Biosecurity Threat Posed by Botulinum Toxin.

Orlando Cenciarelli,Paul William Riley,Agoritsa Baka

doi:10.3390/toxins11120681

Orlando Cenciarelli, Paul William Riley + Show 1 more

Open Access

https://doi.org/10.3390/toxins11120681

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Journal: Toxins	Publication Date: Nov 20, 2019
Citations: 15	License type: CC BY 4.0

Affiliation: European Centre for Disease Prevention and Control

Abstract

The deliberate release of biological agents with terrorist or criminal intent continues to pose concerns in the current geopolitical situation. Therefore, attention is still needed to ensure preparedness against the potential use of pathogens as unconventional weapons. Botulinum neurotoxin (BoNT) is one such biological threat, characterized by an extremely low lethal dose, high morbidity and mortality when appropriately disseminated, and the capacity to cause panic and social disruption. This paper addresses the risks of a potential release of the botulinum neurotoxin and summarizes the relevant aspects of the threat.

Highlights

Botulinum neurotoxin (BoNT), in its purified form, is the most toxic substance known.A double-chain protein with a molecular weight of 150 kDa, it exists in seven different serotypes (A to G) and more than 40 subtypes
This paper addresses the risks of a potential release of the botulinum neurotoxin and summarizes the relevant aspects of the threat
Botulism presents in six recognised clinical forms: foodborne, infant, intestinal, wound, iatrogenic, and inhalational, each characterised by different exposure routes and incubation periods between contamination and the onset of symptoms [4]

Summary

Introduction

Botulinum neurotoxin (BoNT), in its purified form, is the most toxic substance known. Caused by the inhalation of BoNT; the toxin enters the circulatory system through mucosal membranes This is not a natural route of exposure, and it has been described only as an accidental laboratory exposure [4]. In 2013, a human-derived BoNT antitoxin (BIG-IV) for the treatment of infant botulism was licensed in the U.S by the FDA (BabyBIGTM). This formulation has been made available for the treatment of patients under one year of age hospitalized outside the U.S since 2005 [32]. In the case of botulism, there is no person-to-person transmission; treatment of more than a limited number of patients would put a significant strain on the health system due to the high demand of critical care and low availability of antitoxin. BoNT is included in them all, as it displays a lot of the suggested characteristics of a high-threat agent

BoNT as a Weapon

BoNT as an Injectable Preparation

Food and Beverage Contamination with BoNT

Airborne Release of BoNT

Indicators of an Intentional Release of BoNT

Findings

Discussion and Conclusions