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    Slide 1:Food Supply Protection in an Age of Biocrimes, Terrorism, and Emerging Infections

    Bruce Clements, MPH Associate Director, Saint Louis University, Institute for Biosecurity

    Slide 2:Objectives

    Discuss current food supply vulnerabilities Provide case examples exemplifying food risks List the potential pathogenic agents of concern and methods of delivery Describe international and national initiatives to protect the food supply Explain local measures to reduce food supply vulnerability

    Sources of Terrorism State-Sponsored Programs Iraq, Iran, Libya, Syria, North Korea Ideological Extremists Domestic (e.g. Anti-Government, Militia, Single Issue Radicals) New World Terrorists Religious extremists (e.g. Aum Shinrikyo) International (e.g. Osama bin Laden) Lone Wolves Unabombers with specialized chemical/biological/nuclear training

    Slide 4:Trends in Terrorism

    Source: Terrorism in the United States, 1999, Report from the Counterterrorism Threat Assessment and Warning Unit, Federal Bureau of Investigation

    Changing Goals of Terrorism Historically LOW CASUALTY, HIGH VISIBILITY (Political concessions and media attention) Today MASS CASUALTIES (Weapons of mass destruction are appealing) From small car bombs to...

    Slide 6:Weapons of Mass Destruction CBRNE (Formerly NBC, CBR, WMD, etc.)

    C = Chemical Nerve, Blister, Blood, Choking, Incapacitant B = Biological Bacteria, Virus, Toxins, & Rickettsia R = Radiological Dirty bomb N = Nuclear Detonation or Nuclear facility attack E = Explosive Any device that rapidly releases gas & heat

    Slide 7:FBI Definition of Terrorism

    Terrorism is Unlawful use of force and violence against persons or property Intended to intimidate or coerce Committed in support of political or social objectives. Source: Code of Federal Regulations Title 28--JUDICIAL ADMINISTRATION, CHAPTER I--DEPARTMENT OF JUSTICE, PART 0, Subpart P--Federal Bureau of Investigation, Section 0.85 General functions.

    One Definition of Bioterrorism "Bioterrorism - The unlawful use, or threatened use, of microorganisms or toxins derived from living organisms to produce death or disease in humans, animals, or plants. The act is intended to create fear and/or intimidate governments or societies in the pursuit of political, religious, or ideological goals. Note: There is no single, universally accepted definition of bioterrorism.

    Slide 9:The Threats Are Changing

    We have worried about Airports / Aircraft Public Transportation Systems Public Buildings / Commerce Centers We now need to consider the threat of bioterrorism, ecoterrorism, and agroterrorism as they relate to: Food Supply Targeting Humans Indirectly Targeting Crops and Animals Directly Drinking Water Natural Resources

    Slide 10:400 BC Scythian archers used arrows dipped in blood and manure 300 BC Persian, Greek, and Roman literature provide examples of using animal cadavers to contaminate water supplies 190 BC Hannibal hurled venomous snakes onto enemy ships of King Eumenes

    History of Biological Warfare

    History of Biological Warfare 1155 Battle of Tortona Barbarossa put dead bodies in enemy water supplies 1346 Siege of Caffa - Mongols catapulted bodies of plague victims over the city walls 1718 Reval, Estonia - Russians tried the same tactic against Sweden 1763 French & Indian War During the Pontiac Rebellion in New England British forces gave smallpox inoculated blankets to Native Americans 1863 Civil War Retreating Confederate troops left dead animals in water sources to deny safe water to advancing Union soldiers History of Biological Warfare 1915-18 World War I German BW Program: Developed anthrax, glanders, cholera, and wheat fungus as weapons Primarily targeting cavalry animals History of Biological Warfare 1932-1945 Japanese BW Program: 1942-1957 U.K. BW Program 1942-1969 U.S. BW Program 1920-1990 U.S.S.R. BW Program Biopreparat Corporation- a cover for the Soviet BW Program Today At least 17 nations are suspected of having an offensive BW Program History of Biological Warfare During World War II, Canada, Great Britain, Japan, the United States, and the USSR studied many diseases including: Anthrax, brucellosis, and glanders, which are both antipersonnel and antianimal agents Other primarily defensive work was done on rinderpest, Newcastle disease, and fowl plague Crop diseases evaluated and/or produced for potential agroterrorism included: late blight of potato, rice blast, brown spot of rice, rubber leaf blight, southern blight, and wheat rusts History of Biological Warfare

    Slide 16:Recent History of Ecoterrorism

    1989 The Animal Liberation Front set timed incendiary devices beneath a meat company in Monterey, California 1993 A pipe bomb exploded in a window of an unoccupied USDA predator-control office in Southeast Portland 1997 A $1.3 million slaughterhouse was burned down in Redmond, WA on behalf of the Animal Liberation Front 1998 Seven fires broke out on Vail Mountain, Colorado, causing $12 million in damage the Earth Liberation Front (ELF) claimed responsibility

    Slide 17:People for the Ethical Treatment of Animals

    PETA has been described as by far the most successful radical organization in America President and co-founder, Ingrid Newkirk is seeking total animal liberation No meat or dairy, no aquariums, no circuses, no hunting or fishing, no fur or leather, no research using animals, no use of seeing eye dogs PETA handles press for the Animal Liberation Front (ALF), a group of underground extremists who: Plant firebombs in restaurants, destroy butcher shops, and burn down research labs PETAs vegan campaign director stated, It would be great if all the fast food outlets, slaughterhouses, test laboratories, and banks that fund them exploded tomorrow.

    Slide 18:Food Security Defined by the U.N.

    Food security exists when all people, at all times, have access to sufficient, safe and nutritious food to meet their dietary needs for an active and healthy life. 1996 World Food Summit, Rome, Italy

    Slide 19:Food borne Disease Threats

    Bacterial Botulism Brainerd Diarrhea Campylobacter Cholera Clostridium botulinum E.coli O157:H7 Listeriosis Salmonella Enteritidis Salmonellosis Shigellosis Typhoid Fever Vibrio vulnificus Viral Hepatitis A Virus Norovirus (formerly know as Norwalk-like virus) Rotavirus Viral gastroenteritis Parasitic Amebiasis Ascaris, Roundworms Cryptosporidiosis Cyclospora infection Cysticercosis Giardiasis Toxoplasmosis Trichinosis Source: CDC Division of Bacterial and Mycotic Diseases, Food Safety Office

    Slide 20:Early Intentional Foodborne Outbreaks

    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 roundworm infecting pigs

    Slide 21:Case I - Raising Suspicion

    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.

    Slide 22:Case II - 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

    Slide 23:Case III 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

    Lessons from a Shigella dysenteriae Type 2 Outbreak due to Intentional Food Contamination at a Dallas, Texas Hospital Key Reference: Kolavic, SA, et al, An Outbreak of Shigella dysenteriae Type 2 Among Laboratory Workers Due to Intentional Food Contamination. JAMA; 1997; 278(5): 396-398 Case IV Biocrime in Dallas 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 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 Outbreak of Shigella dysenteriae Type 2 Case definition: Lab worker with GI symptoms after 29 October: W/Positive stool sample for S dysenteriae W/Oral temp >37.8C (>100F) Demographics: Mean age = 41 years (range, 33-52 yrs) and 9 (75%) were female All 12 consulted a physician 5 treated in Emergency Departments & released 4 hospitalized, 8 received IV fluids Lessons from Dallas Outbreak of S dysenteriae Type 2 Covert contamination of food items is one of the most uncomplicated forms of bioterrorism Do not consume food or drink items of an unknown origin Better lab security is needed Control access to laboratory stock cultures Lock storage freezers Maintain documentation of every individual gaining access

    Slide 29:Former Secretary of DHHS Outgoing Comments

    "I cannot understand for the life of me why the terrorists have not attacked our food supply, because it's so easy to do, and we're importing a lot of food from the Middle East and it'd be easy to tamper with that" He said the government has made some progress in food biosecurity: food-import inspections have increased from 12,000 to 98,000 per year, and laws now require businesses to give advance notice of the arrival of food shipments from abroad. "But it still is a very minute amount that we're doing," Thompson said. "We've got more tools, but two areas [pandemic flu and food security] need a lot more work."

    Slide 30:Technological Progress

    Modern technology has transformed the production, storage, and preparation of food. What once was a relatively simple system of local farming and home preparation is today complex involving producers, processors, distributors, and retailers. As a result, at many points in the food chain, food safety becomes compromised. Moeller, D.W. Environmental Health, Harvard University Press; 1997.

    Slide 31:Increasing Vulnerability

    Requires a low level of technical expertise Food production and distribution is multi-layered and complex with many opportunities for tampering Numerous opportunities for food supply access by: Random Individuals Employees Activists Criminal Organizations Terrorists Numerous chemical and biological agents are effective The globalization of our food supply increases risk

    Slide 32:Why Would A Terrorist Target A Farm?

    Opportunity: 2 million plus farms; average size, 500 acres Specific targeting: most farms grow one crop/one livestock High concentration of livestock in feed lots, sale barns Disease agents require little specialized expertise Agroterrorism agents easy to conceal, easy to distribute Cost-effective: A small amount can produce an epidemic Low physical risk to carrier, high potential for disruption

    Slide 33:How Bad Could It Be?

    A single vial of Foot and Mouth Disease (FMD) could spread through an entire state within a week In 2001, an FMD outbreak in the UK cost more than $10 billion over 11 months. Related industries, such as transportation, feed suppliers, retailers adversely affected. Agriculture directly or indirectly accounts for more than 800,000 jobs in the U.S. Agricultural exports are $140 billion annually

    Slide 34:Concentrated and intensive contemporary farming practices Highly crowded breeding and rearing conditions Outbreak of a contagious disease would be very difficult to contain Could require the destruction of all exposed livestock Increased susceptibility of livestock to disease This has occurred because of changes in husbandry practices Sterilization programs Dehorning, branding, and hormone injections Overuse and misuse of antibiotics Insufficient farm/food-related security and surveillance Farms seldom incorporate vigorous means to prevent unauthorized access Most animal auctions and barn sales are devoid of organized on-site surveillance Food processing and packing plants tend to lack uniform security and safety

    Source: Rand Research Brief, 2004 Agricultural Vulnerabilities

    Slide 35:Agricultural Vulnerabilities

    An inefficient passive disease-reporting system Responsibility for reporting unusual occurrences of animal disease lies with livestock producers They may have disincentives for reporting due to the lack of a consistent program for agricultural indemnity Inappropriate veterinarian and diagnostic training The number of veterinarians able to recognize and treat foreign livestock diseases is declining Reflects a relatively underpaid profession that suffers from a lack of appropriate training in exotic animal disease epidemiology A focus on aggregate rather than individual livestock statistics The movement toward larger herds and breeding operations largely precludes the option of attending to animals individually Makes it more likely that emerging diseases will be overlooked. Source: Rand Research Brief, 2004

    Slide 36:Soybean Production

    Today, farmers across the U.S. grow soybeans that have been harvested into yields of about 2 billion bushes a year. About half of U.S. soybeans are exported to major markets including the European Community, Japan, Taiwan, Mexico and South Korea. More soybeans are grown in the U.S. than anywhere else in the world.

    Slide 37:Soybean Rust

    An extremely serious fungal disease of soybean First reported in the continental United States in November of 2004. Carried in by Hurricanes Currently, soybean rust has been found in Alabama, Arkansas, Florida, Georgia, Hawaii, Louisiana, Mississippi, Missouri, South Carolina and Tennessee. Soybean rust had previously been reported in Asia, Australia, Africa and South America, where yield losses due to the disease have ranged from 10 to 80%.

    Slide 38:Jaffa Oranges & Mercury

    A 1970s plot by Palestinian terrorists to inject mercury into Jaffa oranges reduced Israels exports of citrus fruit to Europe by 40 percent

    Slide 39:Chilean Grapes and Cyanide

    1989 incident in which a shipment of Chilean grapes to the United States tested positive for cyanide led to international trade suspensions that cost Chile $200 million.

    Slide 40:Beef Safety

    Slide 41:Foot and Mouth Disease

    The U.S. Department of Agriculture estimates that an attack on livestocka successful attempt to infect American cattle with a contagious disease such as foot-and-mouth, for examplecould cause between $10 billion and $30 billion in damage to the U.S. economy. Vesicles on the foot of a pig (Image kindly provided by Dr. Juan Lubroth) Vesicle on the teat of a cow (Image kindly provided by Dr. Juan Lubroth) Excessive salivation in a bovine (Image kindly provided by Dr. Juan Lubroth)

    Slide 42:Prevention and Response

    Distinguishing between a deliberate act and an inadvertent or natural food outbreak can be difficult Therefore the threat must be addressed at every level: The national level, through policies designed to minimize the social and economic costs of an outbreak The agricultural sector level, through disease surveillance, detection, and response procedures The farm level, through facility management techniques designed to prevent disease introduction or transmission The organism level, through animal and plant disease resistance Source: Anne Kohnen Responding to the Threat of Agroterrorism: Specific Recommendations for the USDA

    Slide 43:FDA Regulations

    October 9, 2003 Two FDA regulations enable better targeted efforts to monitor and inspect imported foods May 27, 2004 FDA Rule on Administrative Detention of Suspect Food December 6, 2004 FDA Rule on the Establishment and Maintenance of Records to Enhance the Security of the U.S. Food Supply Under the Bioterrorism Act Source: FDA Food Safety an Terrorism,

    Slide 44:FDA Food Code

    FDA publishes the Food Code Serves as a model to assist food control jurisdictions at all levels of government by providing them with a scientifically sound technical and legal basis for regulating the retail and food service segment of the industry Local, state, tribal, and federal regulators use the FDA Food Code as a model to develop or update their own food safety rules and to be consistent with national food regulatory policy Source: FDA FOOD CODE,

    Slide 45:USDA Regulations

    USDA finalized regulations on agricultural select agents and toxins in March 2005 The USDAs Animal and Plant Health Inspection Service provides lists of regulated select agents and toxins The regulations govern possession, use and transfer of these agents and toxins, which have the potential to pose a severe threat to public health and safety, to animal or plant health, or to animal or plant products Final rule revises format and content of USDA regulations, which prescribe registration, biocontainment / biosafety, incident response and security measures for facilities handling these agents and toxins to protect against the use of such agents in domestic or international terrorism Source: USDA Agricultural Select Agent Program,

    Slide 46:FDA / USDA HACCP Training Program

    Hazard Analysis and Critical Control Point (HACCP) Food safety program developed nearly 30 years ago for astronauts Prevention based approach FDA also established HACCP for: The seafood industry in a final rule December 18, 1995 The juice industry in a final rule released January 19, 2001 Final rule for juice industry took effect on January 22, 2002 for large and medium businesses, January 21, 2003 for small businesses, and January 20, 2004 for very small businesses In 1998, the USDA established HACCP for meat and poultry processing plants FDA considering new regulations to establish HACCP as the food safety standard throughout other areas of the food industry, including both domestic and imported food products HACCP Education Site:

    Slide 47:7 Principles of HACCP

    Analyze hazards. Potential hazards associated with a food and measures to control those hazards are identified. The hazard could be biological, such as a microbe; chemical, such as a toxin; or physical, such as ground glass or metal fragments. Identify critical control points. These are points in a food's production--from its raw state through processing and shipping to consumption by the consumer--at which the potential hazard can be controlled or eliminated. Examples are cooking, cooling, packaging, and metal detection. Establish preventive measures with critical limits for each control point. For a cooked food, for example, this might include setting the minimum cooking temperature and time required to ensure the elimination of any harmful microbes. Hazard Analysis and Critical Control Point

    Slide 48:7 Principles of HACCP

    Establish procedures to monitor the critical control points. Such procedures might include determining how and by whom cooking time and temperature should be monitored Establish corrective actions to be taken when monitoring shows that a critical limit has not been met--for example, reprocessing or disposing of food if the minimum cooking temperature is not met Establish procedures to verify that the system is working properly--for example, testing time-and-temperature recording devices to verify that a cooking unit is working properly Establish effective record keeping to document the HACCP system. This would include records of hazards and their control methods, the monitoring of safety requirements and action taken to correct potential problems Hazard Analysis and Critical Control Point

    Slide 49:USDA Tool

    Industry Self Assessment Checklist for Food Security 9 Sections Food Security Management Plan Outside Security Inside Security Slaughter and Processing Security Storage Security Shipping and Receiving Security Water and Ice Supply Security Mail Handling Security Personal Security

    Slide 50:Reportable Avian (Bird) Diseases

    Avian infectious encephalomyelitis Avian influenza Fowl typhoid (salmonella gallinarum) Infectious laryngotracheitis Mycoplasma gallisepticum (MG) Mycoplasma meleagridis (MM) Mycoplasma synoviae (MS) Paramyxovirus infection (other than Newcastle Disease) Psittacosis (chlamydiosis and ornithosis) Pullorum disease (salmonella pullorum) Salmonellosis caused by Salmonella enteritidis Velogenic viscerotropic Newcastle disease Source: Missouri Department of Agriculture

    Slide 51:Reportable Bovine (Cattle) Diseases

    Akabane Anthrax Bluetongue Bovine babesiosis (Texas fever, piroplasmosis) Bovine spongiform encephalopathy (BSE) Brucellosis Contagious bovine pleuropneumonia East coast fever (coastal fever, theileriosis) Ephemeral fever (3-day sickness) Foot-and-mouth disease Gonderiosis (theileriosis) Heartwater Hemorrhagic septicemia (Asiatic type 1 A shipping fever) Ibaraki Infectious petechial fever Louping III Lumpy skin disease (pseudourticaria) Malignant catarrhal fever Paratuberculosis Pseudorabies Q-fever Rift valley fever Rinderpest (cattle plague) Scabies Screwworm Sweating sickness (tick-borne toxicosis) Tuberculosis Trypanosomiasis (nagana) Vesicular stomatitis Wesselborne disease Source: Missouri Department of Agriculture

    Slide 52:Reportable Caprine-Ovine (Goat & Sheep) Diseases

    Bluetongue Borna disease Brucellosis caused by Brucella meletensis and B. ovis Caseous lymphadenitis Contagious agalactia of sheep and goats Contagious caprine pleuropneumonia Foot-and-mouth disease Goat and sheep pox Gonderiosis (theileriosis) Heartwater Nairobi sheep disease Peste des petits ruminants (kata) Screwworm Tuberculosis Rift Valley fever Scabies Scrapie Vesicular stomatitis Visna-Maedi (chronic progressive pneumonia) Source: Missouri Department of Agriculture

    Slide 53:Reportable Equine (Horse) Diseases

    African Horse sickness Babesiosis (piroplasmosis) Contagious equine metritis Dourine (equine trypanosomiasis) Eastern equine encephalomyelitis Epizootic lymphangitis Equine infectious anemia (EIA) Equine piroplasmosis Equine rhinopneumonitis Equine viral arteritis Glanders Potomac horse fever Venezuelan equine encephalomyelitis Vesicular Stomatitis Western equine encephalomyelitis Source: Missouri Department of Agriculture

    Slide 54:Reportable Porcine (Pig) Diseases

    African swine fever Brucellosis Foot-and-mouth disease Hog cholera Porcine babesiosis Pseudorabies Swine vesicular disease Teschen disease (porcine encephalomyelitis) Vesicular exanthema Vesicular stomatitis Source: Missouri Department of Agriculture

    Slide 55:Reportable Diseases for All Species

    Anthrax Brucellosis Exotic myiasis Foot-and-mouth disease Paratuberculosis (Johnes disease) Rabies Tuberculosis Vesicular exanthema Vesicular stomatitis Source: Missouri Department of Agriculture

    Slide 56:Reportable Animal Diseases With Human Transmission Risk

    Anthrax Arthropod-borne encephalitides: Eastern equine encephalitis LaCrosse encephalitis St. Louis encephalitis Venezuelan equine encephalitis West Nile encephalitis Western equine encephalitis Brucellosis Chlamydia trachomatis infections E. Coli 0157:H7 Ehrlichiosis Glanders Hantavirus Histoplasmosis outbreak Leptospirosis Lyme disease Psittacosis Q-fever Rabies Rocky Mountain spotted fever Salmonella infections Trichinosis Tuberculosis Tularemia These diseases must be reported to the Missouri Department of Health at (573) 751-6113 within 24 hours of suspicion or diagnosis Source: Missouri Department of Agriculture

    Slide 57:Local Level Preparedness Measures

    Food Industry Managers Practice and enforce standard food safety protocols Understand incoming and outgoing supply chain Expand thinking to consider ways to reduce tampering risks All Food Industry Workers (farm to fork) Upgrade integrity of supply chain Protect facilities and product Prevent tampering and contamination Do not wait for legislation Proactively look at your operational security Know your employees, contractors, suppliers Restrict facility access and report suspicious activity

    Slide 58:Food Tampering

    Signs to look for in tampered food include: In packaged food look for broken seals, unusual stains, unusual smells, damaged packaging or other breaks in packaging For unpackaged food, be vigilant of suspicious activity, especially in unsupervised food areas and around condiments or utensils used with food such as straws or plastic cutlery If you see any suspicious activity contact the police immediately If you suspect food has been tampered with: DO NOT SNIFF, TOUCH, EAT OR TASTE THE FOOD. If someone becomes sick after handling a suspect product call an ambulance immediately Do not to handle the product unnecessarily

    Slide 59:Prevention Issues

    Intelligence measures (identify potential threats; understand motivations; predict behavior) Monitoring programs (detect/track specific pathogens/diseases) Establishment of laboratories to research the most-virulent diseases International counterproliferation treaties, protocols, and agreements Creation of agent-specific resistance in livestock Specific vaccination against the most-threatening animal disease agents Modification (where possible) of vulnerable food/agriculture practices Biosecurity and surveillance Education and training (federal, state, and local) SOURCE: Henry Parker, Agricultural Bioterrorism: A Federal Strategy to Meet the Threat, McNair Paper,65,Washington,D.C.,National Defense University,March 00

    Slide 60:Response Issues

    Early detection of exotic/foreign pathogenic agents Early prediction of disease dispersion patterns Early containment procedures Epidemiology and treatment Depopulation and carcass disposal Diplomatic/legal/economic/ political responses Compensation and indemnity Education and training Public awareness and outreach programs Vaccine and pharmaceutical stockpiling SOURCE: Henry Parker, Agricultural Bioterrorism: A Federal Strategy to Meet the Threat, McNair Paper,65,Washington,D.C.,National Defense University,March 00

    Slide 61:Additional Resources

    U.S. Food & Drug Administration, Center for Food Safety & Applied Nutrition, Foodborne Pathogenic Microorganisms and Natural Toxins Handbook (The Bad Bug Book) FDA Food Safety and Terrorism Information Foreign Animal Diseases The Gray Book Gateway to US Government Food Safety Information Community Food Safety Education Program