.
3. Connecting health resources for better health outcome.
15. GOARN: Recent activities
• Outbreak (2 pregnant and 1 elderly) of zika virus
were reported between february 2016 to january 2017
in Bapunagar Ahmedabad, Gujarat. WHO confirmed
it on may 15th
2017.
• WHO dispersed 3.5 million doses of yellow fever
vaccine in response to a outbreak in Brazil. (10th
april
2017)
• Uptil 10th
march 2017 national health and family
planning commission of China (NHHPC) notified
1307 cases of avian influenza (H7N9).
16. Challenges
• Large geographical area/mobile population
Real-time reporting & mapping applications
communication strategy focusing on effective use of
news media
• Early signs/symptoms nonspecific
Provider education through multiple means
17. • Medical and laboratory communities not
familiar with rare BT diseases
establish syndromic surveillance
provide training to increase awareness
enhance collaboration between medical
community and Public Health
18. Anti BT preparedness
1. Community level:
a)Co-ordination between firearm and policemen.
b)Schools, temples etc can be used as a relief
point.
c)Public support: dispensing drugs, mobilize
others for vaccination, surveillance of disease.
2. Staff preparedness:
a)Increase number of staff- increase working
hours, supplemental calling.
b)Training: audio video tapes, paintings, and web
based knowledge
19. Contd….
3. Communication preparedness:
a)External communication: Accurate, non-
confusing and non-contradictory messages
should be delivered so that no false message
spread in the community and thus panic can be
avoided.
b)Internal communication : Intradepartmental
communication in hospital.
4.Government policy: Manage road and transport
system, water supply.
Increase number of beds in the hospital.
20. Contd….
• Bioterrorism act can be passed (like America)
• Toll free no. for 24*7 support.
• Point of dispensing of drugs, food, water can be
created beforehand.
• Real time Outbreak Disease Surveillance (RODS)
like software can be generated.
PPT File
PPT File
21. References
• Park K. Park’s textbook of preventive and social
medicine. 23rd
ed. Jabalpur: M/s Banarsidas Bhanot;
2015.
• Ray T.K. Bioterrorism a public health challenge. 1st
ed. Bangalore: Ahuja Publishing House; 2010.
• Sunder L, Adarsh, Pankaj. Textbook of community
medicine preventive and social medicine. 4th
ed. New
Delhi: CBS Publishers &Distributors Pvt Ltd;2014.
22. • National Health Portal [internet]. [updated Feb 5 2016; cited
May 25, 2017]. Available from
https://www.google.com/url?q=https%3A%2F%2Fwww.nhp.gov.in
• Bioterrorism and millitary health risk[internet].[updated
january 25 2003; cited May 25, 2017]. Available from
http://www.google.com/url?q=http%3A%2F%2Fwww.who.int%2F
23. • Paul John. Three zika virus cases reported in Ahemdabad
since january. New York Times. May 27 2017 [internet].
Available from http://www.google.com/url?q=http%3A%2F
%2Fm.timesofindia.com%2Fcity%2Fahmedabad%2Fwho-
confirms-indias-1st-zika-virus-cases-in-ahmedabad
%2Farticleshow%2F58876030.cms%3Futm_source
%3Dtoiiphoneapp%26utm_medium%3DSms
%26utm_campaign
%3Dshow&sa=D&sntz=1&usg=AFQjCNEO2wzCZIRMKRv
oYP3UcHTuSoS78Q
• American anthrax outbreak of 2001.UCLA department of
epidemiology fielding of school and public health [internet].
[updated may 03 2002; cited May 26, 2017]. Available from
http://www.google.com/url?q=http%3A%2F%2Fwww.ph.ucla.edu%
24. • Zika virus fact sheet. WHO [internet]. [updated sept 6,2016;
cited may 15, 2017]. Available from
http://www.google.com/url?q=http%3A%2F%2Fwww.who.int
%2Fmediacentre%2Ffactsheets%2Fzika%2Fen
%2F&sa=D&sntz=1&usg=AFQjCNFLjrHDt8K2RBtTukqGzk
pr_Ie5fA
• United States of America, disease outbreak news. WHO
[internet]. [updated feb 20,2017; cited may 15, 2017].
Available from http://www.google.com/url?q=http%3A%2F
%2Fwww.who.int%2Fcsr%2Fdon%2Farchive%2Fcountry
%2Fusa%2Fen
%2F&sa=D&sntz=1&usg=AFQjCNGlUA4n_cQnJpulASlTm
EutgevQuA
25. • Anthrax: Public health response plan for Australia, Disease
containment. The Department of Health[internet]. [updated
december 5,2012; cited may 17, 2017]. Available from
http://www.google.com/url?q=http%3A%2F
%2Fwww.health.gov.au%2Finternet%2Fpublications
%2Fpublishing.nsf%2FContent%2Fohp-anthrax-toc~ohp-
anthrax-05-
disease&sa=D&sntz=1&usg=AFQjCNEjXZo2vwPFVZvVef
MmVWgob17A-A
• The smallpox eradication programme-SEP (1966-1980)
WHO [internet]. [updated may 2010; cited may 17, 2017].
Available from http://www.google.com/url?q=http%3A%2F
%2Fwww.who.int%2Ffeatures%2F2010%2Fsmallpox%2Fen
%2F&sa=D&sntz=1&usg=AFQjCNHVfJuJP6hNgXoQn9UM
1A3UnWqVZQ
26. • Epidemiological aspect of smallpox in Yugoslavia in 1972. WHO
[internet]. ]. [updated may 10, 1973; cited may 17, 2017].
Available from https://www.google.co.in/url?
url=http://apps.who.int/iris/bitstream/10665/67617/1/WHO_SE_73
.57.pdf&rct=j&sa=U&ved=0ahUKEwjYr9iLx5LUAhVFrY8KHa
D2CWAQFghfMAk&sig2=TgLIJHoVNg6QcW7ztKdK5g&q=yug
oslavia+smallpox+outbreak&usg=AFQjCNF3UDQe6fbzcBC6452
QDDNiPfl3tQ
