Bioterrorism 29.03.2020

This presentation covers detailed information on what bioterrorism is all about.

1. Bioterrorism/biological warfare
DR. SWATI SHIKHA, MD

2. Learning objectives
What is bioterrorism
Historical perspectives
Bioweapons
Epidemiological clue of a possible bioterrorist attack
Laboratories for detection
Early detection systems
Legal provisions
Indian perspective
Nodal agencies involved
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3. Bioterrorism
Definedas:plannedorintentionaluseoflivingorganismssuchasviruses,bacteria,fungi
ortheirtoxicproductstocausedeath,disabilityordiseaseinman,animalorplantsorto
poisonfoodandwatersupplies.
Ultimateaimistoharmpeople,animalsandplants.
Mostcommonmode:artificialcloudorasaerosolspray
Othermodes:catapulting,contaminatingdrinkingwaterorfood,throughrobotsorother
remotecontroldevides.
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4. Historical perspectives
IstusedduringsixthcenturyB.C.:contaminationofwatersupplywithfungusclaviceps
purpurea(ryeergot)
1346:hurlingofdeadbodiesofplaguevictimstospreadplague
1767:Spreadingofsmallpoxbycontaminatedblankets
Yellowrain:mycotoxins(fungaltoxins)usedinAfghanistan
1984:Mostsignificantbiologicalattackinunitedstateswasintentionlcontaminationof
restaurantsaladbarswithsalmonella
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5. Phases of evolution:
Phase1:worldwar1–useofgaseouschemicals-chlorineandphosgene
Phase2:worldwar2–anthraxandplaguebombs
Phase3:agentorange–duringVietnamwar
Phase4:biotechnologicalrevolutionanduseofgeneticengineering.
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6. Bioweapons
Anymicroorganismhavingthecapacitytocausedeath,disabilityordiseasein
man,animalorplantandhencecauselargescalecasualtyandsufferings.
Alsocalledas:poorman’satomicbomb
canbe:
micro-organisms:natural/geneticallyengineered.
BDBS:biologicallyderivedbioactivesubstances.Eg:cytokines,hormones
Manuallydesignedbiologicaltoxinlikesubstances–eg:nervegases
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7. Features of bioweapons
Consistentlyproduceagiveneffect,deathordiseaseatlowconcentration
Shouldbehighlycontagious
Haveashortandpredictableincubationperiod
Targetpopulationshouldhavenoimmunityagainsttheorganism
Amneabletoeconomicmassproduction
Difficulttoidentifyintargetpopulation
Littleornoprophylaxisortreatmentshouldbeavailable.
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8. Categories of biological disease/ agents
3 categories according to CDC:
A B C
•High priority agents
•Risk to national security
•Have major public health
impact
•Easily transmitted and
disseminated
•Eg: anthrax, botulism,
plague, smallpox,
tularemia etc
•Causes moderate to low
mortality
•Eg: brucellosis,
psittacosis,Q-fever,
shigella, e coli.
•Emerging pathogensthat
could be engineered for
massive destruction
•Easily available
•Easy to produce and
disseminate
•Capacity to cause huge
public health impact
•Eg: nipah, hanta virus,
SARS virus, H1N1.
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9. Challenges and determinants
Challenges posed by bioweapons:
Availability of multiple agents and delivery means
Variable incubation period
High mortality rates
Potential for geographic dispersion of the agent during incubation period
Determinants of bioterrorist attack:
Conquest of power, progress and money
Preserving and promoting religion/race/ideologies
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10. Epidemiological clues of bioterrorist
attack
Diseasemanifestinginmoresevereform
Toomanycasesordeathinparticularregion–suddenriseinhours/days
Unusualrouteofexposure
Transmittedbyunusualvector
Unusualhostfactors
Multiplesimultaneous/serialepidemics
Differentattackrateindifferentarea.
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11. Laboratories for detecting bioweapons
Level A Level B Level C Level D
•Routinepathogens
cultured and
identified
Testsdone:
•Confirmatorytest
•Antibiotic
susceptibilitytest
•Rapidpresumptive
identification
•Molecular level
testing
•Also called:
Hot labs
•Highest in
expertise
•Conducts highly
specialized tests
•To save time consumed by lab tests, a uniform diagnostic protocol is formulated
•A syndrome based diagnostic criteria for suspected infections
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12. Early detection systems
BIDS:Biologicalintegrateddetectionsystem
Geneticandantibodybaseddetectiononsuspectedaerosolparticles
LRBSDS:Longrangebiologicalstandoffdetectionsystem
Detectsaerosolcloudsfromadistanceupto30kmsandcanprovideearlywarning.
SRBSDS:Shortrangebiologicalstandoffdetectionsystem
Usesultravioletandlaserinducedfluorescence
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13. Legal provisions related to
bioterrorism
Geneva protocol 1925
Biological weapons conventions 1972
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14. Geneva protocol
Came into force on 8
th
feb1928
Prohibits use in war of asphyxiating poisons or other gases and of all analogous
liquids, materials or devices and also bacteriological methods of warfare.
Limitations:
Prohibited use but not possession
Not all nations were its signatory
Many states had right to use if attacked by such weapons
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15. Biological weapons convention (BWC)
Came into force on : 26
th
march 1975
Prohibition of development, production and stockpiling of bacteriological and
toxin weapons and their destruction.
Has 2 articles:
Article 1: never in any circumstance to develop, produce, stockpile or acquire/retain
items –microbial/ other biological agents or toxin and weapons, equipmentsor means
of delivery designed to use of such agents
Article 2: destroy/ divert to peaceful purposes all agents, toxins, weapons,
equipmentsand all means of delivery within 9 months of entry into convention.
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16. Indian perspective
India is more at risk due to:
Dense population
Poor hygiene and deprived sanitation
Congenial climatic conditions.
Lack of adequate medical facilities.
Challenges to fight bioterrorism:
Proper collection of specimen at the site and their identification
Recognize the occurrence of attack and quick management of all outbreak.
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17. Ministries dealing with bioterrorism
MinistryofHealthandFamilyWelfare:dealswithepidemics
MinistryofHomeAffairs:preventionofbioterrorism
MinistryofDefence:managesmattersandconsequencesofbiowarfare.
Ministryofenvironment,forestandclimatechange:evaluatingshortandlongterm
consequences
Ministryofagriculture:dealswithbiologicaldisastersrelatedtoplants,animals,livestock
andfisheries.
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18. Role of public health agencies
Surveillance of infectious disease
Detection and investigation of outbreaks
Identification of etiologic agents and their mode of transmission
Development of prevention and control strategies.
Maintainingeffectivediseasesurveillanceandcommunicationsystemarefundamental
componentsofanadequatepublichealthinfrastructure.
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19. Essential activities for successful
response to bioterrorist attack
Completion of following 5 phase of activities prior to an incident are essential:
Preparedness phase
Early warning phase
Notification phase
Response phase
Recovery phase
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20. Thank you