Bioterrorism Awareness: Protection of Human and Animal Health Human Health Professionals.

Bioterrorism Awareness:Protection of Human and Animal HealthHuman HealthProfessionals

Center for Food Security and Public Health Iowa State University 2005

Why Are We Here?Why Are We Here?

• September 11, 2001 changed many things−Worst terrorist act in

U.S. history−Approximately 3000 dead

or missing−Occurred on American soil− Increased sense

of vulnerability


Biological AttackBiological Attack

• Bioterrorism attacks of 2001−Anthrax in postal

system 22 cases 5 deaths

• U.S. public health realm changed forever


Goals of This PresentationGoals of This Presentation

• Animals and public health• Bioterrorism • Government agency preparation• Bioterrorism agents and

zoonotic potential• Your role and responsibility

Animals and Public Health


Number of Animals in U.S.Number of Animals in U.S.

Dogs > 60 millionCats > 70 millionHorses 5 millionPigs 60 millionCattle 97 millionPoultry 440 millionWildlife > 1 billion


Animals and Public HealthAnimals and Public Health

• Human-animal bond• Sport• Livelihood



• Zoonotic disease• Direct transmission• Indirect transmission

−Foodborne illnesses−Vectors−Fomite



• Reservoirs, shedders, spreaders of disease

• Transmission (spillover) from domestic animals to wildlife−Establishment of enzootic cycle−Recurring human infections−Greater costs to control or eradicate−Spread to neighboring states, countries



• Sentinels• Emergence of

new diseases



Philos Trans R Soc Lond B Biol Sci. 2001 Jul 29;356(1411):983-9.


Risk Factors for Transmission of Zoonoses

Risk Factors for Transmission of Zoonoses

• Frequent contact with wild or domestic animals− Living on the fringe of wilderness− Keeping exotic animals as pets− Frequenting live animal markets− Working with livestock

• Exposure to animal waste• Immunocompromised people


Disease ControlDisease Control

• Basic hygiene−Wash hands−Child supervision

• Disinfect/clean up areas contaminated with animal waste−Livestock, pets, wildlife,

rodents


Zoonoses ControlZoonoses Control

• Limit exposure to strays and wildlife

• Cook food properly• Proper pet selection• Use caution at

petting zoos• Guidelines for

immunocompromised



• Interaction with animals−Positive attributes

• Communication between veterinary and human health communities and the public is important

Bioterrorism

Prevention through Preparedness


Preparedness Responsibilities: Human Health Professionals

Preparedness Responsibilities: Human Health Professionals

• Anticipate outbreaks locally• Collect, process, and store samples• Know the agents

−Typical signs of diseases Ask questions about exposure to animals

−How to report suspected cases• Provide leadership and disseminate

information


Biological agents targeting humans, animals, or plants

Biological, chemical, or radiological agents targeting agriculture or its components

•Livestock•Food supply•Crops•Industry•Workers

TerrorismTerrorism

BioterrorismAgroterrorism Other

Conventional, radiological, nuclear, chemical,cyber

•Typically direct human targeting


Many Agents are ZoonoticMany Agents are Zoonotic

• Category ABC disease/agent list


Characteristics of a Biological Attack

Characteristics of a Biological Attack

• 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


Time (Days)

No.

Aff

ecte

d

Exposure

Symptoms

Seek Care

Infectious Disease OutbreakInfectious Disease Outbreak


Clues to Intentional Zoonotic Agent Release

Clues to Intentional Zoonotic Agent Release

• Clustering of morbidity or mortality− Temporally or geographically− Animals or people

• Generally healthy animals or people affected

• Unusual symptoms for area• Unusual age distribution• Disease occurring outside typical season

U.S. Agencies

Dealing with terrorism


Public Health Security and Bioterrorism

Public Health Security and Bioterrorism

• Preparedness Response Act− 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


Department of Homeland Security

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


Centers for Disease Control and Prevention

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 first agencies to respond to anthrax incidents


Strategic National Stockpile (SNS)

Strategic National Stockpile (SNS)

• 12-hour Push Package−Complete package of

medical materials• Vendor Managed Inventory

−Tailored to suspected agents• Technical Advisory

Response Unit−Advise on receiving,

distribution, etc. of SNS material


Insert Your State’s Info HereInsert Your State’s Info Here

• The Iowa slides have been included as an example. Delete them and put in the information appropriate for your state.


Preparing IowaPreparing Iowa

• Iowa’s Homeland Security −Administered by

Iowa Emergency Management Division

−Works with public and private partners

www.iowahomelandsecurity.org

http://www.iowahomelandsecurity.org/

http://www.iowahomelandsecurity.org/


Preparing IowaPreparing Iowa

• Iowa Department of Public Health www.idph.state.ia.us/odedp

• Iowa Department of Agriculture and Land Stewardship−Highly infectious animal

disease program

Category ABC Agent Overview


ClassificationClassification

• Prepared by the CDC’s Bioterrorism Preparedness and Response Office

• Category A: Highest priority• Category B: Second highest priority• Category C: Third highest priority


“Weaponization” of Agents“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

Category ABCDiseases/Agents


Note to presenterNote to presenter

• As time allows select diseases you would like to review.

• If you have limited time you should focus on the Category A agents.

• Disease coverage is brief. If you need more information on a disease, please refer to the disease fact sheet or the disease specific PowerPoint presentation.


Category A : Agents/DiseasesCategory A : Agents/Diseases

• Anthrax• Botulism• Plague• Smallpox• Tularemia• Viral hemorrhagic fevers


Anthrax: The AgentAnthrax: The Agent

• Bacillus anthracis −Spores in soil worldwide

• TransmissionZoonotic Potential−Direct contact (wound)− Inhalation

Contaminated dust− Ingestion

Contaminated meat−Person-to-person transmission rare


Anthrax: The DiseaseAnthrax: The Disease

• Humans− Cutaneous

95% of natural cases Mortality 5-20%

− Pulmonary Mortality 75-95%

− Gastrointestinal Mortality >50% mortality

• Animals− Ruminants at greatest risk

Sudden death, hemorrhage No cutaneous lesions


Anthrax: Zoonotic ImportanceAnthrax: Zoonotic Importance

• Zoonotic potential− Direct contact− Inhalation− Ingestion

• High risk groups: Occupational− Livestock,

slaughterhouse workers− Tannery or wool

industry workers− Veterinarians,

lab workers


Anthrax: The BioweaponAnthrax: The Bioweapon

• Bioweapon−History−Available−Easy to produce−Spores infective and

highly resistant−Aerosolization−Low lethal dose−High mortality


Botulism: The AgentBotulism: The Agent

• Clostridium botulinum−7 different neurotoxins (A-G)

• Transmission− Ingestion (food-borne)−Wound infection−Aerosol

• Zoonotic potential− Improperly fermented fish, undercooked

meat products, honey in infants


Botulism: The DiseaseBotulism: The Disease

• All species, including humans−Clinical signs

Progressive flaccid paralysis Difficulty swallowing Drooping eyelids Paralysis of respiratory muscles

• Death in 24 hours

−Medical emergency


Botulism: The BioweaponBotulism: The Bioweapon

• History−U.S. bioweapons program−Used by Aum Shinrikyo cult in Japan−Produced by Iraq

• Aerosolized• Easy to produce and transport• Potent and lethal• Most poisonous substance known


Plague: The AgentPlague: The Agent

• Yersinia pestis• Transmission

−Flea bite−Direct contact

Infected animal tissue or fluids

−Aerosol−Person-to-person

• Zoonotic potential−Rodents, cats


Plague: The DiseasePlague: The Disease

• Humans−Bubonic (50-60% fatality)−Septicemic (~100% fatality)−Pneumonic (~100% fatality)

Primary or secondary

• Animals−Rodents: reservoir

Ground squirrels, prairie dogs, rats

−Cat: similar to human forms


Plague: Zoonotic ImportancePlague: Zoonotic Importance

• Transfer of infected fleas• Contact with infected rodents• Contact with infected cat

−Sneezing droplets−Flea transfer−Scratch or bite


Plague: The BioweaponPlague: The Bioweapon

• History• Available• Pneumonic form highly contagious• WHO estimate

−50 kg agent: City population 5 million−150,000 cases pneumonic plague−Potential mortality: 100,000


Smallpox: The AgentSmallpox: The Agent

• Orthopoxvirus−Variola virus

• Eradicated worldwide in 1977−Officially declared in 1980

• Transmission−Person-to-person

Direct contact Fomites Aerosol


Smallpox: The DiseaseSmallpox: The Disease

• Human disease− Acute− Initially flu-like

Fever, malaise Headache, backache, vomiting

− Progressive skin eruptions Macules to papules to vesicles

− Hemorrhagic and malignant forms possible Both have high mortality rate (up to 95%)

• Only affects humans− Experimentally

Cynomolgus monkeys


Smallpox: The BioweaponSmallpox: The Bioweapon

• History• Easy to produce large scale• Aerosolization• Diagnosis signals a bioterrorism event• Secondary spread

− Person-to-person− Fomites

• Mortality 30% (unvaccinated)• No effective treatment


Tularemia: The AgentTularemia: The Agent

• Francisella tularensis• Transmission

Zoonotic Potential−Vector: tick, deerfly − Ingestion

Undercooked meat (rabbit)−Aerosolization−Direct contact

Abraded skin−Person-to-person not documented


Tularemia: The DiseaseTularemia: The Disease

• Humans−Glandular, Ulceroglandular,

Oculoglandular, Oropharyngeal−Severe: Typhoidal, Pneumonic

• Animals−Wildlife

Dead or behave strangely

−Other species Signs similar to humans, death


Tularemia: BioweaponTularemia: Bioweapon

• History• Stable • Aerosolized• Low infective dose via inhalation• Case-fatality: 30-60% (untreated)• 1970 WHO estimation

50 kg agent: city population 5 million• 250,000 ill• 19,000 deaths


Viral Hemorrhagic FeversViral Hemorrhagic Fevers

• Ebola and Marburg (Filoviruses)• Machupo and Lassa (Arenaviruses)• Transmission

−Person-to-person−Direct contact−Fomites−Machupo and Lassa (Zoonotic Potential)

Rodent urine or feces or food and water contaminated by these materials


VHF: The DiseaseVHF: The Disease

• Humans−Early: fever, fatigue−Severe

Hemorrhage of internal organs and from body orifices

−Shock, seizures• Animals

−Only non-human primates susceptible


VHF: The BioweaponVHF: The Bioweapon

−Aerosolized −Not readily available−Requires specialized production−Person-to-person and nosocomial

transmission occur−Estimated fatality rate

Variable but can be 50-90% for some


Category B: Agents/DiseasesCategory B: Agents/Diseases

• Brucellosis• Glanders• Melioidosis • Psittacosis • Q Fever• Typhus Fever

• Viral encephalitis• Toxins• Food Safety Threats • Water Safety Threats


Brucellosis: The AgentBrucellosis: The Agent

• Brucella species• Transmission - Zoonotic

−Direct contact (breaks in skin) Vaginal or uterine discharge Placenta, blood, urine

− Ingestion Unpasteurized milk or dairy

−Aerosol−Self-inoculation with vaccine−Person-to-person rare


Brucellosis: Zoonotic PotentialBrucellosis: Zoonotic Potential

Species Natural HostHuman

pathogen

B. abortus Cattle, bison, elk, horses

YES

B. melitensis Goats, sheep, cattle

YES

B. suis Swine, rodents YES

B. canis Dogs YES

B. ovis Sheep NO


Brucellosis: The DiseaseBrucellosis: The Disease

• Humans−Cyclic fever and flu-like symptoms

Muscle aches, headache, weight loss

−Chronic Osteoarticular (20-60% of cases) Chronic fatigue, depression Genitourinary (2-20% of cases)

• Animals−Abortion, infertility, lameness


Brucellosis: The BioweaponBrucellosis: The Bioweapon

• History• Highly infectious• Easily aerosolized• Stable• Prolonged incubation period

−May make diagnosis difficult• Person-to-person unlikely


Glanders: The AgentGlanders: The Agent

• Burkholderia mallei−Gram negative bacterium

• Transmission− Ingestion− Inhalation−Direct contact−Person-to-person rare−Animal-to-human

• Zoonotic potential


Glanders: The DiseaseGlanders: The Disease

• Humans− Localized and Chronic

Nodules, abscesses, ulcers− Pulmonary

Pneumonia, pulmonary abscesses− Septicemia

Fever, chills, death within 7-10 d Case-fatality 50-95% (untreated)

• Horses, mules and donkeys− Acute, Chronic, Latent− Cutaneous & pulmonary lesions− Rapidly fatal illness


Glanders: Zoonotic ImportanceGlanders: Zoonotic Importance

• Animal-to-human transmission−Possible but inefficient−Direct contact with exudates−Aerosolization of agent

• High risk groups−Veterinarians−Horse owners, handlers, groomers−Laboratorians


Glanders: The BioweaponGlanders: The Bioweapon

• History− World War I: Russian horses− World War II: Chinese civilians, horses, POW’s− U.S bioweapon program

• Easy to produce• Highly infectious• Stable• Aerosolized• Overall mortality: 40%

− Septicemia case-fatality: 50-95%


Melioidosis: The AgentMelioidosis: The Agent

• Burkholderia pseudomallei −Gram negative

• Transmission−Direct contact (wounds)− Ingestion− Inhalation−Person-to-person (rare)−Animal-to-person (rare)


Melioidosis: The DiseaseMelioidosis: The Disease• Human

−Focal−Pulmonary−Septicemic−Chronic/Latent

“Vietnamese time bomb”• Animals

−Sheep, goats, and pigs−Horses, dogs, rodents−Asymptomatic−Pneumonia, abscesses−Lameness


Melioidosis: The Bioweapon Melioidosis: The Bioweapon

• Minor history • Easy to produce • Available• Aerosolization

− Increased number of septicemic and pulmonary forms

• Mortality rate can be as high as 90%


Psittacosis: The AgentPsittacosis: The Agent

• Chlamydophila psittaci− Gram negative− Resistant

• Reportable in U.S.− 50-100 reported cases

per year• Transmission

Zoonotic Potential− Inhalation of contaminated dust from feathers

or bird droppings− Person-to-person possible


Psittacosis: The DiseasePsittacosis: The Disease

• Humans− Asymptomatic− Flu-like signs

Fever, chills, headache Nonproductive cough, dyspnea

− Severe pneumonia Especially in adults 30-60 years old

• Birds− Depression, nasal discharge, conjunctivitis,

dyspnea− Yellow-green diarrhea− Possibly neurologic signs


Psittacosis: The BioweaponPsittacosis: The Bioweapon

• Easily obtained• Aerosolized• Stable in the environment


Q Fever: The AgentQ Fever: The Agent

• Coxiella burnetii −Obligate intracellular rickettsia

• TransmissionZoonotic Potential− Inhalation−Direct contact− Ingestion− Inoculation (ticks)−Person-to-person (rare)


Q Fever: The DiseaseQ Fever: The Disease

• Humans−Acute

Flu-like signs, pneumonia, hepatitis

−Chronic Endocarditis, osteomyelitis

• Animals−Most asymptomatic−Abortions, stillbirths


Q Fever: Zoonotic ImportanceQ Fever: Zoonotic Importance

• Parturient material from infected animals

• Urine, feces, milk−Direct contact− Inhalation of droplets− Inhalation of contaminated dust


Q Fever: The BioweaponQ Fever: The Bioweapon

• History• Easily accessible• Environmentally resistant• Highly infectious

−One organism• Aerosolization

−Travel up to ½ mile by wind• Low mortality but chronic morbidity


Typhus Fever: The AgentTyphus Fever: The Agent

• Rickettsia prowazekii• Endemic

−Eastern Europe, Middle East, and parts of Africa

• Transmission−Human body louse feces−Not person-to-person


Typhus Fever: The DiseaseTyphus Fever: The Disease

• Humans−Fever, headache−Macular eruptions−Petechial rash

• Not seen in domestic animals−Documented in flying squirrels

Asymptomatic Few human cases associated


Typhus Fever: The BioweaponTyphus Fever: The Bioweapon

• Available• Can be aerosolized in lice feces• WHO estimation: 1970

−50 kg agent−5 million people in city−125,000 ill

8,000 deaths


Viral Encephalitis: The AgentsViral Encephalitis: The Agents

• Arboviruses−Alphaviruses

Bird Mosquito Horses and humans dead end hosts

• Transmission−Mosquitoes−Person-to-person

possible


Viral Encephalitis: The DiseaseViral Encephalitis: The Disease

• Humans− Asymptomatic to flu-like illness

Fever, myalgia, headache, nausea and vomiting− Neurological

Disorientation, stupor, coma, seizures, paralysis

• Horses− Signs similar to humans

• Birds− Asymptomatic carriers− Neurological or death− Can act as sentinels


Viral Encephalitis: The BioweaponViral Encephalitis: The Bioweapon

• History• Easy to produce• Aerosolization• High rate of infection

−With long term disability possible


Toxins: The AgentsToxins: The Agents

• Staphylococcal enterotoxin B (SEB)

• Ricin toxin from castor plant

• Clostridium perfringens epsilon toxin


Staphyloccal Enterotoxin B (SEB): The Agent

Staphyloccal Enterotoxin B (SEB): The Agent

• Staphylococcus aureus• Transmission: Ingestion and inhalation• Humans

− Fever, chills, headache, myalgia− Inhalation non-productive cough− Ingestion nausea, vomiting, diarrhea

Typically self limiting in 8-24 hours

• Animals− Limited information available− Signs likely to be similar to human


Ricin: The AgentRicin: The Agent

• Toxin from bean of castor plant (Ricinus communis)

• Transmission− Ingestion

Severe gastrointestinal signs Hemorrhagic enteritis

− Inhalation Respiratory signs with death

as rapidly as 36-72 hours− Injection

• Horses most susceptible animal species


Epsilon Toxin: The AgentEpsilon Toxin: The Agent

• Clostridium perfringens type B and D− Increases intestinal and vascular

permeability and liver damage• Clinical signs

−Calves Diarrhea, abdominal pain, listlessness,

neurologic−Sheep, goats

Watery to bloody diarrhea, neurologic−Humans

Little information


Toxins: The BioweaponToxins: The Bioweapon

• History• Aerosolized: SEB, Ricin • Available worldwide• Easy to produce, stable• Many species affected• No person-to-person transmission


Food Safety ThreatsFood Safety Threats

• Campylobacter species• Salmonella species• E. coli 0157:H7 • Others:

−Viruses, parasites, chemicals, toxins

• Ingestion of contaminated food

• Gastrointestinal upset


Food Safety Threats: The Bioweapon

Food Safety Threats: The Bioweapon

• 1984: The Dalles, Oregon−Bagwan Shree

Rajneesh cult−Contaminated salad bars

Salmonella typhimurium

−Goal to incapacitate voters−751 people ill


Water Safety ThreatsWater Safety Threats

• 53% of U.S. drinking water is from ground water

• Cryptosporidium parvum−Protozoan

• Vibrio cholerae−Bacteria


Cryptosporidium: The AgentCryptosporidium: The Agent• Cryptosporidium parvum

−Protozoa• Transmission

− Inhalation, ingestion• Clinical signs

−Humans, calves, others Acute gastroenteritis

−Dogs, cats, horses, pigs: Resistant−Zoonotic Potential


Vibrio cholerae: The AgentVibrio cholerae: The Agent• Vibrio cholerae

− Gram negative bacteria

• Transmission− Fecal-oral− Contaminated shellfish

• Humans− Acute, mild diarrhea− 5% severe disease

• Animals− Resistant to disease


Water Safety: Public Health Significance

Water Safety: Public Health Significance

• 1993−Municipal water supply contaminated

Milwaukee, WI−Cryptosporidum parvum −40,000 ill

• 1997−Decorative water fountain

Minnesota Zoo−369 cases −Mostly young children


Category CCategory C

• Nipah virus• Hantavirus


Nipah Virus: The AgentNipah Virus: The Agent

• Paramyxovirus; Henipavirus• Reservoir: Fruit bats• Transmission

−Aerosol, direct contact with infective tissues

−Not person-to-person• Zoonotic Potential• 2004 break: Bangladesh

−26 human deaths


Nipah Virus: The DiseaseNipah Virus: The Disease

• Humans− Encephalitis

Fever, headache, dizziness, disorientation− Respiratory distress possible

• Swine− Asymptomatic− Severe respiratory disease

Dyspnea, open mouth breathing, barking cough− Neurological signs possible

• Dogs and cats− Neurological and respiratory


Nipah Virus: The BioweaponNipah Virus: The Bioweapon

• Emerging pathogen• Aerosolization potential• Wide host range• High morbidity and

mortality• Biolevel 4


Hantavirus: The AgentHantavirus: The Agent

• Bunyaviridae−Sin Nombre

• Reservoir: Rodents Deer mouse in U.S. Not house mouse

• Transmission− Infective rodent feces, urine or saliva

Inhalation Direct contact Ingestion


Hantavirus: The DiseaseHantavirus: The Disease

• Humans−Fever, myalgia, headache−Rapid progression to severe respiratory

disease Hantavirus Pulmonary Syndrome Hemorrhagic Fever with Renal Syndrome

−Death can occur in 48 hours• Not seen in domestic animals


Hantavirus: The BioweaponHantavirus: The Bioweapon

• Aerosolized• Rapid disease

−Requires hospitalization• Mortality 40%• Hemorrhagic Fever

with Renal Syndrome−Clinical form not

typically seen in U.S.


Other Important DiseasesOther Important Diseases

• Transmissible Spongiform Encephalopathy

• Rift Valley Fever• Hendra Virus• West Nile Virus• Monkeypox• Foot and Mouth Disease


Transmissible Spongiform Encephalopathy: The AgentTransmissible Spongiform

Encephalopathy: The Agent• Prions

−Proteinaceous infectious particles−Mutated proteins

• Very long incubation period• Neurological signs in all species• No treatment available


Bovine Spongiform Encephalopathy

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− First case December 2003− Now have enhanced surveillance


Rift Valley Fever: The AgentRift Valley Fever: The Agent

• Family Bunyaviridae−Phlebovirus

• Transmission−Mosquitoes− Inhalation−Contact with infected body fluids−Not person-to-person

• Zoonotic Potential


Rift Valley Fever: The DiseaseRift Valley Fever: The Disease

• Humans−Asymptomatic or self-limiting

flu-like signs Fever, headache

−Severe disease Retinitis, hemorrhagic fever

• Animals−Abortions, neonatal death


Rift Valley Fever: The BioweaponRift 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


Hendra Virus: The AgentHendra Virus: The Agent

• Newly discovered− Paramyxovirus

Henipahvirus

− 1994: Australia

• Fruit bats• Transmission

− Close contact with urine, body fluids− Ingestion− Not person-to-person



Hendra Virus: The DiseaseHendra Virus: The Disease

• Humans−Flu-like illness−Rapid progression to

respiratory failure or encephalitis• Horses, cats

−Acute respiratory signs−Nasal discharge, fever−Encephalitis−Sudden death


West Nile Virus: The AgentWest Nile Virus: The Agent

• Flavivirus• Reservoir: Birds (Corvids)• Humans and horses

−Dead end hosts• Transmission

−Mosquitoes Culex species

−Person-to-person Blood transfusion, organ donation,

breast feeding


West Nile Virus: The DiseaseWest Nile Virus: The Disease

• Humans−~80% Asymptomatic−~20% “West Nile Fever”

Fever, headache, myalgia, prolonged fatigue 1:150 cases severe

• “West Nile Encephalitis”• Case-fatality 3-15%• Highest in elderly

• Animals−Horses, birds, mammals, and reptiles


West Nile Virus: Public Health Significance

West Nile Virus: Public Health Significance

• 2003−Human illness in U.S.

9,862 cases - 264 deaths−Equine illness in U.S.

4,554 cases 40% of ill result in death

−Other mammals dogs, squirrels, cats

• Method of introduction to U.S. unknown


Map courtesy of CDC


Foot and Mouth Disease: FMDFoot and Mouth Disease: FMD

• Picornavirus• Highly contagious• Minimal risk to humans

−Extremely rare−Mild symptoms in people

• Transmission−Direct contact−Aerosol−Fomites


• Species−Cloven-hoofed animals

Cattle, sheep, goats, swine−Not horses

• Signs−Fever−Vesicles

Mouth, lips, tongue, and hoof lesions

Hypersalivation, anorexia, and lameness

FMD: The DiseaseFMD: The Disease


FMD: Agroterrorism ThreatFMD: Agroterrorism Threat

• Most important livestock disease in the world−Economically devastating

• U.S. agriculture as a target−One sixth of the U.S. domestic

product is tied to agriculture− Immunologically naive population

• Vulnerabilities


Monkeypox: The AgentMonkeypox: The Agent

• Orthopoxvirus−Related to smallpox

• Transmission−Bites−Aerosol−Direct contact−Fomites−Person-to-person



Monkeypox: The DiseaseMonkeypox: The Disease

• Humans−Flu-like signs−Rash, vesicles, pustules−Lymphadenopathy

• Animals-Rodents−Fever−Cutaneous rash and vesicles−Conjunctivitis


Monkeypox: Public Health Significance

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

Responsibility


Integrated Public Health SystemIntegrated Public Health System

• Communication • Be aware, contribute,

assist in development of disease surveillance programs

• Report zoonoses• Be involved with emergency

response plans at all levels


What to do if Bioterrorism is Suspected

What to do if Bioterrorism is Suspected

• Stay informed and remain calm• Response is event specific• Follow the advice of public

health officials • Follow federal and state guidelines• Movement restrictions may

be necessary


ContactsContacts

• Phone numbers to know−Public Health Officials

Local and State

−Local Veterinarian−State Public Health

Veterinarian or State Veterinarian


SummarySummary

• Bioterrorism is a real threat • Many bioterrorism agents are zoonotic• Animals may be the first to show signs• Ask questions about animals exposure

and clinical signs• Public health infrastructure is

being strengthened


SummarySummary

• Awareness education is important component of preparedness and protection

• Prevention, recognition, and response involves everyone

• You play a critical role


ReadingsReadings


ConclusionConclusion

“The best prescription,is knowledge.”

Dr. C. Everett KoopFormer U.S. Surgeon General


AcknowledgmentsAcknowledgments

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.


AcknowledgmentsAcknowledgments

Author:

Co-authors:

Reviewer:

Glenda Dvorak, DVM, MS, MPH

Gayle Brown, DVM, PhDRadford Davis, DVM, MPH

Danelle Bickett-Weddle, DVM, MPH

Bioterrorism Awareness: Protection of Human and Animal Health Human Health Professionals.

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Transcript of Bioterrorism Awareness: Protection of Human and Animal Health Human Health Professionals.