Weapons of Mass Destruction

1. Weapons of Mass Destruction Keneatha Nason, MPH Walden University MPH 6165-5 Dr. Rebecca Heick Summer, 2009

2. Introduction • Since 9/11 the world has been on alert • Public Health is at the forefront of biological agents terrorist attack • CDC list of category A agents: • Based on how easy they are to obtain weaponries • Disseminate • How much death, damage, disruption or fear they might cause Biological and Chemical Terrorism: Strategic Plan for Preparedness and Response – Recommendations of the CDC Strategic Planning Work Group. Retrieved on June 15, 2009 from http://ftp.cdc.gov/pub/Publications/mmwr/RR/RR2904.pdf. Nadaskavukaren, A.(2006).Our global environment, a health perspective (6th ed.) . Long Grove, Illinois: Waveland Press, IncRichmond, T. (2002). Terrorism in the United States Since 9/11. Thorofare, J. Slack, Inc. .

3. Purpose • The purpose of this presentation is to inform the community representatives on the current biological weapons, and their possible impact on the community.

4. Objectives • Ability to identify the three forms of Anthrax. • Ability to identify who can be a host to Smallpox. • Ability to identify what is visual symptom of Smallpox. • Able to identify where Tularemia naturally occurs. • Identify what types of precautions to use with SARS. • Ability to identify how Bird Flu can be transmitted to humans.

5. Anthrax • A bacterial disease • Not transmitted from person to person • Agent: Bacillus anthracis • Three major routes • Inhalation: Most dangerous! • Cutaneous • Gastrointestinal Inglesby TV. Working Group on Civilian Biodefense. Anthrax as a Biological Weapon, Medical and Public Health Management. JAMA, May 12,1999. Richmond, T. (2002). Terrorism in the United States Since 9/11. Thorofare, J. Slack, Inc.

6. Anthrax • If Inhalation spores are released • Flu like symptoms • Incubation 1-6 • Anthrax Vaccine Absorbed (AVA) • 6 dose series • Standard Precaution • Alert local health department Figure 1 Hunt, R. (2009). Retrieved on July 14, 2009 from http://pathmicro.med.sc.edu/ghaffar/anthrax-pennsylvania.htm Richmond, T. (2002). Terrorism in the United States Since 9/11. Thorofare, J. Slack, Inc. Schneider, M.J. (2006, 2nd Ed) Introduction to Public Health. Sudbury, Mass, Jones and Bartlett Publishers.

7. Smallpox • Infectious disease • Humans ONLY Host • Two forms: Variola major, Variola minor • Signs/Symptoms: high fever, aches • Lesions are superficial: (more on trunk, face, and extremities) Inglesby TV. Working Group on Civilian Biodefense. Anthrax as a Biological Weapon, Medical and Public Health Management. JAMA, May 12,1999. Lynn F. Fischer, The Threat of Domestic Terrorism, Terrorism Research Center, at 2007. Retrieved on July 9, 2009 http://www.terrorism.com/terrorism/DomesticThreat.shtml. Nadaskavukaren, A.(2006).Our global environment, a health perspective (6th ed.) . Long Grove, Illinois: Waveland Press, Inc.

8. Smallpox • Eradicated by WHO in 1977 • Any case will be an Public Health Emergency • Person must be isolated • Vaccination available (3-5 days from exposure for best results) Figure 2 Inglesby TV. Working Group on Civilian Biodefense. Anthrax as a Biological Weapon, Medical and Public Health Management. JAMA, May 12,1999.

9. Tularemia • Used a biological agent in history • Zoonotic bacterial disease • In most rural areas except Hawaii Ceci Connolly, "Bioterrorism Vulnerability Cited," The Washington Post, September 28, 2001. Inglesby TV. Working Group on Civilian Biodefense. Anthrax as a Biological Weapon, Medical and Public Health Management. JAMA, May 12, 1999. Lynn F. Fischer, The Threat of Domestic Terrorism, Terrorism Research Center, at 2007. Retrieved on July 9, 2009 Nadaskavukaren, A.(2006).Our global environment, a health perspective (6th ed.) . Long Grove, Illinois: Waveland Press, Inc.

10. Tularemia • Airborne F. Tularensis • Cause pleuropneumonic infection • Lymph nodes swollen and tender • Pneumonic NOT transmitted person to person • Medical emergency • Standard precautions Ceci Connolly, "Bioterrorism Vulnerability Cited," The Washington Post, September 28, 2001. Inglesby TV. Working Group on Civilian Biodefense. Anthrax as a Biological Weapon, Medical and Public Health Management. JAMA, May 12, 1999. Lynn F. Fischer, The Threat of Domestic Terrorism, Terrorism Research Center, at 2007. Retrieved on July 9, 2009 Nadaskavukaren, A.(2006).Our global environment, a health perspective (6th ed.) . Long Grove, Illinois: Waveland Press, Inc.

11. SARS • Severe Acute Respiratory Syndrome (SARS) • First reported in Asia in February 2002 • US there were 192 recovered cases U.S. Army Medical Research Institute of infectious Diseases (USAMRIID) Medical Management of Biological Casualties Handbook Retrieved on July 11, 2009. http://ccc.apgea.army.mil/Documents/HandbookonBioCas/Handbook.htm. http://www.terrorism.com/terrorism/DomesticThreat.shtml Nadaskavukaren, A.(2006).Our global environment, a health perspective (6th ed.) . Long Grove, Illinois: Waveland Press, Inc.

12. SARS • High fever • Droplet precautions • Person to Pperson • No vaccine • Same treatment as other people who have serious pneumonia Figure 3 AP Wide Photos. Retrieved on July 10, 2009 from http://www.cdcfoundation.org/healththreats/sars.aspx U.S. Army Medical Research Institute of infectious Diseases (USAMRIID) Medical Management of Biological Casualties Handbook Retrieved on July 11, 2009. http://ccc.apgea.army.mil/Documents/HandbookonBioCas/Handbook.htm. http://www.terrorism.com/terrorism/DomesticThreat.shtml

13. Avian Bird Flu • Large group of influenza (flu) viruses that primarily affect birds. • Transmission from bird to human is through handling • Transmission from human to human is through coughs, sneezes, and touching U.S. Army Medical Research Institute of infectious Diseases (USAMRIID) Medical Management of Biological Casualties Handbook Retrieved on July 11, 2009. http://ccc.apgea.army.mil/Documents/HandbookonBioCas/Handbook.htm. http://www.terrorism.com/terrorism/DomesticThreat.shtml

14. Avian Bird Flu • Bird migration is one possible route of introduction of highly pathogenic H5N1 virus but it is not known how likely this could be. • No currently available human vaccine for the H5N1 • Can give treatment for flu like infection U.S. Army Medical Research Institute of infectious Diseases (USAMRIID) Medical Management of Biological Casualties Handbook Retrieved on July 11, 2009. http://ccc.apgea.army.mil/Documents/HandbookonBioCas/Handbook.htm. http://www.terrorism.com/terrorism/DomesticThreat.shtml

15. The End Ceci Connolly, "Bioterrorism Vulnerability Cited," The Washington Post, September 28, 2001. Lynn F. Fischer, The Threat of Domestic Terrorism, Terrorism Research Center, at 2007. Retrieved on July 9, 2009 http://www.terrorism.com/terrorism/DomesticThreat.shtml.

16. References • Biological and Chemical Terrorism: Strategic Plan for Preparedness and Response – Recommendations of the CDC Strategic Planning Work Group. Retrieved on June 15, 2009 from http://ftp.cdc.gov/pub/Publications/mmwr/RR/RR2904.pdf. • Ceci Connolly, "Bioterrorism Vulnerability Cited," The Washington Post, September 28, 2001. • Figure 1. Hunt, R. (2009). Retrieved on July 14, 2009 from http://pathmicro.med.sc.edu/ghaffar/anthrax-pennsylvania.htm • Figure 2. Smallpox.(n.d.). Retrieved on July 13, 2009 from http://www.randomhouse.com/features/preston/cobraevent/smallpox1.html • Figure 3. AP Wide Photos. Retrieved on July 10, 2009 from http://www.cdcfoundation.org/healththreats/sars.aspx • Inglesby TV. Working Group on Civilian Biodefense. Anthrax as a Biological Weapon, Medical and Public Health Management. JAMA, May 12, 1999. • Lynn F. Fischer, The Threat of Domestic Terrorism, Terrorism Research Center, at 2007. Retrieved on July 9, 2009 • Nadaskavukaren, A.(2006).Our global environment, a health perspective (6th ed.) . Long Grove, Illinois: Waveland Press, Inc. • Richmond, T. (2002). Terrorism in the United States Since 9/11. Thorofare, J. Slack, Inc. • Schneider, M.J. (2006, 2nd Ed) Introduction to Public Health. Sudbury, Mass, Jones and Bartlett Publishers. • U.S. Army Medical Research Institute of infectious Diseases (USAMRIID) Medical Management of Biological Casualties Handbook Retrieved on July 11, 2009. http://ccc.apgea.army.mil/Documents/HandbookonBioCas/Handbook.htm. • http://www.terrorism.com/terrorism/DomesticThreat.shtml.

17. Further Reading • Henderson, D., Inglesby, T., O’toole, T. (2002).Bioterrorism guidelines for medical and public health management. JAMA and Archives Journal.Chicago: AMA Press. • Center for Disease Control and Prevention (CDC) http://www.bt.cdc.gov/bioterrorism/ • Federal Bureau of Investigation (FBI) http://www.fbi.gov/congress/congress01/caruso110601.htm • Washington Post http://www.washingtonpost.com/wp-dyn/content/article/2008/08/02/AR2008080201624.html • Zubay,G. Agents of Bioterrorism. Columbia Press. 2008.