Threats and preventions of bioterrorism

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  • 1. Threats,Impacts & Preparedness Of Bioterrorism ...the intentional release of an infectious particle, be it a virus or bacterium, from the confines of a laboratory or medical practice must be formally condemned as an irresponsible threat against the whole human community. (Lederberg)

2. Threats (silent threats) Threat To Economy Threat To Wildlife and Biodiversity Psycho-social Factors During Bioterrorism Threat To Population Size 3. Key elements of the threat The who (the actor), The what (the agent), The where (the target), How (the mode of attack). 4. THREAT TO ECONOMY The terrorists have an option to use exotic organisms to spread disease in animals and plants. Animals Disease Imagine somebody spread: Foot and Mouth disease Rinderpest (infectious,viral) Glanders (contagious,bacterial) Swine fever (contagious disease of pigs and wild boar) Fowl plague Rabies and so on. 5. THREAT TO ECONOMY (continued) Similarly Plant Diseases Rice blast (Fungal disease) Late blight of potato (A Serious Disease of Potatoes and Tomatoes) Black Rust (fungal disease) Maize Rust and so on would destroy all the crops and shatter the economy of the country. Eg:-Irish Potato Famine In 1940 due to potato blast half a million people died of starvation and half a million people migrated. It took one century for the countrys economy to recover. Highly pathogenic avian influenza, Hong Kong The outbreak of highly pathogenic avian influenza (HPAI) type A (H5N1) in live market chickens in Hong Kong resulted in 6 million deaths and killing of 1.4 million birds. 6. Threat To Wildlife & Biodiversity Wildlife populations are more vulnerable to biological terrorist attacks than are domesticated species. Access to free-ranging wildlife is unrestricted, chances of a perpetrator being noticed are very low, and wildlife disease surveillance activities are minimal in most areas. Bioterrorist easily spread bioweapons to wild life,due to which extinction of species occurs. Due to extinction of species threat to biodiversity also confronted. As wild animals and plants are the key elements for food,medicines,industries and other things.Nonavailability of these things cause much problems to particular country being attacked. 7. Is distance between human and urban wildlife necessary? The close proximity between humans & urban wildlife provides a bridge for the delivery of infectious disease that easily could be exploited by bioterrorists because of inadequate disease surveillance and monitoring of these wildlife. 8. Psycho-social Factors during bioterrorism Horror Anger at Terrorist/Government Panic ( anxiety ) Magical thinking about microbes Fear of invisible agents and contagion Social isolation Loss of faith in social institutions Attribution of arousal symptoms to infection 9. MANAGEMENT OF PEOPLE WITH PSYCHOLOGICAL PROBLEMS Care of health workers. Confidence building by the medical workers. Critical incidence stress management (CISM) for rescue workers. Dealing with emotional and psychological problems while dealing with the dead. Care of emergency workers, medical and paramedical workers Critical incidence of stress debriefing(CSID) 10. Threat To Population Size & Non.Targeting Organisms Due to lethal bioweapons,death rate increases and population size of particular area decreases. Along with targting,other organism also affected by bioterrorism. 11. BIOTERRORISM: IMPACT Direct infection: Mortality, morbidity(relative incidence of particular disease) Indirect infection: Person-to-person transmission, Environmental impact: Environmental survival, animal infection. Other: Social, political, economic 12. Preparedness Prevention: Regulating environmental and agricultural conditions to minimize threats. Limiting access to certain biological agents. Improving intelligence to uncover plans for biological or chemical attacks. Detection: Health care provider training and education to improve diagnosis Enhanced surveillance & epidemiology to detect outbreaks improved laboratory capabilities 13. Preparedness (continued) Response: establishment of response plans, regular drills or exercises of those plans regional and interagency coordination and communication medical capacity for decontamination, immunization, and treatment Most of these capacities has dual use For natural and bioterroric attacks 14. PREPARATION FOR BIOTERRORISM ATTACK Familiarize medical staff with BT agents Incorporate into Disaster Planning Decontamination & Infection Control Communications with key agencies Laboratory, CDC, Police, FBI, etc. Contacts to obtain stockpiled supplies: antibiotics, immune sera, vaccines, etc. Security preparations 15. Familiarisation Nature of Bioterroric Weapons: Biological weapons are contagious,virulent,robust,difficult to detect drug-resistant, user-controllable. Awareness Public should be warn of invisible enemies Medical professionalist back to school 16. DETECTION Is this the real thing? Indications of a bioweapon attack A rapidly increasing disease incidence (e.g., within hours or days) in a normally healthy population. An unusual increase in the number of people seeking care, especially with fever, respiratory, or gastrointestinal complaints The rapid outbreak of any disease that is not indigenous to the local area (i.e., vector-borne illness) Large numbers of casualties concentrated in a certain area or with wind direction. 17. Lower attack rates among people who have been indoors, especially in areas with filtered air or closed ventilation systems, compared with people who have been outdoors Clusters of patients arriving from a single locale 18. Even a single case may be a signal Caused by an uncommon agent Unusual for region, age group or season Fulminant(sudden) disease in otherwise healthy patient Other cluesSimilar genetic type of agent from distinct source Unusual, atypical, genetically engineered, or antiquated strain Atypical aerosol, food, or water transmission Concurrent animal disease 19. Biosurveillance(Monitoring System Biosurveillance is the science of real-time disease outbreak detection. Made its debut in 1999. This collects data from labs,hospitals, and environmental studies in order to detect bioterror attacks as early as possible. Detection system RODS (Real-Time Outbreak Disease Surveillance). 20. Detecting the existence of a threat Electronic Chips Tiny electronic chips that would contain living nerve cells to warn of the presence of bacterial toxins (identification of broad range toxins) Fiber-optic Fiber-optic tubes lined with antibodies coupled to light-emitting molecules (identification of specific pathogens, such as anthrax, botulinum, ricin) Ultraviolet Avalanche Photodiodes(New research ) Ultraviolet avalanche photodiodes offer the high gain, reliability and robustness needed to detect anthrax and other bioterrorism agents in the air. biodetectors molecular identification 21. WHAT WE NEED TO PREPARE FOR BIOTERRORISM More trained epidemiologists to speed detection Increased laboratory capacity Health Alert Network SPECIAL PROBLEMS WITH BIOTERRORISM Specialized labs needed for some agents Risks to laboratory workers Limited resources Communication between agencies 22. WHAT TO DO IF YOU SUSPECT A BIOTERRORIST DISEASE IMMEDIATELY NOTIFY: Hospital Infection Control Isolation: Smallpox, plague, hemorrhagic fevers Laboratory Hospital Administration Local Public Health Department 23. HOW CAN HOSPITALS PREPARE? Familiarize medical staff and lab with bioterrorist threat and agents Incorporate BT planning into disaster planning Infection control Notification procedures and contact numbers Daily surveillance and reporting Security preparations Media Personal Protective Equipment (PPE) 24. Role of Clinicians & Labs Be prepared to diagnose and treat BT diseases Keep alert to unusual disease patterns Use reportable disease system to alert public Health officials of a potential problem Get involved in disaster planning process Labs should work on advanced detection systems to detect early attacks, identify at-risk areas, and to give proper Treatment Forensic teams work hard to identify biological agents, their origins and effects 25. Factors contribute to the emergence and re-emergence of infectious diseases 1. Unprecedented worldwide population growth draining the natural resources 2. Overcrowding in cities with poor sanitation. 3. Rapid and increased international travel. 4. Increased international trade in animals and food products. 5. Mass distribution of food and unhygienic food preparation practices 6. Increased exposure of humans to disease vectors and reservoirs in nature 7. Man-made changes to the environment and climatic changes which have a direct impact on the population of insect vectors and animal reservoirs. 8. Misuse of antibiotics leading to the evolution of resistant microbes. 26. What is being done? National Pharmaceutical Stockpile Program (NPSP) -- This resource of medical supplies can be sent anywhere in the country within 12 hours of a biological attack.The Health Alert Network (HAN) this organizations is developing a national communication system on the Internet.Health department lab preparedness -- The CDC is working with other officials to ensure that all state health departments are equipped to test suspicious substances.The Association for Professionals in Infection Control and Epidemiology, Inc.(APIC) has worked with the CDC to develop the Bioterrorism Readiness Plan 27. Integrated Disease Surveillance Project (IDSP), a decentralized and state-based surveillance program, was introduced in November 2004 in India. It integratespublic sectorprivate sectorrural and urbanhealth system There is incorporation of International Health Agencies (WHO, CDC, etc.). Its major components i