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Bioterrorism UW- Eau Claire ENPH 210- Introduction to Environmental Health Sarah Arneson Todd Dennis Pamela Dohm Heather Rapala Daniel Rehberger Laura Suppes Kevin Wang

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Page 1: Bioterrorism UW- Eau Claire ENPH 210- Introduction to Environmental Health Sarah Arneson Todd Dennis Pamela Dohm Heather Rapala Daniel Rehberger Laura

Bioterrorism

UW- Eau Claire ENPH 210- Introduction to Environmental Health

Sarah ArnesonTodd Dennis

Pamela DohmHeather Rapala

Daniel RehbergerLaura SuppesKevin Wang

Page 2: Bioterrorism UW- Eau Claire ENPH 210- Introduction to Environmental Health Sarah Arneson Todd Dennis Pamela Dohm Heather Rapala Daniel Rehberger Laura

Definition

• Bioterrorism is terrorism using germ warfare, an intentional human release of a naturally-occurring or human-modified toxin or biological agent 1

Page 3: Bioterrorism UW- Eau Claire ENPH 210- Introduction to Environmental Health Sarah Arneson Todd Dennis Pamela Dohm Heather Rapala Daniel Rehberger Laura

Case study

– Sitting in an office opening up a piece of mail– Few weeks later you start to feel sick– You find out that you have anthrax– Course of antibiotics, mainly doxycycline– Everyone who was in your office is now sick– An act of bio – terrorism

Page 4: Bioterrorism UW- Eau Claire ENPH 210- Introduction to Environmental Health Sarah Arneson Todd Dennis Pamela Dohm Heather Rapala Daniel Rehberger Laura

2

Page 5: Bioterrorism UW- Eau Claire ENPH 210- Introduction to Environmental Health Sarah Arneson Todd Dennis Pamela Dohm Heather Rapala Daniel Rehberger Laura

Brief overview

– We will be covering 6 different topics.• FAQ• Past and present cases• Types of agents that are used and the effects that

these agents have on the human body• How to prevent and protect yourself from bio –

terrorism• Organizations that are trying to protect us from

bio – terrorism and how much money it is costing us

Page 6: Bioterrorism UW- Eau Claire ENPH 210- Introduction to Environmental Health Sarah Arneson Todd Dennis Pamela Dohm Heather Rapala Daniel Rehberger Laura

Frequently Asked Questions

Page 7: Bioterrorism UW- Eau Claire ENPH 210- Introduction to Environmental Health Sarah Arneson Todd Dennis Pamela Dohm Heather Rapala Daniel Rehberger Laura

FAQ

• What is the likelihood of a large-scale attack on the United States?– likelihood of a large-scale attack is low. – Not easy to spread a biologic agent that could

infect lots people. – While a major attack could be devastating,

preparations will minimize casualties.

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Page 8: Bioterrorism UW- Eau Claire ENPH 210- Introduction to Environmental Health Sarah Arneson Todd Dennis Pamela Dohm Heather Rapala Daniel Rehberger Laura

FAQ

• Is the U.S. health system prepared for an act of bioterrorism? – Centers for Disease Control and Prevention, the Public

Health Service, Cook County Public Health Office conduct surveillance for a bioterrorist event.

– Federal, state, and local authorities are working with physicians, hospitals, and the pharmaceutical industry to provide

• information and communication systems and ensure the availability and rapid deployment of life-saving pharmaceuticals, vaccines, and antidotes;

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Page 9: Bioterrorism UW- Eau Claire ENPH 210- Introduction to Environmental Health Sarah Arneson Todd Dennis Pamela Dohm Heather Rapala Daniel Rehberger Laura

FAQ

• Should I be immunized against anthrax?– The anthrax vaccine is only available to military

personnel and those who might come in contact with natural anthrax in their work (special-risk groups such as goat-hair mill or goatskin workers, wool or tannery workers, laboratory workers).

– Physicians do not have this vaccine and cannot obtain it.

– The anthrax vaccine is only recommended for people between 18 and 65 years of age.

3

Page 10: Bioterrorism UW- Eau Claire ENPH 210- Introduction to Environmental Health Sarah Arneson Todd Dennis Pamela Dohm Heather Rapala Daniel Rehberger Laura

FAQ

• Should I be immunized against smallpox?– The last naturally occurring case of smallpox in the

world occurred in 1977.

– The vaccine is not generally available to the public. • 12 to 15 million doses of vaccine remaining in the United

States.

– no treatment for the disease, vaccine provides protection and serves to stop spread of the disease.

3

Page 11: Bioterrorism UW- Eau Claire ENPH 210- Introduction to Environmental Health Sarah Arneson Todd Dennis Pamela Dohm Heather Rapala Daniel Rehberger Laura

FAQ

• Should I ask my doctor for antibiotics to have on hand in case of a bioterrorist attack?

• No. Indiscriminant use of antibiotics could be harmful, particularly for pregnant women and children.

• Keeping a supply of antibiotics on hand poses an additional problem because they have a limited shelf life and will lose potency over time

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Page 12: Bioterrorism UW- Eau Claire ENPH 210- Introduction to Environmental Health Sarah Arneson Todd Dennis Pamela Dohm Heather Rapala Daniel Rehberger Laura

FAQ

• What is the "National Pharmaceutical Stockpile" that health officials talk about on the news?

– This is a large reserve of antibiotics, chemical antidotes, and other medical supplies set aside for emergencies.

– CDC can move stockpiled material to affected areas in the United States within 1 to 2 hours of notification from a state’s Governor.

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Page 13: Bioterrorism UW- Eau Claire ENPH 210- Introduction to Environmental Health Sarah Arneson Todd Dennis Pamela Dohm Heather Rapala Daniel Rehberger Laura

FAQ

• Who do I contact regarding a possible exposure?

– If you believe you have been exposed to an infectious bioagent or if you develop symptoms that you believe might be associated with such an exposure, immediately contact a physician.

3

Page 14: Bioterrorism UW- Eau Claire ENPH 210- Introduction to Environmental Health Sarah Arneson Todd Dennis Pamela Dohm Heather Rapala Daniel Rehberger Laura

FAQ

• What can I do to protect my family and myself?

– Although there is little that you as an individual can do in advance to protect yourself from a bioterrorist attack.

– Government agencies, health care institutions, and public health agencies can and are doing more to improve capacity to protect the public following a bioterrorist attack.

– We can all educate ourselves about this issue, make family preparations for a disaster, and find out ahead of time what our local communities suggest we do.

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Page 15: Bioterrorism UW- Eau Claire ENPH 210- Introduction to Environmental Health Sarah Arneson Todd Dennis Pamela Dohm Heather Rapala Daniel Rehberger Laura

History of Biological Weapon Use(BC- 1986)

Page 16: Bioterrorism UW- Eau Claire ENPH 210- Introduction to Environmental Health Sarah Arneson Todd Dennis Pamela Dohm Heather Rapala Daniel Rehberger Laura

• RYE ERGOT• Used as early as 6th

century B.C.

• Used by Assyrians against enemies (Israelites) to poison wells

• The plant is infected by the fungus Claviceps Purpurea

• Symptoms include: convulsions, gangrenous extremities,

“madness” and death.

4

5, 6, 10

Page 17: Bioterrorism UW- Eau Claire ENPH 210- Introduction to Environmental Health Sarah Arneson Todd Dennis Pamela Dohm Heather Rapala Daniel Rehberger Laura

• Animal Cadavers

• 300 BC

• Romans and Greeks used dead animals to contaminate wells of their enemies and other water sources

7

Page 18: Bioterrorism UW- Eau Claire ENPH 210- Introduction to Environmental Health Sarah Arneson Todd Dennis Pamela Dohm Heather Rapala Daniel Rehberger Laura

• Snake Venom

• 190 BC

• Hannibal at the battle of Eurymedon conquered King Eumerus II of Pergamon

• Hannibal used poisonous snakes by putting them into enemy ships

7

8

Page 19: Bioterrorism UW- Eau Claire ENPH 210- Introduction to Environmental Health Sarah Arneson Todd Dennis Pamela Dohm Heather Rapala Daniel Rehberger Laura

• Human Cadavers

• 12th Century AD

• Battle of Toptona

• Barbossa used the bodies of dead soldiers to poison enemy wells

• Also, Romans, Greeks and Persians dipped arrows into decomposing corpses to contaminate the arrow tips7, 9

Page 20: Bioterrorism UW- Eau Claire ENPH 210- Introduction to Environmental Health Sarah Arneson Todd Dennis Pamela Dohm Heather Rapala Daniel Rehberger Laura

• Plague• 1346- breakout of plague in Tartar

Army during the “Seige of Kaffa”• Tartar soldiers threw plagued

corpses over the walls of Kaffa and infected the city causing surrender

• Infected Kaffans may have contributed to the cause of the “Black Death Pandemic”

• Spread through transmission of flea to human host

• The plague bacilli invades the lymph nodes causing inflammation, which was what “buboes” were named after

10, 12

11

Page 21: Bioterrorism UW- Eau Claire ENPH 210- Introduction to Environmental Health Sarah Arneson Todd Dennis Pamela Dohm Heather Rapala Daniel Rehberger Laura

• Small Pox

• 1753• Beginnings of the French and

Indian War (1754-1763)• Fort Pitt- Pennsylvania Frontier• General Amherst

• The disease was spread by the British “peace gesture” of offering blankets infected with smallpox to Native Americans who were loyal to the French

• Ottowan Chief- Pontiac• The fight during which the

smallpox outbreak took place was named “Pontiac’s Rebellion”

• 1796• British soldiers infected the

Continental Army with smallpox

15

10, 13, 14, 7

Page 22: Bioterrorism UW- Eau Claire ENPH 210- Introduction to Environmental Health Sarah Arneson Todd Dennis Pamela Dohm Heather Rapala Daniel Rehberger Laura

• Robert Koch

• 1870

• first person to discover that microorganisms cause infectious disease

• Does so by injecting mice with anthrax spores

• Mice contract the disease

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16

Page 23: Bioterrorism UW- Eau Claire ENPH 210- Introduction to Environmental Health Sarah Arneson Todd Dennis Pamela Dohm Heather Rapala Daniel Rehberger Laura

• First Vaccines

• 1882

• Louis Pasteur

• Development of the first successful vaccine

• Prevents Anthrax in animals

10

17

Page 24: Bioterrorism UW- Eau Claire ENPH 210- Introduction to Environmental Health Sarah Arneson Todd Dennis Pamela Dohm Heather Rapala Daniel Rehberger Laura

• Glanders--B- Mallei

• 1915

• Germans use the agent Glanders to infect allied countries livestock

• Symptoms include: fever, rigors, sweats, headache, chest pain, and is almost always fatal without treatment

10, 18

19

Page 25: Bioterrorism UW- Eau Claire ENPH 210- Introduction to Environmental Health Sarah Arneson Todd Dennis Pamela Dohm Heather Rapala Daniel Rehberger Laura

• Use of biological agents by the Japanese• 1937

• “Unit 731” in present day Sun Yang China, a base made for the construction of bombs containing deadly biological agents

• The base was disguised as an “Epidemic Prevention and Water Supply Unit”

• The base included 3 crematoriums and 2 secret prisons

• It was the largest weapons of mass destruction center in the world

• Various microorganisms were used on Chinese prisoners

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Page 26: Bioterrorism UW- Eau Claire ENPH 210- Introduction to Environmental Health Sarah Arneson Todd Dennis Pamela Dohm Heather Rapala Daniel Rehberger Laura

• Anthrax inhalation methods were found to be one of them, as well as the use of Plague, Cholera, Gas Gangrene, Brucellosis, Tularemia, and Glanders

• Symptoms for Anthrax include: mild fever, muscle aches, sore throat, malaise and after a few days, they may progress into difficulty breathing and shock

• Inhalation anthrax is usually fatal

• Cholera : Vibrio cholerae is the bacterium which causes the disease in the intestinal track

• It is a diarrheal illness• The disease itself is acute with little or no symptoms

22, 23, 24

Page 27: Bioterrorism UW- Eau Claire ENPH 210- Introduction to Environmental Health Sarah Arneson Todd Dennis Pamela Dohm Heather Rapala Daniel Rehberger Laura

• Gas Gangrene: caused by Clostridium Perfringens bacterium • Symptoms include: pain and swelling around injury, fever, blisters

filled with red fluid, increased heart rate• Caused by the infection of wounds

• Brucellosis: from the genus Brucella• Symptoms include: sweating, weight loss, fatigue, headache,

abdominal pain• Not a deadly disease but is highly contagious and can incapacitate

a person for weeks

• Tularemia: caused by the bacteria Francisella tularensis • Symptoms include: enlarged lymph nodes, sweating, headache,

muscle pain, weight loss• Not very lethal, but also will incapacitate a person for a long

period of time

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Page 28: Bioterrorism UW- Eau Claire ENPH 210- Introduction to Environmental Health Sarah Arneson Todd Dennis Pamela Dohm Heather Rapala Daniel Rehberger Laura

• A testimonial from a Japanese scientist who worked on the base stated in a documentary done years later:

• "I cut him open from the chest to the stomach and he screamed terribly and his face was all twisted in agony. He made this unimaginable sound, he was screaming so horribly. But then finally he stopped. This was all in a day's work for the surgeons, but it really left an impression on me because it was my first time."

• The surgeon soon learned, as stated in the text, that he was subjected to this operation because the man had been purposely infected with the plague, and was there for scientific observation

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Page 29: Bioterrorism UW- Eau Claire ENPH 210- Introduction to Environmental Health Sarah Arneson Todd Dennis Pamela Dohm Heather Rapala Daniel Rehberger Laura

• Plague Infested Fleas

• 1940

• Epidemic in China and Manchuria

• Source of plague came from Japanese planes, which reportedly dropped containers full of plague infested fleas over cities

Page 30: Bioterrorism UW- Eau Claire ENPH 210- Introduction to Environmental Health Sarah Arneson Todd Dennis Pamela Dohm Heather Rapala Daniel Rehberger Laura

• We know today that in 1945 the Japanese had plans to use biological warfare on the U.S.

• The Japanese military developed long-distance traveling balloons

• The balloons contained biological agents such as the ones used on Unit 751, and could reach U.S. shores

• Kamikaze planes were also planned to crash into San Diego in 1945 while carrying plague infested fleas

Page 31: Bioterrorism UW- Eau Claire ENPH 210- Introduction to Environmental Health Sarah Arneson Todd Dennis Pamela Dohm Heather Rapala Daniel Rehberger Laura

• Anthrax - British Military• 1942• Guinard Islands

• Off the coast of Scotland, British military tested Anthrax spores by dumping the spores from planes

• The “Bomblet” used was created at the Crane Naval Air Station in Southern Indiana in 1941

• The experiment killed all of the sheep on the island within 72 hours

• In 1986, the Island was so contaminated, it had to be disinfected

• To disinfect, Formaldehyde and sea water were used

• The island is now officially decontaminated

10

30

Page 32: Bioterrorism UW- Eau Claire ENPH 210- Introduction to Environmental Health Sarah Arneson Todd Dennis Pamela Dohm Heather Rapala Daniel Rehberger Laura

• Anthrax- United States Military

• 1942

• Camp Detrick

• U.S. begins their biological weapons construction

• 5,000 bombs filled with anthrax spores are made

Page 33: Bioterrorism UW- Eau Claire ENPH 210- Introduction to Environmental Health Sarah Arneson Todd Dennis Pamela Dohm Heather Rapala Daniel Rehberger Laura

• U.S. development of vaccines

• 1953

• The first mass development of vaccines to specifically protect U.S. troops against biological warfare

• Other countermeasures, along with vaccines were developed as well

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Page 34: Bioterrorism UW- Eau Claire ENPH 210- Introduction to Environmental Health Sarah Arneson Todd Dennis Pamela Dohm Heather Rapala Daniel Rehberger Laura

• Executive order to stop weapon production

• 1969• Richard Nixon signs an executive order to stop all biological

weapon production as well as research

• 1971-1972• All biological weapons in the U.S. are destroyed

10

Page 35: Bioterrorism UW- Eau Claire ENPH 210- Introduction to Environmental Health Sarah Arneson Todd Dennis Pamela Dohm Heather Rapala Daniel Rehberger Laura

• “Biological Weapons Convention”

• 1972

• Prohibition of the stockpiling of biological weapons for offensive purposes

• Signed by many countries including the U.S., the former Soviet Union, and Iraq

10

Page 36: Bioterrorism UW- Eau Claire ENPH 210- Introduction to Environmental Health Sarah Arneson Todd Dennis Pamela Dohm Heather Rapala Daniel Rehberger Laura

• Accidental release of Anthrax spores

• 1979

• Sverdlovsk, Russia

• Accidental release of airborne Anthrax spores

• 66 confirmed deaths

• Studies indicated that the spores contained 4 different strains of anthrax

10

Page 37: Bioterrorism UW- Eau Claire ENPH 210- Introduction to Environmental Health Sarah Arneson Todd Dennis Pamela Dohm Heather Rapala Daniel Rehberger Laura

• Salmonella

• 1984

• The Rajneeshee cult contaminated a salad bar in Oregon

• attempting to influence a local election by incapacitating voters

• Symptoms include: stomach cramping, bloody diarrhea and nausea

• The fatality rate is small for this disease

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Page 38: Bioterrorism UW- Eau Claire ENPH 210- Introduction to Environmental Health Sarah Arneson Todd Dennis Pamela Dohm Heather Rapala Daniel Rehberger Laura

Bioterrorist Attacks 1986-Present

Page 39: Bioterrorism UW- Eau Claire ENPH 210- Introduction to Environmental Health Sarah Arneson Todd Dennis Pamela Dohm Heather Rapala Daniel Rehberger Laura

Aum Shinrikyo

• The first bioterrorist attack on U.S. soil was not noticed by many. Almost a decade later another cult created a large amount of media attention.

• In 1995, the Aum Shinrikyo cult of Japan released sarin gas in the Tokyo subway. The attack killed 12 and injured thousands.

• The religious group also attempted to spray botulisim and anthrax in Tokyo ten times from 1993 to 1995.

• The failure of the attacks is blamed on insufficient particle size and a non-virulent strain of anthrax.

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Page 40: Bioterrorism UW- Eau Claire ENPH 210- Introduction to Environmental Health Sarah Arneson Todd Dennis Pamela Dohm Heather Rapala Daniel Rehberger Laura

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Page 41: Bioterrorism UW- Eau Claire ENPH 210- Introduction to Environmental Health Sarah Arneson Todd Dennis Pamela Dohm Heather Rapala Daniel Rehberger Laura

Disgruntled Hospital Worker

• In October 1996, 12 lab hospital workers became sick after eating some free doughnuts and muffins.

• Upon analysis of the sick workers Shigella dysenteries type 2 was found in their stool. Analysis of an uneaten muffin contained the same strain.

• A lab technician later admitted to committing the crime and also similarly caused her boyfriend to become sick with infected food.

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Page 42: Bioterrorism UW- Eau Claire ENPH 210- Introduction to Environmental Health Sarah Arneson Todd Dennis Pamela Dohm Heather Rapala Daniel Rehberger Laura

Insurance Fraud in Japan• Another attack on people’s food occurred at a summer

festival in Japan in 1998. At the event 67 people ate curry rice and later became sick.

• At first cyanide poisoning was suspected but later it was discovered to be arsenic added to the rice. Four people died from the attack.

• It is believed that Masumi and Kenji Hayashi carried out the poisoning but Kenji has never admitted guilt for the event. Kenji was a termite exterminator which would have given him access to arsenic.

• While the mass-poisoning in Wakayama instilled terror in the population, the intent was allegedly to perpetrate insurance fraud, which Masumi had done in the past.

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Page 43: Bioterrorism UW- Eau Claire ENPH 210- Introduction to Environmental Health Sarah Arneson Todd Dennis Pamela Dohm Heather Rapala Daniel Rehberger Laura

Anthrax Letters• In the fall of 2001, letters containing anthrax spores

were mailed to many prominent people in the U.S.• Tom Brokaw, Senator Tom Daschle, and the offices

of the New York Post were among those who were targeted.

• According to the CDC 23 people were infected and five died.

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3637

Page 45: Bioterrorism UW- Eau Claire ENPH 210- Introduction to Environmental Health Sarah Arneson Todd Dennis Pamela Dohm Heather Rapala Daniel Rehberger Laura

Types of Biological Agents

Page 46: Bioterrorism UW- Eau Claire ENPH 210- Introduction to Environmental Health Sarah Arneson Todd Dennis Pamela Dohm Heather Rapala Daniel Rehberger Laura

AIDS• Stands for Acquired Immunodeficiency Syndrome• Viral disease caused by HIV, Human Immunodeficiency Virus• Attacks body’s immune system and leaves it vulnerable to

other infections and diseases• Currently no cure, but there are many drug treatment options• AIDS is becoming a threat to national security around the

world but especially in Sub-Saharan Africa where the disease evolved

• AIDS can be transmitted only through sexual intercourse with an infected person, contact with contaminated blood, transmission from an infected mother to her child before or during birth or during breastfeeding

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Page 47: Bioterrorism UW- Eau Claire ENPH 210- Introduction to Environmental Health Sarah Arneson Todd Dennis Pamela Dohm Heather Rapala Daniel Rehberger Laura

AIDS

• Symptoms start out as flu-like with nausea, fever, sore throat, and headache which last around 4 weeks, after that time has passed the body starts to battle the HIV and the person can enter a symptom free period of ten or more years

• AIDS could be used for a bio-terrorist weapon because there is no current cure

• AIDS has a huge impact on the communities that it thrives in which leads to undermining government relations such as has what has happened in some parts in Africa where AIDS is virtually uncontrolled

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Page 48: Bioterrorism UW- Eau Claire ENPH 210- Introduction to Environmental Health Sarah Arneson Todd Dennis Pamela Dohm Heather Rapala Daniel Rehberger Laura

Anthrax• caused by Bacillus Anthracis, a bacterium that forms spores.• Spore is a cell that is dormant but may come to life with the right conditions• Three types of anthrax:

-Skin (cutaneous)-Lungs (inhalation)-Digestive (gastrointestinal)

• not known to spread from person to person

• infection from infected animals, handling products or infected meat, of breathing anthrax spores

• Classified as a Category A agent by the Centers for Disease Control and Prevention which means that:

-It poses the greatest possible threat for a bad effect on public health-Spreads across a large area and needs public awareness-Needs a great deal of planning to protect the public’s health

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Page 49: Bioterrorism UW- Eau Claire ENPH 210- Introduction to Environmental Health Sarah Arneson Todd Dennis Pamela Dohm Heather Rapala Daniel Rehberger Laura

Anthrax

• Symptoms include:• Cutaneous- small sore develops into a blister then develops

into a skin ulcer with a black area in the center. (These sores do not usually hurt)

• Gastrointestinal- nausea, loss of appetite, bloody diarrheas, fever, stomach pain

• Inhalation- cold and flu-like symptoms, sore throat, fever, cough, shortness of breath, muscle aches

• Symptoms appear around 7 days after contact for all 3 types; inhalation can take a week to 42 days to appear

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Page 50: Bioterrorism UW- Eau Claire ENPH 210- Introduction to Environmental Health Sarah Arneson Todd Dennis Pamela Dohm Heather Rapala Daniel Rehberger Laura

Anthrax

• Treatment is 60 days of antibiotics• The CDC is preparing for an anthrax bio-terrorist

attack by-Planning the response to an attack-Training emergency response teams-Educate health care providers-Educate general public-Develop national electronic database to

track potential cases of anthrax-Making sure there are enough supplies in

case of an attack

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Page 51: Bioterrorism UW- Eau Claire ENPH 210- Introduction to Environmental Health Sarah Arneson Todd Dennis Pamela Dohm Heather Rapala Daniel Rehberger Laura

Plague

• Caused by bacterium Yersinia Pestis

• Yersinia Pestis is easily destroyed by sunlight and drying but it can still live up to an hour in the air

• 3 kinds of plague:– Pneumonic- Y. pestis infects the lungs, spreads from person to person through the

air, and requires direct or close contact with an ill animal or human to transmit.

– Bubonic- most common type, caught when an infected flea bites a person, develops swollen tender lymph glands, fever, headache, chills, and weakness, does not spread from person to person.

– Septicemic- When plague bacteria multiply in the blood, it can be a combination of pneumonic and bubonic plague or it can occur by itself. Symptoms include fever, chills, abdominal pain, shock, bleeding into the skin and organs, does not spread from person to person.

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Page 52: Bioterrorism UW- Eau Claire ENPH 210- Introduction to Environmental Health Sarah Arneson Todd Dennis Pamela Dohm Heather Rapala Daniel Rehberger Laura

Plague

• Treatment- antibiotics given within 24 hours of the first symptoms, antibiotics include streptomycin, gentamicin, tetracycline, and chloramphenicol. Currently there is no plague vaccine.

• Plague could be used in an aerosol attack in which people would develop symptoms 1-6 days after exposure.

• Plague occurs naturally in the world. The World Heath Organization reports 1000-3000 worldwide occurrences every year, most are bubonic, outbreaks are readily controlled by standard public health responses and measures.

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Page 53: Bioterrorism UW- Eau Claire ENPH 210- Introduction to Environmental Health Sarah Arneson Todd Dennis Pamela Dohm Heather Rapala Daniel Rehberger Laura

Q Fever

• Zoonotic disease caused by Coxiella Burnetii• Organisms are excreted in milk, urine, and feces of

infected animals• Organisms are resistant to heat, drying, and common

disinfectants• Organisms survive for long periods in the environment,

making them ideal for a bio-terrorist weapon• Only about half of the people infected show symptoms

which include high fever, headache, sore throat, chills, sweats, nausea, vomiting, abdominal pain, and chest pain

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Page 54: Bioterrorism UW- Eau Claire ENPH 210- Introduction to Environmental Health Sarah Arneson Todd Dennis Pamela Dohm Heather Rapala Daniel Rehberger Laura

Q Fever

• Only 1-2% of people infected with acute Q fever die

• Most patients are ill 2-3 weeks after exposure• Treatment includes antibiotics which are most

effective the first 3 days of illness• Q Fever is ideal for bio-terrorism because it is

highly infectious, very resistant to heat and drying and can become airborne and inhaled by humans

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Page 55: Bioterrorism UW- Eau Claire ENPH 210- Introduction to Environmental Health Sarah Arneson Todd Dennis Pamela Dohm Heather Rapala Daniel Rehberger Laura

Salmonellosis

• Infection caused by bacteria salmonella• Develop diarrhea, fever, abdominal cramps• Symptoms usually last 4-7 days and people usually

recover without treatment• Caught by eating foods contaminated with animal

feces• Prevention includes not eating raw or uncooked

eggs, poultry, and meat and washing your hands before handling foods

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Page 56: Bioterrorism UW- Eau Claire ENPH 210- Introduction to Environmental Health Sarah Arneson Todd Dennis Pamela Dohm Heather Rapala Daniel Rehberger Laura

Shigellosis

• Caused by bacteria Shiglla• People infected develop diarrhea, fever, and stomach cramps

which start 1-2 days after exposure• shigellosis usually clears up in 5-7 days• Treatment for shigellosis is through antibiotics• Transmitted from person to person usually through fecal-oral

transmission, eating contaminated foods, and drinking or swimming in contaminated water

• Prevention includes washing your hands and not swimming in contaminated waters

• 18,000 cases are reported annually in the United States• Effective for bio-terrorism because it is easy to transmit from

person to person44

Page 57: Bioterrorism UW- Eau Claire ENPH 210- Introduction to Environmental Health Sarah Arneson Todd Dennis Pamela Dohm Heather Rapala Daniel Rehberger Laura

Botulism

• is a rare but serious paralytic illness caused by a nerve toxin that is produced by the bacterium Clostridium botulinum.

• There are three main kinds of botulism. – Food borne botulism is caused by eating foods that contain the

botulism toxin. – Wound botulism is caused by toxin produced from a wound infected

with Clostridium botulinum. – Infant botulism is caused by consuming the spores of the botulinum

bacteria, which then grow in the intestines and release toxin. All forms of botulism can be fatal and are considered medical

emergencies. Food borne botulism can be especially dangerous because many people can be poisoned by eating a contaminated food.

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Page 58: Bioterrorism UW- Eau Claire ENPH 210- Introduction to Environmental Health Sarah Arneson Todd Dennis Pamela Dohm Heather Rapala Daniel Rehberger Laura

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.

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Page 59: Bioterrorism UW- Eau Claire ENPH 210- Introduction to Environmental Health Sarah Arneson Todd Dennis Pamela Dohm Heather Rapala Daniel Rehberger Laura

Marburg Hemorrhagic Fever

• rare, severe type of hemorrhagic fever which affects both humans and non-human primates.

• Caused by a genetically unique zoonotic (that is, animal-borne) RNA virus of the filovirus family, its recognition led to the creation of this virus family.

• The four species of Ebola virus are the only other known members of the filovirus family

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Page 60: Bioterrorism UW- Eau Claire ENPH 210- Introduction to Environmental Health Sarah Arneson Todd Dennis Pamela Dohm Heather Rapala Daniel Rehberger Laura

Ricin

• Ricin is a poison that can be made from the waste left over from processing castor beans.

• It can be in the form of a powder, a mist, or a pellet, or it can be dissolved in water or weak acid.

• Ricin is a stable substance. For example, it is not affected much by extreme conditions such as very hot or very cold temperatures.

• Ricin works by getting inside the cells of a person’s body and preventing the cells from making the proteins they need. Without the proteins, cells die. Eventually this is harmful to the whole body, and death may occur.

• Effects of ricin poisoning depend on whether ricin was inhaled, ingested, or injected.

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Page 61: Bioterrorism UW- Eau Claire ENPH 210- Introduction to Environmental Health Sarah Arneson Todd Dennis Pamela Dohm Heather Rapala Daniel Rehberger Laura

Ricin

• Inhalation: Within a few hours of inhaling significant amounts of ricin, the likely symptoms would be respiratory distress (difficulty breathing), fever, cough, nausea, and tightness in the chest.

• Heavy sweating may follow as well as fluid building up in the lungs (pulmonary edema).

• This would make breathing even more difficult, and the skin might turn blue.

• Excess fluid in the lungs would be diagnosed by x-ray or by listening to the chest with a stethoscope.

• Finally, low blood pressure and respiratory failure may occur, leading to death.

• In cases of known exposure to ricin, people having respiratory symptoms that started within 12 hours of inhaling ricin should seek medical care.

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Page 62: Bioterrorism UW- Eau Claire ENPH 210- Introduction to Environmental Health Sarah Arneson Todd Dennis Pamela Dohm Heather Rapala Daniel Rehberger Laura

Ricin

• Ingestion: If someone swallows a significant amount of ricin, he or she would develop vomiting and diarrhea that may become bloody. Severe dehydration may be the result, followed by low blood pressure.

• Other signs or symptoms may include hallucinations, seizures, and blood in the urine.

• Within several days, the person’s liver, spleen, and kidneys might stop working, and the person could die.

• Skin and eye exposure: Ricin in the powder or mist form can cause redness and pain of the skin and the eyes.

• Death from ricin poisoning could take place within 36 to 72 hours of exposure, depending on the route of exposure (inhalation, ingestion, or injection) and the dose received.

• If death has not occurred in 3 to 5 days, the victim usually recovers.

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Smallpox• is a serious, contagious, and sometimes fatal infectious disease. • There is no specific treatment for smallpox disease, and the only prevention is vaccination. • The name smallpox is derived from the Latin word for “spotted” and refers to the raised

bumps that appear on the face and body of an infected person. • There are two clinical forms of smallpox. • Variola major is the severe and most common form of smallpox, with a more extensive rash

and higher fever. • There are four types of variola major smallpox:

– ordinary (the most frequent type, accounting for 90% or more of cases)

– modified (mild and occurring in previously vaccinated persons) – flat; and hemorrhagic (both rare and very severe).Historically, variola major has an overall fatality rate of about

30%; however, flat and hemorrhagic smallpox usually are fatal.

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Smallpox

• Variola minor is a less common presentation of smallpox, and a much less severe disease, with death rates historically of 1% or less.

• Except for laboratory stockpiles, the variola virus has been eliminated. However, in the aftermath of the events of September and October, 2001, there is heightened concern that the variola virus might be used as an agent of bioterrorism.

• Generally, direct and fairly prolonged face-to-face contact is required to spread smallpox from one person to another.

• Smallpox also can be spread through direct contact with infected bodily fluids or contaminated objects such as bedding or clothing.

• Rarely, smallpox has been spread by virus carried in the air in enclosed settings such as buildings, buses, and trains.

• Humans are the only natural hosts of variola. • Smallpox is not known to be transmitted by insects or animals.

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Tularemia

• Potentially serious illness that occurs naturally in the United States. • It is caused by the bacterium Francisella tularensis found in animals

(especially rodents, rabbits, and hares). • Symptoms of tularemia could include: sudden fever, chills, headaches,

diarrhea, muscle aches, joint pain, dry cough, and progressive weakness.

• People can also catch pneumonia and develop chest pain, bloody sputum and can have trouble breathing and even sometimes stop breathing.

• Other symptoms of tularemia depend on how a person was exposed to the tularemia bacteria. These symptoms can include ulcers on the skin or mouth, swollen and painful lymph glands, swollen and painful eyes, and a sore throat.

• Symptoms usually appear 3 to 5 days after exposure to the bacteria, but can take as long as 14 days

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Tularemia

• People can get tularemia many different ways:– being bitten by an infected tick, deerfly or other insect – handling infected animal carcasses – eating or drinking contaminated food or water – breathing in the bacteria, F. tularensis

• Tularemia is not known to be spread from person to person.

• People who have been exposed to the tularemia bacteria should be treated as soon as possible.

• The disease can be fatal if it is not treated with the right antibiotics.

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Protection and Prevention

Page 68: Bioterrorism UW- Eau Claire ENPH 210- Introduction to Environmental Health Sarah Arneson Todd Dennis Pamela Dohm Heather Rapala Daniel Rehberger Laura

Water Storage

• Store at least one gallon per person and pet per day.

• Store at least a three-day supply of water for each member of your family

• Store in a cool, dark place in your home, each vehicle and your workplace.

• Change stored water every six months.

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Water Sources

Water sources in your home:• your hot-water tank• pipes and faucets• ice cubesWater sources outside your home:• Rainwater• Streams and rivers• Ponds and lakes• Natural springs

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Page 70: Bioterrorism UW- Eau Claire ENPH 210- Introduction to Environmental Health Sarah Arneson Todd Dennis Pamela Dohm Heather Rapala Daniel Rehberger Laura

Food Storage

• Store enough food for two weeks.

• Store foods that require no refrigeration, preparation or cooking .

• Include vitamin, mineral and protein supplements.

• Eat salt-free crackers, whole grain cereals and canned foods with high liquid content if your water supplies are low.

• If there's a power outage, eat food in the refrigerator first, then from the freezer, and finally from stored supplies.

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Page 71: Bioterrorism UW- Eau Claire ENPH 210- Introduction to Environmental Health Sarah Arneson Todd Dennis Pamela Dohm Heather Rapala Daniel Rehberger Laura

Supplies. • Kitchen Supplies (manual can opener, plastic baggies, knife)• Battery-powered radio or television• Extra batteries• Flashlights • First aid kit • Change of clothing and footwear for each person• Blankets or sleeping bags• Sanitation and hygiene items (soap/shampoo, hand sanitizer, bleach)• Entertainment (magazines, books, games)• Matches in a waterproof container • Paper and Pencil

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Page 72: Bioterrorism UW- Eau Claire ENPH 210- Introduction to Environmental Health Sarah Arneson Todd Dennis Pamela Dohm Heather Rapala Daniel Rehberger Laura

Shelter

• Bring everyone indoors

• Choose interior room with few windows or doors – If a chemical has been released, choose a room above ground level,

because some chemicals are heavier than air and may seep below ground. If there are radioactive particles in the air, you should choose an interior room or basement.

• Lock doors and windows and close curtains

• Turn off fans, heating, air conditioning

• Seal any openings with duct tape/plastic sheeting

• Listen to radio/TV

• Stay off phone (but keep near by)

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Page 73: Bioterrorism UW- Eau Claire ENPH 210- Introduction to Environmental Health Sarah Arneson Todd Dennis Pamela Dohm Heather Rapala Daniel Rehberger Laura

Treatment

• ThyroSafe Tablets (potassium iodide) as a thyroid-blocking agent for use in radiation emergencies.

• ATNAA (atropine/pralidoxime) autoinjector to treat nerve gas intoxication. .

• Reactive Skin Decontamination Lotion for use by the military to remove or neutralize chemical warfare agents and T-2 fungal toxin from the skin.

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Page 74: Bioterrorism UW- Eau Claire ENPH 210- Introduction to Environmental Health Sarah Arneson Todd Dennis Pamela Dohm Heather Rapala Daniel Rehberger Laura

Treatment/Prevention

• Smallpox can be prevented through vaccination (Dryvax)

• The treatment for all types of anthrax is antibiotics. The antibiotics approved by the FDA are Cipro (ciprofloxacin), drugs in the tetracycline class such as doxycycline, and some drugs in the penicillin class such as procaine penicillin G; there is also a vaccine.

• Antibiotics such as streptomycin, doxycycline, and other drugs in the tetracycline class are used to treat plague.

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Page 75: Bioterrorism UW- Eau Claire ENPH 210- Introduction to Environmental Health Sarah Arneson Todd Dennis Pamela Dohm Heather Rapala Daniel Rehberger Laura

Government Prevention

• The Centers for Disease Control and Prevention (CDC) is the U.S. government agency responsible for controlling the spread of disease.

• State and local health departments have emergency preparedness and response plans.

• Quarantine (have been exposed to a contagious disease but who may or may not get sick) and isolation (known to have a contagious disease) control the spread of disease.

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Page 76: Bioterrorism UW- Eau Claire ENPH 210- Introduction to Environmental Health Sarah Arneson Todd Dennis Pamela Dohm Heather Rapala Daniel Rehberger Laura

Government prevention

• Public Health Security and Bioterrorism Preparedness and Response Act of 2002

• Amended Section 319 of the Public Health Service Act to increase protections associated with public health.

• The Act requires the Secretary of Health and Human Services (HHS), along with Federal department and agency officials, to launch a combined effort on preparedness for acts of bioterrorism.

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Organizations and Costs

Page 78: Bioterrorism UW- Eau Claire ENPH 210- Introduction to Environmental Health Sarah Arneson Todd Dennis Pamela Dohm Heather Rapala Daniel Rehberger Laura

Organizations and Costs

• September 11th it was proposed that within the next 5 years 3.2 billion dollars should be set aside and used against bio – terrorism. (Adams, 2001)

– Quote

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Organizations and Costs

• December of 2001 the house passed a bill that allowed 2.9 billion dollars for bio – terrorism, less than 7 days later the senate passed the same bill only adding 300 million dollars more

– Quote from Tommy Thompson

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Organizations and Costs

• The CDC, Health and Human Services; – the money that they used in 2002 was used “for

vaccines and other pharmaceutical to prepare for a possible bio-terror attack, and for the response to the limited anthrax assault that occurred”. (Adams, 2002)

• In 2003 the “BioWatch Initiative” was started by US HSD.

– Quote

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The main goal

• CDC, FDA, and our government is making sure that all of us are more aware of the threat of bio – terrorism

• Stockpiling drugs and medical equipment is currently occurring

• Making laws tougher against those that use or even possess the possible agents

Page 82: Bioterrorism UW- Eau Claire ENPH 210- Introduction to Environmental Health Sarah Arneson Todd Dennis Pamela Dohm Heather Rapala Daniel Rehberger Laura

Summary

• Bioterriorism is a real – However it is hard to spread the biological

agents• There are a lot of different agents and a lot of

different treatments

– You can protect yourself and your family– Agencies are spending lots of money to protect

us

Page 83: Bioterrorism UW- Eau Claire ENPH 210- Introduction to Environmental Health Sarah Arneson Todd Dennis Pamela Dohm Heather Rapala Daniel Rehberger Laura

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