This presentation covers detailed information on what bioterrorism is all about.

1. Bioterrorism/biological warfare
DR. SWATI SHIKHA, MD

2. Learning objectives
 What is bioterrorism
 Historical perspectives
 Bioweapons
 Epidemiological clue of a possible bioterrorist attack
 Laboratories for detection
 Early detection systems
 Legal provisions
 Indian perspective
 Nodal agencies involved
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3. Bioterrorism
 Defined as : planned or intentional use of living organisms such as viruses, bacteria, fungi
or their toxic products to cause death, disability or disease in man, animal or plants or to
poison food and water supplies.
 Ultimate aim is to harm people, animals and plants.
 Most common mode: artificial cloud or as aerosol spray
 Other modes: catapulting, contaminating drinking water or food, through robots or other
remote control devides.
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4. Historical perspectives
 Ist used during sixth century B.C.: contamination of water supply with fungus claviceps
purpurea ( rye ergot)
 1346: hurling of dead bodies of plague victims to spread plague
 1767: Spreading of smallpox by contaminated blankets
 Yellow rain : mycotoxins(fungal toxins) used in Afghanistan
 1984: Most significant biological attack in united states was intentionl contamination of
restaurant salad bars with salmonella
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5. Phases of evolution:
 Phase 1: world war 1 – use of gaseous chemicals- chlorine and phosgene
 Phase 2: world war 2 – anthrax and plague bombs
 Phase 3: agent orange – during Vietnam war
 Phase 4: biotechnological revolution and use of genetic engineering.
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6. Bioweapons
 Any micro organism having the capacity to cause death, disability or disease in
man, animal or plant and hence cause large scale casualty and sufferings.
 Also called as : poor man’s atomic bomb
 can be :
 micro-organisms : natural/ genetically engineered.
 BDBS: biologically derived bioactive substances. Eg: cytokines, hormones
 Manually designed biological toxin like substances – eg: nerve gases
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7. Features of bioweapons
 Consistently produce a given effect, death or disease at low concentration
 Should be highly contagious
 Have a short and predictable incubation period
 Target population should have no immunity against the organism
 Amneable to economic mass production
 Difficult to identify in target population
 Little or no prophylaxis or treatment should be available.
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8. Categories of biological disease/ agents
 3 categories according to CDC:
A B C
• High priority agents
• Risk to national security
• Have major public health
impact
• Easily transmitted and
disseminated
• Eg: anthrax, botulism,
plague, smallpox,
tularemia etc
• Causes moderate to low
mortality
• Eg: brucellosis,
psittacosis, Q-fever,
shigella, e coli.
• Emerging pathogens that
could be engineered for
massive destruction
• Easily available
• Easy to produce and
disseminate
• Capacity to cause huge
public health impact
• Eg: nipah, hanta virus,
SARS virus, H1N1.
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9. Challenges and determinants
 Challenges posed by bioweapons:
 Availability of multiple agents and delivery means
 Variable incubation period
 High mortality rates
 Potential for geographic dispersion of the agent during incubation period
 Determinants of bioterrorist attack:
 Conquest of power, progress and money
 Preserving and promoting religion/race/ideologies
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10. Epidemiological clues of bioterrorist
attack
 Disease manifesting in more severe form
 Too many cases or death in particular region – sudden rise in hours/ days
 Unusual route of exposure
 Transmitted by unusual vector
 Unusual host factors
 Multiple simultaneous/ serial epidemics
 Different attack rate in different area.
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11. Laboratories for detecting bioweapons
Level A Level B Level C Level D
• Routine pathogens
cultured and
identified
Tests done:
• Confirmatory test
• Antibiotic
susceptibility test
• Rapid presumptive
identification
• Molecular level
testing
• Also called:
Hot labs
• Highest in
expertise
• Conducts highly
specialized tests
• To save time consumed by lab tests, a uniform diagnostic protocol is formulated
• A syndrome based diagnostic criteria for suspected infections
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12. Early detection systems
 BIDS: Biological integrated detection system
 Genetic and antibody based detection on suspected aerosol particles
 LRBSDS: Long range biological stand off detection system
 Detects aerosol clouds from a distance upto 30 kms and can provide early warning.
 SRBSDS: Short range biological stand off detection system
 Uses ultraviolet and laser induced fluorescence
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13. Legal provisions related to
bioterrorism
 Geneva protocol 1925
 Biological weapons conventions 1972
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14. Geneva protocol
 Came into force on 8th feb 1928
 Prohibits use in war of asphyxiating poisons or other gases and of all analogous
liquids, materials or devices and also bacteriological methods of warfare.
 Limitations:
 Prohibited use but not possession
 Not all nations were its signatory
 Many states had right to use if attacked by such weapons
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15. Biological weapons convention (BWC)
 Came into force on : 26th march 1975
 Prohibition of development, production and stockpiling of bacteriological and
toxin weapons and their destruction.
 Has 2 articles:
 Article 1: never in any circumstance to develop, produce, stockpile or acquire/retain
items – microbial/ other biological agents or toxin and weapons, equipments or means
of delivery designed to use of such agents
 Article 2: destroy/ divert to peaceful purposes all agents, toxins, weapons,
equipments and all means of delivery within 9 months of entry into convention.
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16. Indian perspective
 India is more at risk due to:
 Dense population
 Poor hygiene and deprived sanitation
 Congenial climatic conditions.
 Lack of adequate medical facilities.
 Challenges to fight bioterrorism:
 Proper collection of specimen at the site and their identification
 Recognize the occurrence of attack and quick management of all outbreak.
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17. Ministries dealing with bioterrorism
 Ministry of Health and Family Welfare : deals with epidemics
 Ministry of Home Affairs : prevention of bioterrorism
 Ministry of Defence : manages matters and consequences of biowarfare.
 Ministry of environment, forest and climate change: evaluating short and long term
consequences
 Ministry of agriculture : deals with biological disasters related to plants, animals, livestock
and fisheries.
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18. Role of public health agencies
 Surveillance of infectious disease
 Detection and investigation of outbreaks
 Identification of etiologic agents and their mode of transmission
 Development of prevention and control strategies.
Maintaining effective disease surveillance and communication system are fundamental
components of an adequate public health infrastructure.
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19. Essential activities for successful
response to bioterrorist attack
 Completion of following 5 phase of activities prior to an incident are essential:
 Preparedness phase
 Early warning phase
 Notification phase
 Response phase
 Recovery phase
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20. Thank you