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Bioterrorism, Food Terrorism, & Agroterrorism

Bioterrorism, Food Terrorism, & Agroterrorism. Ryan Newkirk, MPH National Center for Food Protection and Defense. Presentation Overview. Objectives Definitions Bioterrorism Brief history Government roles and responsibilities Food and Agroterrorism Brief history

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Bioterrorism, Food Terrorism, & Agroterrorism

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  1. Bioterrorism, Food Terrorism, & Agroterrorism Ryan Newkirk, MPH National Center for Food Protection and Defense

  2. Presentation Overview • Objectives • Definitions • Bioterrorism • Brief history • Government roles and responsibilities • Food and Agroterrorism • Brief history • Government roles and responsibilities • Questions

  3. Objectives • Bioterrorism and agroterrorism definitions • Understand the general concepts of bio- and agroterrorism • Understand government roles & responsibilities

  4. Bio- and Agroterrorism

  5. The Answer

  6. Definitions • Terrorism • An act which is intended to create fear; is perpetrated for an ideological goal; and deliberately targets civilians • Bioterrorism • Deliberate release of viruses/bacteria/toxins used to cause illness or death in people/animals/plants • Agroterrorism • Deliberate introduction of a disease agent, either against livestock or into the food chain, for the purposes of undermining stability and/or generating fear

  7. Bioterrorism Agroterrorism Food terrorism

  8. Bioterrorism History • Hannibal ordered pots of snakes thrown onto ships -- 184 B.C. • Plague used in the 14th century in Kaffa • Smallpox blankets in French and Indian War • Japanese Imperial Unit 731 • Plague bombs • Botulinum in food • State weapons programs

  9. Previous and Current Weapons Programs Algeria Canada China Egypt France Germany India Iran Iraq Israel Japan Libya North Korea Pakistan Russia South Africa Syria Taiwan United Kingdom United States History

  10. Actors • State • USSR • >1000 metric tons of Smallpox / year • Non-state • Terrorist organizations • Al Qaeda • Aum Shinrikyo • Lone Wolf

  11. Dissemination • Multiple routes • Aerosolization • Explosives • Foodborne • Person to person • Vectorborne • Zoonotic

  12. CDC Bioterrorism Agent Categories • 3 categories • A - C • Categorization based on • Ease of dissemination or transmission • Potential for major public health impact • Potential for public panic / social disruption • Requirements for public health preparedness

  13. Category A Characteristics • Easily disseminated / transmitted person-to-person • Cause high mortality, with potential for major public health impact • Might cause public panic / social disruption • Require special action for public health preparedness

  14. Category A Agents • Smallpox • Anthrax • Plague • Clostridium botulinum toxin • Tularaemia • Viral hemorrhagic fevers (e.g., Ebola)

  15. Category B Characteristics • Moderately easy to disseminate • Cause moderate morbidity / low mortality • Require specific enhancements of CDC's diagnostic capacity / enhanced disease surveillance • Examples • Ricin toxin • Salmonella species • Most food-terrorism agents are in this category

  16. Category C Characteristics • Emerging pathogens that could be engineered for mass dissemination in the future • Examples • Nipah virus • Hanta virus • Multidrug-resistant tuberculosis

  17. Government Preparedness & Response

  18. Biodefense for the 21st Century • Four themes • Threat Awareness • Prevention & Protection • Surveillance & Detection • Response & Recovery • FY 2010 • > $6 billion • FYs 2001 – 2010 • $55 billion

  19. Government Responsibility • Bioterrorism preparedness and response: Public health response • FBI • HHS • CDC, FDA, NIH • DHS • DoD • State Police and Health Departments • Local Health Departments • Local Police

  20. Homeland Security

  21. Public Health Preparedness Modalities • Preparedness & prevention • Detection & surveillance • Diagnosis & characterization of biological agents • Response • Communication

  22. 1. Preparedness and Prevention • Plans / Guidelines • Community-based Mass Prophylaxis • Bioterrorism Readiness Plan: A Template for Heatlhcare Facilities • Public Health Emergency Response Guide for State, Local, and Tribal Public Health Directors

  23. 1. Preparedness and Prevention • Exercises • Table top • Full-scale • Establish intra- and interagency contacts • Establish MOUs / MOAs

  24. 2. Detection and Surveillance • Challenges in detecting attacks • Medical community unfamiliar with BT diseases • Surveillance systems might be inadequate to detect attacks • Surveillance systems • Syndromic surveillance • BioWatch • BioSense

  25. 2. Detection and Surveillance • Syndromic surveillance • Using health-related data that precede diagnosis • Signal a sufficient probability of a case or an outbreak

  26. 2. Detection and Surveillance • BioWatch • Air-monitoring system • Initial positives rescreened with more sensitive tests • Early warning in urban areas • 30 cities

  27. 2. Detection and Surveillance • BioSense • Scans, collects, analyzes medical information • ERs • Pharmacies • BioWatch • 550+ civilian hospitals • 1300+ DoD and VA hospitals and healthcare facilities • Receives an average of 175,000 near real-time messages per hour

  28. 2. Detection and Surveillance • Epidemiology • Who, what, where, when? • Case definition of illness • Surveys • Biological samples from labs • Data analysis, interpretation • Communication

  29. 2. Detection and Surveillance • Epidemiologic indicators of an attack • Increased morbidity / mortality • Atypical seasonal appearance of disease • Possible time/geo-spatial morbidity / mortality patterns • Increased severity of symptoms • Increased failure rate to traditional drug therapies

  30. 3. Agent Diagnosis/Characterization • Laboratory-based surveillance • Test clinical specimens • Positive findings sent to public health • Can detect outbreaks, particularly when cases are geographically scattered or clinical symptoms are nonspecific

  31. 3. Agent Diagnosis/Characterization • Laboratory-based surveillance for foodborne outbreaks • Detection by early typing of isolates of pathogens • Routine typing may detect an outbreak and link apparently unrelated infections • FoodNet, PulseNet

  32. 3. Agent Diagnosis/Characterization • Laboratory Response Network • Nationwide ~150 labs • 3 tiered • Purpose • Network that can respond to bio- and chemical terrorism, and other public health emergencies

  33. 3. Agent Diagnosis/Characterization • National • Can handle highly infectious agents • Can identify specific agent strains • Reference • Perform tests to detect / confirm a threat agent • Ensure a timely local response • Sentinel • Represent hospital-based labs on the front lines • Responsibility is to refer a suspicious sample to reference labs

  34. 4. Response • National Disaster Medical System Special Teams • Disaster Medical Assistance Team (DMAT) • Veterinary Medical Assistance Teams (VMAT) • National Nurse Response Team (NNRT) • National Pharmacy Response Teams (NPRT) • Disaster Mortuary Operational Response Teams (DMORT)

  35. 4. Response • Strategic National Stockpile • Antibiotics, chemical antidotes, antitoxins, life-support medications • Airway maintenance supplies, and medical/surgical items • Flexible • 12-hour Push Packages

  36. 4. Response • Isolation • Persons who are KNOWN to be ill with a contagious disease • Quarantine • Those who have been EXPOSED to a contagious disease but who may or may not become ill • Will rarely be used

  37. 5. Communication • HAN system • Epi-X • EOCs • eLexnet

  38. National Institutes of Health • BioShield • Accelerate research, development, purchase, and availability of medical countermeasures against CBRN agents • 4 main areas • Basic research • Diagnostics • Vaccines • Therapeutics

  39. Food and Agroterrorism

  40. Food and Agroterrorism • Definition: • Deliberate introduction of a disease agent, either against livestock or into the food chain, for the purposes of undermining stability and/or generating fear

  41. Food and Agroterrorism • "I, for the life of me, cannot understand why the terrorists have not, you know, attacked our food supply because it is so easy to do" • Tommy Thompson, Former HHS Secretary, 12/2004

  42. Why Food and Ag? • Everyone eats everyday • Myriad vulnerabilities • Difficult to distinguish between natural vs deliberate contamination • Interconnected systems

  43. Why Food and Ag? • Incredibly complex • 2.2 million farms • 880,500 firms • 1,086,800 facilities • FDA oversees • 80% of food • 235,000 grocery stores • 945,000 restaurants

  44. Why Food and Ag? • Intricately connected to • Water/sewer systems • Transportation system • Energy system • Food processing • Banking and finance • Chemical industry • Defense • Private industry

  45. Why Food and Ag? • Accounts for ~20% of economic activity • 1 in 8 people are employed by some sector of the food industry • 16 – 25 millions jobs • US is a major food/ag exporter • $100 billion FY 2010

  46. History

  47. History

  48. Methods of Dissemination • Similar to bioterrorism • Target crops and animals • Contaminate raw ingredients / feed • Sabotage mass produced food • Tamper with prepared food

  49. Vulnerable Areas in Food • Food concentration, processing, and distribution Source: National Minerals Industry Safety and Health Risk Assessment Guideline

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