definition#agents#history#phases #covid 19

1. BIOTERRORISM AND
EMERGING INFECTIOUS
DISEASES(COVID 19)
DR Y L S

2. BIOTERRORISM
Bioterrorism is the intentional release or threat of
release of biologic agents (i.e. viruses, bacteria, fungi
or their toxins) in order to cause disease or death
among human population or food crops and livestock
to terrorize a civilian population or manipulate the
government.

4. MEANS OF TERRORISM
4 physical means of terrorism:
 Conventional Weaponare
 Biological
 Chemical
 nuclear

5. KEY FEATURES OF BIOLOGICALAGENTS
USED AS BIOWEAPONS
• Cause morbidity and mortality
• Disrupt health services
• Induce fear in the population
• Disrupt society
• Force change of govt / govt policies
• Potential to spread from person to person
• Low infective dose and highly infectious by aerosols
• Potential to cause anxiety
• Lack of rapid diagnostic capability and effective
vaccine

6. Why are they used???
• Can easily disseminate
and cause wide spread
fear and panic.
• They are relatively easy
and inexpensive to
obtain.
• They can cause wide
spread damage to
economy of the country
eg-foot and mouth
disease.

12. POTENTIALAGENTS TO CAUSE
BIOTERRORISM
 Easily available from other laboratories / easily
prepared from local materials
 Safe to generate and weaponize
 Easily and safely disseminated as an aerosol -1-5 mm
particles
 Long lasting and stable in the environment to prolong
infectivity
 Contagious secondary spread.

13. • High infectivity, virulence and mortality rate.
• No effective treatment of those with clinical disease.
• No effective prophylaxis for infected, asymptomatic
people.
• Requires special actions for public health agencies.

14. • At times prompt identification or
distinction between a bioterrorist attack
and natural disease outbreak may be
difficlt.
• The important prophylactic
drugs/vaccines may not be available during
a bioterrorist attack or have limited shelf
lives and cannot be stockpiled.
• Even today, at least 17 countries are
known to have a biological weapons
program.

15. The bioterrorist agents with highest priority are
the causes of
• Anthrax (Bacillus anthracis)
• Botulism(Clostridium botulinum)
• Plague (Yersinia pestis)
• Smallpox (variola major)
• Tularaemia (Francisella tularensis)
• Viral haemorrhagic fevers (filoviruses and arena viruses).

18. BIOLOGICAL DELIVERY METHODS
• Food /water
• Aircraft sprayers
• Vehicle sprayers
• Hand sprayers
• Human vectors
• Animal vectors
• Air handling systems

19. Is it really a bioterrorism???
• Outbreak of a rare disease
• Seasonal disease at wrong time
• Unusual distribution of age
• Unusual clinical symptoms
• Unusual epidemiological features
• Outbreak in region/geographic location where it is
nit normally seen

20. • IDENTIFICATION OF THE EVENT
• Any small or large outbreak of disease should be
evaluated as a potential bioterrorist attack.
• Doctors in hospital out patient departments (OPDs),
private.
• Practioners and family physicians could play a vital
role in the initial recognition of a potential
bioterrorism attack.

21. • The first to notice could be a hospital laboratory
seeing unusual strains of organisms
• an epidemiologist keeping track of hospital
admissions
• even pharmacists distributing more antibiotics than
usual.

22. "SYNDROME SURVEILLANCE"
• Syndrome surveillance has been used for early
detection of outbreaks to follow the size, spread and
tempo of outbreaks, to monitor disease trends and to
provide reassurance that an outbreak has not
occurred.

23. BIOWATCH
• Environmental monitoring
program managed in
coordination with the CDC
,EPA US security.
• Uses air samples to test for
aerosolized biological
agents.
• Rapid detection to minimize
morbidity and mortality.

24. • A single diagnosed or strongly suspected case of
smallpox, inhalational anthrax, cutaneous anthrax ,viral
hemorrhagic or more than one case of pneumonic plague,
pneumonic tularaemia (with at least one laboratory
confirmed case, no known compatible risk factors and
occurring in a brief time period)
• A higher than expected number of unexplained morbidity
and mortality in a brief time period within a defined
geographic region should point towards possibility of a
bioterrorist attack.

25. PREPAREDNESS PHASE
Include evaluation of the laboratory facilities.
• Evaluating the hospital preparedness in emergency
response and case management in case of an
imminent attack.
• conduct training of health professionals.
• Rapid response team (RRT) and quick response
medical team (QRMT).
• organize mock drills.
• prepare contact details.

26. EARLY WARNING PHASE
• surveillance system includes activities like
• case definitions
• notification
• compilation and interpretation of epidemiological
data.

27. NOTIFICATION PHASE
• Rapid epidemiological investigations.
• Quick laboratory support for confirmation of
diagnosis.
• quarantine
• isolation
• keeping health care facilities geared for impending
casualty management and evolving public health
facilities for control.

28. RESPONSE PHASE
• Activities include
• Rapid epidemiological investigation
• Quick laboratory support
• Mass casualty management
• Initiation of preventive, curative and specific control
measures for containing the further spread of the
disease.

29. In order to achieve them, following steps can
be followed
• (i) Assess the situation: in terms of time, place and
person distribution of those affected
• Routes of transmission
• Its impact on critical infrastructure and health
facilities
• The agencies and organizations involved in
responding to the event
• Communicate to the public health responders for
event management etc.

30. ii)Contact key health personnel:
• Contact and coordinate with personnel within the
health department that have emergency response
roles and responsibilities.
• Record all contacts and follow-up actions.

31. • (iii) Develop action plan:
• Develop initial health response objectives that are
specific, measurable and achievable. Establish an
action plan based on the assessment of the situation.
• Assign responsibilities and record all actions

32. • IV)Implementation of the action plan
• Disease incidence, collect samples.
• Hospitals are alerted for receiving the
patients. If necessary tented hospitals are set
up.
• Methods to control the disease and
quarantinemeasures are instituted.
• Once the disease is identified, treatment
protocols are sent to all concerned by the
fastest possible means.

33. • Standard operating procedures (SOP) for
laboratory testing is made by the identified
laboratory and the same is sent to all the hospital
laboratories and district hospitals for
implementation.
• Laboratory reagents are distributed to the
concerned laboratories.
• Public is taken into confidence to prevent any
panic.
• The list of 'Do’s and Don’ts' are circulated through
the print and electronic media.

34. • Hospitals ensure appropriate isolation, quarantine,
waste disposal and personal protective measures.
• All contaminated clothing and equipment are
carefully disposed of by incineration.
• An impact assessment team assesses the impact of
the attacks on humans, animals and plants.

35. (E) RECOVERY PHASE
• The setbacks suffered are restored and lessons learnt
in this phase are incorporated in the future
preparedness plans.
• The damage done to the public health facilities and
the essential items utilized during the response
phase are replenished.
• Public advisories are issued regarding restoration of
normalcy.
• The RRTs compile and analyze deficiencies
experienced. The necessary modifications are then
incorporated in the contingency plan for future

36. EMERGING INFECTIOUS DISEASES
• Diseases that have newly appeared in a population or
have existed but are rapidly increasing in incidence or
geographic range.
• Ex: Escherichia Coli0157:H7
• West Nile virus
• Zika virus

37. SPILL OVER/ EVOLUTIONARY JUMP
• Transmission of a pathogen from a natural animal
host to novel host leading to infection in the novel
host.
• Ex: HIV, Ebola, yellow fever, dengue, measles, small
pox.

39. Covid-19(SARS-CoV 2)
• Earlier classified as zoonotic disease.
• So, proposed to classified as an “ emerging infectious
disease of probable animal origin”.
• Bats are natural host of diverse strains of alpha and
beta corona viruses.

44. CONCLUSION
• Bioterrorism remains a legitimate threat both from
domestic and international terrorist groups.
• Timely surveillance, awareness of syndromes
resulting from bioterrorism, epidemiologic
investigation capacity, laboratory diagnostic capacity
and the ability to rapidly communicate critical
information.

45. • Ensuring adequate supply of drugs, laboratory
reagents, antitoxins and vaccines is essential.
• Formulating and putting into practice SOPs/drills at
all levels of health care will go a long way in
minimizing mortality and morbidity in case of a
bioterrorist attack.
• National level mass awareness program should be
arranged and every person must take care of himself
and people around him.

46. REFERENCES
• Recent advances –Histopathology-edition 22;
Chapter-12.
• Robbins and cotron ,text book of pathology,
edition -10,chapter-08.