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Mitigating the Effects of AllegedEBOLA Attacks at Multiple Airports
Dorothy A. Canter, Ph.D.JHU Applied Physics Laboratory
USSOCOM CBR Conference and ExhibitionTampa, FL
December 8, 2005
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Presentation
• USSOCOM Scenario/Presentation Assumptions
• Ebola Virus Information
• Ebola Notional Incident Timeline
• Ebola Best Case Decontamination Timeline
• Ebola Notional Public Health Timeline
• Recommended Preparedness Activities
• Potential Roles for Military in Responsesto Bioterrorism
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USSOCOM-Specified EBOLA Scenario
• Reports on blogs/websites that “FreedomFighters” infected airline passengers at O’Hare,Logan, Hartsfield and Heathrow Airports withEbola virus
• Police, FBI, TSA find crude devices in airports
• Devices, environmental samples sent to labs foranalysis
• Boston police officer reports over nonsecureradio “We found the bioweapon in the trash..”- picked up by media
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USSOCOM-Specified EBOLA Scenario
• Delta Flight 20, low on fuel, told to holdapproach pattern to Frankfurt Airport andawait further instructions
• Leader of Hartsfield baggage handlers uniontells members to stop unloading aircraft
• CNN reporter, wearing respirator, broadcasts“Breaking News”
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My Assumptions
• Releases occur at same time at all airports
• Blogs/websites report incidents within one hour ofreleases
• Devices found in trash of food court area in securearea of terminal at all four airports
• Delta flight originated at Hartsfield Airport
• Incidents will yield confirmed attacks at Hartsfield,Logan and Heathrow Airports; O’Hare incident willbe hoax
• No sensitive electronic equipment(e.g., scanning equipment) affected by attacks
• Best case response based upon significantpreparedness and response planning/training
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EBOLA Virus
• Fragile, RNA-containing Filovirus; causesEbola Hemorrhagic Fever (EHV)
• Incubation period of 2-21 days
• Symptoms include sudden onset of fever,weakness, muscle pain, headache; followedby vomiting, diarrhea, rash, impairedkidney/liver function, and internal/externalbleeding
• High mortality – no known treatment, onlysupportive medical care
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EBOLA Virus
• Human-to-human transmission throughcontact with bodily fluids
– Risk greatest during latter stages ofdisease when viral loads highest
• Cases must be isolated from other patients– Soiled clothing/bed linens must be
disinfected
• Health care workers must use strict barriernursing techniques
– Non-disposable protective equipmentmust be disinfected prior to re-use
• Airborne transmission uncertain
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EBOLA Virus
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Facts About EBOLA Incidents
• No potentially exposed passengers, airline or airportworkers will become ill for about 2-21 days, if at all
• None of the above persons will be able to transmit thevirus before becoming ill
• If anyone develops EHF, that person(s) will need to beisolated
• Fragile virus, if viable, will not live long in air or onnonporous surfaces (at most several days)
• No antimicrobial products registered by EPA for useagainst Ebola virus, but number of products areregistered for use against viruses, including Vacciniavirus, on hard, non-porous sources
• Barrier nursing equipment available in CDC StrategicNational Stockpile (SNS)
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Phases of EBOLA Airport Incidents
• Suspicious Incidents– Sufficient evidence to consider as credible
threats, no analytical laboratory confirmation– Online reports + finding of devices
• Presumed Positive Events– Positive findings in PCR, virus isolation,
antigen detection tests– Available within hours*
– US analyses done at CDC, USAMRIID only –BL-4 facilities
• Confirmed Attacks– Definitive tests at CDC/USAMRIID yield
positive findings– Results available within ½ to ¾ day*
*Source: Tom Ksiazek, CDC
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EBOLA Notional Incident Timeline
Day 1 Day 2
Loga
nA
irpor
tH
eath
row
Airp
ort
O’H
are
Airp
ort
Blog
s/Web
sites
Broa
dcas
tRe
lease
s
Rel
ease
of S
pray
SuspiciousIncidents
PreliminaryLab Results
Crude DevicesFound
Terminal OperationsSuspended
Terminal OperationsSuspended
Terminal OperationsSuspended
+
+
-
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 25 26 27 28Hour
AirportClosed
TerminalOpens
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SamplesArrive
SamplesArrive
SamplesArrive
AirportClosed
AttacksConfirmed
DefinitiveEbolaTest
+
+
-
Har
tsfie
ldA
irpor
t
PresumptivePositiveEvents
Terminal OperationsSuspended
+Samples
Arrive
AirportClosed+
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Other Notional Activities During SuspiciousIncident Phase of Attacks
• Airport managers alert Mayors who alertGovernors who alert Secretary, DHS,and President
• Airports give media interviews
• Delta flight diverted to US air basein Germany
• Hartsfield baggage handlers unload baggageafter meeting with airport management andreceipt of Fact Sheets and FAQs
• Airports on high alert globally
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Other Notional Activities During PresumptivePositive Phase of Attacks
• US airports activate Incident Command System
• EOCs activated (EPA, CDC, HSOC);PFOs appointed by DHS
• Interagency Committee on DomesticResponse Preparedness holds secureteleconference/prepares for next steps
• Decision to federalize National Guard units inaffected cities if attacks are confirmed
• Continuing interactions among governmentalunits and airport management
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Other Notional Activities DuringPresumptive Positive Phase of Attacks
• Interactions among all airports
• CDC/local health departments confer onpotential public health responses
• Continuing airport briefings of media,distribution of Fact Sheets/FAQs
• Delta flight lands at Hartsfield/passengersquarantined
• Airlines notify passengers/flight crews onaffected planes
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Responses to Confirmed Attacks
• Decontamination Activities
• Public Health Activities
• Forensic Activities
• International Coordination
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EBOLA Best Case Decontamination Timeline
Day 2
Loga
nA
irpor
tH
eath
row
Airp
ort
3 6 9 12 15 18 21 24Hour
Day 3 Day 4 Day 5
3 6 9 12 15 18 21 24 3 6 9 12 15 18 21 24 3 6 9 12 15 18 21 24
* Unified Incident Commands
CoordinateWith UICs
Agree onClean-Up
Procedures
CBIRFArrives
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Removal of Materials From Airportsfor Disposal Bleach Treatment
Removal of Materials From Airportsfor Disposal Bleach Treatment
FormUIC
CoordinateWith
HeathrowWasteRemoval
WasteRemoval
ECCMeets
AirportReopens
Har
tsfie
ldA
irpor
t
CBIRFArrives
Bleach TreatmentRemoval of Materials From Airportsfor DisposalForm
UIC*
CoordinateWith
HeathrowWasteRemoval
ECCMeets
AirportReopens
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EBOLA Notional Public Health Timeline
0 3 6 9 12 15 18 21 24Day 2 (Hours) Days
Hour 3.5Activation of Strategic NationalStockpile (SNS)
Hours 5-6Designation of Quarantine Areasin Affected Cities
0 3 6 9 12 15 18 21 24
Day
4 FBI DetectsSuspiciousActivity onVideotapes
Labs ReportVirus NotWeaponizedD
ay 5
EBF Casein Atlanta –CDC/WHONotifiedD
ay 6
3 4 5 6 7 8 9 10 11 30
3 4 5 6 7 8 9 10 11 30
PeopleFleeAtlantaPanicD
ay 6
-7
Day 13: EHF Case inLondon Suburb –Day 19: People Returnto Boston and AtlantaDay 22: QuarantineLifted for ExposedPersonsDay 30: CommissionsAppointed to InvestigateAttacks/Responses
Day
s 11
-30
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ExposedPersons
QuarantinedDay
3
FBIIdentifiesCases asPerpsD
ay 1
0
PeopleFleeBostonD
ay 9
-10
EBF Casein Boston –CDC/WHONotifiedD
ay 9
Days 1 - 4: Airlines/Airports Notify Potentially Exposed Persons
Days 3 - 22: Role of National Guard (NG) in Enforcing Quarantine
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Response Assumptions
• Significant preparedness and response planning,including regular training, has occurred inadvance
• Teams are ready and equipment is pre-positioned
• Responses are 24/7• Interagency coordination alive and well• Effective audibles were called when needed at all
airports and immediately communicated to otherairports
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• Fact Sheets and FAQs on biothreat agentsavailable at all US airports
– Cover public health, decontamination,and notification/management issues fortop bioterrorism agents
– Also distributed to First Responders,police
– Regularly updated
• Coordinated preparedness and responsetraining, including table tops
– Address both public health anddecontamination issues
Recommended PreparednessPlanning Activities
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Recommended PreparednessPlanning Activities
Decontamination Related Activities
• Prototypical Health and Safety Plans(HASPs) for airports
• Designated areas of airport for detainmentof persons potentially exposed to bioagents
• Guidance on decontamination proceduresfor various biothreat agents
• Availability of portable PPE deconunits/pre-determined sites for theirlocation
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Decontamination Activities (cont’d)
• Reachback
• Current lists of contractors withdemonstrated experience in bioagentdecontamination, waste removal
• Existing relationships with wastedisposal facilities
• Templates for remediation action plans
• Creation of Technical Advisory Committee(s)to provide guidance to airports on terrorismincidents – both real and hoaxes
• Possibly regional/national
Recommended PreparednessPlanning Activities
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Interagency Committee on Domestic Response Preparedness
• Purpose– Planning for improved responses to multiple
domestic terrorist attacks with potentiallycatastrophic consequences• Research/Training/Coordination
– Advisory role during actual responses
• Co-chaired by DHS, DOD, and DHHS• Membership
– Civilian federal agencies: DHS (OP, TSA, FEMA),EPA, CDC (NIOSH, NCID), NIH, DOT,FAA, FBI, CIA, DOS
– DOD agencies: SOCOM, NORTHCOM, STRATCOM, others– State/local advisors– Member/surrogate from each agency -
electronically connected at all times onsecure equipment
Recommended PreparednessPlanning Activities
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Potential Roles for Military in Responsesto Bioterrorism
• Transport of samples to analytical labs
• Analysis of clinical/environmental samples
• Role of CBIRF/CST units indecontaminations
• Use of National Guard armories aspotential quarantine centers/distribution ofSNS meds
• Role for USSOCOM OCONUS inidentifying/neutralizing terrorist cells
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Need to be Prepared for theNext Bioattack,
Not Just the Last One!
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If you have seen one bioattack,you’ve seen one bioattack
We need to be complete and flexibleto respond to asymmetric attacks
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Contact Information
Dorothy A. Canter, PhD
240-228-2616
The Johns Hopkins UniversityApplied Physics Laboratory
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