Bioterrorism diseases

Bioterrorism is the intentional use of pathogenic microorganisms or toxins to cause disease or death in plants, animals, and humans. Deliberate bioterrorism attacks are often perpetuated by individuals, groups, or hostile governments for financial, political, or ideological purposes. 

Information about clinical diagnosis and management can be found elsewhere.1-9 Additional information about responding to bioterrorism is available from CDC at http // www.bt.cdc.gov the U.S. Army Medical Research Institute of Infectious Diseases at http // www.usamriid.army.mil/education/bluebook.html the Association for Infection Control Practitioners at http //www.apic.org and the Johns Hopkins Center for Civilian Biodefense at http //www.hopkins-biodefense.org. 

Until October 2001, no deaths from bioterrorism were reported in the U.S. On September 11, 2001, after the attacks on New York City and Washington, the Centers for Disease Control recommended that the nation increase its surveillance for unusual disease occurrences or clusters, asserting that they could be sentinel indicators of bioterrorist attacks. As predicted, cases of anthrax were reported in Florida, New York City, the District of Columbia, and New Jersey. Over the years, it has become evident that not only is biological warfare attractive to governments, it is equally attractive to terrorist cells because the agents are relatively inexpensive and easy to make. 

With respect to five-membered lactones fused to hexopyranose units, some approaches have been reported so far and the exploitation of their synthetic potential has led to the access of new carbohydrate derivatives. Bicyclic derivatives of this type are key intermediates in the synthesis of the epimer at C-3 of the sugar moiety contained in miharamycins [212, 213]. The latter are antibiotics known to inhibit strongly Pyricularia oryzae, which produces the rice blast disease. These compounds are also considered to be a potential bioterrorism agent (Scheme 42). Hence, the 3,3-spiroepoxide 176 was converted into the 3-C-cyanomethyl derivative 177, the hydrolysis of which led to spontaneous cyclization in the presence of... 

Anthrax, a disease caused by infection by Bacillus anthracis via spores, can be transmitted to humans or animals ruminants such as sheep, goats, cattle, and deer are most susceptible. The handling of infected animals or animal products may also lead to human infection. Recently, anthrax has been considered to be a potential candidate for bioterrorism activity. The spores are extremely hardy and may come into contact with humans through a cut or abrasion, through consumption of infected meat, or by inhalation. The Center for Disease Control (CDC) lists anthrax as a category A disease, and the only vaccine that currently exists has a number of drawbacks and health risks. 

Since the terrorist attack on New York s World Trade Center, discussions about the global exchange of disease have often focused on bioterrorism. In response to a possible bioterrorist release of smallpox, the U.S. government has stockpiled vaccine and implemented a largely unsuccessful program to vaccinate first responders (Gursky and Parikh 2005). Yet, if smallpox reappears, it will likely do so from the laboratories in the world s most scientifically developed nations. When it comes to infectious diseases, each part of the world threatens and is a threat to its neighbors. 

Case Example An outbreak of an infectious disease leads public health officials to believe that a bioterror attack has occurred. To avoid panic in the public, however, they have made no public announcement of their suspicions. They have requested, however, that nurses be on the alert for new cases of the infectious disease and to report it to them immediately, along with certain information about the patient. A nurse asks her supervisor if she can legally make such reports. 

Case Example Because public health officials suspect a stealth bioterror attack, they request that hospitals secretly test all of their new patients for the suspected contagious disease. The patient is to be notified only if he or she tests positively for the disease, and he/she will be offered standard medical treatment. Reports are to go directly to public health officials. Can a nurse legally or ethically participate in such a program ... 

In the event of a public health crisis resulting from a bioterror attack, there may be a public health need to screen the population for a disease. The MSEHPA would allow medical examinations and testing performed by any qualified person authorized by the public health authority (MSEHPA, 2002, 602(a)). Persons who refuse the medical examination or treatment could be isolated or quarantined (MSEHPA, 2002, 602(c)). The authors of the MSEHPA recognize that testing can cause harm to particular individuals and, thus, require that the tests must not be such as are reasonably likely to lead to serious harm to the affected individual (MSEHPA, 2002, 602(b)). It is not clear who would make this determination. It may be that this would be left to the discretion of the health professional administering the test. On the other hand, it may be that the public health authority (such as the state health department) would issue exceptions for particular classes of individuals (MSEHPA, 2002). 

Gostin, L. 0., Sapsin, J. W., Teret, S. P., Burris, S., Mair, J. S., Hodge, J. G., et al. (2002). Model State Emergency Health Powers Act Planning for and response to bioterrorism and naturally occurring infectious diseases. Journal of the American Medical Association, 288 S), 622-628. 

Horton, H. H., Misrahi, J. J., Matthews, G. W., Kocher, P. L. (2002). Critical biological agents Disease reporting as a tool for determining bioterrorism preparedness. The Journal of Law, Medicine Ethics, 30(2), 262-266. 

In today s mass society, mass-mediated emergency response must be an integral part of effective disaster management—especially in the face of bioterrorism, emerging infectious diseases, or other public health crises. Although each emergency situation has its own unique features and requires different approaches for dealing with public information and media relations, this chapter... 

Hazard vulnerability risk assessments need to be reviewed at least on an annual basis. A new industry may have located to the area, or events of the world may have changed. For example, the threat of bioterrorism, emerging infectious diseases, or civil strife may become part of our reality. The emergency management plan may have to be revised, and an appendix may have to be added for newly identified risks. This process then leads to the next phase of disaster management—mitigation. 

The notion of bioterrorism has a particularly frightening and intimidating aura for most people (including these writers) and may also possess an apocalyptic mystique for both terrorists and the public. Still, BW is essentially an infectious disease problem, or public health in reverse. In keeping with this theme of bioterrorism being the deliberate cause of infectious disease. 

This chapter provides a brief overview of systems currently in piace for the detection of biological events, either naturaiiy occurring disease outbreaks or deliberate bioterror events. Basic concepts related to infectious disease epidemiology and surveillance are presented. Different types of surveillance systems, including syndromic surveillance, are described. The roles of the... 

An often over-looked aspect of surveillance for bioterror events is surveillance of animal populations. Several of the agents considered to have bioterror potential are diseases of animals, for example, anthrax and brucellosis (Franz et al., 2001 Inglesby et al., 1999 USAM-RIID, 2005). A covert attack may first become apparent when animals become ill. The need to coordinate information from medical and veterinary sources was illustrated by the epidemiologic investigation during the 1999 West Nile Virus outbreak in New York City. Investigators found that there had been an outbreak in birds several weeks prior to the human outbreak (Fine Lay-ton, 2001). The current surveillance plan for monitoring West Nile Virus infection in the U.S. includes sentinel surveillance of several animal populations (CDC, 2003). 

Fine, A., Layton, M. (2001). Lessons from the West Nile viral encephalitis outbreak in New York City, 1999 Implications for bioterrorism preparedness. Clinical Infectious Diseases, 32, 277-282. 

Jernigan, J. A., Stephens, D. S., Ashford, D. A., Omenaca, C., et al. (2001). Bioterrorism-related inhalational anthrax The first 10 cases reported in the United States. Emerging Infectious Diseases, 7, 933-944. 

DeMaria, A., Jr., et al. (2002). Use of automated ambulatory-care encounter records for detection of acute illness clusters, including potential bioterrorism events. Emerging Infectious Diseases, 8(8), 753-760. 

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