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Molecular diagnostic techniques for use in response to bioterrorism.

The use of micro-organisms as agents of biological warfare is considered inevitable for several reasons, including ease of production and dispersion, delayed onset of symptoms, ability to cause high rates of morbidity and mortality and difficulty in diagnosis. Therefore, the clinical presentation and pathogenesis of the organisms posing the highest threat (variola major, Bacillus anthracis, Yersinia pestis, Clostridium botulinum toxin, Francisella tularensis, filoviruses, arenaviruses and Brucella species), as well as the available diagnostic techniques and treatments for such infections, will be reviewed in this article. Due to the necessity of rapid identification and diagnosis, molecular techniques have been the ongoing focus of current research. Consequently, the molecular diagnostic techniques that have recently been developed for the diseases associated with these agents will be emphasized.

Animals↗

[Biological warfare, bioterrorism and public health].

Biological agents as weapons are not new to mankind. For centuries and into the present, biological warfare has been the subject of much research and speculation, but little action. Their limited use has probably been due to fear of unexpected counter-effects and doubts about their efficiency as weapons. Recently a new form of terrorism employing infectious agents has emerged slowly and without much fanfare, until the recent events with Bacillus anthracis in the United States. Smallpox is potentially the most devastating of these agents. Less than 25 years after the eradication of smallpox, the public health field is now forced to deal with the possibility of its re-introduction. The author discusses the scenario of smallpox re-introduction into Brazil.

Biological Warfare↗

[Care protocols for diseases caused by bioterrorism].

Epidemics due to bioterrorist actions and prevention and control measures of these infections have been worrying not only the policy makers but also health professionals in general. Health professionals have to recognize these diseases earlier. Information and updated studies about the issue are needed. This study is a literature review in the MEDLINE and LILACS databases, books and online information (from 1993 to 2001) about epidemic aspects of the main diseases due to bioterrorist actions and care recommendations for infection control and occupational risk minimization. Healthcare professionals, who assist patients directly, should be prepared to assist patients who become ill in isolated or epidemic situations.

Bioterrorism↗

Bioweapons, bioterrorism and biodiversity: potential impacts of biological weapons attacks on agricultural and biological diversity.

Diseases and biological toxins have been used as weapons of war throughout recorded history, from Biblical times through to the present day. Bioweapon uses have historically been directed primarily, although not exclusively, against human populations. Specialised technicians and state-of-the-art research facilities are no longer necessary for the production or deployment of many known bioweapon agents and commercially available technologies now permit the large-scale production of bioweapon agents in small-scale facilities at relatively low cost. Failures in the detection and containment of bioweapon and emerging disease outbreaks among populations of wildlife and indigenous peoples in developing countries could result in severe erosion of genetic diversity in local and regional populations of both wild and domestic animals, the extinction of endangered species and the extirpation of indigenous peoples and their cultures. Our ability to understand and control the spread of diseases within and among human and animal populations is increasing but is still insufficient to counter the threats presented by existing bioweapon diseases and the growing number of highly pathogenic emergent infections. Interdisciplinary and international efforts to increase the monitoring, surveillance, identification and reporting of disease agents and to better understand the potential dynamics of disease transmission within human and animal populations in both industrialised and developing country settings will greatly enhance our ability to combat the effects of bioweapons and emerging diseases on biological communities and biodiversity.

Agriculture↗

Public perception and risk communication in regard to bioterrorism against animals and plants.

This paper examines the total international prohibition on the use of disease to attack humans, animals and plants, noting that in the past several countries had developed programmes for attacks on animals and plants as well as humans. Current activities undertaken by intergovernmental organisations - the World Health Organization (WHO), Food and Agricultural Organization (FAO) and World Organisation for Animal Health (OIE)--to counter the threat of attacks on humans, animals and plants are examined. Effective countermeasures to deliberate attacks need to be developed in harmony with existing measures to control natural or accidental outbreaks of disease. Finally the paper assesses the risk and the public perception of it, and considers what risk communication is needed and to whom. Clear mandates are needed for the FAO and OIE to be prepared to deal with outbreaks of disease, and with contamination of the food supply chain, whether accidental or intentional.

Animal Diseases↗

Modeling for a smallpox-vaccination policy against possible bioterrorism in Japan: the impact of long-lasting vaccinal immunity.

BACKGROUND: There has been concern that variola virus might be held clandestinely elsewhere. Through constructing mathematical model based on the detailed epidemiologic data, we focused on simulating the various possible scenarios arising from a bioterrorist attack whereby smallpox virus was introduced into Japan, and sought to develop the most effective way of nationwide vaccination policy based on the theory of residual immunity. METHOD: The analysis is based on a deterministic mathematical model which predicted the epidemiologic outcome while simultaneously evaluating the effect of any specified control strategy of the smallpox epidemic. To clarify the required amount of vaccines, we performed mathematical analysis for hypothetical population to acquire herd immunity based on long-lasting vaccinal immunity. RESULTS: It is demonstrated that the crude size of the potential epidemic could be greatly affected by possible level of residual immunity. The results also suggest the possibility to develop optimal distribution of nationwide vaccination according to the immune status. The prevalence at 50th day among population without immunity in our simulation would be approximately 405 times greater than expected population with residual immunity, and required amount of vaccines for equal distribution would be 3.13 times more than optimal distribution. CONCLUSION: The mathematical model formulated could determine the vaccination priority based on the real status of immunity which required much less amount of vaccinations than would be calculated using an equal distribution program. It is therefore crucial to determine the real immunity status of the population via epidemiologic studies.

Bioterrorism↗

Bioterrorism: crime and opportunity.

The unprecedented and tragic terrorist attacks in the United States (US) have sent shock waves through national administrations that have grown accustomed to fighting expenditure wars in the health area and had relegated public health vigilance and emergency preparedness to the back burner. It was obvious from the immediate reaction to the horrors and menaces of the autumn of 2001 that, insofar as health and safety is concerned, governments continued to measure success by the degree of quietness, remoteness and uneventful normality that is achieved by those entrusted with the responsibility to protect health. The paradox of health and safety is that you are winning when you hear nothing: any publicity is bound to be bad publicity.

Bioterrorism↗