Bioterrorism

MLAB 2434: MicroiologyKeri Brophy-Martinez

TermsBioterrorism: use of bacteria, viruses, fungi or toxins to

injure people, animals or crops to cause civil and economic unrest.

Biological warfare: use of bacteria, viruses, fungi or toxins to

injure people, animals or crops to gain military advantage.

Biosafety Levels (BSL)

Based on microorganism disease potential

Combination of standard procedures and techniques, safety equipment and facilities designed to minimize the exposure of workers and the environment to infectious agents.

Each increase in level indicates more precautions and work controls

BSL’sBSL-1

Organisms that do not normally cause human disease

Minimal safety procedures & equipmentEx: Bacillus subtilis

BSL-2Organisms cause human disease but are not

transmitted among hostsWork should be performed under class II

biological hoodEx: HBV, Salmonellae

BSL’sBSL-3

Organism transmitted by respiratory routeCauses serious diseaseRequires use of separate air ventilation systemsEX: Mycobacterium tuberculosis

BSL-4 Organism transmitted by respiratory route High risk of disease Strict precautions, require containment suits No treatment or vaccine EX: Ebola

3 Categories for Public Health PreparednessA: Agents of greatest impact

EX: Bacillus anthracis, Yersinina pestis

B: Easily disseminated EX: Brucella, E. coli 0157: H7

C: Emerging pathogens Mass dissemination EX: Multidrug resistant MTB, hantavirus

Considerations

Biological weapons usually enter host via respiratory tract, GI tract, skin and mucous membranes

Primarily aerosolsFood or water sources usually not utilized

Laboratory Response Network (LRN)

Established in 1999 by CDC, FBI and United States Army Medical Research Institute of Infectious Disease(USAMRIID)

Goal:Link state and locate labs with advanced

capacity clinical, military, veterinary, agricultural, H20 and food testing labs

Decentralize testing capabilities

Laboratory Response Network (LRN)Structure

1. SentinelRole

Rapid detection and reporting of potential threats

Rule out or refer suspicious isolates, not to ID

Provide assistance on proper collection, processing, and handling of samples

Community hospitals with microbiology capabilities

BSL-2

Laboratory Response Network (LRN)

2. ReferenceRole

o Offer confirmatory testing for biothreat agentso Culture ID• Examples: State public health labs & Dept. of Defense

labs

3. National Role

o Perform all reference lab tests, and forensic testingo Definite ID of biothreat agentsExamples: CDC, USAMRIID, National Research Medical

CenterBSL-4

Indicators of a Potential Biocrime Event

A disease entity that is usual or that does not occur naturally in a given geographic area.

Multiple disease entities in the same patients.Higher than average morbidity & mortality relative to the

number of personnel at risk or within a population that inhabits the same area.

Massive point source outbreak.Aerosol route of infection. Illness limited to located or circumscribed geographic areas

with filtered air supplies or closed ventilation systems.Sentinel dead animals of different species.Absence of a competent natural vector in the area of an

outbreak.

Agents of BioterrorBacillus anthracisYersinia pestisFrancisella tularensisBrucella speciesBurkholderia speciesCoxiella burnetiiVariola virus- smallpoxViral hemorrhagic fever- Ebola & Marburg virusRicinStaph enterotoxinsClostridium botulinum toxin

ReferencesMahon, C. R., Lehman, D. C., &

Manuselis, G. (2011). Textbook of Diagnostic Microbiology (4th ed.). Maryland Heights, MO: Saunders.

Patton, M. T. (2010, October). In the Wake of an Attack: Laboratorians on the front line of bioterrorism defense. Advance for Medical Laboratory Professionals, 22(20), 6-7.