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Bioterrorism and Food Safety Gregory Evans, PhD, MPH JAPHI ANNUAL CONFERENCE October 28, 2004

Bioterrorism and Food Safety Gregory Evans, PhD, MPH JAPHI ANNUAL CONFERENCE October 28, 2004. Subway riders injured in Aum Shinrikyo Sarin gas attack, Tokyo, March 20, 1995. (AP Photo/Chikumo Chiaki ) . http://www.terrorismanswers.com/groups/aumshinrikyo.html. Anthrax Spores.

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Bioterrorism and Food Safety Gregory Evans, PhD, MPH JAPHI ANNUAL CONFERENCE October 28, 2004

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  1. Bioterrorism and Food SafetyGregory Evans, PhD, MPHJAPHI ANNUAL CONFERENCEOctober 28, 2004

  2. Subway riders injured in Aum Shinrikyo Sarin gas attack, Tokyo, March 20, 1995. (AP Photo/Chikumo Chiaki ) http://www.terrorismanswers.com/groups/aumshinrikyo.html

  3. Anthrax Spores

  4. “in the Soviets’ view, the best biological agents were those for which there was no prevention and no cure. For those agents for which vaccines or treatment existed,… antibiotic-resistant or immuno-suppressive variants were to be developed.” Ken Alibek

  5. The Quranic Concept of War Terror struck into the hearts of the enemies is not only a means, it is the end in itself. Once a condition of terror into the opponent’s heart is obtained hardly anything is left to be achieved. It is the point where the means and the end meet and merge. Terror is not a means of imposing decision upon the enemy; it is the decision we wish to impose upon him.

  6. Courtesy of the US Department of State http://www.state.gov/s/ct/rls/pgtrpt/2001/html/10237.htm

  7. Courtesy of the US Department of State http://www.state.gov/s/ct/rls/pgtrpt/2001/

  8. Religiously Motivated Terrorism

  9. Courtesy of The Federal Bureau of Investigation http://www.fbi.gov/terrorinfo/terrorism.htm

  10. Why an Increasing Risk of Bioterrorism

  11. Changing Goals of Terrorism

  12. Advantages to Biological Agent Use

  13. Most Likely Agents

  14. Most Likely Agents • Category 1 = Anthrax Smallpox • Category 2 = Plague Tularemia • Category 3 = Botulism ToxinViral Hemorrhagic Fever

  15. Likely Bioterrorism Agents • Category B • c. burnetti (Q Fever) • brucella spp. (Brucellosis) • burkholderia mallei (Glanders) • burkholderiapseudomallei (Melsosdosis) • alphaviruses (Viral Encephalitis) • rickettsia prowazekii (Typhus) • Toxins (Ricin) • Staph Enterotoxin B • chlamydia psittaci (Psittacosis) • Other Foodborne agents • Other Waterborne agents Source: Centers for Disease Control and Prevention, Critical Biological Agents for Public Health Preparedness, 1999

  16. Some Examples of Bioterrorism Involving Food

  17. Outbreak of Shigella dysenteriae Type 2 • Dallas, Texas – A large Medical Center • 29 Oct – 1 Nov 96 – 12 Laboratory workers experienced severe gastrointestinal illness • All had eaten pastries left in their breakroom between the night and morning shifts on October 29th 1996

  18. Shigella dysenteriae Type 2 • Rare organism • Also known as Schmitz bacillus • Does not produce Shiga toxin • Much less severe infection than Type 1 • Initial symptoms – Nausea, abdominal discomfort, and bloating. Followed approximately 24hrs later by diarrhea • Infection confirmed with positive stool culture for S dysenteriae

  19. Lessons from Dallas Outbreak of S dysenteriae Type 2 • Covert contamination of food items is one of the most uncomplicated forms of bioterrorism • Better lab security is needed • Control access to laboratory stock cultures • Lock storage freezers • Maintain documentation of every individual gaining access

  20. Other Foodborne“Bioterrorism” Incidents • 1960s – Several Japanese outbreaks of typhoid and dysentery traced to research biologist intentionally contaminating food items • 1970 – 4 Canadian students were ill after consuming food contaminated with embryonated Ascaris suum ova, a large ringworm infecting pigs. • 1984 – In Oregon, more than 750 people became ill after being exposed to Salmonella from contaminated salad bars.

  21. Salad Bar Contamination • September 1984, The Dalles, Oregon • 10 salad bars contaminated with Salmonella bacteria • More than 750 people became sick • Officials slow to identify the outbreak as deliberate • “We really lost our innocence over this. We weren't suspicious enough." Michael Skeels of the Oregon State Public Health Laboratory in Portland.

  22. Food Supply Vulnerability • January 2003, Michigan • Four families (18 people) experienced acute illness • Burning of the mouth, nausea, vomiting, dizziness • Recall of 1,700 pounds of beef • 148 more illnesses reported following recall • Four hospitalized, no fatalities • February 12, 2003, supermarket employee indicted • Poisoned 200 pounds of meat with “Black Leaf 40” insecticide, primary ingredient is nicotine

  23. Failing to Report • Saturday, in March 1997 • Sun Harbor Airport, Phoenix, Arizona • 737 arrives from Acapulco, 50+ on board w/diarrhea • Plane offloads 25 passengers to ambulances • 6 patients admitted to local hospital • County Health Officer learned of the event listening to the radio (NPR) the following Monday • Public Health had no names and no stool samples • The aircraft was cleaned, reloaded and continued to Detroit the same day

  24. Steps in Food Safety and Security • Identify the hazards • Assess the risk • Analyze risk control measures • Make control decisions • Implement risk controls • Supervise and review

  25. Identify the Hazards • Conduct review of each activity in food production process • Concentrate on where people have access to the process • Food can be contaminated with biological and chemical agents at all points in process

  26. Assess the Risk • Risk level severity can go from catastrophic to negligible • Risk level probability can go from frequent to unlikely

  27. Examples of Hazards • Trucks not secured • Little security in hiring personnel • Water to clean products could be contaminated • Facilities not secured

  28. Risk Control Measures • Put up security cameras • Put guard on doors • Provide warning devices on doors • Lock doors and use panic bars to open • Put new hires under close supervision for first 90 days • Do background checks on employees

  29. Make Risk Control Decisions • Determine which risks are the most severe • Determine which risk are the most probable

  30. Implement Risk Control Decisions • Put control measures in budget • Train personnel on new procedures • Develop incentives for employees and management to implement control measures

  31. Supervise and Review • Monitor effectiveness of controls • Provide frequent feedback to employees and management

  32. 2000-2001 Bioterrorism Survey

  33. Bioterrorism Risk Perceptions

  34. Bioterrorism Risk Perceptions

  35. Bioterrorism Risk Perceptions

  36. Bioterrorism Risk Perceptions

  37. Questions? www.bioterrorism.slu.edu www.emerginginfections.slu.edu www.cfsan.fda.gov

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