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Emergency Response to Terrorism: Operations A Safe Response for Public Safety Personnel. The International Association of Fire Fighters. General President Harold A. Schaitberger. General Secretary-Treasurer Vincent J. Bollon. UNIT 5: Biological Agents. BIOLOGICAL AGENTS. Introduction. - PowerPoint PPT Presentation
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Emergency Response to Terrorism: Operations
A Safe Response for Public Safety Personnel
The International Association of Fire Fighters
General PresidentHarold A. Schaitberger
General Secretary-Treasurer Vincent J. Bollon
UNIT 5: Biological Agents
Introduction
• Group ActivityBIOLOGICAL AGENTS
Objectives
• By the end of this unit, you will:
• Recognize the threat characteristics of biological agents
• Determine possible types of harm posed to First Responders at biological WMD incidents
• Describe the use of First Responder PPE and its limitations at biological WMD incidents
• Identify First Responder protective actions at incidents involving biological hazards
Background
• May seem unlikely
• Availability greater• 20+ Countries with Active CW Programs• 12+ Countries with Active BW Programs• 30+ Countries with Nuclear Capabilities
• At home - FBI• 37 cases - 1996• 74 cases - 1997• 181 cases - 1998• 2001 + - ???
The Worst Source of Contagion
…Your Fingers
Did you know that 80 % of all infectious illnesses, from the common cold, to flesh eating bacteria, to lethal viruses (i.e. EBOLA), are transmitted by touch?
The Secret Life of Germs
Grand Central Station Hidden Camera
• 60% of people observed did not wash their hands after using the restroom
• 90% of those who did wash their hands did not wash them effectively
• Tested random headsets and found: • E Coli; Fecal germ
• Tested a bar glass at an exclusive hotel and found: • Group D Strep; Fecal germ
• Tested public telephone on Madison Avenue and found:– Hemolytic Strep A; Flesh eating bacteria
New York Observer Swipe Study
Bathroom
• Potential Sources• Toothbrush• Soap Bars• Hand Towels
Flushing a toilet spreads contamination……
everywhere in YOUR bathroom
Stomach Viruses
• 80% of all are foodborne
• Found often on cruise ships
• Doctors call them stomach viruses• ie; E Coli, Shigella Coli
• Transmitted via Fecal-Oral route
What’s In a Sneeze?
• Aerosolized dispersion
• Particles may travel up to 20’
• Coughs can also spread bacteria
Identify Responder Issues SM 5-5
• Determine the following:
• Team 1: Threat Characteristics
• Team 2: Types of Harm
• Team 3: PPE Considerations
• Team 4: First Responder Protective Actions
Team 1
• Threat Characteristics
• Exposure/Contamination
• Secondary devices
• Other hazardous materials
Team 2
• Types of Harm
• Illness
• Death
Team 3
• Personal Protective Equipment
• Self Contained Breathing Apparatus (SCBA)
• Body Substance Isolation (BSI)
Team 4
• First Responder Protective Actions
• Establish Command
• Isolate/Assess
• Prepare for Decon
Biological
WMD
Pathogen Toxin (poison)
Biological
WMD
Pathogen
Bacteria or Viruses
Living organisms
Can be contagious
Symptoms are often delayed
Examples
Bacillus anthracis
Ebola virus
Hepatitis B
HIV
Biological
WMD
Toxin (poison)
Non-living
Not contagious
Symptoms may develop in minutes to hours
ExamplesBotulinumRicinSEB (staphylococcal enterotoxon B)
Biological
Toxin (poison)
Non-living
Not contagious
Symptoms may develop in minutes to hours
Examples
Botulinum
Ricin
SEB (staphylococcal-enterotoxon B)
Pathogen
Bacteria or Viruses
Living organisms
Can be contagious
Symptoms are often delayed
Examples
Bacillus anthracis
Ebola virus
Hepatitis B
HIV
Threat Characteristics
• Pathogens
• Are living organisms
• Multiply once released into the environment or host (carriers)
• Symptoms are often delayed from days to weeks
• Bloodborne and airborne
Threat Characteristics
• Toxins
• Are not living organisms
• Do not multiply once released into the environment or host
• Not transmitted by carriers
• Symptoms may happen within minutes to hours
Threat Characteristics
Pathogens(bacteria, viruses)
examples: Bacillus anthracis bacteria (Anthrax)*, Ebola virus, Hepatitis B virus, HIV, Mycobacterium tuberculosis
Toxins
examples: Botulinum, Ricin (derived from castor beans), Saxitoxin, SEB (Staphylococcal Enterotoxin B
Living organisms; can multiply after dispersion
Non-living; cannot multiply after dispersion
Can be contagious; can cause epidemics/mass casualties
Not contagious; do not cause epidemics
Symptoms often delayed several days to weeks
Symptoms may develop within minutes to hours
Workbook Task SM 5-7
List three ways First Responders can contract diseases in the course of their work.
• Inhalation of pathogens spread through coughs or sneezes of sick patients
• Ingestion of pathogens spread through food and water
• Injection/needle sticks with infected blood/body fluids
Threat Characteristics
• Dissemination• Needs to contact as many as possible
• Aerosols most effective
• Others?
Dissemination
• Unusually high number of sick patients• Numerous patients with similar symptoms• Unusual number of patients within the same neighborhood/s• First Responders may have asked and discovered that patients recently ate at the same restaurants
Discussion - Recognizing a Problem
In the 1980s, members of a cult in Oregon contaminated several salad bars with salmonella bacteria in an effort to affect the outcome of a local election. As a result, 751 people became ill; 45 were hospitalized.
What is the Threat? SM 5-7
Bloodborne/Body FluidBloodborne/Body FluidAirborneAirborne
Not usually transmittedBloodborne/AirborneAirborneNot usually transmittedAirborne
Threat CharacteristicsKey Point
• Importance of BSI
• Use Protective Clothing
• Use Respiratory Protection
Types of Harm SM 5-15
• Fill in the blanks
on page 5-15
Naturally Occurring Diseases
Body System/s
Affected
Initial Signs and Symptoms
AIDS Immune
Hepatitis B, C
Lack of appetite, mild abdominal pain, nausea and vomiting, jaundice; many patients experience no symptoms
Influenza Respiratory
Tuberculosis Most patients show no signs or symptoms
WMD-Related Diseases
Body System/s
Affected
Initial Signs and Symptoms
Anthrax Initial symptoms include fever, malaise, mild cough, chest pain
Hemorrhagic fevers Blood, Liver, Kidneys
Pneumonic plague Respiratory
Ricin Weakness, fever, cough, pulmonary edema, pulmonary distress
Smallpox
Early symptoms resemble the flu, then small blisters develop on the face, hands, and forearms and, eventually, the trunk
Symptoms are often delayed for years; eventually may be noticed as skin lesions and respiratory infections occur
Liver
Fever, headache, body aches, cough, malaise
Systemic, beginning with respiratory
Respiratory
Initial symptoms resemble the flu—sudden onset of fever, headache, malaise
Early symptoms resemble the flu
Respiratory
Systemic, beginning with skin
Page 5-15
PPE
• Review Routes of Entry• Absorption• Inhalation• Injection• Ingestion
• Types of PPE• Fire• EMS
PPE
• How to enhance PPE Effectiveness
• Open building windows• Open ambulance windows• Increase air flow in the area of the patient• Put a mask on the patient• Avoid blood and body fluids• Limit crew exposure
• Review Workbook Activity – SM 5-19
PPE
• First Responder Protective Actions
• Establish Command• Isolate hazard/assess situation• Evaluate rescue• Decon• Call for technical assistance
• Does the ERG help?
25 meters (75 feet) in all directions
ERG 2004 ERG 2004
First Responder ActionsQuestion to Consider SM 5-21
• How do you protect yourself if encountering a patient who has been exposed to a biological release?
• Wear appropriate PPE (SCBA, barrier materials)
• Utilize Back-up team
• Victims must be viable
• Victims can be quickly removed
Decontamination
• Removing contaminated clothing may remove up to 80% of contamination
• Use of hypochlorite is controversial
• Use on equipment
• Technical Assistance
Team Activity: Identify Responder Issues SM 5-25
• Determine the following:
• Team 1: Threat Characteristics
• Team 2: Types of Harm
• Team 3: PPE Considerations
• Team 4: First Responder Protective Actions
Team Activity SM 5-25Your department has been called to assist law enforcement personnel at a self-storage facility. They have gathered information that leads them to believe that evidence, including biological materials, may be stored inside the self-storage unit.
Three days following your response to this situation, your department conducts a post-incident analysis. The stored product was tested and has been identified as Ricin.
Team 1
• Threat Characteristics
• Exposure/Contamination
• Secondary devices
• Other hazardous materials
Team 2
• Types of Harm
• Illness
• Death
Team 3
Personal Protective Equipment
• Self Contained Breathing Apparatus (SCBA)
• Body Substance Isolation (BSI)
Team 4
• First Responder Protective Actions
• Establish Command
• Isolate/Assess
• Prepare for Decontamination
Case Study
• Answers are basically the same
• Good, basic protective actions --- used all the time --- protect against hoaxes and real incidents