BIOTERRORISM
BIOTERRORISM
• Center for Disease Control (CDC) is a
civilian agency responsible for combating
biological and chemical weapons
– Epidemic Intelligence Service (EIS)
• Detects and analyzes the effects of biological
weapons and man-made epidemics
• Consists of medical doctors, researchers, and
scientists
• Is a 2 year assignment
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logo.svg.png
MICROBIAL FORENSICS
• Use DNA, RNA, or proteins to identify a
microbe (virus, bacteria, protist, etc.) used
in an attack
• Trace back to a person/group, piece of
equipment, or country of origin
• Use carbohydrates or proteins on the
microbe surface as a “fingerprint”
• Similar techniques used in molecular
epidemiology
• Has to hold up with judges and jury
BIOTERRORISM
Sites of Epidemic Intelligence Service EPI-AID
Investigations During the 1990s
POTENTIAL AGENTS
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Anthrax (“Amerithrax”)
Smallpox
Q fever (Coxiella burnetti) goats, sheep, cattle
Ebola and Marburg viruses
Plague (Yersinia pestis)
Tularemia
Ricin
Botulism and other food-borne diseases
Brucellosis
Typhus (not related to Typhoid Mary Mallon)
Viral encephalitis
ANTHRAX
• Caused by the soil bacteria Bacillus anthracis, a
bacterium that forms spores
– A spore is a cell that is dormant (asleep) but may come
to life in the right conditions.
• There are three types of anthrax:
– skin (cutaneous)
– lungs (inhalation)
– digestive (gastrointestinal)
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appened-per-CDC-Head-650x487.jpg
How Dangerous Is Anthrax?
• Anthrax is classified as a Category A agent. Category A
agents are those that:
– pose the greatest possible threat to public health
– may spread across a large area or need public awareness
– need a great deal of planning to protect the public’s
health
• In most cases, early treatment with antibiotics can cure
cutaneous anthrax. Even if untreated, 80 percent of people
who become infected with cutaneous anthrax do not die.
• Gastrointestinal anthrax is more serious because between
one-fourth and more than half of cases lead to death.
• Inhalation anthrax is much more severe. In 2001, about
half of the cases of inhalation anthrax ended in death.
CAUSES
• Ingestion of undercooked food
http://www.llnl.gov/s
• Inhalation of spores
tr/Weinstein.html
• Handling animals (wool)
• Bioterrorism--2001 letters were sent a week after 9/11 to
media members and senators.17 were infected and 5
people were killed. Bruce Edwards Ivins who was a
scientist at the biodefense labs in Fort Detrick was
identified. He later committed suicide via acetaminophen.
Cutaneous Anthrax—Vesicle Development
Day 2
Ulcer and vesicle ring
Day 6
Day 4
Black eschar, redness remains
SMALLPOX
• Caused by Variola virus
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Virus acquired by inhalation
No specific treatment, the only prevention is vaccination
Eradicated—last case in Somalia in 1977
Two types
– Variola major—most severe
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• Hemorrhagic—all ages
• Flat-type—children
• Modified—vaccinated patients
– Variola minor seen only in 1% of cases. Small
hemorrhages on the heart and liver cause death by
toxemia (leads to heart failure)
TULAREMIA
• Also known as “rabbit fever,”
• Caused by the bacterium Francisella tularensis.
• Typically found in animals, especially rodents, rabbits, and
hares.
• Usually a rural disease but has been reported in all U.S.
states except Hawaii.
• People become infected through the bite of infected insects
(most commonly, ticks and deerflies), by handling infected
sick or dead animals, by eating or drinking contaminated
food or water, or by inhaling airborne bacteria.
https://www.cdc.gov/tularemia/images/TularemiaHome.jpg
TULAREMIA
• Symptoms include skin ulcers, swollen and painful lymph
glands, inflamed eyes, sore throat, mouth sores, diarrhea or
pneumonia.
• If the bacteria are inhaled, symptoms can include abrupt
onset of fever, chills, headache, muscle aches, joint pain,
dry cough, and progressive weakness.
• People with pneumonia can develop chest pain, difficulty
breathing, bloody sputum, and respiratory failure.
• Tularemia can be fatal if the person is not treated with
appropriate antibiotics.
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vention.jpg
Why are we concerned about
tularemia being used as a
bioweapon?
• Francisella tularensis is highly infectious. A small
number of bacteria (10-50 organisms) can cause
disease.
• If Francisella tularensis were used as a
bioweapon, the bacteria would likely be made
airborne so they could be inhaled.
• People who inhale the bacteria can experience
severe respiratory illness, including
life-threatening pneumonia and systemic infection,
if they are not treated.
• Hurts economy
BOTULISM
● Botulism is a muscle-paralyzing disease caused by a toxin
(BTX) made by a bacterium called Clostridium
botulinum.
● Foodborne botulism occurs when a person ingests the
pre-formed toxin. This leads to illness within a few hours
to days. Foodborne botulism is a public health emergency
because the contaminated food may still be available to
other persons besides the patient.
● Infant botulism occurs in a small number of susceptible
infants each year who harbor C. botulinum in their
intestinal tract.
● Wound botulism occurs when wounds are infected with C.
botulinum that secretes the toxin.
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ulism_1.jpg
BRUCELLOSIS
• Brucellosis is an infectious disease caused by the bacteria
of the genus Brucella. These bacteria are primarily passed
among animals, and they cause disease in many different
vertebrates. Various Brucella species affect sheep, goats,
cattle, deer, elk, pigs, dogs, and several other animals.
• Humans become infected by coming in contact with
animals or animal products that are contaminated with
these bacteria
• In humans, brucellosis can cause a range of symptoms that
are similar to the flu and may include fever, sweats,
headaches, back pains, and physical weakness.
• Severe infections of the central nervous systems or lining
of the heart may occur. Brucellosis can also cause
long-lasting or chronic symptoms that include recurrent
fevers, joint pain, and fatigue.
BRUCELLOSIS
• Humans are generally infected in one of three ways: eating or
drinking something that is contaminated with Brucella,
breathing in the organism (inhalation), or having the bacteria
enter the body through skin wounds. The most common way to
be infected is by eating or drinking contaminated milk products.
• When sheep, goats, cows, or camels are infected, their milk is
contaminated with the bacteria. If the milk is not pasteurized,
these bacteria can be transmitted to persons who drink the milk
or eat cheeses made it.
• Inhalation of Brucella organisms is not a common route of
infection, but it can be a significant hazard for people in certain
occupations, such as those working in laboratories where the
organism is cultured. Inhalation is often responsible for a
significant percentage of cases in abattoir (slaughterhouse)
employees.
• Contamination of skin wounds may be a problem for persons
working in slaughterhouses, meat packing plants, veterinarians,
hunters
BRUCELLOSIS
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Escherichia coli
O157:H7
• Close to 75,000 cases of infection and 60 deaths occur in
the United States each year.
• Often leads to bloody diarrhea and occasionally to kidney
failure.
• Shiga toxin gained from Shigella
• Transmission occurs by eating undercooked, contaminated
ground beef, bean sprouts or fresh leafy vegetables such as
lettuce and spinach, unpasteurized milk,
sewage-contaminated water
• Person-to-person contact in families and child care centers
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is also a known mode of transmission.
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Salmonella typhi
1984, Oregon town called The Dalles
● 10 salad bars were sprayed with Salmonella
● 174 people contracted it
● 45 people had to be hospitalized
● Terrorists wanted to infect voters to
influence a Wasco county election
● Considered the 1st and largest bioterrorist
attack on U.S. soil
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CHOLERA
• Cholera is an acute, diarrheal illness caused by infection of
the intestine with the bacterium Vibrio cholerae.
• The infection is often mild or without symptoms, but
sometimes it can be severe.
• Approximately one in 20 infected persons will have severe
disease characterized by profuse watery diarrhea,
vomiting, and leg cramps. In these persons, rapid loss of
body fluids leads to dehydration and shock.
• Without treatment, death can occur within hours!
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EBOLA
• Viral hemorrhagic fevers are a group of febrile illnesses
caused by several distinct families of viruses, all of which
are enveloped and have RNA genomes.
• These groups include Ebola and Marburg viruses, Lassa
fever virus, the New World arenaviruses (Guaranito,
Machupo, Junin, and Sabia), and Rift Valley fever and
Crimean Congo hemorrhagic fever viruses.
• Although some types cause relatively mild illnesses, many
of these viruses can cause severe, life-threatening disease.
Severe illness is characterized by vascular damage and
increased permeability, multiorgan failure, and shock.
EBOLA
ENVELOPED RNA VIRUSES
Virus Types
RICIN
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• A potent toxin that has potential to be used as an agent of
biological warfare
• Inhibits protein synthesis
• Derived from the beans of the castor plant (Ricinus
communis).
• Can be disseminated as an aerosol, by injection, or as a
food and water contaminant.
• Causes severe gastroenteritis, GI hemorrhage, and hepatic,
splenic, and renal necrosis
• If injected, can cause severe local necrosis of muscle and
regional lymph nodes with organ involvement and death
BIOTERRORISM DETECTION
BIOTERRORISM DETECTION
http://www.llnl.gov/str/Weinstein.html
BIOTERRORISM DETECTION
BIOTERRORISM DETECTION
http://www.llnl.gov/str/Weinstein.html
BIOTERRORISM DETECTION
http://www.llnl.gov/str/Weinstein.html
BIOTERRORISM DETECTION
http://www.llnl.gov/str/Weinstein.html
VACCINES
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SMALLPOX
• Made from related Vaccinia virus (so cannot get smallpox)
• First dose offers protection for 3-5 years and maybe as
long as 10 years
• Delivered with a bifurcated (two pronged) needle that is
dipped within the vaccine. It then pokes the skin about 15
times in a few seconds
• If successful, a red and itchy bump forms and blisters.
Scab falls off in third week leaving a scar
• Side effects include rash, fever, and aches. Severe effects
seen in only 15 out of a million vaccinated
ANTHRAX VACCINE
• Contains the protective antigen—inactivated
vaccine
• Contains aluminum—attracts WBC and acts as a
storage depot
• Contains benzethonium chloride—antimicrobial
• Contains formaldehyde (small amount)—longer
shelf life
• Does not contain mercury, penicillin, fetal tissue
(MMR), eggs or pork
• Schedule for vaccine is 0, 2-4 weeks, 6-12-18
months, annual boosters