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Weaponized Bioagents
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Transcript of Weaponized Bioagents
Weaponized Bioagents
YSU – Agents of Mass Casualty
Agent Classification
• Military– Foundations may be foreign– May have practical roots
• Civilian– CDC Classification
Military “C”
• “C” = Class
• Chemical Classes– C01 to C24
• Biological Classes– C25 to C29
Chemical Agents
• Sub-Codes – Examples C01– GA– GB– GD– GF
Military Classes - Bioagents
• C24 – Anti-Personnel
• C25 – Anti-Personnel/Vector
• C26 – Anti-Personnel/Ingestion
• C27 – Anti-Animal
• C28 – Anti-Plant
• C29 - Simulants
CDC & EM Classification
• Category A – Weaponized or Available– Variola virus– Bacillus anthracis– Yersinia pestis– Botulinum toxin– Francisella tularensis– Filoviruses & Arenaviruses
CDC & EM Classification
• Category B – Lower Virulence/Possible Agents– Coxiella burnetii– Brucellae– Burkholderia mallei– Alphaviruses– Ricin– SEB– Foods Agents – E. coli 0157:H7, Salmonellae– Water Threat – Vibrio cholera, Cryptosporidium
CDC & EM Classification
• Category C– Any other emerging pathogen or biological
toxin that might be a threat.
Anthrax – B. anthracis
• 12 hrs-5 days (except delay)
• Inhalation – flu-like, fluid in lungs, severe difficulty breathing, broadening mediastinum
• Not Contagious – Aerosol or powder
• Treat With Antibiotics
• Military Vaccine
• 30% Mortality (untreated may be higher)
Botulinum Toxin
• Affects in 12 hours to 3 days
• Flu-like symptoms, difficulty speaking, swallowing, drooping eyelids, paralysis
• Antitoxin available (not reversible damage)
• No commercial vaccine
• Probably disseminated in liquid droplets or on food.
Cholera – V. cholera
• 12 hours to 5 days
• Severe diarrhea, vomiting and weakness, leg cramps and fluid loss.
• Not contagious – disseminated in food or water.
• Treatable with antibiotics – high fluids
• Newer vaccines not available in U.S. Old vaccine low effectiveness, short-lived
Glanders – B. mallei
• 1-14 days• Fever and headache, muscle
tightness, chest pain, tearing and light sensitivity
• Not highly contagious – aerosol diss.• Treatable with antibiotics• Very few historical cases, up to 50%
mortality possible.• No vaccine
Plague – Y. pestis
• 1-6 days
• Flu-like, lymph node pain (buboes), blood-streaked sputum, septic shock
• Aerosol or food – pneumonic transmissible
• Treatable with antibiotics – time is critical
• Vaccine, once available did not prevent pneumonic form. Discontinued in 1999.
Q-Fever – C. burnetii
• 2-3 weeks
• High fever, throbbing headache, sweating, auditory and visual hallucinations, hepatitis
• Aerosol or food dissemination, not very transmissible
• Low mortality, most recover without treatment.
• Vaccine not available to general public
Smallpox – V. major
• 10-14 days
• High fever, aches, rash starts in face and arms (then trunk – unlike chickenpox)
• Aerosol or person-to-person. Contagious stage comes with symptoms.
• Vaccination 3-5 days after exposure may avoid or lessen disease.
• No treatment (supportive therapy only)
Tularemia – F. tularensis
• 1-14 days in nature (3-5 in a deliberate act)
• Flu-like + lethargy. Swollen lymph nodes in systemic infections, red, sore eyes, pneumonia
• Disseminated as aerosol or on food – no human to human
• Antibiotics. Some weaponized strains may be abx. resistant.
Mortality
• 1970 World Health Organization
• Assumed 50 kg of dried agent
• Disseminated on a 2 km line
• Upwind of a population of 500,000
Results
Agent Distance Carried (km)
Fatalities Casualties
(Total)
VEE 1 400 35,000
Typhus 5 9,500 35,000
Brucellosis 10 19,000 85,000
Plague 10 500 100,000
Q-Fever >20 150 125,000
Tularemia >20 30,000 125,000
Anthrax >>20 95,000 125,000
Other Concerns
• Residential backflow protectors
• Food QC
• Availability of viral hemorrhagic fevers
• Soviet brain drain
Soviet Bioweapons - Rating
• Smallpox
• Plague
• Anthrax
• VEE
• Tularemia
• Q-Fever
• Marburg virus
Others include the flu virus, glanders and epidemic typhus.
Detection
• Rapid Dx Assays– Military
• Botulinum, SEB, SEA-C-D• Dengue Fever, Q-Fever, Plague,
Tularemia, Typhus, West Nile
– Civilian• SMART Tickets• DNA Techniques
Decon
ER + Decon
• Isolate small areas to 100 ft or more
• Note weather, population, density and time of day
• For airborne cloud – shelter-in-place
• Field Detection – Not Recommended
• PPE– General rule – Level A – Latex may not be
fully protective
ER + Decon
• Remove clothing (aerosol or powder)
• Double bag
• Wash w/soap + water
• 10% bleach wash (10-15 minutes)
• Rinse solutions should be retained if possible
ER + Decon
• Careful of reaerosolization
• Treat all items as Haz-Waste
• Note airflow around patients (bioaerosols)
• Always try to decon at site if possible
NPS or SNS• Future module will address
• Located at secret locations around the nation (12 hour deployment on gov. req.)
• Enough to treat, perhaps hundreds of thousands (depending on disease)
Antibiotics
• May be classified:– By spectrum– Method of administration– Activity (bacteriacide vs. bacteriastat)– Chemical structure
• Useful because those in the same class will show similar side-effects, action, toxicity etc.
Antibiotics
• Penicillins
• Cephalosporins
• Fluoroquinolones
• Tetracyclines
• Aminoglycosides
Antibiotics
• Penicillins– Oldest– Similar in chemistry to cephalosporins– Bacteriacidal– Natural penicillins (“G”) (methycillin)– Aminopenicillins (Amoxil) – broader may
require penicillinase inhibitor
Antibiotics
• Cephalosporins– Bacteriacidal– May show similar allergic problems to pen.– 1st, 2nd and 3rd generation– 3rd generation cross blood-brain barrier– Work on anaerobes
Antibiotics
• Fluoroquinolones– Synthetic– Reach deep tissues– Bacteriacidal– Cipro, Penetrex, Floxin, Trovan
Antibiotics
• Tetracyclines– Derrived from strep bacteria– Bacteriostatic– Effective against rickettsia + parasites
• Macrolides– Emycin, Z-pak, Clarithromycin– Effective to penetrate lung tissue– Spectrum similar to penicillins