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CHEMICAL AND BIOLOGICAL WARFARE AND TERRORISM

CHEMICAL AND BIOLOGICAL WARFARE AND TERRORISM. By LCDR Rita McCarthy, MSC, USN Pharmacist. Early Biological Warfare. The use of filth, dead human bodies, animal carcasses, and contagion to cause disease in the enemy camps or cities

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CHEMICAL AND BIOLOGICAL WARFARE AND TERRORISM

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  1. CHEMICAL AND BIOLOGICAL WARFARE AND TERRORISM By LCDR Rita McCarthy, MSC, USN Pharmacist

  2. Early Biological Warfare • The use of filth, dead human bodies, animal carcasses, and contagion to cause disease in the enemy camps or cities • 400 BC Scythian archers dipped arrows in blood, manure, and dead bodies • 1346 Siege at Kaffa: Tartar soldiers launched bodies of their fellow soldiers who died of plague over the wall into the city

  3. Early biological continued • 1710 Russian troops used plague infected bodies against Sweden • 1767 French and Indian Wars (Colonial America): • The British Commander orders small pox infected blankets to be given to the Indians loyal to the French defending Fort Carillon

  4. Modern Development of BW • WWI: Germans infected horses with glanders that were being sold to Allied forces • Transferred from horses to humans • acute: coughing, fever and the release of an infectious nasal discharge, followed by septicemia and death within days. • Chronic: nasal and subcutaneous nodules develop, eventually ulcerating. Death can occur within months, while survivors act as carriers. • 1937-1945: Japan had program with live subjects in Manchuria • Chinese, Russian, and American prisoners of war; tens of thousands die of bubonic plague, cholera, anthrax and other diseases • Accidentally infected own military units on multiple occasions

  5. Biological Warfare • The intentional use of disease producing microorganisms or biologically derived toxins as weapons to kill or injure humans, animals, or plants

  6. Bio-Terrorism • The use of (or a threat to use) a biological or chemical agent by an individual or a group in order to intimidate or coerce a government of a society in the pursuit of political, religious, ecological, or other ideological objectives

  7. Why use Chem/Bio agents for terror? • Cost • Biological agent $1 • Chemical agent $600 • Conventional explosive $2000 • Easily produced • Difficult to detect • FEAR & TERROR OF GENERAL PUBLIC!

  8. Classification of Agents of Biological Origin • Pathogens • BACTERIA • Viruses • Toxins

  9. Bacteria • Mechanism of disease • Invasion and infection of tissue • Produce toxins • Prevention • Immunization • Active: vaccine • Passive: from mother to child • Treatment • Specific antibiotics

  10. What makes a good biological agent? • Availability and ease of production • Incapacitate or lethal? • Particle size • Ease of dissemination • Stability after production • Susceptibility of population

  11. Bacterial Agents • Anthrax • Plague • Tularemia • Brucellosis • Q Fever

  12. Anthrax • Bacillus anthracis • 1876: first disease for which a microbial cause was established (Koch) • 1881: Attenuated spore vaccine for livestock • 1949: human vaccine developed (licensed in 1970)

  13. Why use Anthrax as a Weapon? • Easy to produce in large quantities • Spores can be spread by aerosol • Short incubation period • Highly lethal

  14. Anthrax Epidemiology • Reservoir: Soil • Herbivores infected during grazing • Transmission to humans • Contact with contaminated animals, hides, wool • Ingestion of contaminated meat • Inhalation of dust with spores • Annual incidence: 2,000 cases world-wide

  15. Anthrax Pathogenesis • Spore enters the body • Germinates and transported to lymph nodes • Local production of toxins lead to edema and tissue destruction • Spread from lymph nodes…bacteria and toxin into blood

  16. Inhalation Anthrax • Incubation period: 1-7 days • Initial symptoms: mild and flu-like • Followed by shortness of breath, labored breathing, rapid heart rate • Rapid progression to shock and death if not treated soon enough

  17. Treatment of Anthrax • High does antibiotics • Ciprofloxacin • Doxycycline • Penicillin

  18. Plague • Bubonic • Malaise, high fever, tender lymph nodes • If untreated: • Blood poisoning, death • Pneumonic • High fever, chills, headache, coughing up blood, blood poisoning • If untreated: • Respiratory failure, circulatory collapse, heavy bleeding, death

  19. Tularemia • Swollen glands, fever, headache, malaise, weight loss, nonproductive cough • Generally not fatal

  20. Brucellosis • Can spread to humans if they come in contact with infected animals, or by eating or drinking unpasteurized milk or cheese. • May begin with mild flu-like symptoms, muscle pain, swollen glands • May be chronic and last for years • Generally not fatal

  21. Q Fever • Fever, cough, chest pain • Generally not fatal

  22. Viruses • Smallpox • Ebola • Venezuelan Equine Encephalitis • Yellow Fever

  23. Smallpox History • 1500s: >3.5 million die after Europeans introduce smallpox to the New World • 1796: Vaccine developed by Jenner • 1813: Madison encouraged vaccination • 1949: last outbreak in the US • 1960: Worldwide eradication program • 1980: WHO declares earth free of smallpox

  24. Smallpox as a BW or Terrorist Threat • Highly communicable disease (person-to-person transmission) • Vaccine use discontinued…makes a target population that is susceptible

  25. Smallpox • Incubation 7-14 days • Fever, headache, general illness, vomiting • Skin “seeded” with virus • Scabs form 8-14 days after onset • Scabs infectious

  26. Medical Management • Confirm • Quarantine all cases • Vaccination of all contacts: available from the CDC

  27. Toxins • Saxitoxins and Conotoxins: marine animals • Botulinum: bacteria • Mycotoxins: fungus • Snake venom • Ricin: plant

  28. Natural origin Stable More toxic Legitimate medical use Only one active on skin Man-made Less stable Less toxic Only use is weapons All active on skin Toxin vs. Chemical Agents

  29. Botulinum Toxin • Clostridium botulinum • Tetanus • Botulism • One of the most toxic substances known • Neurotoxin • The toxin has a legitimate medical use • Botox • Treat muscle contractions and can offer relief from sweating of the hands, feet and underarms

  30. Mucous in throat Difficulty swallowing Feels like a cold No fever Blurred vision Mental numbness Slow eye movements Dilated pupils Indistinct speech Difficulty walking Extreme weakness “Floppy Paralysis” Clinical Symptoms of Botulism3rd day post-exposure 4th day post-exposure

  31. Medical Management • Vaccine is available but general use is not necessary • Treat with immunoglobulin before onset of symptoms (from the CDC) • May need to assist with breathing if severely affected or treatment not started in time • May lead to death

  32. Saxitoxins • Paralytic Shellfish Poisoning: • From eating shellfish contaminated by "red tides" or algal blooms • Symptoms: tingling, numbness, weakness, limb paralysis • Onset of symptoms: almost immediate;exposure by inhalation leads to extremelyrapid development of symptoms with death occurring within minutes if not treated.

  33. Conotoxins • Paralytic poisons from Pacific cone snails • Symptoms: burning pain; local numbness, spreading rapidly to involve the entire body but without pain; some cardiac and respiratory distress at the height of the poisoning • Onset of symptoms:almost immediate upon injection from the snail

  34. Mycotoxins • Produced by microfungi that are capable of causing disease and death in humans and other animals • Some used as antibiotics, growth promotants, and other kinds of drugs; still others have been implicated as chemical warfare agents • Severity of mycotoxin poisoning can be compounded by other illnesses; mycotoxicoses can heighten vulnerability to microbial diseases, worsen the effects of malnutrition, and interact synergistically with other toxins • Almost no treatments for mycotoxin exposure

  35. Ricin • Protein toxin from castor beans • Plant found world-wide • Toxin is fairly easy to produce • Castor oil used as lubricant for motors

  36. Symptoms of Ricin Poisoning • Oral ingestion: least toxic (8-10 hours) • Bleeding and tissue damage in GI tract • Nausea, vomiting, diarrhea, cramps • Inhaled: most common • Nausea, vomiting, diarrhea, cramps, dilated pupils, fever, headache • Shock, edema, pneumonia • Death on 3rd or 4th day!

  37. Medical Management • Identify if toxin, asthma, or chemical poisoning • Supportive care • For oral ingestion: administer activated charcoal to absorb toxin • No anti-toxin or immunization yet

  38. Chemical Agents: Early Chemical Warfare • 423 BC Sparta used toxic and irritant smoke to capture a fort held by Athenians • 700 AD Greeks invent and use “Greek Fire” (pitch, sulfur, and rosin) which floated on water to set enemy ships on fire • Pitch: a viscous substance produced by plants or formed from petroleum • Sulfur: used to make gun powder • Rosin: type of resin • 15th and 16th Centuries: Venice used poison chests to contaminate water

  39. Modern Chemical Warfare • 1st gas attack: April 22, 1915 • Chlorine gas used by Germany in Belgium • WWII no confirmed use by Germany on the battlefield, however, cyanide and other gasses were used in concentration camps • Cyanide makes the cells of an organism unable to use oxygen • 1980’s Iraq used chemical agents against Iran and against it’s own people (Kurds)

  40. Chemical Agents • Lethal (toxic) agents • Nerve agents • Choking agents • Blood agents • Blister agents • Incapacitating agents • Irritants

  41. Chemical Agents • Solid • Liquid • Gas • Persistent: effective for >12 hours • Non-persistent: inactivated <12 hours

  42. Nerve Agents • Sarin (GB) • Soman (GD) • Tabun (GA • GF • VX

  43. Sarin • Lethal agent • Developed in 1940s by Germany • Original use was an insecticide • Causes death by asphyxiation • Is a liquid at room temperature

  44. Soman, Tabun, and VX • Lethal agents • Soman: synthesized by Germany in 1944; similar to sarin • Tabun: synthesized by Germany in 1936 • VX developed by USA • Victims of Soman, Tabun, and VX ,make it harder to treat casualities than with Sarin

  45. Physical Properties • Clear colorless liquids (when fresh) • Not nerve gas! • Tasteless: each has identifiable odor • May be spread by fine vapor “gas” or as a liquid on skin • Onset of symptoms within seconds to minutes • Large exposure can cause death

  46. Pinpoint pupils Sweating Drooling & runny nose Convulsions Involuntary urination Coma Possible death Decontamination Atropine Assist with breathing Anti-seizure drugs Nerve Agents Symptoms Treatment

  47. Choking Agents • Chorine and Phosgene • Developed and used during WWI • Head delayed reation time • Causes lung damage • Can cause blindness if gets into eyes • Gas or liquid

  48. Blister Agents • Mustard (H) • Nitrogen Mustard (HN) • Lewisite (L) • Phosgene oxime (CX) • Causes skin blisters • Usual/ly does not kill

  49. Others • Blood agent • cyanide • Incapacitating agents • Psychological effects (LSPD and BZ) • Riot control agents • Peper spray, tear gas, mace

  50. Treatment • Decontamination • Special antidotes • Anti-convulsant drugs • Supportive care

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