Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Bioterrorism”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,171 records · Page 65Linked to original sources
PubMedDate not supplied

Correlates of public health workforce acceptance of smallpox immunization in Virginia.

OBJECTIVE: By October 24, 2003, 38,577 of 500,000 targeted civilians received smallpox vaccine in the Pre-Event Smallpox Vaccination Campaign, Phase I. We investigated reasons for the low vaccination uptake. DESIGN: Cross-sectional survey, conducted in May 2004. SAMPLE: We surveyed 225 health care personnel, potential members of smallpox response teams in Virginia, who were offered vaccination. We assessed respondents' acceptance of vaccination and its association with factors potentially influencing vaccination: perceptions of vaccine safety, contraindications, concerns about bioterrorism, and workplace influences. RESULTS: Among nonvaccinees (n=44), 70% had a contraindication to the vaccine compared with 8% among vaccinees (n=132). The desire to prepare America for potential bioterrorist attack was associated with acceptance of smallpox vaccination (odds ratio [OR]: 17.7, 95% confidence interval [CI]: 3.6-85.9). Among respondents with contraindications, vaccinees reported more often than nonvaccinees having been asked by their supervisors to be vaccinated (OR: 5; 95% CI: 1.1-22.1) and to have been concerned that their vaccination choice would affect positively their job evaluation (OR: 11; 95% CI: 1.6-81.1). CONCLUSION: Concerns about bioterrorism and willingness to help in the preparedness effort were motivations for vaccination. Continued vigilance to avoid vaccination of those with contraindications is needed.

Adult↗
PubMed2006

Review of syndromic surveillance: implications for waterborne disease detection.

Syndromic surveillance is the gathering of data for public health purposes before laboratory or clinically confirmed information is available. Interest in syndromic surveillance has increased because of concerns about bioterrorism. In addition to bioterrorism detection, syndromic surveillance may be suited to detecting waterborne disease outbreaks. Theoretical benefits of syndromic surveillance include potential timeliness, increased response capacity, ability to establish baseline disease burdens, and ability to delineate the geographical reach of an outbreak. This review summarises the evidence gathered from retrospective, prospective, and simulation studies to assess the efficacy of syndromic surveillance for waterborne disease detection. There is little evidence that syndromic surveillance mitigates the effects of disease outbreaks through earlier detection and response. Syndromic surveillance should not be implemented at the expense of traditional disease surveillance, and should not be relied upon as a principal outbreak detection tool. The utility of syndromic surveillance is dependent on alarm thresholds that can be evaluated in practice. Syndromic data sources such as over the counter drug sales for detection of waterborne outbreaks should be further evaluated.

Animals↗
PubMed2003

The threat of plant pathogens as weapons against U.S. crops.

The U.S. National Research Council (NRC) concluded in 2002 that U.S. agriculture is vulnerable to attack and that the country has inadequate plans for dealing with agricultural bioterrorism. This article addresses the vulnerability of U.S. crops to attack from biological weapons by reviewing the costs and impact of plant diseases on crops, pointing out the difficulty in preventing deliberate introduction of pathogens and discovering new disease outbreaks quickly, and discussing why a plant pathogen might be chosen as a biological weapon. To put the threat into context, a brief historical review of anti-crop biological weapons programs is given. The argument is made that the country can become much better prepared to counter bioterrorism by developing a list of likely anti-crop threat agents, or categories of agents, that is based on a formal risk analysis; making structural changes to the plant protection system, such as expanding diagnostic laboratories, networking the laboratories in a national system, and educating first responders; and by increasing our understanding of the molecular biology and epidemiology of threat agents, which could lead to improved disease control, faster and more sensitive diagnostic methods, and predictions of disease invasion, persistence, and spread following pathogen introduction.

Bioterrorism↗
PubMed2004

When pestilence prevails...physician responsibilities in epidemics.

The threat of bioterrorism, the emergence of the SARS epidemic, and a recent focus on professionalism among physicians, present a timely opportunity for a review of, and renewed commitment to, physician obligations to care for patients during epidemics. The professional obligation to care for contagious patients is part of a larger "duty to treat," which historically became accepted when 1) a risk of nosocomial infection was perceived, 2) an organized professional body existed to promote the duty, and 3) the public came to rely on the duty. Physicians' responses to epidemics from the Hippocratic era to the present suggests an evolving acceptance of the professional duty to treat contagious patients, reaching a long-held peak between 1847 and the 1950's. There has been some professional retrenchment against this duty to treat in the last 40 years but, we argue, conditions favoring acceptance of the duty are met today. A renewed embrace of physicians' duty to treat patients during epidemics, despite conditions of personal risk, might strengthen medicine's relationship with society, improve society's capacity to prepare for threats such as bioterrorism and new epidemics, and contribute to the development of a more robust and meaningful medical professionalism.

American Medical Association↗
PubMed2005

Nevada's academic-practice collaboration: public health preparedness possibilities outside an academic center.

The Nevada State Health Division developed a local academic-practice partnership with the University of Nevada Reno's Master of Public Health Program to assess the bioterrorism risk communication, information, response, and training needs of professional and public stakeholder groups throughout Nevada. Between October 16, 2002, and April 13, 2004, 22 needs assessment focus groups and 125 key informant interviews were conducted to gather information on the diverse needs of the stakeholders. The themes that emerged from these activities included the need for effective pre-event education and training; a coordinated and responsive public health preparedness infrastructure; honest, accurate, and timely communication in the event of a bioterrorism situation; and appropriate information dissemination methods and technology. The data collected through this needs assessment gave the Nevada State Health Division vital information to plan public health preparedness initiatives. The establishment of local academic-practice partnerships for states without a Centers for Disease Control and Prevention-funded Academic Center for Public Health Preparedness is an effective way for health departments to develop their public health preparedness infrastructure while simultaneously training the future public health workforce.

Bioterrorism↗
PubMedDate not supplied

Alleged B. anthracis exposure claims in a workers' compensation setting.

OBJECTIVES: Workers' compensation insurance in some states may not provide coverage for medical evaluation costs of workplace exposures related to potential bioterrorism acts if there is no diagnosed illness or disease. Personal insurance also may not provide coverage for these exposures occurring at the workplace. Governmental entities, insurers, and employers need to consider how to address such situations and the associated costs. The objective of this study was to examine characteristics of workers and total costs associated with workers' compensation claims alleging potential exposure to the bioterrorism organism B. anthracis. METHODS: We examined 192 claims referred for review to the Ohio Bureau of Workers' Compensation (OBWC) from October 10, 2001, through December 20, 2004. RESULTS: Although some cases came from out-of-state areas where B. anthracis exposure was known to exist, no Ohio claim was associated with true B. anthracis exposure or B. anthracis-related illness. Of the 155 eligible claims, 126 included medical costs averaging dollar 219 and ranging from dollar 24 to dollar 3,126. There was no difference in mean cost for government and non-government employees (p = 0.202 Wilcoxon). CONCLUSIONS: The number of claims and associated medical costs for evaluation and treatment of potential workplace exposure to B. anthracis were relatively small. These results can be attributed to several factors, including no documented B. anthracis exposures and disease in Ohio and prompt transmission of recommended diagnostic and prophylactic treatment protocols to physicians. How employers, insurers, and jurisdictions address payment for evaluation and treatment of potential or documented exposures resulting from a potential terrorism-related event should be addressed proactively.

Adult↗
PubMed2006

Public health emergencies: nurses' recommendations for effective actions.

During a public health emergency such as an influenza pandemic or a bioterrorism attack, nurses may be at risk for exposure to lethal infectious diseases when caring for victims. The aim of this study was to identify interventions nurses believe will support their ability to cope during public health emergencies. A qualitative research design was used with 33 nurses from designated bioterrorism-receiving hospitals. Nurses recommended adequate protective equipment, education, drills, accessible information and available content experts, and available administrators. Other recommendations included increased security to protect nurses, emotional and physical support, communication with nurses' families, and commitment from institutions to care for ill or injured nurses. Preparations for emergencies should include assessments of nurses' and other stakeholders' concerns. These nurses proposed specific measures to improve safety, reduce anxiety, increase trust in hospitals, and provide physical and emotional support.

Adaptation, Psychological↗
PubMed2006

Enhanced pharmacy training for counter-terrorism and disaster response.

State and federal authorities in the USA have identified pharmacists as important in terrorism detection activities. However few pharmacists are trained for disaster response planning, or providing services at disaster sites. A distance training programme was created by the College of Pharmacy at the University of Kentucky, Chandler Medical Center (UKCMC) in collaboration with an academic Medical Center, urban and rural community pharmacists, experts in pharmacy and infectious disease, and two state pharmacy associations. There was a substantial improvement in bioterrorism training knowledge as judged by pre- and post-test results. During two years of training, a total of 142 licensed pharmacists received certification (approximately 4.7% of all those in Kentucky). In addition, a network of bioterrorism-trained pharmacists was created for the state.

Bioterrorism↗
PubMed2004

Smallpox: clinical features, prevention, and management.

OBJECTIVE: To describe a general overview of smallpox, clinical presentation, diagnosis, adverse events, and management of both pre- and postexposure vaccination. DATA SOURCES: Literature was identified by search of MEDLINE (1966-June 2003) and International Pharmaceutical Abstracts (1966-May 2003) databases using the key terms smallpox, bioterrorism, biological warfare, and smallpox vaccine. STUDY SELECTION AND DATA EXTRACTION: Articles identified from data sources were evaluated, and relevant information was included in this review. DATA SYNTHESIS: Smallpox is spread by human-to-human contact with an infected host and therefore can be contagious. The mortality rate for smallpox is approximately 30%. While the disease was completely eradicated by 1980 with successful use of smallpox vaccine, concern has been raised that smallpox may emerge as a tool of bioterrorism. This concern, combined with the reality of current smallpox vaccination programs in the military and selected civilian populations, mandates a clear understanding of vaccination-related adverse events and contraindications by all healthcare professionals. The vaccine may cause moderate to severe adverse events such as eczema vaccinatum, progressive vaccinia, and generalized vaccinia. CONCLUSIONS: The balance between the risks and benefits of mass vaccination in prevention of an epidemic is not clear. The Centers for Disease Control and Prevention has established a guideline for appropriate use of smallpox vaccine in the civilian population.

Antiviral Agents↗
PubMedDate not supplied

The primary care differential diagnosis of inhalational anthrax.

PURPOSE: Inhalational anthrax is an extremely rare infectious disease with nonspecific initial symptoms, thus making diagnosis on clinical grounds difficult. After a covert release of anthrax spores, primary care physicians will be among the first to evaluate cases. This study defines the primary care differential diagnosis of inhalational anthrax. METHODS: In May 2002, we mailed survey instruments consisting of 3 randomly chosen case vignettes describing patients with inhalational anthrax to a nationwide random sample of 665 family physicians. Nonrespondents received additional mailings. Physicians were asked to provide their most likely nonanthrax diagnosis for each case. RESULTS: The response rate was 36.9%. Diagnoses for inhalational anthrax were grouped into 35 diagnostic categories, with pneumonia (42%), influenza (10%), viral syndrome (9%), septicemia (8%), bronchitis (7%), central nervous system infection (6%), and gastroenteritis (4%) accounting for 86% of all diagnoses. Diagnoses differed significantly between cases that proved to be fatal and those that proved to be nonfatal. CONCLUSIONS: Inhalational anthrax resembles common diagnoses in primary care. Surveillance systems for early detection of bioterrorism events that rely only on diagnostic codes will be hampered by false-positive alerts. Consequently, educating frontline physicians to recognize and respond to bioterrorism is of the highest priority.

Anthrax↗
PubMedDate not supplied

Preparing for the unknown, responding to the known: communities and public health preparedness.

More than four years after September 11, 2001, bioterrorism preparedness remains a high priority for federal, state, and local governments. With reasonably flexible federal funding, communities have strengthened their ability to respond to public health emergencies, according to assessments by stakeholders and market observers. Collaborative relationships developed for bioterrorism preparedness have proved useful in addressing other threats, such as natural disasters and infectious disease outbreaks. Major ongoing challenges include funding constraints, inadequate surge capacity, public health workforce shortages, competing priorities, and jurisdictional issues.

Bioterrorism↗
PubMed2004

The Internet as a vehicle to communicate health information during a public health emergency: a survey analysis involving the anthrax scare of 2001.

BACKGROUND: The recent public health risks arising from bioterrorist threats and outbreaks of infectious diseases like SARS (Severe Acute Respiratory Syndrome) highlight the challenges of effectively communicating accurate health information to an alarmed public. OBJECTIVE: To evaluate use of the Internet in accessing information related to the anthrax scare in the United States in late 2001, and to strategize about the most effective use of this technology as a communication vehicle during times of public health crises. METHODS: A paper-based survey to assess how individuals obtained health information relating to bioterrorism and anthrax during late 2001. We surveyed 500 randomly selected patients from two ambulatory primary care clinics affiliated with the Brigham and Women's Hospital in Boston, Massachusetts. RESULTS: The response rate was 42%. While traditional media provided the primary source of information on anthrax and bioterrorism, 21% (95% CI, 15%-27%) of respondents reported searching the Internet for this information during late 2001. Respondents reported trusting information from physicians the most, and information from health websites slightly more than information from any traditional media source. Over half of those searching the Internet reported changing their behavior as a result of information found online. CONCLUSIONS: Many people already look to the Internet for information during a public health crisis, and information found online can positively influence behavioral responses to such crises. However, the potential of the Internet to convey accurate health information and advice has not yet been realized. In order to enhance the effectiveness of public-health communication, physician practices could use this technology to pro-actively e-mail their patients validated information. Still, unless Internet access becomes more broadly available, its benefits will not accrue to disadvantaged populations.

Ambulatory Care Facilities↗
PubMed2003

The foot-and-mouth disease epidemic of 2001 in the UK: implications for the USA and the ""war on terror".

While there is no evidence to suggest that the recent epidemic of foot-and-mouth disease (Fmd) in the Uk and its subsequent spread to continental Europe were caused by bioterrorism, the extent of the epidemic shows that Fmd could be a very powerful weapon for a bioterrorist wishing to cause widespread disease in livestock and economic disruption for the targeted country. This paper describes the epidemic. It then examines the contentious issues that arose through the use of extensive slaughter to control the epidemic and explores how, in turn, the concerns of society are being translated into a radical change in policy within the European Union with respect to the control of Fmd and other foreign animal diseases. The crisis generated by the Fmd epidemic in Europe in 2001 provides many lessons to be learned for the US and highlights the need for creative thinking in research and teaching within colleges of veterinary medicine to more effectively address the threat of epidemic diseases under the "new world order." There is general agreement that the veterinary profession in the US plays a unique role in protecting the nation against epidemic livestock diseases, whether caused naturally or through bioterrorism. The profession also has a significant role in protecting the public's health, since several epidemic diseases of animals, such as rift valley fever, are zoonotic. However, improved financial support at the federal and state levels is urgently needed to support epidemic-diseases research and teaching in colleges of veterinary medicine.

Animals↗
PubMed2004

Smallpox models as policy tools.

Mathematical models can help prepare for and respond to bioterrorism attacks, provided that their strengths and weaknesses are clearly understood. A series of initiatives within the Department of Health and Human Services brought modelers together with biologists and epidemiologists who specialize in smallpox and experts in bioterrorism response and health policy and has led to the parallel development of models with different technical approaches but standardized scenarios, parameter ranges, and outcome measures. Cross-disciplinary interactions throughout the process supported the development of models focused on systematically comparing alternate intervention strategies, determining the most important issues in decision-making, and identifying gaps in current knowledge.

Bioterrorism↗
PubMed2005

Emerging infectious diseases: a 10-year perspective from the National Institute of Allergy and Infectious Diseases.

Although optimists once imagined that serious infectious disease threats would by now be conquered, newly emerging (e.g., severe acute respiratory syndrome [SARS]), reemerging (e.g., West Nile virus), and even deliberately disseminated infectious diseases (e.g., anthrax bioterrorism) continue to appear throughout the world. Over the past decade, the global effort to identify and characterize infectious agents, decipher the underlying pathways by which they cause disease, and develop preventive measures and treatments for many of the world's most dangerous pathogens has resulted in considerable progress. Intramural and extramural investigators supported by the National Institute of Allergy and Infectious Diseases (NIAID) have contributed substantially to this effort. This overview highlights selected NIAID-sponsored research advances over the past decade, with a focus on progress in combating HIV/AIDS, malaria, tuberculosis, influenza, SARS, West Nile virus, and potential bioterror agents. Many basic research discoveries have been translated into novel diagnostics, antiviral and antimicrobial compounds, and vaccines, often with extraordinary speed.

Anthrax↗
PubMed2005

Chips and SNPs, bugs and thugs: a molecular sleuthing perspective.

Recent events both here and abroad have focused attention on the need for ensuring a safe and secure food supply. Although much has been written about the potential of particular select agents in bioterrorism, we must consider seriously the more mundane pathogens, especially those that have been implicated previously in foodborne outbreaks of human disease, as possible agents of bioterrorism. Given their evolutionary history, the enteric pathogens are more diverse than agents such as Bacillus anthracis, Francisella tularensis, or Yersinia pestis. This greater diversity, however, is a double-edged sword; although diversity affords the opportunity for unequivocal identification of an organism without the need for whole-genome sequencing, the same diversity can confound definitive forensic identification if boundaries are not well defined. Here, we discuss molecular approaches used for the identification of Salmonella enterica, Escherichia coli, and Shigella spp. and viral pathogens and discuss the utility of these approaches to the field of microbial molecular forensics.

Bacteria↗
PubMed2005

Risk assessment of malicious biocontamination of food.

Throughout the last decades of the 20th century, the biological threat evolved from primarily a government-controlled weapon to a tool of terrorism. One of the consequences of this trend is the near impossibility of foreseeing when and how an act of bioterrorism will occur. The suitability of food products for such an act stems from the multitude of microorganisms that may be used for contamination and the vulnerability of the products during and after processing. Tests that would enable the detection of a large variety of microorganisms quickly, reliably, and economically should also provide satisfactory means to prevent acts of malicious biocontamination of food products. Until such means become available, a priority-based approach to the problem is probably the most practical. Priorities should be determined based on a systematic risk assessment to define the relative likelihood of a certain microorganism being used in an act of malicious food contamination. Criteria to be evaluated are availability, weaponization processes, delivery of an effective dose, probability of early detection, and the microorganism's resistance to the conditions to which it will be exposed. Because the results of such an assessment may vary according to prevailing conditions, the assessment must be based on the existing circumstances. The results of the assessment should then be applied to the various procedures of food processing, which should further reduce the number of potential microbial threats. Existing methods of screening food for contaminating microorganisms and existing food safety and security procedures such as hazard analysis and critical control point programs may have to be modified to become suitable for the detection of acts of bioterrorism.

Animals↗