Wadsworth Center’s Bioterrorism Experience
Transcript of Wadsworth Center’s Bioterrorism Experience
Wadsworth Center’sBioterrorismExperience
EnvironmentalAnthrax Threats
In New York
History of Human Anthrax in New York State
109 cases, 5 deaths, from 1943 to 1960
107 cutaneous anthrax
1 Bacteremia
1 Meningitis
Most cases involved employees of carpet mills or leather industries
Prior to 2001, last reported case in 1961
Emerging and Reemerging Infectious Agents
Found in New York State Since 1990
AnthraxBabesiaBrucellaCalicivirusCoccidioidesCryptosporidiumCyclosporaE. coli O157:H7EhrlichiaGiardiaGroup A Strep-Necrotizing
FascitisHantavirus
ListeriaMalariaQ-feverRaccoon rabiesRocky Mountain
Spotted FeverSilver Haired Bat
Rabies VariantVancomycin-Intermediate
Resistant Staphylococcus Aureus
West Nile Virus
Wadsworth CenterAnthrax Incident Log: 1999-2000
Letter/Brown PowderNew YorkNew York City11/28/200017
Letter/PowderNew YorkNew York City11/24/200016
Letter/PowderNew YorkOrange County11/02/200015
LetterVermontBennington1/06/200014
LetterVermontWilliston1/05/200013
LetterNew York CityNew York City1/04/200012
LetterNew York CityBronx1/03/200011
EnvelopeUlsterSaugerties12/07/199910
Letter/BladesOnondagaPompey8/19/19999
LetterNassauHempstead6/15/19998
LetterNassauCanister6/15/19997
CanisterNew York CityBrooklyn5/19/19996
Letter/PowderOnondagaSyracuse5/17/19995
Letter/PowderOnondagaSyracuse5/17/19994
Letter in garbage bag?ColumbiaHudson2/22/19993
LetterVermontSt. Johnsbury1/19/19992
LetterVermontBurlington2/19/19991
THREATCOUNTY/STATETOWN/CITYDATENo.
Photo courtesy: The Albany Times Union
NYC Anthrax Case Summary
SOURCELOCATIONONSETSITEAGE
??MEETH10/25Inhal61 F
Letter 9/18NY Post10/23Cutan38 M
Letter 9/18NY Post10/19Cutan34 M
+env swabCBS News10/01Cutan27 F
+env swabABC News9/29Cutan<1 M
Letter 9/18NBC News9/28Cutan23 F
Letter 9/18NBC News9/25Cutan38 F
Letter 9/18NY Post9/22Cutan32 F
Anthrax Testing Since October 2001
Environmental samples tested: >900
Number positive: 24
Some specimenssubmitted fortesting werevalid concerns…
But many others were the resultof hoaxes or hysteria
Laboratory Response Network
LEVEL A: Rule out critical biological agents Refer positives to higher level laboratory
LEVEL B: BSL-3 facility with rapid, presumptive identification; Refer positives to higher level laboratory
LEVEL C: BSL-3 facility with molecular testing capability; Serve as surge capacity; Refer positives to higher level laboratory
LEVEL D: BSL-4 laboratory capability; High-level characterization; Evaluate unknown agents; Secure storage of organisms
Potential Laboratory Response Network Participants
Clinical Laboratory Reference System (935 )
Clinical Microbiology 293
Virology 76
Environmental Laboratory Approval Program ( 734 )
Environmental Microbiology 282
BT Testing Capabilities
METHODBT AGENT
(EM), (PCR)Smallpox (Variola)
Culture, FA, Antigen capture, (PCR)Francisella tularensis
Culture, Phage-lysis, FA, Antigen capture, (PCR) Yersinia pestis
Culture, (PCR)Brucella spp.
Animal toxicity/neutralization, (PCR)Clostridium botulinum
toxin
Culture, Phage-lysis, FA, Antigen capture, PCRBacillus anthracis
BT Laboratory Preparedness Requirements
Dedicated modern Biosafety Level 3 laboratory for bioterrorism testing, with surge capacity
Specially trained team of scientists to coordinate bioterrorism testing
Validated protocols in place for testing criticalCategory A biological agents assigned toBiosafety Level 3
Concluding Thoughts
Response capabilities and capacities must be developed before they are needed
Current definitions of laboratory functions are becoming outmoded
“Clinical” laboratories are testing environmental samples
“Environmental” laboratories are undertaking biomonitoring
Future incidents could involve multiple/mixed agents
(In the early 1960’s) “American germ-warfare scientists had developed a special cocktail of two germs and one biological toxin designed to work sequentially so that victims would come down with uncommonly long periods of sickness and debilitation…The toxin of the cocktail was staphylococcal enterotoxin B…The virus in the mix caused Venezuelan equine encephalitis…The final element was the bug that caused Q fever.”
From Germs Biological Weapons and America’s Secret WarBy Judith Miller, Stephen Engelberg, William Broad