Kelli+&+Caylin

= = Bioterrorism and Its Levels of Importance: By: Kelli Finn Demeber 7, 2010

Abstract: Bioterrorism is a and highly complex form of terrorism that can have devastating and far reaching effects. Predators use this form of terrorism because it is very hard for us to detect and can be spread not only through the air, but also through water supply and food. Not to mention infectious diseases like smallpox can be spread very quickly from person to person. There are three different categories of bioterrorism that are based on its agents and effects. Level A agents are considered the most risky and are of highest priority. Following is level B which have moderate morbidity rates and low mortality rates. Level C agents consist of emerging pathogens that could be engineered for mass dissemination. Category C bioterrorism is said to be the most accessible form of bioterrorism because of how easy it is to engineer and spread mass amounts of infectious diseases and bacteria. The most devastating bioterrorism attacks from the past have involved deadly agents and bacteria such as anthrax, botulism, plague, smallpox, and tularemia. There is a lot of preparation and training being done in order to educate people on the matter in efforts to prevent it as much as possible. As of 2002 there has also been updated food and health regulations in order to protect our food and water supply.

Introduction: I was interested in researching what bioterrorism was and what the extent of its effects are because it is a serious matter concerning the health and well being of our country. Before doing my research the only bioterrorism that I had ever heard about was the use and threat of anthrax. I had no idea that there was such a complex categorical system used for ordering the level of importance of each type of agent. I found most of my interesting information from the official “Center of Disease Control and Prevention” website. I also used an SSU database and found interesting information on the history of bioterrorism and what the effects have been not only in the US but also in countries such as Japan and Russia.

Discussion: Categories: A: pathogens that are rarely seen in the United States. High-priority agents include organisms that pose a risk to national security.


 * Anthrax: //Bacillus anthracis//
 * Botulism: //Clostridium botulinum// toxin
 * Plague: //Yersinia Pestis//
 * Smallpox: //Variola major//
 * Tularemia: //Francisella tularensis//

B: Second highest risk and include agents that have moderate morbidity rates and low mortality rates.


 * Brucellosis: //Brucella// species
 * Epsilon toxin of //Clostridium perfringens//
 * Food safety threats: //Salmonella, E. coli//
 * Glanders: B//urkholderia pseudomallei//

C: Third highest priority agents include emerging pathogens that could be easily engineered.
 * Emerging infectious diseases

The most easily accessible are the category C agents because they can be easily engineered and distributed. When looking at the table in our text book of various bacteria that are the cause of most emerging infectious diseases I noticed that a lot of them match up with the bacteria noted for each category of bioterrorism agents. The agents that are most commonly used, however, are category A agents because they are the most threatening and deadly.

History: In the past Europe has been drastically effects by two outbreaks of smallpox in the early 1970s. In addition to that Russia has suffered from an accidental emergence of anthrax that was administered through a bioweapons facility 1979. D.A. Henderson that wrote the article on emerging infectious diseases actually states in his article that many people have refrained from writing about with fear of people experimenting with various agents. Henderson states that until recently he was also scared to publish information about bioterrorism, but because of the recent evidence that predators have already demonstrated every possible scenario, he decided it was time to publish his findings and educate people on the matter.

Prevention and Control: In order to prevent and control bioterrorism there had been a lot of training and education on certain agents such as anthrax and smallpox. Those agents are currently the most threatening and there is surveillance being done on them in order to try and control their emergence. The CDC has a lot to do with protecting the well being of our country and doing everything in their power to prevent an outbreak. There are also a ton of podcasts and webcasts that are available for the general public to view and educate on the matter.

Literature Cited:
 * Centers for Disease and Prevention. “Emergency Preparedness and Response”
 * Fauci, Anthony. Lane, Clifford. Montagne, John. “Bioterrorism: A Clear and Present Danger” Nature Medicine 7.12 (2001): 1271
 * Henderson, D.A. "Bioterrorism as a Public Health Threat." Emerging Infectious Diseases 4.3 (1998): 488.
 * Henderson, Donald. “The Looming Threat of Bioterrorism” Science 283.5406 (1999): 4
 * Tortora, Gerard J., Berdell R. Funke, and Christine L. Case. "Emerging Infectious Diseases." Microbiology an Introduction. Benjamin Cummings, San Francisco, p417

=Anthrax and Bio-warfare=

__ABSTRACT__
=== Anthrax is caused by the bacterium //Bacillus anthracis//. //B. anthracis// is an aerobic, gram-positive, spore-forming, non-motile rod === shaped bacterium. Their ability to create dormant endospores allows them to survive in the harshest conditions for long periods of time. When these spores are inhaled, ingested or come in contact with any open sores, they rapidly multiple and in most cases the result is fatal. This disease was first found in livestock, and did become a huge scare across the world. Today, however, governments are using this bacterium for another reason: a weapon of mass destruction.

It is found that Anthrax is more deadly than the poison gas used in World War II and has the potential to cause multiple fatalities. Because of this, as well as the fact that the bacterium is adaptable to most environments makes this disease a prime candidate to use in bio-warfare.

**__INTRODUCTION__**

I became interested in this subject as I saw it occurring more and more in our news. I wanted to see how so ﻿ mething so small such as //Bacillus anthracis// could be used in such a destructive manner. I wanted to know how using this bacterium in this manner initiated and why we (the world) are still invested in the project. By doing my research I found the affects Anthrax spores has on a person as well as several ways it can be administered (Schoenstadt, 2008). My hope is by doing this research, people will see how using this microorganism for this use is inhumane and hopefully the world will stop experimenting with this form of terror.

__HISTORY TIMELINE__

 * 1857**: Robert Koch a German Bacteriologist proved that it was the rod shaped //B. Anthracis// that caused the disease Anthrax. This is monumental because it was the first disease shown to be cause by microorganisms.


 * 1881**: Louis Pasteur produced a successful vaccine to prevent infection by injecting cows with //B. Anthracis//.


 * 1905**: Outbreak occurred in the United Kingdom, and resulted in becoming one of the most fatal and widespread contagious fevers.


 * 1909**: 260 farms in Minnesota lost livestock due to Anthrax. Found grazing animals were more likely to be infected with the disease, especially if grazing in an area where previous animals had died.


 * 1930's**: Anthrax was tested by Unit 731 of the Japanese Army in Manchuria. They did intentional infections to prisoners of war which resulted in thousands dying.


 * 1937**: Sterne's live spore vaccine was created. Was a modification of Pasteur's and is used to this day especially with livestock.


 * 1942**: Britain created their first Anthrax bomb (known as Agent N) and tested it on the Scottish Island Gruinard (Death Island) where several sheep died. To this day Gruinard is inhabitable. The idea was to use Anthrax as a weapon in the war. At first they were going to send five million cattle cakes infected with Anthrax spores to German soil, as well as drop Anthrax on several German cities, however the operations were never occurred. (Thompson, 2004) and ("Timeline: Anthrax through the ages," 2001)


 * 1944**: Anthrax was estimated to be 300,000 times more powerful than poison gas and it started being viewed worldwide as a weapon with "appalling potentiality."


 * 1969**: President Nixon ordered the dismantling of bio-warfare programs and the destruction of all existing stockpiles of bio-weapons in the U.S.


 * 1972**: United States used weaponized Anthrax prior to 1972 with the signing of the Biological Weapons Convention.


 * 1978**: Used by Rhodesian Government against animals and people during its war with the black nationalists.


 * 1979**: Accidental release of Anthrax occurred in Sverdlovsk resulting in 78 being infected and several casualties. At the time it was the largest Anthrax outbreak of the 20th century.


 * 1980**: U.S. questioned Soviet's involvement with Anthrax since the Sverdlovsk epidemic.


 * 1991**: U.S. felt the Middle East was tapping into resources and going to come out with a weapon using Anthrax.


 * 2001**: After September 11 attacks, people became more fearful of a bio-warfare attack.


 * 2001**: Dr. Bruce Ivans put spores into the mail of news media offices, as well as two Democratic Senators. Twenty-two were infected, five died as a result. Also cause several Anthrax hoaxes to occur. [|The Anthrax Attacks]


 * 2010**: Anthrax found in new regions of North Dakota. State is urging farmers to get their animals vaccinated.

[|History of Bioterrorism]

("Timeline: Anthrax through the ages," 2001)

**__DISCUSSION__**

(**Todar, 2009) and ( **Schoenstadt, 2008) and ( **Weyant, 2001) **
 * //Bacillus anthracis// can enter the body 3 ways:**
 * 1) Cutaneous
 * 2) Inhalation
 * 3) Ingestion

-Once contaminated at the site of the spore entrance an ulcer will begin to form within two to five days. -Shows up as a boil-like lesion on the skin and in time will form an ulcer with a black center (anthracis derives from the Greek word for coal because of these black centers). - Unlike other lesions and bruises Ant hrax ulcers do not cause any pain - Rarely fatal even without treatment -Treatment in most cases is antibiotic therapy (**Todar, 2009) and ( **Schoenstadt, 2008) and ( **Weyant, 2001) **
 * Cutaneous:**
 * 20 percent of people who have cutaneous Anthrax and do not seek treatment progress to death.
 * This is due to the fact that the infection area is only limited to the skin
 * Preventing the Lethal Factor, the Edema Factor and the Protective Antigen from entering and in turn preventing them from destroying vital organs

-Anthrax as a result of inhalation affects the respiratory system by -Symptoms include: -Treatment is imperative and must be done in early stages -Mortality rate was at 93 percent, however with the subjects exposed to Anthrax in 2001 by mail because they were caught early the mortality was 45 percent. -Most people who get Inhaled Anthrax work close with animals -This is the form of Anthrax being used in Bio-Warfare (**Todar, 2009) and ( **Schoenstadt, 2008) and ( **Weyant, 2001) **
 * Inhalation:**
 * Travels into alveoli in the lungs
 * Picked up by macrophages in the lungs
 * Transported through small vessels into the lymph nodes in the central chest cavity
 * In the lymph nodes bacilli become active and multiple
 * Enters the bloodstream
 * Where bacilli release 3 proteins
 * 1) Protective antigen
 * 2) Edema factor
 * 3) Lethal factor
 * At first appearing as a common cold or flu-like symptoms
 * After a few days, a respiratory collapse occurs which in some cases can be fatal
 * Because the disease presents itself at first as any normal respiratory infection, hard to detect early enough
 * Treatment started in later stages hardly saves people's lives.
 * Spores can be found in animals:
 * Hides
 * Furs
 * Horns

-This form of Anthrax is mostly the result of eating anthrax-infected meat -Affects the gastrointestinal system -Ingesting Anthrax results in the following characteristics: -After the bacterium invades the intestinal tract it uses the lymph nodes to get into the blood stream, and spreads throughout the body causing more toxins -Sometimes lesions can be found in the mouth and inside the intestines -Depending on when treatment begins, mortality rate varies from 25 percent to 60 percent -This is the rarest form of Anthrax and there has been only one case found in the United States [|Anthrax] (**Todar, 2009) and ( **Schoenstadt, 2008) and ( **Weyant, 2001) **
 * Ingestion:**
 * Gastrointestinal difficulty
 * Vomiting blood
 * Severe diarrhea
 * Inflammation of the intestinal tract
 * Loss of appetite

-Two reasons:
 * Why is Anthrax Lethal?**
 * Poly-D-glutamic acid capsule
 * Protects bacterium from phagocytosis from host immune response
 * Tripartite protein toxin called anthrax toxin
 * Mixture of three protein components
 * 1) Protective antigen
 * 2) Edema factor
 * 3) Lethal factor

(Taylor, 2001) and (Inglesby, 2002) [|3 proteins]
 * Individually these 3 proteins are non-toxic[[image:biowarfare1_(250_x_282).jpg align="right" caption="http://euroyank.blogspot.com/2007/07/biowar-depopulation-plans-of-criminal.html"]]
 * When the protective antigen mixes with edema factor it creates the edema toxin
 * When the protective antigen mixes with lethal factor it creates the lethal toxin
 * Edema toxin causes tissue swelling
 * Lethal toxin causes death

-Readily available since it can be found anywhere and can survive harsh conditions and live dormant for years. -Also can be cultivated and stored in a dry form and still be viable -Even after use or release, it will be very hard if not impossible to disinfect the area, causing destruction to occur for years. -100 million doses lethal doses can be found in 1 gram of anthrax material -Silent, invisible killer (<span style="font-family: Calibri,sans-serif; font-size: 15px; line-height: 17px;">Inglesby, 2002) and (Taylor, 2001) and ("Weapons and Terrorism," 2001)
 * Why is Anthrax Chosen to be used as a Weapon?**
 * -**studies done during World War II show that Anthrax is 300,000 times more effective than poison gas.

**__PREVENTION AND CONTROL__**

-Currently, there is a vaccination approved by the FDA produced from a non-virulent of the anthrax bacterium. It is known as Anthrax Vaccine Absorbed (AVA) but the trade name is BioThrax. The vaccination consists of six-dose series at 0, 2, 4 weeks and then 6, 12, and 18 months. And to maintain immunity you must receive a booster yearly. <span style="color: black; font-family: Calibri,sans-serif; font-size: 11pt; line-height: 115%;">(Merkel, 2010) and (Todar, 2009) and (Weyant, 2001)
 * Vaccines:**

-If you come in contact with Anthrax on your clothing or other articles, since the disease cannot be administered without inhalation, ingestion, or coming in contact with a open wound, you can disinfect the area by using either antimicrobial soap and water or by burning. Chlorine bleach will not kill the endospores.
 * Treatments:**

-For Anthrax Infections:
 * As soon as you know you have Anthrax it is vital that you immediately seek treatment with antibiotics.
 * Take large doses of oral antibiotics such as
 * ciprofloxacin
 * doxycycline
 * erythromycin
 * vancomycin
 * penicillin

-If death occurs, drastic isolation precautions must be taken in order for the disease to not spread. Burial of the body will not kill the spores. (<span style="font-family: Calibri,sans-serif; font-size: 15px; line-height: 17px;">Merkel, 2010) and (Todar, 2009) and (Weyant, 2001)

**__LITERATURE CITED__**

<span style="font-family: 'Times New Roman',Times,serif; font-size: 16px; line-height: 32px;">Inglesby, Thomas. "Anthrax as a Biological Weapon." // Anthrax as a Biological Weapon //. American Medical Association, 2002. Web. 1 Dec. 2010. <http://jama.ama-assn.org/content/287/17/2236.full.pdf>.

<span style="font-family: 'Times New Roman',Times,serif; font-size: 16px; line-height: 32px;">Merkel, Tod J., and Thomas A. Waldmann. "Development of a Highly Efficacious Vaccinia-based Dual Vaccine Against Smallpox and Anthrax, Two Important Bioterror Entities." // Proceedings of the National Academy of Sciences of the United States of America //. National Academy of Sciences, 2010. Web. 27 Nov. 2010. <http://www.pnas.org/content/early/2010/09/27/1013083107.short>.

<span style="font-family: 'Times New Roman',Times,serif; font-size: 16px; line-height: 32px;">Schoenstadt, Arthur. "Bacillus Anthracis." // EMedTV //. 29 Oct. 2008. Web. 27 Nov. 2010. <http://anthrax.emedtv.com/bacillus-anthracis/bacillus-anthracis.html>.

<span style="font-family: 'Times New Roman',Times,serif; font-size: 16px; line-height: 32px;">Taylor, Eric R. // Lethal Mists: an Introduction to the Natural and Military Sciences of Chemical, Biological Warfare and Terrorism //. Huntington, NY: Nova Science, 2001. Print.

<span style="font-family: 'Times New Roman',Times,serif; font-size: 16px; line-height: 32px;">Thompson, Harvey. "Britain: Cover-up of Chemical Warfare Tests on Servicemen Exposed." // World Socialist Web Site //. 11 Dec. 2004. Web. 3 Dec. 2010. <http://www.wsws.org/articles/2004/dec2004/port-d11.shtml>.

**<span style="font-family: 'Times New Roman',Times,serif; font-size: 16px; font-weight: normal; line-height: 32px;">Todar, Kenneth. "Bacillus Anthracis and Anthrax." // Todar's Online Textbook of Bacteriology //. 2009. Web. 5 Dec. 2010. <http://www.textbookofbacteriology.net/Anthrax_5.html>. **

**<span style="font-family: 'Times New Roman',Times,serif; font-size: 16px; font-weight: normal; line-height: 32px;">Weyant, Robbin, John Ezzell, and Tanja Popovic. "Bacillus Anthracis." // Basic Laboratory Protocol //. Centers for Disease Control and Prevention, 18 Apr. 2001. Web. 23 Nov. 2010. <http://www.bt.cdc.gov/agent/anthrax/anthracis20010417.pdf>. **

**<span style="font-family: 'Times New Roman',Times,serif; font-size: 16px; font-weight: normal; line-height: 32px;">"Anthrax as a Bioterrorism Agent." // YouTube //. 5 Mar. 2009. Web. 27 Nov. 2010. <http://www.youtube.com/watch?v=x1VhZXnN6pM>. **

<span style="font-family: 'Times New Roman',Times,serif; font-size: 16px; font-weight: normal; line-height: 32px;">"Timeline: Anthrax through the Ages." // CNN.com //. 16 Oct. 2001. Web. 3 Dec. 2010. <http://edition.cnn.com/2001/HEALTH/conditions/10/16/anthrax.timeline/>.

<span style="font-family: 'Times New Roman',Times,serif; font-size: 16px; font-weight: normal; line-height: 32px;">"Weapons and Terrorism." Terrorism Files. Www.Nabou.com, Inc., 2002. Web. 4 Dec. 2010. www.terrorismfiles.org/.../anthrax_biological_warfare_agent.html>.

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