Bioterrorism
Awareness:
Protection of
Human and Animal
Health
Food animal
veterinarians
Why Are We Here?
•
September 11, 2001
changed many things
− Worst
terrorist act in U.S.
history
− More than 3,000 presumed
dead
− Occurred on American soil
− Increased sense of
vulnerability
Center for Food Security and Public Health
Iowa State University 2005
Biological Attack
•
Bioterrorism attacks of 2001
•
Anthrax in postal system
•
•
•
22 cases
5 deaths
U.S. public health realm changed
forever
Center for Food Security and Public Health
Iowa State University 2005
Preparedness Responsibilities:
Veterinarians
Anticipate outbreaks on the local level
• Collect and label samples
• Know the agents
• Know the typical signs of diseases
•
−
Animals and human
Know how to report suspected cases
• Disseminate knowledge
•
Center for Food Security and Public Health
Iowa State University 2005
Overview
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Bioterrorism
Zoonoses and bioterrorism
Disease control and biosecurity
U.S. Government agencies involved
Bioterrorism agents/diseases
Your role and responsibility
Center for Food Security and Public Health
Iowa State University 2005
Terrorism
Agroterrorism
Biological,
chemical, or
radiological
agents targeting
agriculture or its
components
•Livestock
•Food supply
•Crops
•Industry
•Workers
Bioterrorism
Biological agents
targeting humans,
animals, or plants
Other
Conventional,
radiological,
nuclear,
chemical,
cyber
•Typically
direct
human
targeting
Center for Food Security and Public Health
Iowa State University 2005
Characteristics of a
Biological Attack
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Difficult to detect release
Dissemination may cover large area
Possible secondary spread
Recognition of agent may be delayed
days to weeks
Difficulties in catching perpetrator
Center for Food Security and Public Health
Iowa State University 2005
Infectious Disease Outbreak
Exposure
Symptoms
No. Affected
Seek Care
Time (Days)
Center for Food Security and Public Health
Iowa State University 2005
Clues Suggesting Biological
Agent Release
•
Clustering of morbidity or mortality
− Temporally
or geographically
− Large numbers of animals and/or people
− Atypical symptoms
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•
•
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Normally healthy people affected
Unusual symptoms for area
Unusual age distribution
Disease occurring outside typical
season
Center for Food Security and Public Health
Iowa State University 2005
Many Agents are Zoonotic
Disease may be seen in animals
before humans
• Animals are sentinels
•
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Pets, livestock,
wildlife
Center for Food Security and Public Health
Iowa State University 2005
Factors That Promote
Transmission of Zoonoses
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Frequent contact with
domestic or wild animals
Overlap with wildlife habitat
Intensive livestock production
Poor animal sanitation
Poor personal hygiene
Poor animal health
Center for Food Security and Public Health
Iowa State University 2005
Disease Control:
Client Education
•
Disinfect/clean up areas
contaminated with animal waste
− Livestock,
•
pets, wildlife, rodents
Basic hygiene
− Wash
hands
− Child supervision
Center for Food Security and Public Health
Iowa State University 2005
Zoonoses Control:
Client Education
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Proper pet selection
Use caution at petting zoos
Cook food properly
Control strays
Communication with physician and
veterinarian
Follow guidelines for
immunocompromised people
Center for Food Security and Public Health
Iowa State University 2005
Biosecurity Education
for the Producer
•
Develop and implement
a biosecurity plan
•
Train employees to help
maintain the plan
•
Post signs restricting
access to areas of the
farm and control traffic
flow
Center for Food Security and Public Health
Iowa State University 2005
Biosecurity Education
for the Producer
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•
Regulate visitors
Keep visitors sanitary
− Clean
clothing, boots
− Disposable plastic
shoe/boot covers
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•
Implement insect,
bird, and animal control
Secure water, feed, and nutrient
sources
Center for Food Security and Public Health
Iowa State University 2005
Biosecurity Education
for the Producer
Maintain healthy herd
− Vaccinations
− Proper hygiene for
animals and handlers
• Purchase from
reputable sources
• Quarantine newly
purchased animals
• Separate sick animals
•
Center for Food Security and Public Health
Iowa State University 2005
Biosecurity: Veterinarians
Disinfect your clothes, boots, equipment
between farms
• Avoid vehicle contamination
• Follow biosecurity guidelines set forth by
species-specific associations
•
Center for Food Security and Public Health
Iowa State University 2005
U.S. Agencies
Dealing with terrorism
Public Health Security and Bioterrorism
Preparedness Response Act of 2002
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•
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June 12, 2002
Improve ability of the U.S. to
prevent, prepare for, and respond to
bioterrorism and other public health
emergencies
$4.3 billion to various federal, state
and local agencies
− Upgrade
facilities, enhance security, etc
Center for Food Security and Public Health
Iowa State University 2005
Department of Homeland
Security (DHS)
•
•
Established January, 2003
Mission
− Prevent,
protect, and respond to acts of
terrorism on U.S. soil
•
Established four policy directorates
− Responsibilities
for coordinating HHS and
USDA
− Guard borders and airports, coordinate
the response for future emergencies,
analyze threats and intelligence, protect
our critical infrastructure
Center for Food Security and Public Health
Iowa State University 2005
Centers for Disease Control
and Prevention
•
CDC's Mission
− Promote
health and quality
of life by preventing and
controlling disease, injury,
and disability
• Preparing for bioterrorism since 1998
• One of the first agencies to respond to
anthrax incidents of 2001
Center for Food Security and Public Health
Iowa State University 2005
Strategic National Stockpile
•
12-hour Push Package
−
•
Complete package of
medical materials
Vendor Managed Inventory
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Tailored to suspected agents
Center for Food Security and Public Health
Iowa State University 2005
Insert Your State’s Info Here
Center for Food Security and Public Health
Iowa State University 2005
Preparing Iowa
•
Iowa’s Homeland
Security
− Administered
by
Iowa Emergency
Management
Division
− Works with public
and private
partners
www.iowahomeland
security.org
Center for Food Security and Public Health
Iowa State University 2005
Preparing Iowa
Iowa Department of Public Health
www.idph.state.ia.us/odedp
• Iowa Department of Agriculture and
Land Stewardship
•
Highly infectious animal disease program
− IRVIN: Iowa Rapid Veterinary Information
Network
−
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CFSPH training veterinarians to educate
others
Center for Food Security and Public Health
Iowa State University 2005
Category ABC
Agent Overview
Classification
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Prepared by the CDC’s Bioterrorism
Preparedness and Response Office
Category A: highest priority
Category B: second highest priority
Category C: third highest priority
Center for Food Security and Public Health
Iowa State University 2005
“Weaponization” of Agents
•
Alter characteristics of a pathogen to
make it a more effective weapon
− Enhance
transmission
− Increase virulence
− Resistant to antibiotics
− Evade vaccine protection
− Alter clinical signs
Center for Food Security and Public Health
Iowa State University 2005
Note to presenter
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As time allows select diseases you would like
to review.
If you have limited time you should focus on
the Category A agents.
The disease coverage is brief. If you would
like more information on a disease, refer to
the fact sheet or to the disease specific
presentation.
Center for Food Security and Public Health
Iowa State University 2005
Category A : Agents/Diseases
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Anthrax
Botulism
Plague
Smallpox
Tularemia
Viral hemorrhagic fevers
Center for Food Security and Public Health
Iowa State University 2005
Anthrax: The Agent
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•
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Bacteria: Bacillus anthracis
Forms spores
Human disease
− Skin
− Intestinal
− Pulmonary
•
Animal disease
− Septicemia
and rapid death
Center for Food Security and Public Health
Iowa State University 2005
Anthrax: The Bioweapon
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History
Available & easily
produced
Spores infective
Aerosolization
Low lethal dose
High mortality
Person-to-person transmission rare
Center for Food Security and Public Health
Iowa State University 2005
Anthrax: The Response
•
Vaccine
− Humans
− Animals
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Antibiotics
− Treatment
− Prophylaxis
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Disinfection
− Sporicidal
agents, sterilization
Center for Food Security and Public Health
Iowa State University 2005
Botulism: The Agent
•
Clostridium botulinum – Gram pos,
spore-forming bacteria
•
7 different neurotoxins
− Types
•
A-G
Clinical signs
− Flaccid
paralysis
− Pigs, dogs, and cats
fairly resistant
Center for Food Security and Public Health
Iowa State University 2005
Botulism: The Bioweapon
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•
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Used by Aum Shinrikyo
cult in Japan
Aerosolized
Easy to produce and
transport
Potent and lethal
Most poisonous substance
known
Center for Food Security and Public Health
Iowa State University 2005
Botulism: The Response
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Toxoids for high risk people
Antitoxin available
− Case-by-case
•
basis
Botulinum toxins are easily
inactivated with many
disinfectants and heat
Center for Food Security and Public Health
Iowa State University 2005
Plague: The Agent
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Yersinia pestis
− Gram
neg, transmitted by
fleabites, aerosol, direct contact
•
Symptoms: Humans
− Bubonic,
•
septicemic, pneumonic
Symptoms: Animals
− Cat:
similar to human
− Dogs, livestock: Somewhat
resistant
Center for Food Security and Public Health
Iowa State University 2005
Plague: The Bioweapon
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WHO estimate
− 50kg
agent: City population 5 million
− 150,000 cases pneumonic plague
− Potential mortality: 100,000
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•
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Available
Person-to-person transmission
Pneumonic form ~ 100% fatal if
untreated
Center for Food Security and Public Health
Iowa State University 2005
Plague: The Response
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Antibiotics generally effective if given
early
Killed vaccine available
Isolation of sick individuals
Susceptible to a number of common
disinfectants
Center for Food Security and Public Health
Iowa State University 2005
Smallpox: The Agent
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Variola virus, Orthopoxvirus
Eradicated from the world in 1977
Narrow host range: Humans only
Transmission: Person-to-person,
fomites, aerosols
Clinical signs
− Flu-like,
progressive skin
eruptions
Center for Food Security and Public Health
Iowa State University 2005
Smallpox: The Bioweapon
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•
Used historically
Disease signals a bioterrorism event
− Susceptible
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•
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population
Easy to produce large scale
Aerosolization
Secondary spread
− Person-to-person
− Fomites
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Mortality approximately 30%
Center for Food Security and Public Health
Iowa State University 2005
Smallpox: The Response
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No specific treatment
Vaccinia virus vaccination
Vaccinia Immune Globulin
Isolation of infected individuals
Ring vaccination program
Disinfection of environment, clothing
with various chemicals, boiling or
autoclaving
Center for Food Security and Public Health
Iowa State University 2005
Tularemia: The Agent
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•
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Francisella tularensis
Transmitted by ingestion,
inhalation, vectors, direct
contact through skin
Six clinical forms in humans
Glandular
Ulceroglandular
Center for Food Security and Public Health
Iowa State University 2005
Tularemia: The Agent
•
Sheep, young pigs, horses,
dogs, cats
• Sudden
fever, lethargy, stiffness,
prostration, and death
•
Wildlife
• Usually
find dead
• Rabbits behave strangely
•
Cattle, older pigs resistant
Center for Food Security and Public Health
Iowa State University 2005
Tularemia: The Bioweapon
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Stable
Aerosolized
Low infective dose via inhalation
Case fatality: 30-60% (untreated )
WHO estimation: 1970
− 50
kg agent: City population 5 million
 250,000 ill
 19,000 deaths
Center for Food Security and Public Health
Iowa State University 2005
Tularemia: The Response
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Person-to-person transmission not
documented
Antibiotics effective if early or
prophylactic
Vaccine
− For
high risk individuals
− Unknown efficacy
against inhalational
tularemia
Center for Food Security and Public Health
Iowa State University 2005
Viral Hemorrhagic Fevers:
The Agents
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Ebola, Marburg, Lassa, Machupo
Human clinical presentation
− Early:
Fever, fatigue
− Severe: Bleed from internal
organs, body orifices
− Progression to shock &
seizures
•
Vincent Massey
Animals: Only non-human
primates susceptible
Center for Food Security and Public Health
Iowa State University 2005
VHF: The Bioweapons
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Aerosolized
Not readily available, require
specialized production
Person-to-person and nosocomial
transmission occur
Untreated fatality rate variable
− Humans:
25-90%
− Non-human primates: 50-100%
Center for Food Security and Public Health
Iowa State University 2005
VHF: The Response
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Intensive supportive care
Ribavirin has shown some efficacy
Susceptible to bleach solutions,
phenolic disinfectants, and UV light
Center for Food Security and Public Health
Iowa State University 2005
Category B: Agents/Diseases
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Brucellosis
Glanders
Melioidosis
Psittacosis
Q Fever
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Typhus fever
Viral encephalitis
Toxins
Food Safety Threats
Water Safety Threats
Center for Food Security and Public Health
Iowa State University 2005
Brucellosis: The Agent
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•
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Gram-negative bacteria
Ingestion, inhalation, or
direct contact
Clinical signs
− Humans:
Cyclic fever and
flu-like symptoms
− Animals: Reproductive signs
Center for Food Security and Public Health
Iowa State University 2005
Brucellosis: The Agent
Species
Natural Host
Human
Pathogen
B. abortus
Cattle, bison, elk,
horses
Yes
B.melitensis
Goats, sheep, cattle
Yes
B. suis
Swine, hares, reindeer,
caribou, rodents
Yes
B. canis
Dogs, other canids
Yes
B. ovis
Sheep
No
Center for Food Security and Public Health
Iowa State University 2005
Brucellosis: The Bioweapon
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History
Highly infectious
Easily aerosolized
Stable
Prolonged incubation period
− May
•
make diagnosis difficult
Person-to-person unlikely
Center for Food Security and Public Health
Iowa State University 2005
Brucellosis: The Response
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Long term antibiotics generally
effective
Vaccinate calves, no human vaccine
Eliminate reservoir
Standard precaution
to avoid exposure
Thorough disinfection
Center for Food Security and Public Health
Iowa State University 2005
Glanders: The Agent
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Burkholderia mallei: Gram-negative
Transmission by
ingestion, inhalation, or
direct contact
− Animal-to-human
transmission is inefficient
•
Clinical signs
− Humans
& horses: Cutaneous &
pulmonary lesions, rapidly fatal illness
Center for Food Security and Public Health
Iowa State University 2005
Glanders: The Bioweapon
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History
− WWI
Russian horses
− WWII Chinese civilians, horses, POW’s
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Easy to produce
Aerosolized, highly infectious
Mortality high in chronic form
− 50-70%
•
Person to person transmission: Rare
Center for Food Security and Public Health
Iowa State University 2005
Glanders: The Response
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No vaccine
Antibiotic therapy likely effective
Destroyed by various chemicals
Center for Food Security and Public Health
Iowa State University 2005
Melioidosis: The Agent
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Burkholderia pseudomallei:
Gram-negative
Transmission: Contact,
ingestion, inhalation
Clinical signs: Humans,
sheep, goats, and pigs
− Asymptomatic
to
pneumonia, lung and
wound abscesses
Center for Food Security and Public Health
Iowa State University 2005
Melioidosis: The Bioweapon
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Easy to produce
Available
Aerosolization
High mortality: 90%
Person-to-person (rare)
Animal-to-person (rare)
Center for Food Security and Public Health
Iowa State University 2005
Melioidosis: The Response
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Long-term, multiple
antibiotics effective
Vaccines available:
Not in U.S.
Easily destroyed by
disinfectants
Center for Food Security and Public Health
Iowa State University 2005
Psittacosis: The Agent
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Chlamydophila psittaci
− Gram-negative
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•
•
Occurs worldwide
Reportable in U.S.
Clinical disease in humans and birds
− Asymptomatic
− Systemic
illness with severe pneumonia
Center for Food Security and Public Health
Iowa State University 2005
Psittacosis: The Bioweapon
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Easily obtained
Aerosolized
Stable in the
environment
Person-to-person
transmission rare
Low mortality
Center for Food Security and Public Health
Iowa State University 2005
Psittacosis: The Response
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•
Antibiotics
generally effective
Decontamination
possible with most
disinfectants
Center for Food Security and Public Health
Iowa State University 2005
Q Fever: The Agent
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•
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Coxiella burnetii
Transmission: Inhalation,
direct contact, ingestion, ticks
Disease symptoms
− Humans:


Acute: Flu-like + pneumonia & hepatitis
Chronic: Endocarditis, osteomyelitis
− Animals:

Most asymptomatic
Sheep, cattle and goats: Abortions
Center for Food Security and Public Health
Iowa State University 2005
Q Fever: The Bioweapon
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History
Easily accessible
Environmentally
resistant
Highly infectious
Aerosolization
− Travel
•
½ mile by wind
Low mortality- chronic morbidity
Center for Food Security and Public Health
Iowa State University 2005
Q Fever: The Response
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•
•
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Often self-limiting disease
Antibiotic therapy may limit
complications
Vaccine developed, not available in
U.S.
Variable susceptibility to disinfectants
Center for Food Security and Public Health
Iowa State University 2005
Typhus Fever: The Agent
Rickettsia prowazekii: Rickettsial organism
• Endemic in Eastern Europe, Middle East,
and parts of Africa
• Transmitted in feces of
human
body louse
• Clinical signs: Humans
•
−
•
Fever, headache, macular
eruptions, and petechial rash
J. Kalisch
Not seen in domestic animals
Center for Food Security and Public Health
Iowa State University 2005
Typhus Fever:
The Bioweapon
•
WHO estimation: 1970
− 50
kg agent; 5 million people in city
− 125,000 ill
− 8,000 deaths
•
•
Available
Can be aerosolized
in lice feces
U.S. Typhus Commission
Center for Food Security and Public Health
Iowa State University 2005
Typhus Fever: The Response
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•
Antibiotics are generally effective
Vaccine, not commercially available
Center for Food Security and Public Health
Iowa State University 2005
Viral Encephalitis: The Agent
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•
•
The Alphaviruses: EEE, WEE, and VEE
Transmitted via mosquito
Clinical signs
− Humans,
horses, donkeys,
mules: Often asymptomatic
to flu-like
− Encephalitis in small proportions
•
Birds are asymptomatic carriers, act
as sentinels
Center for Food Security and Public Health
Iowa State University 2005
Viral Encephalitis:
The Bioweapon
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•
•
•
Easy to produce
Aerosolization
High rate of infection
Person-to-person transmission
possible
Center for Food Security and Public Health
Iowa State University 2005
Viral Encephalitis:
The Response
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•
Supportive care
Vaccine
•
Virus unstable in
environment
− Equine
− Human:
High risk
Center for Food Security and Public Health
Iowa State University 2005
Toxins: The Agents
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•
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Staphylococcal
enterotoxin B (SEB)
Ricin toxin from
castor plant
Clostridium
perfringens epsilon
toxin
Center for Food Security and Public Health
Iowa State University 2005
SEB: The Agent
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•
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Staphylococcal enterotoxin B (SEB)
A common cause of food poisoning
Clinical signs: Humans
− Fever,
chills, headache, myalgia
− Non-productive cough if inhaled
− GI signs if swallowed
•
Animals: Likely similar to human
Center for Food Security and Public Health
Iowa State University 2005
Ricin: The Agent
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•
•
Ricin toxin from bean of castor plant
Available worldwide
Clinical signs
− Acute
onset of fever,
chest tightness, cough,
dyspnea, nausea
Center for Food Security and Public Health
Iowa State University 2005
Epsilon Toxin: The Agent
•
•
•
Clostridium perfringens type B and D
Increases intestinal and vascular
permeability, liver and neurological
damage
Clinical signs
− Calves:
Diarrhea, abdominal pain,
listlessness, neurologic
− Sheep, goats: Watery to bloody
diarrhea, neurologic
− Humans: Little information
Center for Food Security and Public Health
Iowa State University 2005
Toxins: The Bioweapon
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History
Aerosolized: SEB, ricin
Available worldwide
Easy to produce, stable
Many species affected
No person-to-person transmission
Center for Food Security and Public Health
Iowa State University 2005
Toxins: The Response
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•
•
•
Supportive care
No vaccines currently available for
SEB or ricin
Vaccines for animals for clostridial
disease
Toxins are inactivated with common
disinfectants
Center for Food Security and Public Health
Iowa State University 2005
Food Safety Threats
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•
•
•
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Campylobacter species
Salmonella species
E. coli 0157:H7
Viruses, parasites,
chemicals, toxins
Ingestion of
contaminated food
Gastrointestinal upset
Center for Food Security and Public Health
Iowa State University 2005
Food Safety Threats:
The Bioweapon
•
1984, The Dalles, Oregon
− Bagwan
Shree Rajneesh cult
− Contaminated salad bars

Salmonella typhimurium
− Goal:
Incapacitate voters
− 751 people ill
Center for Food Security and Public Health
Iowa State University 2005
Food Safety Threats:
The Response
•
•
•
•
Constant vigilance to improve food
safety
Food irradiation at processing plants
Wash hands and utensils frequently
Proper cooking temperature and
storage
Center for Food Security and Public Health
Iowa State University 2005
Water Safety Threats
•
•
•
53% of US drinking
water is from ground
water
Cryptosporidium
parvum- protozoa
Vibrio choleraebacteria
Center for Food Security and Public Health
Iowa State University 2005
Cryptosporidium: The Agent
•
•
•
Cryptosporidium parvum- protozoa
Transmission: Inhalation, ingestion
Clinical signs: Humans, calves,
others
− Acute
•
gastroenteritis
Dogs, cats, horses, pigs: Resistant
Center for Food Security and Public Health
Iowa State University 2005
Vibrio cholerae: The Agent
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•
•
Vibrio cholerae- Gramnegative bacteria
Transmission: Fecal-oral,
contaminated shellfish
Clinical signs, humans
− Acute,
mild diarrhea
− 5% severe disease
•
Animals are resistant to
disease
Center for Food Security and Public Health
Iowa State University 2005
Water Safety:
Public Health Significance
•
1993: Municipal water supply
contaminated in Milwaukee
− Cryptosporidum
− 40,000
•
parvum
ill
1997: Decorative water fountain at
the Minnesota Zoo
− C.
parvum
− 369 cases
− Mostly young children
Center for Food Security and Public Health
Iowa State University 2005
Water Safety Threats:
The Response
•
•
Government has laws
to protect our water
supply
Treatment facilities
are equipped and will
likely inactivate most
organisms
− Chlorination,
•
filtration, ozone
Dilution factor
Center for Food Security and Public Health
Iowa State University 2005
Category C
•
•
Nipah virus
Hantavirus
Center for Food Security and Public Health
Iowa State University 2005
Nipah Virus: The Agent
•
•
•
Paramyxovirus
Fruit bat reservoir
Clinical signs
− Humans:
Encephalitis
− Pigs: Respiratory, neurological
− Dogs and cats: “Distemper”
Center for Food Security and Public Health
Iowa State University 2005
Nipah Virus: The Bioweapon
•
•
•
•
Aerosolization
potential
Wide host range
No person-to-person
transmission
expected
High morbidity and
mortality
Center for Food Security and Public Health
Iowa State University 2005
Nipah Virus: The Response
•
•
•
Avoid contact with all
infected animals and
fluids
Vaccine being researched
Call authorities
immediately
Center for Food Security and Public Health
Iowa State University 2005
Hantavirus: The Agent
•
•
•
•
Bunyaviridae family
Asymptomatic reservoir: Rodents
Transmission: Inhalation,
ingestion, direct contact
Human clinical signs
− Fever,
myalgia, headache
− Hantavirus Pulmonary Syndrome
− Hemorrhagic Fever with Renal Syndrome
•
Not seen in domestic animals
Center for Food Security and Public Health
Iowa State University 2005
Hantavirus: The Bioweapon
•
•
•
Aerosolized
Hospitalization
Unexpected disease
in the U.S.
− HFRS
limited to
Asia/Europe to date
Center for Food Security and Public Health
Iowa State University 2005
Hantavirus: The Response
•
•
Supportive care
Limit exposure to
rodent excrement
− Wear
mask
•
gloves, face
Virus is deactivated
with bleach
Center for Food Security and Public Health
Iowa State University 2005
Other Important
Diseases
•
•
•
•
•
•
Transmissible Spongiform
Encephalopathy (TSE)
Rift Valley Fever
Hendra Virus
West Nile Virus
Foot and Mouth Disease
Monkeypox
Center for Food Security and Public Health
Iowa State University 2005
Transmissible Spongiform
Encephalopathy: The Agent
•
Prions
− Proteinaceous
infectious particles
− Mutated proteins
•
•
•
Very long incubation period
Neurological signs in all species
No treatment available
Center for Food Security and Public Health
Iowa State University 2005
Bovine Spongiform
Encephalopathy
•
•
•
Mad cow disease
Incubation: 2 to 8 years
1995, United Kingdom
− vCJD
− People

•
exposed to BSE
Before bovine offal ban in
1989
Active U.S. surveillance
since 1990
Center for Food Security and Public Health
Iowa State University 2005
TSE: The Response
•
Very resistant
− Heat,
•
sterilization and disinfectants
Early identification not possible
− Lack
of host immune response
− Long incubation period
•
•
•
No effective treatment or vaccine
Surveillance program
Import restrictions
Center for Food Security and Public Health
Iowa State University 2005
Rift Valley Fever: The Agent
•
•
•
Phlebovirus in family Bunyaviridae
Transmission: Mosquito, inhalation,
contact with infected body fluids
Clinical signs
− Humans:
headache

Flu-like, fever,
Severe disease: Retinitis,
hemorrhagic fever
− Animals:
Abortions, death in neonates
Center for Food Security and Public Health
Iowa State University 2005
Rift Valley Fever:
The Bioweapon
•
WHO estimate: 1970
− 50
kg of virus aerosolized
− 35,000 incapacitated
− 400 deaths (1% mortality)
•
•
Stable at most temperatures
Inactivated by various chemicals
Center for Food Security and Public Health
Iowa State University 2005
Rift Valley Fever:
The Response
•
•
•
Vaccinate ruminants in
endemic areas
Control mosquitoes
Avoid contact with
infected tissues & blood
− Wear
•
protective clothing
No person-to-person
transmission
Center for Food Security and Public Health
Iowa State University 2005
Hendra Virus: The Agent
•
Newly discovered
−
Australia
Fruit bats
• Transmission: Urine, body fluids
• Incubation: 6-18 days
• Humans
•
−
•
Flu-like illness, respiratory failure
Horses, cats
−
Acute respiratory signs, nasal discharge,
fever, encephalitis, sudden death
Center for Food Security and Public Health
Iowa State University 2005
Hendra Virus: The Response
•
•
•
Little is known about disease
Highest level of security to work with
the agent
Potentially serious consequences
− High
mortality rate
− Lack of treatment
Center for Food Security and Public Health
Iowa State University 2005
West Nile Virus: The Agent
Flavivirus
• Transmission
•
Mosquitoes: Culex species
− Blood transfusion, organ
donation, breast feeding
−
Animals: Horses, birds,
mammals, and reptiles
• Humans
•
Duration: 3-6 days
− 80% have no signs
− 20% develop “West Nile Fever”
−
Center for Food Security and Public Health
Iowa State University 2005
West Nile Virus:
Public Health Significance
•
Human illness in U.S. in 2003
− 9,100
•
cases, 222 deaths
Horses illness in U.S. in 2003
− 4,554
cases
− 40% of ill result in death
•
Method of introduction to U.S.
unknown
*data current as of 1/30/04
Center for Food Security and Public Health
Iowa State University 2005
Spread of WNV in the U.S.:
1999-2002
Center for Food Security and Public Health
Iowa State University 2005
West Nile Virus:
The Response
Treatment: Supportive care
• Vaccine available for horses, not humans
• Source elimination
•
−
•
Mosquito larval habitats
Personal protection
Reduce time outdoors
− Wear long pants and sleeves
− Use mosquito repellent
−
Center for Food Security and Public Health
Iowa State University 2005
Foot and Mouth Disease: FMD
•
•
•
•
•
Picornavirus
Transmission: Direct contact,
aerosol, fomites
Species: Cloven-hooved
animals (not horses)
Signs: Fever, vesicles,
salivation, lameness
Extremely rare, mild
symptoms in people
Center for Food Security and Public Health
Iowa State University 2005
FMD: Agroterrorism Threat
•
•
Most important livestock disease
in the world
U.S. agriculture as a target
− One
sixth of the U.S. domestic
product is tied to agriculture
− Immunologically naive population
•
Vulnerabilities
− Increased
travel, poor biosecurity
Center for Food Security and Public Health
Iowa State University 2005
FMD: The Response
•
•
•
•
USDA upgrading safeguarding
measures
Strict biosecurity
Notify authorities immediately
Response and recovery plans
− Quarantine
− Depopulation
− Disinfection
•
Vaccination – complex decision
Center for Food Security and Public Health
Iowa State University 2005
Monkeypox: The Agent
•
•
Orthopoxvirus, related to
smallpox
Transmission
−
−
−
•
•
Reservoir may be African squirrel
Bites, aerosol, direct contact
Zoonotic, animal-to-animal,
person-to-person
Animals: Fever, rash, pustules
conjunctivitis
Humans: Flu-like, rash,
pustules, lymphadenopathy
Center for Food Security and Public Health
Iowa State University 2005
Monkeypox:
Public Health Significance
•
2003 U.S. Outbreak
Zoonotic disease
− 6 Midwestern states
−
•
Animal illness
Suspect cases: 93
− Confirmed cases: 10
−
•
Human illness
Suspect cases: 72
− Confirmed cases: 37
−

•
All had contact with infected prairie dogs
Potential bioweapon
Center for Food Security and Public Health
Iowa State University 2005
Monkeypox: The Response
Treatment: supportive care
• Smallpox vaccination
•
Moderately protective (85% of cases)
− 30 individuals in 2003, no adverse events
−
•
Infection Control
EPA registered detergent disinfectant
− 0.5% sodium hypochlorite (bleach)
−
Embargo
• Euthanasia of animals
• Quarantine for 6 weeks
•
Center for Food Security and Public Health
Iowa State University 2005
The Veterinarian’s
Responsibility
Opportunities for the
Veterinary Profession
•
Integrate into the public health
system
− Be
aware, contribute, assist in
development of surveillance programs
− Report trends in disease and clinical
signs
− Be involved with emergency response
plans at all levels
Center for Food Security and Public Health
Iowa State University 2005
The Veterinarian’s
Responsibility
•
•
•
•
Guardian of animal and public health
Sharpen awareness of potential
bioterrorism
Alert officials early
You are the expert
− Provide
leadership and input to clients
and community
Center for Food Security and Public Health
Iowa State University 2005
What to do if bioterrorism
is suspected
•
•
•
•
•
•
Stay informed and remain calm
Response is event specific
Response is everyone's responsibility
Follow the advice of public health
officials
Follow federal and state guidelines
Movement restrictions may be
necessary
Center for Food Security and Public Health
Iowa State University 2005
Contacts
•
Phone numbers to know
− State
Veterinarian
− State Public Health
Veterinarian
− APHIS- Area Veterinarian
in Charge
− Public Health Officials
Center for Food Security and Public Health
Iowa State University 2005
Summary
•
•
•
•
Bioterrorism is a real threat
Public health infrastructure is being
strengthened
Many bioterrorism agents are
zoonotic
Awareness education is an important
component of preparedness and
protection
Center for Food Security and Public Health
Iowa State University 2005
Summary
•
•
•
Prevention, recognition, and
response involves everyone
Report any suspicious activity,
unexplained behavior or death loss
in your clients’ herd or flock
You play a critical role
Center for Food Security and Public Health
Iowa State University 2005
Conclusion
“The best prescription,
is knowledge.”
Dr. C. Everett Koop
Former U.S. Surgeon General
Center for Food Security and Public Health
Iowa State University 2005
Acknowledgments
Development of this
presentation was funded
by a grant from the
Centers for Disease Control
and Prevention to the
Center for Food Security
and Public Health at Iowa
State University.
Center for Food Security and Public Health
Iowa State University 2005
Acknowledgments
Author:
Danelle Bickett-Weddle, DVM, MPH
Reviewers:
Radford Davis, DVM, MPH
Gayle Brown, DVM, PhD
Jean Gladon, BS
Center for Food Security and Public Health
Iowa State University 2005