Bioterrorism Agents And Barrier Protection

History and Evolution of Bioterrorism KEY BIOTERRORIST EVENTS Geneva Protocol signed to prohibit research and development of biological weapons. United States offensive biological weapons program dismantled. Biological and Toxin Weapons Convention signed. Bioterrorism is not a new phenomenon and has been used as a weapon for centuries. In 700 BC, the Assyrians poisoned the water wells of their enemies with the poison rye ergot. In the 1300s, during the siege of Kaffa (now in Ukraine), the Tartars catapulted plague-infected corpses over the walls of the city, which probably led to the Black Death plague epidemic that followed. It has been said that during Pizarro’s conquest of South America in the 1600s, he ensured his victory by giving the natives “gifts” of clothing that had been tainted with the smallpox virus. In 1763, during the French and Indian War and under the guise of friendship, Native Americans were given gifts of blankets that had been previously used by patients that died of the smallpox virus. In 1797, Napoleon attempted to force the surrender of Mantua by infecting the citizens with swamp fever. During the Civil War, Confederate troops left carcasses of dead animals, usually horses, in the Union soldiers’ source of drinking water. During World War II, allegations were made against the Germans for attempting to spread cholera in Italy and plague in Leningrad, and use biological bombs over Britain. Also, it was alleged that the Germans deployed anthrax against their enemies in both World Wars I and II. Other significant events in the history of bioterrorism include: 1925: The Geneva Protocol was signed. This document prohibited research and development of biological weapons, although history has proven that offensive biological programs continued despite the treaty. 1940: The Chinese dropped ceramic containers containing plague-infected fleas on Manchuria. 1969: President Nixon dismantled the United States offensive biological weapons program, although research related to defense against biological weapons continues to this day. 1972: The Biological and Toxin Weapons Convention was signed and ratified by 140 nations. This agreement required termination of all offensive weapons research and destruction of existing stockpiles of agents. 1978: In London, an alleged KGB agent assassinated a Bulgarian dissident using ricin toxin. 1984: To alter the outcome of a local election, Rajneesh cult members’ sprayed salmonella on salad bars in Oregon, causing more than 700 people to become ill. 1995: The Aum Shinrikyo cult used sarin gas to attack subway passengers in Tokyo. 2001: Letters laden with anthrax were mailed to media, news organizations, and politicians. Biological weapons have distinct advantages over traditional weapons. First, they can attack a very large area in a very short period of time using aerosolized biological agents. The detection of the biological release would most likely be delayed since these agents are odorless, colorless, and tasteless. Unless the terrorists call and announce the agent they released, the public will not be aware until victims become ill, which is usually days or weeks later. Using biological agents as weapons also has the advantage of a delayed recognition in the medical community. The diseases produced by biological agents all present with very similar symptoms in the beginning, usually non-specific flu-like symptoms that make early diagnosis difficult. Further, many physicians have not seen these diseases in their medical practice and have only read about them in medical textbooks. Another reason that the threat of using biological agents as weapons has increased is that biological weapons are very inexpensive to create. Experts once estimated that fifteen hundred dollars in traditional nuclear weapon killing power is equal to about a penny’s worth of anthrax.1 While nuclear weapons production requires specific facilities, anthrax can be germinated in a basement laboratory. Also, the knowledge to produce and disseminate these agents is easily accessible through current technology, such as the Internet. Furthermore, at the end of the Cold War, many Russian scientists working in offensive biological programs lost their jobs. It has been reported that some of these Soviet scientists went to work for terrorist organizations and rogue nations, taking their knowledge, equipment, and even samples, including smallpox, with them. Biological agents can be delivered in several different ways, including orally in food, and through water or air. Today, most experts predict the most likely method of biological attack would be a large-scale attack using an aerosolized agent that may or may not be contagious. Which biological agents would pose the greatest threat when used as a weapon? Potentially, thousands of agents could be used in a bioterrorism attack. However, the Centers for Disease Control (CDC) and the US Army Medical Research Institute of Infectious Diseases (USAMRIID) narrowed the list based on a number of criteria, including how easy it is to obtain and produce the agent, the agent’s stability in the environment, and whether the agent is contagious and/or lethal. Next, the CDC grouped the agents into three categories based on the likelihood of their use as a biological weapon. The categories are A, B, and C, with Category A being the most likely agents to be used. Category A consists of six diseases: anthrax, smallpox, botulism, viral hemorrhagic fevers, tularemia, and plague. This study guide will review the six Category A diseases, providing a description, clinical manifestations, diagnosis, treatment, post-exposure prophylaxis, and infection control, including appropriate barrier protection.

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