Bioterrorist Attack Research Articles

Knowledge Attitude and Preparedness among Different Health Professionals Towards Potential Bioterrorism Attacks

INTRODUCTION: The threat of bioterrorism, long ignored and denied, has heightened over the past few years. Bioterrorism is the malpractice of microbial agents and their products in-order to create terror or slay humans or animals.AIM: To assess the knowledge, attitude and preparedness regarding bioterrorism among dental, medical and nursing group of colleges in and around Visakhapatnam, India.MATERIALS AND METHOD: A descriptive cross-sectional study with structured self-administered questionnaire with 14 validated questions was done among 1,412 health care providers which includes medical and dental interns, postgraduates, nursing third and final year students and faculty that includes both the practitioners and academicians from 6 medical, 2 dental and 3 nursing colleges in and around Visakhapatnam, India. The data was analysed using, Analysis of Variance (ANOVA) test and Tukey’s post hoc test.RESULTS: On overall comparison among the three group of colleges, the knowledge, attitude and preparedness concerning bioterrorism is higher in medical colleges, followed by dental colleges and nursing colleges respectively that are statistically significant.CONCLUSION: Most of the study population are willing to help the government during the outbreak of bioterrorism but lack of knowledge is hindering them. Hence the curriculum of medical, dental and nursing colleges must be reformed and training courses are to be planned for better knowledge, preparedness and attitude of doctors as well as nurses.

Bioterrorism Preparedness and Response in Poland: Prevention, Surveillance, and Mitigation Planning.

Biological weapons are one of the oldest weapons of mass destruction used by man. Their use has not only determined the outcome of battles, but also influenced the fate of entire civilizations. Although the use of biological weapons agents in a terrorist attack is currently unlikely, all services responsible for the surveillance and removal of epidemiological threats must have clear guidelines and emergency response plans. In the face of the numerous threats appearing in the world, it has become necessary to put the main emphasis on modernizing, securing, and maintaining structures in the field of medicine which are prepared for unforeseen crises and situations related to the use of biological agents. This article presents Poland's current preparation to take action in the event of a bioterrorist threat. The study presents both the military aspect and procedures for dealing with contamination. In Poland, as in other European Union countries fighting terrorism, preparations should be made to defend against biological attacks, improve the flow of information on the European security system, strengthen research centers, train staff, create observation units and vaccination centers, as well as prepare hospitals for the hospitalization of patients-potential victims of bioterrorist attacks.

COVID 19: ARE WE PREPARED FOR THE CRISIS?-REFLECTION ON CRISIS BEHAVIOUR

COVID 19 infection started from Wuhan of China and has engulfed most countries in the world. The virus did not discriminate, religious beliefs, gender, political barriers and other geo-climatic boundaries. While some countries are still trying to digest the fact of death tolls in their territory, others are busy combating it by all available means. As compared to its large population, India seems to be less affected by the virus today but the coming weeks are very crucial for her. However, the crisis behaviour of people in India is leading to the spread of COVID 19. Nurses can do huge work as change agents to prepare masses for appropriate crisis behaviour. The foregoing pages of this review takes into account the COVID 19 infection as bioterrorism attack, reflects on the crisis behaviour of people and evaluates the role of nurses as community advocates.

Conceptual Delimitations in the Field of Biosecurity

Abstract Biosecurity is a term who was brought more into our attention after the events of September 11, 2010 who have been followed by the most famous bioterrorist attack with the anthrax letters. Defining biosecurity is not as easy how it looks at first side because this term it has a lot of interpretations according to various disciplines where it is used. At the beginning biosecurity was introduced as a set of measures with the purpose to reduce the risk of transmission of the infectious diseases in living modified organism, quarantined pests and infectious diseases in livestock and crops. Nowadays the term includes also the biological threats to environment, industries and to people and brings into our attention terms like bioterrorism, bioattack, bioweapons, biodefense, biosafety, biohazard, biorisk, biocontainment and biosurety. This article has one primary objective and that is to assess the roots and etymology of the term biosecurity by presenting a short historical perspective which will lead to a better delimitation of the concept, and to define some key concepts related to this area. The result of this conceptual delimitation of the biosecurity is to bring into attention the importance of this area which before COVID-19 events wasn’t took into consideration at the level it should be.

Developing Optimal Policies to Fight Pandemics and COVID-19 Combat in the United States

The world has faced many outbreaks and pandemics with hundreds of millions of deaths throughout its history. Those epidemics are global health concerns and as well as serious economic issues. There is certain need to allocate scarce sources efficiently to fight such epidemics in both personal and global dimensions. Here we develop and propose two optimization models to maximize the total protection from any epidemic, pandemic or bioterror attacks; the first one is personal protection model or protocol and the other one is mass protection model that is inspired by the well-known weapon-target assignment problem of operations research. These efforts are optimal allocation of scarce medical and economic resources to save millions of lives- gift of life. We implement our general mathematical programming models with real-world data to fight the coronavirus pandemic for a person and the United States. Our personal protection protocol provides 99.99% protection from COVID-19 for an American through personal strategies when the mass protection model supplies 96.961% protection on average from coronavirus pandemic for the United States through across country policies. The mass protection model which recommends general policy frame for health care policy makers could be applied for any epidemic at any level from county to city, to state and country as well as in global scale. The mathematical relation between the personal protection protocol and the mass protection model also highlights the fact of unus pro omnibus, omnes pro uno (one for all, all for one) for fighting epidemics- particularly the moving enemy, novel coronavirus which is double invisible due to its viral nature and the availability of the high level of asymptomatic cases. Recognize the enemy, as protecting yourself means protecting people, love life, follow the rules and stay at home. That is the greatest ever social impact.Published on 28 April 2020.

Knowledge and Preparedness of Healthcare Providers Towards Bioterrorism

Introduction: Several emergent circumstances require healthcare providers to be able to recognize the dangerous and uncommon pathogenic agents. An in-depth literature review showed that studies about bioterrorism preparedness amongst healthcare providers from the Middle East, including Saudi Arabia, are lacking. Therefore, we conducted this study to investigate the knowledge and preparedness level of first emergency respondents towards bioterrorism events, which are the emergency department (ED) healthcare providers and the poison control center/clinical laboratory staff. Methods: A cross-sectional study was conducted between at the Emergency departments and poison control centers/clinical laboratories three in major tertiary care hospitals in Riyadh city, Saudi Arabia. The subjects were randomly selected to complete the self-administered questionnaire to collect study outcomes. Results: A total of 1030 participants were included in the final data analysis. The majority were nurses, 516 (50.1%) and doctors 351 (34.1%), and females 550 (53.6%). Overall, the findings revealed a mean knowledge score of 4.92 ± 1.86 out of 12 in the basic concepts of bioterrorism and basic clinical presentations of bioterrorism-related agents. Moreover, the findings showed a mean knowledge score of 22.80 ± 3.92 out of 38 in the bioterrorism preparedness and governing policies and procedures. Respondents who received previous training in bioterrorism preparedness had a significantly higher number of perceived benefits than those not sure and without prior training (z = -2.67, p = 0.008) and (z = - 4.4, p < 0.0001), respectively. About 79.4% of participants did not have previous training in bioterrorism preparedness, but 68.7% expressed willingness in the institution's response and control to assist in the event of a bioterrorist attack. Conclusion: Although healthcare professionals have reported their willingness to assist in bioterrorism events, they need to enhance their knowledge towards bioterrorism preparedness. Funding Statement: The study was funded by King Fahad Medical City, Riyadh, Saudi Arabia. Declaration of Interests: Authors have no conflict of interests. Ethics Approval Statement: The study was reviewed and approved by the institutional review boards at the study site. Participants’ completion of the questionnaire implied their consent to take part in the study.

Abstract No. 431 Investigating a potential device to limit gentamicin systemic toxicity

Anthrax is one of the most potent bioterrorism drug agents in the world. The CDC has designated anthrax as one of the most likely agents to be used in a bioterrorism attack. In 2001, anthrax spores were deliberately placed into letters and mailed. 22 people became infected, 5 of whom died. Current treatment for anthrax includes penicillin G and streptomycin; however, 10% of the human population is allergic to penicillin and cannot tolerate it as a potential treatment. One highly potent alternative is gentamicin; however, gentamicin’s known nephrotoxicity limits its use in high doses. In this study we investigate the potential use of a temporary filter device deployed in the renal artery to reduce local drug concentration. Experiments were conducted in Medium 199 with kidney epithelial cells. Dowex Cation Exchange Resin was used to test ionic binding to gentamicin. Cells were incubated at the appropriate environment until a 60-70% confluency. Media was exchanged with media containing 0mM gentamicin (negative control), 10mM (positive control), 2mM (prefiltered sample), and 2 passes through the flow system (Pass 1, Pass 2). The flow system consisted of 50mL of 2mM gentamicin, pushed through a column containing the Dowex resin at a rate of 25 mL/min. After 24 hours cells were imaged and counted. Data is expressed as percentage of live cells relative to the total number of cells counted. Cell viability in negative and positive controls are 90% (89.3 – 90.7) and 15% (14 – 16) respectively. The prefilter sample (2mM) had a cell viability of 46% (37.2 – 54.7) which increased to 70% (65.9 – 74.1) after first pass and to 85% (82.0 – 88.0) after second pass. HPLC conducted on the filtered samples showed an 88.3% reduction in gentamicin mass after the first pass and approximately 98.7% reduction after the second pass. Dowex resin filters can bind a significant volume of gentamicin and demonstrates continued efficacy on subsequent passes, resulting in significant preservation of renal cell viability. An intravascular device with similar binding properties may serve as a viable way to increase the loading dose of Gentamicin while minimizing renal toxicity.

Foodborne zoonotic agents and their food bioterrorism potential: Areview

Bioterrorism is anact of deliberate release and dissemination of biological agents such as pathogenicmicroorganisms or their products in a naturally occurring or human-modifiedform. Bioterrorist attacks are aimed at causing death, disease or otherbiological malfunction in humans, animals or plants, in order to achievecertain political goals through creating fear and panic among the populationand influencing government’s behaviour. Historical data showed that zoonoticpathogens have been most commonly used as agentsfor bioterrorism. Applied through the food production systems or directly toprocessed foods asbiologicalweapons, zoonotic pathogens canhavefast anddevastating effects on humanhealth with enormous economic andsocial impact. Despite the development of different countermeasuresand the application of hazard analysis and critical control point (HACCP)systems in the food industry, the bioterrorists’ attacks as intentional actscannot be predicted, but could be avoided by strengthening food control measures.

Awareness on Bioterrorism among qualified dentists in a teaching dental institution in southern India

Background: Bioterrorism covers a vast spectrum of concerns, from catastrophic terrorism with mass casualties, to micro-events using low technology but producing civil unrest, disruption, disease, disabilities, and death. In such a situation, the medical community should educate the public about the threat. Education of the dental profession regarding the medical and oral manifestations of diseases that may result from a bioterrorist attack will be important. Thus, our aim of the study was to assess the knowledge, practice, and attitude toward bioterrorism among postgraduate dental students and dental staff in a private institution. Methods: Using convenience sampling, postgraduate dental students and the teaching staff of an institute in Guntur were given a questionnaire to assess them regarding bioterrorism. The questionnaires were collected, and the Chi-square test was performed with IBM. SPSS Statistics version 20 windows program software. Results: About 61.9% of postgraduate dental students and dental staff were aware of the term bioterrorism. More than 68.18% of postgraduate dental students and 67.7% of dental staff were not aware of the pathogenic agents of bioterrorism, and they have not attended either any lecture on it. Conclusion: Dental staff had better knowledge about bioterrorism compared to postgraduate dental students. Hence, there is a need to include training and education in the predoctoral dental and dental hygiene curriculums and developing CE courses for practicing dental professionals.

Bio-weapons and Bio-terrorism Attacks on Commercial Shipping in Nigeria: The Potential Trojan Horse of the 21st Century

Biological attacks by terrorists may seem more like a plot element in an action film than a realistic threat. The possibility of biological weapons attack could be very remote. Scholars are divergent in their opinions on the plausibility of a biological attack. The U.S. Office of the Director of National Intelligence and the National Intelligence Council stated in 2008 that bio-terrorism is a more likely threat than nuclear terrorism. Researches have revealed that of all weapons of mass destruction, biological weapons constitute the greatest worry. The most likely target for bio-terrorism is a major city or other densely crowded areas, such as transportation hubs like sea ports. This paper probes into Nigerian legislations especially the Nigerian Port Authority Act, the NIMASA Act, the Terrorism Act and the NAFDAC Act regarding biological weapons and bio-terrorism in maritime commerce parlance. It is observed in this paper that all these Acts lack preventive mechanisms in the case of the emergence of the scourge. It is argued that Nigeria is vulnerable to bio-terrorism owing to a dearth of detective measure in the boarder ports. The paper concludes that there is an urgent need to revamp the legal framework to tame the threat of bio-terrorism.

Rapid and sensitive identification of ricin in environmental samples based on lactamyl agarose beads using LC-MS/MS (MRM).

Ricin, a plant-derived toxin extracted from the seeds of Ricinus communis (castor bean plant), is one of the most toxic proteins known. Ricin's high toxicity, widespread availability, and ease of its extraction make it a potential agent for bioterrorist attacks. Most ricin detection methods are based on immunoassays. These methods may suffer from low efficiency in matrices containing interfering substances, or from false positive results due to antibody cross reactivity, with highly homologous proteins. In this study, we have developed a simple, rapid, sensitive, and selective mass spectrometry assay, for the identification of ricin in complex environmental samples. This assay involves three main stages: (a) Ricin affinity capture by commercial lactamyl-agarose (LA) beads. (b) Tryptic digestion. (c) LC-MS/MS (MRM) analysis of tryptic fragments. The assay was validated using 60 diverse environmental samples such as soil, asphalt, and vegetation, taken from various geographic regions. The assay's selectivity was established in the presence of high concentrations of competing lectin interferences. Based on our findings, we have defined strict criteria for unambiguous identification of ricin. Our novel method, which combines affinity capture beads followed by MRM-based analysis, enabled the identification of 1 ppb ricin spiked into complex environmental matrices. This methodology has the potential to be extended for the identification of ricin in body fluids from individuals exposed (deliberately or accidentally) to the toxin, contaminated food or for the detection of the entire family of RIP-II toxins, by applying multiplex format.

Bioterrorism and Chemical Attacks

Bioterrorism and Chemical Attacks

Evaluation of Security Measures to Mitigate the Effects of Bioterror Attacks on Buildings Using a System Dynamics Method

AbstractThis paper describes the use of a system dynamics (SD) computational method to evaluate initial designs or upgrades of security measures to protect a building and its occupants from bioterr...

Syndromic surveillance using ambulance transfer data in Tokyo, Japan

Bioterrorism attacks become more probable when important high-profile international or political events are held, such as G7 summit meetings or mass gathering events including Olympic and Paralympic games and FIFA World Cup tournaments. Outbreaks of infectious disease and widespread incidents of food poisoning are also public health concerns at such times. In Japan, the Tokyo Metropolitan Government operates Ambulance Transfer Syndromic Surveillance (ATSS), which can help monitor such incidents. The present study presents and assesses the ATSS framework. During the study period of October 2017 through November 2018, we monitored 33 areas for symptoms of 9 categories: vomiting/nausea, dizziness, palpitation, unconsciousness, breathing disorder, fever, spasm/paralysis, collapse/weakness, and bloody emesis/nasal hemorrhage. Among all symptoms, we found 9929 low-level aberrations, 2537 medium-level aberrations, and 577 high-level aberrations, with respective frequencies of 9.2%, 2.3%, and 0.5%. Of those, Tokyo Metropolitan Institute of Public Health reported the information to Tokyo Metropolitan Government 28 times during the period. Of the 28 identified clusters, Tokyo Metropolitan Government judged the necessity for investigating 7. All of those were investigated at hospitals by the jurisdictional public health center. Because ATSS covers almost the entire Tokyo metropolitan area, with about 13.8 million residents, it is definitely the largest syndromic surveillance in the world.

Agroterrorism; Iranian Criminal Policy

Background and Aim: This article presents some perspective on bioterrorism by focuses on Agroterrorism cases. This study focuses attention on the issue of Agroterrorismand discusses criminal response against it in Iranian Criminal law. Materials and Methods: A handful of studies and researches have been reviewed for preparing this study.Ethical Considerations:Honesty in the literature and citation analysis and reporting were considered.Findings: Agroterrorism attack may results in the agricultural and food industries, loss of confidence in government, and possibly human casualties. The fear of a bioterrorist attack in the world have changed public health in countries. Based on these facts, a sharp and quick response including criminal responses against this kind of terrorism to protect the safety of community as well as health policies is necessary.Conclusion: Agroterrorism is a new form of terrorism which falls in the realm of bioterrorism. This kind of offence against the community attracts policy makers’ high level of attentions. Iranian legislator amongst other policies prosecute offenders with article 286 of Penal Code: “Corruption on Earth”. This question that this title is appropriate to combat Agroterrorism depends on the extent of the behaviors results. This title belongs to situation that vast geographic area or huge number of populations was affected due to terroristic attacks. The punishment of offender(s) is capital punishment.

The risk of bioterrorist and biocrime attack in the contemporary world

The biological attack is the artificial spread by various means of pathogens that can cause serious infectious and contagious diseases as well as the spread of germ toxins that can be used by an aggressor as a means of fighting in order to reduce the troops’ fighting force, by causing serious disease outbreaks or by killing people, animals and/or plants. Biological agents are microorganisms and/or microbial, animal or plant toxins, used as specific ammunition for biological weapons or used by terrorists in "bio-chem" attacks. The risks of bioterrorism and biocrime attack in the contemporary world are real, and the history of the 20th century and the beginning of the 21st century confirms this. It is necessary for preventive measures to be implemented on the unlawful use of biological agents. Early medical and nonmedical countermeasures must be prepared for the prophylaxis, treatment and cessation of the consequences of any biological attack.

OR Forum—Public Health Preparedness: Answering (Largely Unanswerable) Questions with Operations Research—The 2016–2017 Philip McCord Morse Lecture

Public health security—achieved by effectively preventing, detecting, and responding to events that affect public health, such as bioterrorism, disasters, and naturally occurring disease outbreaks—is a key aspect of national security. However, effective public health preparedness depends on answering largely unanswerable questions such as determining the chance of a bioterror attack in the United States over a given time horizon, or chance of an anthrax attack, or the location and magnitude of such an attack. In “Public Health Preparedness: Answering (Largely Unanswerable) Questions with Operations Research—The 2016–2017 Philip McCord Morse Lecture,” Margaret Brandeau describes the important role that OR-based analyses can play in providing insight into complex public health preparedness planning problems, thereby supporting good decisions. The author presents three examples from her work: logistics of response to an anthrax attack, prepositioning of medical countermeasures for anthrax, and stockpiling decisions for the United States’ Strategic National Stockpile.

Rapid identification of unknown pathogens in environmental samples using a high-throughput sequencing-based approach

In the event of a bioterror attack, a prompt, sensitive and definite identification of the agents involved is of major concern for confirmation of the event and for mitigation of countermeasures. Whether the information from intelligence forces is limited concerning the biothreat identity or one suspects the presence of a novel or engineered agent, the genetic identification of microorganisms in an unknown sample is challenging. High-throughput sequencing (HTS) technologies can sequence a heterogeneous mixture of genetic materials with high sensitivity and speed; nevertheless, despite the enormous advantages of HTS, all previous reports have analyzed unknown samples in a timeframe of a few days to a few weeks. This timeframe might not be relevant to an emergency scenario. Here, we present an HTS-based approach for deciphering the genetic composition of unknown samples within a working day. This outcome is accomplished by a rapid library preparation procedure, short-length sequencing and a prompt bioinformatics comparison against all available microbial genomic sequences. Using this approach, as a proof of concept, we were able to detect two spiked-in biothreat agents, B. anthracis and Y. pestis, in a variety of environmental samples at relevant concentrations and within a short timeframe of eight hours.

Multiplex Detection of Three Select Agents Directly from Blood by Use of the GeneXpert System.

Francisella tularensis, Bacillus anthracis, and Yersinia pestis are tier 1 select agents with the potential to rapidly cause severe disease. Rapid detection of these bacteria from patient samples at the point of care could contribute to improved clinical outcomes in the event of a bioterrorism attack. A multiplex nested PCR assay for detection of F. tularensis, B. anthracis, and Y. pestis directly from patient blood samples was developed using the GeneXpert system. The multiplex GeneXpert cartridge-based assay includes all necessary sample processing and amplification reagents. Blood samples spiked with different numbers of CFU were used to measure the analytical limit of detection (LOD) and dynamic range. Sensitivity was determined by testing spiked blood samples and negative-control blood in a blind manner. Specificity was determined by testing against nontarget pathogens and blood samples from clinical patients. The assay LOD was 8.5 CFU/ml for F. tularensis, 10 CFU/ml for B. anthracis, and 4.5 CFU/ml for Y. pestis The sensitivity was 100% at the LOD for all three select agent bacteria in spiked patient blood samples. The assay specificity was 100% when it was tested against both nontarget pathogens and clinical patient blood samples. The total assay time was approximately 100 min. This automated assay, which is suitable for use at the point of care, identifies three select agents directly in blood without the need for enrichment with a high sensitivity within 100 min. This assay may enable rapid detection and treatment of patients infected with the target organisms in the event of a bioterrorism attack.

Biological Toxins as the Potential Tools for Bioterrorism.

Biological toxins are a heterogeneous group produced by living organisms. One dictionary defines them as “Chemicals produced by living organisms that have toxic properties for another organism”. Toxins are very attractive to terrorists for use in acts of bioterrorism. The first reason is that many biological toxins can be obtained very easily. Simple bacterial culturing systems and extraction equipment dedicated to plant toxins are cheap and easily available, and can even be constructed at home. Many toxins affect the nervous systems of mammals by interfering with the transmission of nerve impulses, which gives them their high potential in bioterrorist attacks. Others are responsible for blockage of main cellular metabolism, causing cellular death. Moreover, most toxins act very quickly and are lethal in low doses (LD50 < 25 mg/kg), which are very often lower than chemical warfare agents. For these reasons we decided to prepare this review paper which main aim is to present the high potential of biological toxins as factors of bioterrorism describing the general characteristics, mechanisms of action and treatment of most potent biological toxins. In this paper we focused on six most danger toxins: botulinum toxin, staphylococcal enterotoxins, Clostridium perfringens toxins, ricin, abrin and T-2 toxin. We hope that this paper will help in understanding the problem of availability and potential of biological toxins.