MMI 445 > Bioterrorism > Flashcards

Bioterrorism Flashcards

(43 cards)

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1
Q

Bioterrorism

A

the “intentional use of microorganisms, or toxins, derived from living organisms, to produce disease and death in humans, animals, or plants.”

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2
Q

What are signs that are suggestive to a bioterrorism attack?

A
  • Occurrence of disease in geographic area where it
    does not (naturally) occur, or where vector is not found
  • Evidence of multiple disease entities in same group of patients
  • Illness unusual for age/ population type
  • Excessive/unexplained
    morbidity/mortality
  • Epidemiologic data suggests focused source of outbreak
  • Infection is by an unexpected route, for
    example aerosol vs. direct contact for anthrax
  • Illness confined to narrow geographic area
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3
Q

Human pathogens and toxins act

A
  • Introduced in 2015
  • The purpose of this Act is to establish a safety and security program to protect the health and safety of the public against the risks posed by human pathogens and toxins.
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4
Q

What are some requirements for a HPTA Liscenced lab in Canada?

A

Biosaftey officer (BSO)
Containment level
Incident reporting
Biosecurity plan
Training

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5
Q

Biosaftey Officer

A

Appointment of a BSO is required to oversee the biosafety program and monitor compliance with the HPTA

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6
Q

Containment level

A

Physical and operational requirements must meet the Canadian Biosafety Standard (CBS).

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7
Q

Incident Reporting

A

License holders must report laboratory incidents involving RG2/RG3/RG4 pathogens, including exposures, laboratory-acquired infections, or theft, to PHAC.

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8
Q

Biosecurity Plan

A

A, security plan is required to manage risks of unauthorized access to pathogens.

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9
Q

HPTA training

A

Personnel must receive appropriate biosafety and
biosecurity training.

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10
Q

What pathogen risk groups (RG) are regulated under the HPTA?

A

RG2, RG3 and RG4

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11
Q

RG1 Pathogen

A

Indivisual Risk: no to low
Community Risk: low
Example: commensal bacteria

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12
Q

RG2 pathogen

A

Indivisual Risk: moderate
Community Risk: low
Example: pathogenic E. coli

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13
Q

RG3

A

Indivisual Risk: high
Community Risk: low
Example: Bacillus anthracis

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14
Q

RG4

A

Indivisual Risk: high
Community Risk: high
Example: Ebola virus

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15
Q

Security sensitive biological agents (SSBAs)

A

a subset of RG3 and RG4 pathogens and perscribed toxins that are included in Schedule 1 of the Human Pathogens and Toxins Regulation

If they are misused, SSBAs can pose a risk to Canada’s national security, which is why individuals who work with them will be assessed through the HPTA Security
Clearance process.

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16
Q

Why do SSBAs pose a high risk to national security?

A

– Easily transmitted
– High mortality rates
– Major public health impact

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17
Q

Name some examples of SSBAs?

A
  • Anthrax (Bacillus anthracis)
  • Botulism (Clostridium botulinum toxin)
  • Plague (Yersinia pestis)
  • Smallpox
  • Tularemia (Francisella tularensis)
  • Viral hemorrhagic fevers
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18
Q

Describe the possible mechanisms of delivery for SSBAs?

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A

Aerosol Route:
- Easiest to disperse
- Highest number of people exposed
- Most infectious
- Undetectable to Humans

Food/Waterborne:
- less likely
- Larger volumes required
- More technically difficult

19
Q

Siege of Kaffa (1346)

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A

Tartar army in Crimea catapulted bodies of plague victims over the walls of the town

20
Q

French and Indian wars against the British (1763)

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A

blankets covered in smallpox given to indians with intention to start outbreak

21
Q

WWI Bioterrorism use

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A

German army developed glanders, anthrax and cholera and infected enemies horses and mules.

22
Q

WWII bioterrorism use

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A

Japanese forces operated a secret biological warfare research facility (Unit 731) and conducted experiments on prisoners - anthrax, botulism, plague, brucella, cholera

Japanese dropped porcelain bombs containing billions of plague infected fleas over Manchuria

23
Q

Sverdlosk accident (1979)

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A
  • Accidental release of dried anthrax from a biological weapons facility
  • Total death toll ~105
  • Russian government claimed the deaths were due to infected meat
  • In 1992, Boris Yeltsin admitted to the accident
24
Q

1989-1992 bio warfare

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A
  • Former USSR biological warfare scientists defect to the US
  • Ken Alibek publishes book exposing the extent of the USSR biological weapons program
25
Canadian Public Health Laboratory Network (CPHLN)
Consortium and partnership of laboratories that provide immediate and sustained laboratory testing and communication in support of public health emergencies, particularly in response to acts of bioterrorism each province has their own provincial labratory
26
Describe the labrator structure for a bioterrorism response (triangle).
Base of Pyramid: LRN Sentinel Labs (Tier 1 = Level 2), CLIA and CMS certified microbiology laboratories and hospital microbiology labs. These recognize, rule-out and refer. Middle of Pyramid: Refrence labs (LRN Public Health Labs, Tier 2 = Level 2, 3). These are highly specialized and provincial PHL that can provide definitive confirmation of organisms Tip of Pyramid: LRN National Labs (Tier 3 = Level 2, 3, 4). Federal = Public Health Agency of Canada, DRDC, CFIA. These play a role in isolation and identification of BSL4 agents such as Ebola, Marburg and Smallpox viruses
27
Centre for Emergency Preparedness and Response
Canada’s central coordinating point for public health security issues. Responsibilities isnclude: - develops and maintains national emergency response plans for the Public Health Agency of Canada and Health Canada - monitors outbreaks and global disease events; - assesses public health risks during emergencies - contributes to keeping Canada's health and emergency policies in line with threats to public health security and general security for Canadians in collaboration with other federal and international health and security agencies - is responsible for the important federal public health rules governing laboratory safety and security, quarantine and similar issues - is the health authority in the Government of Canada on bioterrorism, emergency health services and emergency response.
28
In almost all cases, when we isolate or detect these organisms in the laboratory, they are from a natural infection, and NOT a bioterrorism event. Do they still pose a risk to lab workers?
Yes
29
What are some high risk procedures in a Microbiology lab?
When performed outside of a biosafety cabinet: * Venting blood culture bottles * Vortexing without a cover * Centrifugation in a non-sealed rotor * Catalase (and other biochemical tests) * Tissue grinding * MALDI spotting * Gram staining * Smelling plates
30
What are common labratory routes of exposure to infectious agents?
Inhalation route: proceddures that produce aerosols (centrifugion, mixing, vortexing, spills/splashes, pouring/decanting, or manipulation of inoculation loop Inoculation route: needlestick or lacerations from sharp objects Ingestion route: splashs to mouth, formites, consumption of food in lab, mouth pippetting Contamination of skin/mucous membranes: splashes or contact with formites
31
Anthrax
- Causes by Bacillus anthracis - Major pathogen of the genus - Primarily infects herbivores (ie: cows, sheep), - humans are incidental hosts - endemic in many regions: Africa, Asia, C. & S. America, etc. - Transmitted via direct contact with animal products or inhalation of endospores
32
What are the 4 types of Anthrax?
Cutaneous: 95-99% of human anthrax cases worldwide, Acquired by direct mucosal contact with infected animals, animal products, soil or exposure to spores, and 10-20% mortality Inhalational: 90% fatal Gastrointestinal: Acquired by ingestion of inadequately cooked foods containing spores or vegetative bacilli, and 20-60% fatal if left untreated Injectional
33
Lab ID of B. anthracis
- Large Gram positive, sporeforming bacillus - Catalase positive - Non-motile - Non-hemolytic
34
Brucellosis
- Caused by: Brucella abortus (cattle), Brucella melitensis (goats, sheep, and camels), Brucella suis (pigs), and Brucella canis (dogs) - B. melitensis most common and severe cause of human infection - ingestion of unpasteurized cheese, milk and other dairy products - Zoonosis-NO person-to person transmission
35
Clinical manifestation of Brucellosis
- Clinical manifestations vary widely as brucellosis is a systemic disease which may involve many organ systems. - Most commonly described symptoms include: Relapsing fever, Chills, Night sweats, Headache, Body aches, Anorexia, and Malaise
36
Lab ID of Brucella spp.
- Gram negative coccobacillus - Slow growth - Oxidase, catalase, urease positive - Primarily diagnosed by serology
37
Tularemia
- Caused by Francisella tularencis - Humans usually acquire infection by direct contact with infected animals or by infected ticks - Ulceroglandular (70%) and disseminated forms (typhoidal and pneumonic) - High mortality rates if untreated (30-60% for severe forms of disease)
38
Lab ID of Francisella tularencis
- Faintly staining Gram negative coccobacillus - Oxidase negative - Catalase weak positive - B-lactamase positive - Often diagnosed by serology
39
Meliodosis
- Caused by Burkholderia pseudomallei - Acute (1-21 days from inoculation) and chronic (up to 60 years!) forms - Causes a number of different types of infections - Transmitted via inhalation or direct inoculation from soil
40
Lab ID of B. pseudomallei
- Gram negative rod, safety pin appearance - Grows well on all routine agar types - Oxidase positive - 24h growth-creamy white becoming wrinkled at 48h
41
Plague
- Caused by Yersinia pestis - Endemic in Western US; rodents including squirrels & prairie dogs - Transmitted to humans by animals and their infected fleas
42
3 Types of Plauge
1. Bubonic Plague (80-90% of cases) - High fever, painful swelling of lymph nodes (buboes) - Usually fatal if untreated 2. Pneumonic Plague - Fever, swelling of lymph nodes - Malaise, pulmonary signs - Airborne or spread from bubonic plague - Rapidly fatal and most deadly 3. Septicemic Plague - Similar to bubonic, but no lymph node swelling
43
Lab ID of Yersinia pestis
- Plump Gram negative rods - Slow growing, but grows on all routine media - Catalase positive - Oxidase and urease negative
MMI 445
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