Bioterrorism - Saraniecki Flashcards by Molly h

What is the definition of bioterrorism?

deliberate release of viruses, bacteria, or other germs, toxins, or agents used to cause illness or death in people, animals, plants
ultimate goal - mass panic

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How does bioterrorism differ from biowarfare?

when the release is intended as a weapon of war
goal - incapacitate and/or kill the enemy

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What is our food defense?

resiliency of the food system
reduces the impact of intentional system attacks or catastrophic events

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How does food safety act as protection against bioterrorism?

our food system reliability
reduces exposure to natural hazards, unintentional errors, and/or failures in the food system

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What is food security defined as?

food supply sufficiency
access to nutritionally adequate safe food

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What is the CARVER system from a general standpoint?

originally developed by the US military to identify areas that may be vulnerable to an attacker
in food defense, it is used to identify areas that are most likely to be potential vulnerabilities in the food supply chain

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What does CARVER + Shock stand for?

Critically - impact on PH&S
Accessibility - ease to access target
Recuperability - recovery from an attack
Vulnerability - can attack be easily accomplished
Effect - direct loss from an attack
Recognizability - ease of identifying target by terrorist
Shock - health, economic, psychological impacts of an attack

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What are two examples of Agro-terrorism?

1999 - cow carcasses intentionally contaminated with chlordane by environmental extremists in WI sent to rendering plant and converted into animal feed
1997 - restaurant grease contaminated with fungicide by rival company and recycled into poultry feed

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What are three examples of US Bioterrorism

1763 - smallpox blankets given to Chief Pontiac’s warriors in Pittsburg
1984 - Bagwan Shree Rajneesh followers contaminated salad bar in the Dalles, OR 751 Salmonella cases, no deaths
2001 - Anthrax sent through US mail, 22 cases, 5 deaths

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What is a Category “A” Definition in bioterrorism?

high priority agents that pose risk to national security
can be easily disseminated or transmitted from person to person
result in high mortality rates and have the potential for major public health impact
might cause public panic and social disruption
require special action for public health preparedness

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What are the category “A” agents? (7)

Anthrax - Bacillus anthracis
Botulism - Clostridium botulinum toxin
Plague - Yersinia pestis
Smallpox - Variola major
Tularemia - Francisella tularensis
Viral hemorrhagic fevers ie ebola, lassa, machupo, marburg
Water safety threats - vibrio cholerae, cryptosporidium parvo

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Anthrax
Describe
Transmission? (3)
Treatment?

Spore forming bacterium Bacillus anthracis
cutaneous exposure - blister then black ulcer
ingestion - nausea, bloody diarrhea, fever
inhalation - flu or cold-like symptoms
treatment - early dx and antibiotics, 80% mortality from inhalation or GI
Vaccines available to high risk personnel

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Smallpox
Still around?
Survivability?
Symptoms?

Eradicated in 1977 globally, 1949 US from vaccines
Repositories - CDC Atlanta and Vector Lab, Siberia
Highly transmissible person to person
Variola major - 30-40% mortality, minor - 1% mortality
very painful disfigurement and rash
Outbreak would cause shutdown of air and train transportation

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What is the Category “B” Definition in bioterrorism?

second highest priority agents
moderately easy to disseminate
result in moderate morbidity rates and low mortality rates

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What are some Category “B” Agents?
(11)

Brucellosis (Brucella spp.)
Epsilon toxin of Clostridium perfringens
Salmonella, E. coli O127:H7, Shigella
Glanders - Burkholderia mallei
Meliodosis - Burkholderia pseudomallei
Psittacosis - Chlamydia psittaci
Q fever - Coxiella burnetii
Ricin toxin - Ricinus communis
Staphylococcal enterotoxin B
Typhus fever - Rickettsia prowazekii
Viral encephalitis

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Why is Salmonella a concern?

for perpetrators, it is easy to make, store, and distribute relatively safely
low security of vulnerable tagets
mimics naturally occurring FBIs
simultaneous multi-outbreaks possible, especially through imported fresh produce

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What is RICIN and how is it contracted?

extremely toxic plant protein from the seed of the castor bean plant
inhalation exposure thru aerosolized powder
ingestion of contaminated food, water, or agricultural products
cutaneous through abraded skin or wounds
eye exposure through direct contact with aerosols

How is RICIN a threat?

Category B bioterrorism agent
Schedule 1 chemical warfare agent
exposure to amounts equal to a few grains of salt can cause death
death caused by inhibition of protein synthesis in body, symptoms between 7 and 24 hours
ricin is several orders of magnitude less toxic than botulism, anthrax, tetanus

What should you do in case of a ricin exposure?

remove clothes as fast as possible without touching exterior
do not lift over head, clothes should be removed by someone in PPE cutting off
wash entire body ASAP
contact lenses removed and discarded
all clothes discarded in plastic bag for authorities

What is Glanders?
Why are we concerned with it?

caused by Burkholderia mallei
mostly a disease in horses, rare in humans and US
very low inoculant rate with untreated mortality rate 95%
transmission via aerosols to skin abrasions and mucous membranes, also food

What is Meliodosis?

aka Whitmore’s disease
caused by Burkholderia pseudomallai
clinically and pathologically similar to Glanders
transmission via contaminated water and soil
mortality rate 40%

What is the definition for Category “C” bioterrorism?

third highest priority
includes emerging pathogens that could be engineered for mass dissemination due to availability, ease of production and dissemination, and potential for high morbidity/mortality rates

What are some examples of Category “C” agents? (3)

Emerging infectious disease
Nipah virus found in Australian Bats
Hantavirus
Multi-drug resistant Tuberculosis

What is SARIN?

human made chemical warfare nerve agent
highly toxic, 1-10 ml skin exposure = death
clear, colorless, tasteless, odorless liquid
easily evaporates making is an immediate but short-lived threat
can be mixed with water and used to contaminate crops (vapor will not)
vapor is heavier than air

What are exposure risks to SARIN?

primary exposure risk is skin and eye secondary is inhalation mixes easily with water to form poison vapor exposed clothing is hazardous for over 30 mins, should be removed asap

When has SARIN been seen used?

March 1995 Fatalist cult members of Aum Shinrikyo in Japan released this gas in Tokyo subway 5000 injured, only 12 deaths

What is the DHS BioWatch program?

early warning network of AIR sensors to detect biological and chemical aerosol attacks currently monitoring 31+ cities and portable units goal is to monitor 90% population's air in 50 jurisdictions and 160 high risk facilities current detection lapse is 6 hrs, goal is 4

What is the CDC BioSense 2.0 Program?

cloud based electronic data aggregator of emergency dept visits and hospitalizations based on sx and ICD 10 codes, lab response network of 150+ labs, pharmacy rx and OTC meds, health depts allows enhanced surveillance during emergencies and mass gatherings such as inaugurations, super bowl

What does syndrome surveillance mean?

BEFORE diagnosis in ER

What does Biosafety Level 1 entail?

minimal potential hazard to lab personnel PPE: lab goats, gloves Equipment: open bend, open sink, hand sink General lab practices Agents: non-pathogenic E. coli

What does Biosafety Level 2 entail?

moderate potential hazards to personnel and the environment requires specific training in handling infectious agents requires class 2 safety cabinets and autoclave PPE: lab coat, gloves, face splash protection, no respiratory PPE sharps precautions

What agents are found in BSL 2? (12)

C. difficile HAV HBV HIV Influenza A Lyme disease Dengue fever Salmonella Mumps Measles Shigella Yersinia pestis

What does Biosafety Level 3 entail?

indigenous or exotic agents with potential for aerosol transmission, disease may have serious or lethal consequence through inhalation decontamination of all wastes and lab clothing baseline serum testing of lab workers controlled lab access PPE: coats, gloves, face guard, respiratory protection exhaused negative air flow self-closing double door

What are some BSL 3 agents? (9)

Leishmania ssp Mycobacterius tuberculosis Bacillus anthracis WNV EEE Salmonella typhii Coxiella burneti Rickettsia rickettsii yellow fever

What does Biosafety Level 4 entail?

dangerous/exotic agents which pose high risk of life-threatening disease, aerosol-transmitted lab infections, or related agents with unknown risk of transmission same as BSL3 but clothing change before entering, shower on exit, full body air supply positive pressure personnel moon suite separate building or isolated zone, dedicated supply, exhaust, and decon systems

What are some BSL 4 agents? (5)

Marburg virus Ebola virus Lassa fever Crimean-Congo fever Smallpox

What did the 2002 Bioterrorism Act require of facilities in refards to FDA?

food facilities are required to register with FDA FDA must be given advance notice on shipments of imported foods all domestic and foreign facilities that manufacture, process, pack, or hold food for human or animal consumption is US must register with FDA and renew registration every 2 years

What are some exempt facilities from the 2002 Bioterrorism Act?

a foreign facility whose manufacturing/processing occurs outside US farms retail food establishments non-profit charitable food establishments fishing vessels USDA inspected plants (meat, poultry,egg) facilities that process food contact substances

What does the 2002 Bioterrorism Act require of community drinking water systems?

Systems serving more than 3300 persons must: conduct vulnerability assessment certify and submit a copy of the vulnerability assessment to the EPA administrator prepare emergency response plan based on results of vulnerability assessment certify to EPA within 6 months that emergency response has been completed

What are the three FDA recall classifications?

Class I- potential for serious injury or death Class II- possibility of serious adverse events with irreversible consequences Class III- not likely to cause adverse health consequences, but still a chance

What are the three USDA recall classifications?

Class 1 - food will cause health problems or death Class 2 - remote probability of health adversities Class 3 - food will not cause adverse health effects