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Introduction, Background and Potential of Biological Weapons

Introduction, Background and Potential of Biological Weapons. Part 1 of 13 Comments and contributions are encouraged: please e-mail D Rcomments@hpa.org.uk. HPA Centre for Infections. Reviewed April 2009. Bioterrorism: sets of slides in this series.

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Introduction, Background and Potential of Biological Weapons

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  1. Introduction, Background and Potential of Biological Weapons Part 1 of 13 Comments and contributions are encouraged: please e-mailDRcomments@hpa.org.uk HPA Centre for Infections Reviewed April 2009

  2. Bioterrorism: sets of slides in this series • Introduction, background and potential of biological weapons • Clinical scenarios • 3. Syndromic presentations • 4 - 9. The top six Agents: anthrax, plague, smallpox/ summary of the smallpox plan, botulism, VHF, tularemia • 10. What to do • 11. Sources of information • 12. Unusual illnesses

  3. History of Biowarfare (BW) (1) • 14th. C - siege of Kaffa (plague infected bodies) • 18th. C - smallpox infected blankets to Indians • WWI - German sabotage in neutral countries • 1925 - Geneva Protocol • 1932  1945 - Japan’s Unit 731 in Manchuria

  4. History of BW (2) • WWII to the end of the Cold War - USA, Canada and UK had BW programs • Nixon’s statement to Congress 1969 • 1972 - Biological And Toxic Weapons Convention (BTWC - now ratified by >140 countries)

  5. 1972 - signed BTWC 1973 - Biopreparat 55,000 staff 52 establishments Field test site on Vozrozhdeniye (Rebirth) island, Aral Sea Smallpox, anthrax, plague, tularemia, glanders,VEE, Marburg BW in USSR • Map of defence establishments including CBRN (CIA website,www.cia.gov)

  6. The Potential of Bioterrorism • Cheap (low cost/kill ratio) • Simple to produce (but not to deliver) • Defense is difficult • Expertise available • PUBLIC PANIC • Devastating effect • Terrain denying

  7. Aum Shinrikyo and the Tokyo Subway Incident • 1995; sarin nerve gas released on Tokyo Metro • 12 killed; 5,000 injured • Research on anthrax, botulinum and Q fever • 8 abortive biological attacks (anthrax) • Attempt to obtain Ebola in Zaire • Aircraft equipped with spray tanks

  8. The Potential of Bioterrorism Agent Lethal infective doses in 5mls Cyanide 50 Mustard gas 100 Sarin 5,000 Botulinum toxin 1,000,000 Anthrax 50,000,000, Tularemia 50,000 x 106

  9. A release of 50 kg agent in an area with population 5 million…. Anthrax 250,000 cases 100,000 deaths Plague 150,000 cases 36,000 deaths Tularemia 250,000 cases 19,000 deaths Worst case scenarioWHO Estimates, 1970

  10. Features Easily disseminated or transmitted person - person High mortality – major public health impact Public panic and social disruption Special action for public health preparedness Agents Anthrax Plague Smallpox Tularemia Viral haemorrhagic fevers Botulinum toxin Potential BW Agents: CDC Category A

  11. Features Moderately easy to disseminate Moderate morbidity, low mortality Require enhancement of diagnostic capacity and surveillance Agents Q fever Brucellosis Glanders & melioidosis VEE, EEE and WEE Enteric pathogens Other toxins Potential BW Agents: CDC Category B

  12. Features Emerging agents Availability Easy to produce and disseminate Potential for high mortality and morbidity Agents Nipah virus Hantaviruses Tickborne HF Tickborne encephalitis Yellow fever MDRTB Potential BW Agents: CDC Category C

  13. CDC Category A ANTHRAX PLAGUE SMALLPOX BOTULISM Tularemia Viral haemorrhagic fevers & encephalitides Agents of Bioterrorism- the Main Suspects

  14. OVERT Hoaxes & false alarms Genuine Early recognition Police COVERT Delayed recognition Health Care Staff Types of Deliberate Release

  15. Overt Release- relatively easy to recognise, emergency services will probably be involved first – priorities:  controlling area  identifying agent  giving health advice Covert Release- probably first recognised by health services  need for awareness against a background of atypical presentations of endemic disease Types of Deliberate Release

  16. Inhalation Powder Spray - Small scale - Large scale Explosive Contact/inoculation Fomites Explosive Ingestion Modes of Exposure

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