BIOTERRORISM
DR. MD.
KHALID
ANJUM
14.09.2018
DEFINITION
BIOTERRORISM :-
A form of terrorism ( unlawful use of weapon
against mankind) where there is intentional and
deliberate release of biological agents (bacteria,
viruses, fungi or their toxins) to cause mass illness
or death of people, animals, or plants.
CDC defined it as;
Deliberate release, by attackers, of an agent that
causes one or more of a variety of different
diseases.
Continued….
A bioterrorism event, also known as a Biocrime, is
an intentional assault on a person, or group of
people, using a pathogen or toxin.
The assault may be OVERT or COVERT.
An overt attack is announced.
E.g; The letters sent to Senators Daschle and
Leahy in 2001.
A covert attack is unannounced; the recipient
receives no indication that a threat is present.
E.g; The package sent to the journalist at
American Media, Inc.
KEY FEATURES
Should produce high morbidity and mortality in the
community.
Potential for person-to-person spread.
Should be of low infective dose.
Should be highly infectious by aerosol.
Lack of rapid diagnostic facilities.
Effective vaccine should not be available globally.
Potential to cause anxiety.
Availability of pathogen and feasibility of production.
Environmental stability- should have the potential to be
weaponized.
HISTORY OF BIOTERRORISM
ATTACKS
1346 -Siege of Kaffa; (Feodosia,Ukraine); Plague.
1763- French and Indian War; Smallpox
WW I -German program; anthrax, glanders.
1925 -Geneva protocol bans biological weapons
WW II –Japanese planes dropped canisters of fleas
carrying Yersinia pestis bacteria on China.
1946 -U.S. announces its involvement in bio-
weapons research.
Continued…..
1975- Biological Weapons Convention banned
possession and development of biological weapons.
1975 -Accidental release of B.anthracis endospores at
bio-weapon research center, Sverdlovsk, U.S.S.R.
1984- Rajneesh cult members contaminate salad bar
with Salmonella typhimurium in Oregon.
1992-Ricin attack planned by Minnesota militia.
1996- Shigella dysenteriae type 2 outbreak among
microbiologist technologist in Dallas.
2001 -Anthrax releases in Fla, DC, NY, NJ
Continued…..
LIST OF SELECTED AGENTS
VIRUSES:-
Crimean-Congo Hemorrhagic Fever virus
Eastern Equine Encephalitis virus
Ebola viruses
Hendra virus
Herpes virus 1 (Herpes B virus)
Lassa Fever virus
Marburg virus
Monkey pox virus
Continued….
Nipah virus
Reconstructed 1918 influenza virus
Rift Valley Fever virus
South American Hemorrhagic Fever viruses
(Junin, Machupo, Sabia, Guanarito etc).
Tick-borne encephalitis complex viruses
Variola major virus (smallpox virus)
Variola minor virus (Alastrim)
Venezuelan Equine Encephalitis Virus
Continued…
RICKETTSIAE :-
Coxiella burnetii
Rickettsia prowazekii
Rickettsia rickettsii
Continued….
BACTERIA :-
Bacillus anthracis
Brucella abortus, Brucella melitensis, Brucella suis
Burkholderia mallei
Burkholderia pseudomallei
Clostridium botulinum
Francisella tularensis
Yersinia pestis
Continued….
TOXINS :-
Abrin,
Botulinum toxins,
Clostridium perfringens epsilon toxin,
Conotoxins,
Diacetoxyscirpenol,
Ricin,
Saxitoxin,
Shiga-like ribosome inactivating proteins,
Shigatoxin,
Staphylococcal enterotoxins,
T-2 toxin,
Tetrodotoxin.
CLASSIFICATION
Bioterrorism agents are divided into three
categories: A, B, and C.
A. CATEGORY “A” :-
These agents can be easily disseminated or
transmitted from person to person.
Result in high mortality and have the potential for
major public health impact.
Might cause public panic and social disruption,
Require special action for public health
preparedness.
Continued….
Examples:
Anthrax (Bacillus anthracis)
Botulism (Clostridium botulinum toxin)
Plague (Yersinia pestis)
Tularemia (Francisella tularensis)
Small pox (Variola major)
Hemorrhagic viruses.
Arena-viruses: Lassavirus
Bunya-viridae: Crimean Congo virus
Filo-viridae: Ebola, Marburg virus
CATEGORY “B”
Moderately easy to disseminate
Result in moderate morbidity rates and low
mortality rates
Require specifically enhanced diagnostic capacity.
EXAMPLES :-
Melioidosis (Burkholderia pseudomallei)
Glanders (Burkholderia mallei)
Brucellosis (Brucella species)
Psittacosis (Chlamydophila psittaci,)
Continued…..
Q fever (Coxiella burnetti)
Typhus fever (Rickettsia prowazekii)
Toxin: Ricin, S.auerus Enterotoxin B, Epsilon toxin
of Clostridium perfringe
Viral encephalitis, [Alphaviruses; e.g; Venezuelan,
eastern, and western equine encephalitis].
Food threats: Salmonella, Shigella, E.coli 0157.
Water threats: Vibrio cholerae, Cryptosporodium.
Continued….
CATEGORY “C” :-
These agents could be engineered for mass
dissemination in the future because of availability,
ease of production, and ease of dissemination.
They have a potential for high morbidity and
mortality rates.
EXAMPLES :-
Nipah virus
Hantavirus
SARS coronavirus
Pandemic influenza virus
MDR-TB
Yellow fever virus
BIOSECURITY
Laboratories must conduct a risk assessment and
threat analysis to write a security plan.
Some commercial laboratories store select agents for
use as positive controls for comparison with suspect
samples. These laboratories must write Standard
Operating Procedures (SOPs) for;
The access of select agents;
Specimen accountability;
The receipt of select agents into the laboratory;
The transfer or shipping of select agents from the
laboratory;
Continued…..
The reporting of incidents, injuries, and breaches
of security; and
An emergency response plan if security is
breached or the isolate is unintentionally
released during an accident. They must also
register the agents with the CDC.
Continued…..
New Technologies and Techniques to Identify
Bio-weapons :-
Monitoring public health, and reporting incidence of
diseases,.
The faster a potential incident is uncovered, the greater
the chance for containment.
Rapidtests are being investigated to detect genetic
changes in hosts due to bio-weapons even before
symptoms develop.
Early-warning systems, such as DNA chips or Recombinant
cells that fluoresce in the presence of a bio-weapon, are
also being developed.
Continued…..
Laboratory Response Network
CDC, in partnership with the Association of Public
Health Laboratories and the Federal Bureau of
Investigation, established the Laboratory
Response Network (LRN).
The LRN is a three-tier system.
1. Sentinel (formerly level A) laboratories.
2. Reference laboratories.
3. National laboratories.
ROLE OF THE SENTINEL LABORATORY
The main role of sentinel microbiology laboratories
is to determine whether a targeted agent is
suspected in a human specimen.
Detection and recognition of a possible bioterrorism
event depend on the following;
A laboratory having an active microbial surveillance
and monitoring program.
Vigilant technologists looking for a disease that ;
1. Does not occur naturally in a particular geographic
region
(e.g., plague in New York City);
2. Is transmitted by an aerosol route of infection; and
Continued…..
3. Is a single case of disease caused by an
unusual agent
(e.g., Burkholderia mallei).
Good communication with infection control
practitioners, Infectious disease physicians, and
local or regional public health laboratories.
Continued…..
Continued…..
Vaccination: A Key Defense :-
When the use of biological agents is considered a
possibility, military personnel and first -responders
(health care personnel and others) are vaccinated—if
a vaccine for the suspected agent exists.
U.S. government’s strategy following a confirmed
smallpox outbreak includes “Ring containment and
voluntary vaccination.”
A “Ring” of vaccinated/protected individuals is built
around the bioterrorism infection case and their
contacts to prevent further transmission.
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