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Published on December 18, 2007

Author: Cinderella

Source: authorstream.com

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Slide1:  Current Thought on Bioterrorism: The Threat, Preparedness and Response Office of Basic Energy Sciences Workshop on Basic Research Needs to Counter Terrorism February 28 - March 1, 2002 Gaithersburg, MD 20878 David R. Franz, DVM, Ph.D Southern Research Institute University of Alabama at Birmingham Examples of diseases often mentioned in the context of biological warfare :  Examples of diseases often mentioned in the context of biological warfare Human diseases Smallpox Cholera Shigellosis Anthrax Brucellosis Coccidioidomycosis EEE / VEE / WEE Japanese B Ebola/Marburg Histoplasmosis Animal diseases African Swine Fever Foot and Mouth Fowl Plague Newcastle Rinderpest Melioidosis Glanders Plague Psittacosis Q Fever Rabies Tularemia Zoonoses Botulism SEB intoxication B.W. Agents Differ from C.W. Agents:  B.W. Agents Differ from C.W. Agents Biological Agents Natural Production difficult None volatile Many toxins more toxic Infectious agents replicate Not dermally active Legitimate medical use Odorless and tasteless Diverse pathogenic effects Many are effective immunogens Aerosol delivery Delayed Onset (Days to Weeks) A few are contagious Chemical Agents Man-made Production difficult (industrial) Many volatile Less toxic than many toxins Do not replicate Many are dermally active No use other than as weapons Odor or taste when contaminated Fewer types of effects Poor immunogens Mist / droplet / aerosol delivery Rapid Onset (Minutes) Not Contagious Implications and Constraints for the Weaponeer:  Implications and Constraints for the Weaponeer Must be presented as a respirable aerosol Preparation and weaponization may jeopardize viability Aerosols are dependant on meteorological conditions However... Contagious agents can be delivered without weaponization Some agents can be spread by vectors It follows therefore that... Implications for Public Health:  Implications for Public Health Many diseases begin as “flu-like illness” Definitive diagnostics are specific and complex Treatment after clinical diagnosis may be too late Preclinical diagnostics are not generally available Few antiviral drugs available Vaccines are very specific and require years to field Prophylaxis may be socially or politically unacceptable Potential for complex psychological response Slide6:  HAZMAT EVENT-----------------------------------PUBLIC HEALTH PROBLEM Chemical Terrorism Biological Terrorism Biological Terrorism and Public Health Slide7:  Anthrax (and most others) Plague Smallpox Outbreak or Epidemic ? Day 0 Slide8:  Plague Smallpox Outbreak or Epidemic ? Day 10 Anthrax (and most others) Slide9:  Plague Smallpox Outbreak or Epidemic ? Day 20 Anthrax (and most others) Slide10:  Plague Smallpox Outbreak or Epidemic ? Day 30 Anthrax (and most others) Slide11:  Plague Smallpox Outbreak or Epidemic ? Day 40 Anthrax (and most others) The “Unique” Threat:  The “Unique” Threat • Dual-Use Nature • Evolving Technology • Political Factors Expression of cereolysine AB genes in Bacillus anthracis vaccine strain ensures protection against experimental hemolytic anthrax infection :  Expression of cereolysine AB genes in Bacillus anthracis vaccine strain ensures protection against experimental hemolytic anthrax infection A.P. Pomerantsev, N.A. Staritsin, Yu. V. Mockov and L.I. Marinin ….results describe the modulation of immunopathogenic properties of B. anthracis due to expression of cereolysin AB genes. Vaccine. Vol 15, 1997 Technological Change Could Make Biological Warfare a Moving Target:  Technological Change Could Make Biological Warfare a Moving Target Genomics Proteomics Automated Sequencing Cloning Transfection Polymerase Chain Reaction Access to technologies and information is getting easier Altered agent Tropism Production methods Enhanced Stability The Moscow Times Thursday, January 20, 1994:  The Moscow Times Thursday, January 20, 1994 Yeltsin Names Core of New Government Ruble Falls and Rush Continues Funds Disappearing Cold-War Solutions:  Cold-War Solutions Vaccines, Drugs and Diagnostics Environmental Sensors and Masks The Biological Weapons Convention The Biological Threat has Changed:  The Biological Threat has Changed Tactical use on the battlefield ….and strategic use against the U.S. “Terrorist” use against the force or our cities Cold War Gulf War Today… & Tomorrow? Why Bioterrorism in the US Today?:  Why Bioterrorism in the US Today? We’re the nation to beat They can’t do it conventionally Looking for a great equalizer Biological warfare expertise is available Dual-use nature makes it hard to detect We’re still vulnerable Biotechnology may make it easier But, fortunately, it’s still not easy to do The Biological Terrorist Spectrum:  The Biological Terrorist Spectrum The Biological Terrorist Spectrum:  The Biological Terrorist Spectrum 1997: 27 hoaxes Since then: ca. 200/yr October 2001: > Thousands 1987: Salmonella on salad bar….now B. anthracis None Tools for Identification of Biological agents:  Tools for Identification of Biological agents Culture and Isolation (1 - 30 days) Animal Inoculation (2 - 30 days) Immunoassays (2 - 6 hours) Nucleic Acid Assays (3 - 5 hours) Mass Spectroscopy (1 - 8 hours) The Challenge of Environmental Detection:  The Challenge of Environmental Detection Logistics (e.g.. power and reagents) Sensitivity Background Interference Timeliness Detect to Warn or Detect to Treat Bill Patrick’s Relative Aerosol Potency Chart:  Bill Patrick’s Relative Aerosol Potency Chart Detector Sensitivity Requirements:  Detector Sensitivity Requirements IF…...ID50 is 100 organisms AND..Aerosol retention is 60% AND..Minute volume is 10 liters AND..Cloud is on site for 10 min 100 org X 60% = 60 org 10 l /min X 10 min = 100 liters Must detect 60 org in 100 liters OR 0.6 org/liter (or 6 organisms / 10 liters) ID50 Human. Sensor Reqmt. 10 6 org/100 l 10 org/100 l 100 6 org/10 l 10 org/10 l 1,000 6 org/l 10 org/ l 10,000 60 org/ l 100 org/l Note: The human must see 10 orgs to retain 6 The Challenge of Timely Diagnostics:  The Challenge of Timely Diagnostics Sample collection Sample preparation (clean-up) Complex matrices/background Accurate differentiation Miniaturization Reasonable Goals: Sample Prep in <5min Gene Amplification and Detection in <25min Complexity of the Problem:  Complexity of the Problem Targets may be military, civilian or both Threat footprint may be very small It may appear to be a naturally occurring disease Attribution will not always be possible Fundamentally, it’s a public health problem Materiel solutions alone are not enough Military and Public preparedness is a deterrent The New, Multivalent Threat: Reducing Proliferation:  The New, Multivalent Threat: Reducing Proliferation NO SINGLE APPROACH FOR ALL SITUATIONS Russia Current economic weakness provides threat reduction options China A growing world-power in biotechnology; the great unknown Smaller threat nations Many may be capable of producing effective biological weapons Subnational Groups….or individuals? The new threat may look like the 1999 West Nile Outbreak What has changed…:  What has changed… Something related to “intent to harm” New diseases added to physician differentials Public understanding of the biological threat Funding for Bioterrorism Preparedness National...and apparently international...will And even, thought of immunizing the population …and what hasn’t? The technical difficulty of agent preparation The importance of meteorology to the attacker The difficulty of intelligence collection The value of Public Health for preparedness The value of our Science and Technology base The value of Education Since 9-11 The Way Ahead:  The Way Ahead Surveillance (diagnostics and communication) Education Proactive Deterrence Public Health Infrastructure HUMINT Biomedical Research The Way Ahead:  The Way Ahead Surveillance (diagnostics and communication) Education Proactive Deterrence Public Health Infrastructure HUMINT Biomedical Research It’s not about: - Suits - Masks - Decon Stations It’s Public Health The Way Ahead:  The Way Ahead Surveillance (diagnostics and communication) Education Proactive Deterrence Public Health Infrastructure HUMINT Biomedical Research But it’s not JUST Public Health…. It’s Public Health (+) Bioterrorism: Lessons Learned :  Bioterrorism: Lessons Learned Think Public Health (plus) Think Dual-use Investments Think Tech-base not Materiel Think Education Think Cost-Benefit Think Long-Term The Future …challenges and potential solutions:  The Future …challenges and potential solutions The last 5-6 years: Rapid Change :  The last 5-6 years: Rapid Change Nonprolif. Treaties……………..Cooperative Threat Reduction Focus Cold-War defense…..Domestic Preparedness PCMs DoD masks……………New clothing technologies MCMs Specific Vaccines…..Diagnostics, Drugs, Generic CMs Intel Humint……………….Masint and Threat Analysis Surveillance Nuclear……………….Bio Analysis DoD………………..…DoD/CDC/DoJ/DoE…State and Local Complexity Low…………………...High Experts Few…………………..(Many) Mgt DoD……………….….HHS, FEMA, DoJ Research $ $\ DoD……………....$/ HHS, DoJ, DoD, DoE, IC $137M in DoD in ‘97..$11B Nationally in ‘03 Education DoD………….……….DoD, DoJ, HHS, Academia, Industry The Enemy Soviet Union (80s)…..State and Non-state actors Collaborators Allies…………………..Russian Colleagues Hoaxes Almost none………….Routine……..Overwhelming Interest Low…………………....High……..Extremely High “Wish List” for the Future:  “Wish List” for the Future Nonprolif. “Trust” pills PCMs In-place oro-nasal “filter” and non-invs. Ind. exposure alarm Detection Simple, cheap, generic, integrated……..dual-use MCMs Pre-clinical diagnostic, Generic therapeutic drugs Triage Within-4hr minimally invasive “triage machine” Intel “Intent” meter Surveillance Satellite-based, high sensitivity, immediate Management Educated, objective Leadership Mission oriented; willing to take responsibility/share results Education CB “M.A.S.H.” of Seinfield Series…..The “anthrax” letters Regulatory Effective FDA teaming…..we’re getting there Research Risk-benefit based, dual-use, basic Hoaxes Airplane hijacking model?….but this is more difficult Policy Swift retaliation and extreme measures

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