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Bioterrorism Awareness: Protection of Human and Animal Health. General Public. Why Are We Here?. September 11, 2001 changed many things Worst terrorist act in U.S. history More than 3,000 presumed dead Occurred on American soil Increased sense of vulnerability. Biological Attack.

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Presentation Transcript
why are we here
Why Are We Here?
  • September 11, 2001 changed many things
    • Worst terrorist act in U.S. history
    • More than 3,000 presumed dead
    • Occurred on American soil
    • Increased sense of vulnerability

Center for Food Security and Public Health Iowa State University 2005

biological attack
Biological Attack
  • Bioterrorism attacks of 2001
    • Anthrax in postal system
      • 22 cases
      • 5 deaths
  • U.S. public health realm changed forever

Center for Food Security and Public Health Iowa State University 2005

overview
Overview
  • Bioterrorism
  • Zoonoses and bioterrorism
  • Disease control
  • U.S. Government agencies involved
  • Bioterrorism agents/diseases
  • Your role and responsibility

Center for Food Security and Public Health Iowa State University 2005

slide5

Agroterrorism

Bioterrorism

Other

Terrorism

  • Biological, chemical, or radiological agents targeting agriculture or its components
    • Livestock
    • Food supply
    • Crops
    • Industry
    • Workers
  • Conventional, radiological, nuclear, chemical,cyber
    • Typically direct human targeting

Biological agents targeting humans, animals, or plants

Center for Food Security and Public Health Iowa State University 2005

characteristics of a biological attack
Characteristics of a Biological Attack
  • Difficult to detect release
  • Dissemination may cover a large area
  • Possible secondary spread
  • Recognition of agent may be delayed days to weeks
  • Difficulties in catching perpetrators

Center for Food Security and Public Health Iowa State University 2005

infectious disease outbreak

Exposure

Symptoms

Seek Care

No. Affected

Infectious Disease Outbreak

Time (Days)

Center for Food Security and Public Health Iowa State University 2005

clues suggesting biological agent release
Clues Suggesting Biological Agent Release
  • Clustering of morbidity or mortality
    • In time and space
    • Large numbers of animals and/or people
    • Symptoms that are not typical
  • Normally healthy people affected
  • Unusual symptoms for area
  • Unusual age distribution
  • Disease occurring outside typical season

Center for Food Security and Public Health Iowa State University 2005

many agents are zoonotic
Many Agents are Zoonotic
  • Zoonotic means disease can be transmitted from animals to humans
  • Disease may be seen in animals before humans
  • Animals are sentinels
    • Pets, livestock, wildlife

Center for Food Security and Public Health Iowa State University 2005

factors that promote transmission of zoonoses
Factors That Promote Transmission of Zoonoses
  • Frequent contact with domestic or wild animals
  • Overlap with wildlife habitat
  • Intensive livestock production
  • Poor animal sanitation
  • Poor personal hygiene
  • Poor animal health

Center for Food Security and Public Health Iowa State University 2005

routes of transmission
Routes of Transmission
  • Direct contact
    • Gel, liquid, powder
    • Scratches
    • Droplet spray onto mucous membranes
  • Indirect contact: ingestion, injection
    • Contaminated food, water
    • Vector
  • Aerosol

Center for Food Security and Public Health Iowa State University 2005

disease control
Disinfect/clean up areas contaminated with animal waste

Livestock, pets, wildlife, rodents

Basic hygiene

Wash hands

Child supervision

Disease Control

Center for Food Security and Public Health Iowa State University 2005

zoonoses control
Zoonoses Control
  • Proper pet selection
  • Use caution at petting zoos
  • Cook food properly
  • Control strays
  • Visit and communicate with physician and veterinarian
  • Follow guidelines for immunocompromised people

Center for Food Security and Public Health Iowa State University 2005

u s agencies

U.S. Agencies

Dealing with terrorism

public health security and bioterrorism preparedness response act of 2002
Public Health Security and Bioterrorism Preparedness Response Act of 2002
  • June 12, 2002
  • Improve ability of the U.S. to prevent, prepare for, and respond to bioterrorism and other public health emergencies
  • $4.3 billion to various federal, state and local agencies
    • Upgrade facilities, enhance security, etc

Center for Food Security and Public Health Iowa State University 2005

department of homeland security dhs
Department of Homeland Security (DHS)
  • Established January, 2003
  • Mission
    • Prevent, protect, and respond to acts of terrorism on U.S. soil
  • Established four policy directorates
    • Responsibilities for coordinating HHS and USDA
    • Guard borders and airports, coordinate the response for future emergencies, analyze threats and intelligence, protect our critical infrastructure

Center for Food Security and Public Health Iowa State University 2005

centers for disease control and prevention
Centers for Disease Control and Prevention
  • CDC's Mission:
    • Promote health and quality of life by preventing and controlling disease, injury, and disability
  • Preparing for bioterrorism since 1998
  • One of first agencies to respond to anthrax incidents

Center for Food Security and Public Health Iowa State University 2005

strategic national stockpile
Strategic National Stockpile
  • 12-hour Push Package
    • Complete package of medical materials
  • Vendor Managed Inventory
    • Tailored to suspected agents

Center for Food Security and Public Health Iowa State University 2005

insert your state s info here
Insert Your State’s Info Here

Center for Food Security and Public Health Iowa State University 2005

preparing iowa
Preparing Iowa
  • Iowa’s Homeland Security
    • Administered by Iowa Emergency Management Division
    • Works with public and private partners

www.iowahomelandsecurity.org

Center for Food Security and Public Health Iowa State University 2005

preparing iowa1
Preparing Iowa
  • Iowa Department of Public Health www.idph.state.ia.us/odedp
  • Iowa Department of Agriculture and Land Stewardship
    • Highly infectious animal disease program
    • IRVIN: Iowa Rapid Veterinary Information Network
  • CFSPH training veterinarians to educate others

Center for Food Security and Public Health Iowa State University 2005

classification
Classification
  • Prepared by the CDC’s Bioterrorism Preparedness and Response Office
  • Category A: Highest priority
  • Category B: Second highest priority
  • Category C: Third highest priority

Center for Food Security and Public Health Iowa State University 2005

note to presenter
Note to presenter
  • As time allows select diseases you would like to review.
  • If you have limited time you should focus on the Category A agents.
  • The disease coverage is brief. If you would like more information on a disease refer to the fact sheet or to that disease’s specific presentation.

Center for Food Security and Public Health Iowa State University 2005

category a agents diseases
Category A : Agents/Diseases
  • Anthrax
  • Botulism
  • Plague
  • Smallpox
  • Tularemia
  • Viral hemorrhagic fevers

Center for Food Security and Public Health Iowa State University 2005

anthrax
Anthrax
  • Bacteria: Bacillus anthracis
  • Forms spores
  • Human disease
    • Skin
    • Intestinal
    • Inhalation
  • Animal disease
    • Spreads through the body system; rapid death

Center for Food Security and Public Health Iowa State University 2005

botulism
Botulism
  • Clostridium botulinum: A bacteria that produces different toxins
  • Affects the nervous system
  • Clinical signs
    • Generalized weakness
    • Pigs, dogs, and cats fairly resistant

Center for Food Security and Public Health Iowa State University 2005

plague
Plague
  • Bacteria: Yersinia pestis
  • Transmission: Fleabites, aerosol, direct contact
  • Symptoms: Humans
    • Enlarged lymph nodes, blood infection, respiratory
  • Symptoms: Animals
    • Cat: Similar to human
    • Dogs, livestock: Somewhat resistant

Center for Food Security and Public Health Iowa State University 2005

smallpox
Smallpox
  • Variola virus
  • Eradicated from the world in 1977
  • Narrow host range: Humans only
  • Transmission: Person-to-person, contaminated items
  • Clinical signs
    • Flu-like, progressive skin eruptions

Center for Food Security and Public Health Iowa State University 2005

tularemia
Tularemia
  • Bacteria: Francisella tularensis
  • Transmitted by ingestion, inhalation, tick bites, direct contact through skin
  • Six clinical forms in humans

Glandular

Ulceroglandular

Center for Food Security and Public Health Iowa State University 2005

tularemia1
Tularemia
  • Sheep, young pigs, horses, dogs, cats
    • Sudden fever, lethargy, stiffness, prostration and death
  • Wildlife
    • Usually find dead
    • Rabbits behave strangely
  • Cattle, older pigs resistant

Center for Food Security and Public Health Iowa State University 2005

viral hemorrhagic fevers
Viral Hemorrhagic Fevers
    • Early: Fever, fatigue
    • Severe: Bleed from internal organs, body openings
    • Progression to shock and seizures
  • Animals: Only non-human primates susceptible
  • Ebola, Marburg, Lassa, Machupo
  • Human clinical presentation

Vincent Massey

Center for Food Security and Public Health Iowa State University 2005

category b agents diseases
Brucellosis

Glanders

Psittacosis

Q Fever

Typhus fever

Viral encephalitis

Toxins

Food Safety Threats

Water Safety Threats

Category B: Agents/Diseases

Center for Food Security and Public Health Iowa State University 2005

brucellosis
Brucellosis
  • Bacteria: Brucella spp.
  • Ingestion, inhalation or direct contact
  • Clinical signs
    • Humans: Cyclic fever and flu-like symptoms
    • Animals: Reproductive signs

Center for Food Security and Public Health Iowa State University 2005

glanders
Glanders
  • Bacteria: Burkholderia mallei
  • Transmission by ingestion, inhalation or direct contact
    • Animal-to-human transmission is inefficient
  • Clinical signs
    • Humans & horses: Skin and lung lesions, rapidly fatal illness

Center for Food Security and Public Health Iowa State University 2005

psittacosis
Psittacosis
  • Bacteria: Chlamydophila psittaci
  • Occurs worldwide
  • Reportable in U.S.
  • Clinical disease
    • Humans and birds: Ranges from no symptoms to systemic illness with severe pneumonia

Center for Food Security and Public Health Iowa State University 2005

q fever
Q Fever
  • Coxiella burnetii
  • Transmission: Inhalation, direct contact, ingestion, ticks
  • Disease symptoms
  • Humans:
    • Acute: Flu-like, pneumonia & liver disease
    • Chronic: Heart complications, bone inflammation
  • Animals: Most have no signs
    • Sheep, cattle and goats: Abortions

Center for Food Security and Public Health Iowa State University 2005

typhus fever
Typhus Fever
  • Transmitted in feces of human body louse
  • Clinical signs: Humans
    • Fever, headache, red blotches, and a red-dot rash
  • Not seen in domestic animals
  • Rickettsia prowazekii
  • Endemic in Eastern Europe, Middle East, and parts of Africa

J. Kalisch

Center for Food Security and Public Health Iowa State University 2005

viral encephalitis
Viral Encephalitis
  • Viruses causing EEE, WEE and VEE
  • Transmitted via mosquito
  • Clinical signs
  • Birds do not become ill but are carriers; act as sentinels
  • Humans, horses, donkeys, mules: Often no signs or flu-like illness
  • Brain inflammation in some patients

Center for Food Security and Public Health Iowa State University 2005

food safety threats
Food Safety Threats
  • Campylobacter species
  • Salmonella species
  • E. coli 0157:H7
  • Viruses, parasites, chemicals, toxins
  • Ingestion of contaminated food
  • Gastrointestinal upset

Center for Food Security and Public Health Iowa State University 2005

food safety threats the bioweapon
Food Safety Threats: The Bioweapon
  • 1984, The Dalles, Oregon
    • Bagwan Shree Rajneesh cult
    • Contaminated salad bars
      • Salmonella typhimurium
    • Goal: incapacitate voters
    • 751 people ill

Center for Food Security and Public Health Iowa State University 2005

water safety threats
Water Safety Threats
  • 53% of US drinking water is from ground water
  • Cryptosporidium parvum- protozoa
  • Vibrio cholerae- bacteria

Center for Food Security and Public Health Iowa State University 2005

cryptosporidium
Cryptosporidium
  • Cryptosporidium parvum- protozoa
  • Transmission: Inhalation, ingestion
  • Clinical signs: Humans, calves, others
    • Acute gastroenteritis
  • Dogs, cats, horses, pigs: Resistant

Center for Food Security and Public Health Iowa State University 2005

vibrio cholerae
Vibrio cholerae
  • Vibrio cholerae- bacteria
  • Transmission: Fecal-oral, contaminated shellfish
  • Clinical signs in humans
    • Acute, mild diarrhea
    • 5% severe disease
  • Animals are resistant to disease

Center for Food Security and Public Health Iowa State University 2005

water safety public health significance
Water Safety: Public Health Significance
  • Cryptosporidum parvum
    • 1993: Municipal water supply contaminated in Milwaukee
    • 40,000 ill
    • 1997: Decorative water fountain at the Minnesota Zoo
    • 369 cases
    • Mostly young children

Center for Food Security and Public Health Iowa State University 2005

category c
Category C
  • Nipah virus
  • Hantavirus

Center for Food Security and Public Health Iowa State University 2005

nipah virus
Nipah Virus
  • Paramyxovirus
  • Fruit bat reservoir
  • Clinical signs
    • Humans: Encephalitis
    • Pigs: Respiratory, neurological
    • Dogs and cats: “Distemper”

Center for Food Security and Public Health Iowa State University 2005

hantavirus
Hantavirus
  • Asymptomatic reservoir: Rodents
  • Transmission: Inhalation, ingestion, direct contact
  • Human clinical signs
    • Fever, muscle pain, headache
    • Hantavirus Pulmonary Syndrome
    • Hemorrhagic Fever with Renal Syndrome
  • Not seen in domestic animals

Center for Food Security and Public Health Iowa State University 2005

other important zoonotic diseases
Other Important Zoonotic Diseases
  • Transmissible Spongiform Encephalopathies
  • West Nile Virus
  • Monkeypox

Center for Food Security and Public Health Iowa State University 2005

transmissible spongiform encephalopathy
Transmissible Spongiform Encephalopathy
  • Prions are mutated proteins thought to cause disease
  • Very long incubation period
  • Neurological signs in all species
  • Invariably fatal
  • No treatment available

Center for Food Security and Public Health Iowa State University 2005

bovine spongiform encephalopathy
Bovine Spongiform Encephalopathy
  • Mad cow disease
  • Incubation: 2 to 8 years
  • 1995, United Kingdom
    • vCJD
    • People exposed to BSE
      • Before bovine offal ban in 1989
  • Active U.S. surveillance since 1999

Center for Food Security and Public Health Iowa State University 2005

west nile virus
West Nile Virus
  • Transmission
    • Mosquitoes
    • Blood transfusion, organ donation, breast feeding
  • Animals: horses, birds, mammals and reptiles
  • Humans
    • Duration: 3-6 days
    • 80% have no signs
    • 20% develop “West Nile Fever”

Center for Food Security and Public Health Iowa State University 2005

west nile virus public health significance
West Nile Virus: Public Health Significance
  • Human illness in U.S. in 2003
    • 9,100 cases, 222 deaths
  • Horses illness in U.S. in 2003
    • 4,554 cases
    • 40% of ill result in death
  • Method of introduction to U.S. unknown

*data current as of 1/30/04

Center for Food Security and Public Health Iowa State University 2005

spread of wnv in the u s
Spread of WNV in the U.S.

Center for Food Security and Public Health Iowa State University 2005

west nile virus the response
West Nile Virus: The Response
  • Treatment: Supportive care
  • Vaccine available for horses, not humans
  • Source elimination
    • Eliminate mosquito larval habitats
  • Personal protection
    • Reduce time outdoors
    • Wear long pants and sleeves
    • Use mosquito repellent

Center for Food Security and Public Health Iowa State University 2005

monkeypox
Monkeypox
  • Virus related to smallpox
  • Transmission
    • Reservoir may be African squirrel
    • Bites, aerosol, direct contact
    • Zoonotic, animal-to-animal, person-to-person
  • Animals: Fever, rash, pustules, red eyes
  • Humans: Flu-like, rash, pustules, swollen lymph nodes

Center for Food Security and Public Health Iowa State University 2005

what to do if bioterrorism is suspected
What to do if bioterrorism is suspected
  • Stay informed and remain calm
  • Response is event specific
  • Response is everyone's responsibility
  • Follow the advice of public health officials
  • Follow federal and state guidelines
  • Movement restrictions may be necessary

Center for Food Security and Public Health Iowa State University 2005

contacts
Contacts
  • Phone numbers to know
    • Local veterinarian
    • Local physician
    • Public health officials

Center for Food Security and Public Health Iowa State University 2005

summary
Summary
  • Bioterrorism is a real threat
  • Public health infrastructure is being strengthened
  • Many bioterrorism agents are zoonotic
  • Awareness education is an important component of preparedness and protection

Center for Food Security and Public Health Iowa State University 2005

summary1
Summary
  • Prevention, recognition and response involves everyone
  • Report any suspicious activity, unexplained behavior or death loss your animals
  • You play a critical role

Center for Food Security and Public Health Iowa State University 2005

conclusion1
Conclusion

“The best prescription

is knowledge.”

Dr. C. Everett Koop

Former U.S. Surgeon General

Center for Food Security and Public Health Iowa State University 2005

acknowledgments
Acknowledgments

Development of this presentation was funded by a grant from the Centers for Disease Control and Prevention to the Center for Food Security and Public Health at Iowa State University.

Center for Food Security and Public Health Iowa State University 2005

acknowledgments1
Acknowledgments

Author:

Reviewer:

Ann Peters, DVM, MPH

Jamie Snow, DVM, MPH

Radford Davis, DVM, MPH

Gayle Brown, DVM, PhD

Center for Food Security and Public Health Iowa State University 2005