MLAB 2434: Microiology Keri Brophy-Martinez

1. MLAB 2434: MicroiologyKeri Brophy-Martinez Bioterrorism

2. Terms Bioterrorism: use of bacteria, viruses, fungi or toxins to injure people, animals or crops to cause civil and economic unrest. Biological warfare: use of bacteria, viruses, fungi or toxins to injure people, animals or crops to gain military advantage.

3. Biosafety Levels (BSL) • Based on microorganism disease potential • Combination of standard procedures and techniques, safety equipment and facilities designed to minimize the exposure of workers and the environment to infectious agents. • Each increase in level indicates more precautions and work controls

4. BSL’s • BSL-1 • Organisms that do not normally cause human disease • Minimal safety procedures & equipment • Ex: Bacillus subtilis • BSL-2 • Organisms cause human disease but are not transmitted among hosts • Work should be performed under class II biological hood • Ex: HBV, Salmonellae

5. BSL’s • BSL-3 • Organism transmitted by respiratory route • Causes serious disease • Requires use of separate air ventilation systems • EX: Mycobacterium tuberculosis • BSL-4 • Organism transmitted by respiratory route • High risk of disease • Strict precautions, require containment suits • No treatment or vaccine • EX: Ebola

6. 3 Categories for Public Health Preparedness • A: Agents of greatest impact • EX: Bacillus anthracis, Yersinina pestis • B: Easily disseminated • EX: Brucella, E. coli 0157: H7 • C: Emerging pathogens • Mass dissemination • EX: Multidrug resistant MTB, hantavirus

7. Considerations • Biological weapons usually enter host via respiratory tract, GI tract, skin and mucous membranes • Primarily aerosols • Food or water sources usually not utilized

8. Laboratory Response Network (LRN) • Established in 1999 by CDC, FBI and United States Army Medical Research Institute of Infectious Disease(USAMRIID) • Goal: • Link state and locate labs with advanced capacity clinical, military, veterinary, agricultural, H20 and food testing labs • Decentralize testing capabilities

9. Laboratory Response Network (LRN) • Structure • Sentinel • Role • Rapid detection and reporting of potential threats • Rule out or refer suspicious isolates, not to ID • Provide assistance on proper collection, processing, and handling of samples • Community hospitals with microbiology capabilities • BSL-2

10. Laboratory Response Network (LRN) • Reference • Role • Offer confirmatory testing for biothreat agents • Culture ID • Examples: State public health labs & Dept. of Defense labs • National • Role • Perform all reference lab tests, and forensic testing • Definite ID of biothreat agents • Examples: CDC, USAMRIID, National Research Medical Center • BSL-4

11. Indicators of a Potential Biocrime Event • A disease entity that is usual or that does not occur naturally in a given geographic area. • Multiple disease entities in the same patients. • Higher than average morbidity & mortality relative to the number of personnel at risk or within a population that inhabits the same area. • Massive point source outbreak. • Aerosol route of infection. • Illness limited to located or circumscribed geographic areas with filtered air supplies or closed ventilation systems. • Sentinel dead animals of different species. • Absence of a competent natural vector in the area of an outbreak.

12. Agents of Bioterror • Bacillus anthracis • Yersinia pestis • Francisella tularensis • Brucella species • Burkholderia species • Coxiella burnetii • Variola virus- smallpox • Viral hemorrhagic fever- Ebola & Marburg virus • Ricin • Staph enterotoxins • Clostridium botulinum toxin

13. References • Mahon, C. R., Lehman, D. C., & Manuselis, G. (2011). Textbook of Diagnostic Microbiology (4th ed.). Maryland Heights, MO: Saunders. • Patton, M. T. (2010, October). In the Wake of an Attack: Laboratorians on the front line of bioterrorism defense. Advance for Medical Laboratory Professionals, 22(20), 6-7.