Bioterrorism and Infectious Agents (eBook)

A New Dilemma for the 21st Century

Kenneth Alibek, I.W. Fong (Herausgeber)

eBook Download: PDF

2010 | 2009
XVI, 273 Seiten
Springer New York (Verlag)
978-1-4419-1266-4 (ISBN)

Infos

Compiled by two leading experts in the field, this volume provides a concise, timely, and authoritative review of some of the most problematic infections of the new century. It presents issues and new ideas for preventing and controlling infectious diseases.

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Since the terrorist attack on the United States on September 11, 2001 and subsequent cases of anthrax in Florida and New York City, attention has been focused on the threat of b- logical warfare and bioterrorism. Biological warfare agents are de?ned as "e;living org- isms, whatever their nature, or infected material derived from them, which are used for h- tile purposes and intended to cause disease or death in man, animals and plants, and depend for their efforts on the ability to multiply in person, animal or plant attacked."e; Biological warfare agents may be well suited for bioterrorism to create havoc and terror in a civilian population, because they are cheap and easy to obtain and dispense. Infectious or contagious diseases have played a major part in the history of warfare - deliberately or inadvertently - in restricting or assisting invading armies over the centuries. In 1346, the Tartars catapulted plaque-infected bodies into Kaffa in the Crimea to end a 3-year siege. Blankets contaminated with smallpox to infect North American Indians were used by British forces in the 18th century. More recently, the Japanese released ?eas infected with plaque in Chinese cities in the 1930s and 1940s. Biological research programs for both offensive and defensive strategies have been developed by the United States, Britain, the former Soviet Union, and Canada; several other nations are thought to have such programs.

Inhalt

Contributors 6
Preface 8
Contents 9
Chapter 1 17
Anthrax: A Disease and a Weapon 17
1. History of Anthrax 17
1.1. Anthrax in the United States 19
2. Anthrax as a bioogical weapon 20
3. The organism 24
4. Pathogenesis of Anthrax infection 26
5. Clinical manifestation of Anthrax infection 29
5.1. Cutaneous Anthrax 30
5.2. Systemic Anthrax 30
5.2.1. General Symptoms of Anthrax Infection 31
5.2.2. Respiratory Symptoms and Findings 33
5.2.3. Neurological Symptoms and Signs 34
5.2.4. Cardiovascular Symptoms and Signs 35
5.2.5. Gastrointestinal Symptoms and Signs 35
5.2.6. Miscellaneous 36
5.2.7. Findings – Autopsies 37
6. Conssiderations on clinical manifestations of system Anthrax 39
7. Laboratory diagnosis 40
8. Vaccination 40
9. Postexposure prophylaxis 41
10. Treatment of Anthrax infection 41
11. Protection 44
12. Isolation 45
13. Afterward 45
Acknowledgments 45
References 45
Chapter 2 52
Plague as a Biological Weapon 52
1. History of Plague and Its Potential as A Weapon of Bioterrorism 52
1.1. Pandemic History and Epidemic Potential 52
1.2. Plague as a Weapon of Biological Warfare 53
1.3. US Countermeasures to Plague as a Weapon of Terrorism 54
1.4. Preparedness and Response to a Possible Plague Attack 55
2. Plague Microbiology and Pathogenesis 56
2.1. The Agent 56
2.1.1. General Characteristics 56
2.1.2. Molecular Genetics 57
2.2. Pathogenicity of Y. pestis 57
2.2.1. Virulence Factors 57
2.2.2. Pathology of Infection 58
3. Clinical spectrum 59
3.1. Bubonic Plague 59
3.2. Septicemic Plague 61
3.3. Pneumonic Plague 63
3.4. Other Clinical Syndromes 65
3.5. Pediatric Plague 65
3.6. Plague in Pregnancy 66
4. Diagnosis 66
4.1. Laboratory Diagnosis 66
4.1.1. Laboratory Response Capabilities 66
4.1.2. Collection and Processing of Specimens 67
4.2. Recognizing a Plague Outbreak Resulting from Intentional Release 68
4.3. Detection of Y. pestis in the Environment 68
5. Medical Management of Plague patients 70
5.1. Antimicrobial Treatment of Acute Illness in Naturally Occurring Plague 70
5.2. Postexposure Prophylaxis 72
5.3. Treatment of Cases and Case Contacts in a Bioterrorism Event 73
6. Infection control 75
6.1. Hospital Infection Control 75
6.2. The Role of Isolation and Quarantine 76
7. Prevention 77
7.1. Prevention and Control of Naturally Occurring Plague 77
7.1.1. General Guidelines 77
7.2. Plague Vaccine 78
8. Research directions 78
References 79
Chapter 3 86
Tularemia and Bioterrorism 86
1.Introduction 86
2. Microbilogy 87
2.1. Taxonomy 87
2.2. Virulence 88
3. Pathogenesis 89
3.1. Pathophysiology 89
3.2. Host Immunity 90
3.2.1. Humoral Immunity 90
3.2.2. Cellular Immunity 91
3.2.2.a. Early responses. 91
3.2.2.b. Cell-mediated immunity. 91
3.2.3. Immune Responses in the Lungs 92
4. Epidemiology 93
5. Clinical manifestation 95
5.1. Nonpneumonic Tularemia 95
5.2. Pneumonic Tularemia 97
5.3. Spectrum of Disease following Intentional Release of F. tularensis 98
5.4. Complications 99
6. Diagnosis 99
7. Treatment 101
7.1. Treatment of Endemic Tularemia 101
7.2. Treatment of Tularemia Resulting from Bioterrorism 103
8. Intection control 104
9. Prevention 105
9.1. Antibiotic Prophylaxis 105
9.2. Vaccination 106
10. Future direction 107
References 107
Chapter 4 114
Melioidosis and Glanders as Possible Biological Weapons 114
1. Introduction 114
2. History, Distribution, and Epidemiology 114
2.1. Melioidosis 114
2.2. Glanders 116
3. Microbiology and Pathogenesis 116
3.1. Taxonomy 116
3.2. Characteristics 117
3.2.1. General 117
3.2.2. Antigenic Structure 117
3.3. Ecology and Environmental Survival 119
3.4. Antibiotic Susceptibility 119
3.5. Genomics 120
3.6. Typing Systems 121
3.7. Bacterial Virulence 121
3.7.1. Endotoxin and Lipids 121
3.7.2. Capsule 122
3.7.3. Flagella 122
3.7.4. Exotoxins and Enzymes 122
3.7.5. Secretion Systems 123
3.7.6. Siderophores 123
3.7.7. Adhesion 123
3.7.8. Intracellular Growth 124
3.8. Host Defense 125
3.8.1. Humoral Immunity 126
3.8.2. Intrinsic and Cellular Immunity 126
3.8.3. Immunopathogenesis 127
4. Clinical spectrum 127
4.1. Melioidosis 127
4.1.1. Mild and Subclinical Infections 128
4.1.2. Latent Infections 128
4.1.3. Clinical Disease 128
4.2. Glanders 130
5. Animal models 131
5.1. Melioidosis 131
5.2. Glanders 132
6. Potential as a Biological weapon 132
6.1. Glanders 132
6.2. Melioidosis 133
7. Diagnosis and Treatment 134
7.1. Clinical Diagnosis 134
7.2. Laboratory Diagnosis 135
7.2.1. Microscopy and Culture 135
7.2.2. Serological Methods 137
7.2.3. Molecular Diagnosis 138
7.3. Treatment 139
7.3.1. General 139
7.3.2. Specific Chemotherapy 139
7.3.3. Adjunctive Treatments 141
7.3.4. Outcome and Follow-up 141
8. Infection control measssures 141
8.1. Secondary Spread and Isolation 141
8.2. Environmental Contamination 142
8.3. Antibiotic Prophylaxis and Vaccines 142
9. Future direction 143
References 144
Chapter 5 161
Smallpox as a Weapon for Bioterrorism 161
1.Introduction 161
2. Virology 161
3. Pathology 162
4. Clinic disease 163
5. Diagnosis 165
6. Epidemiology 167
6.1. Surveillance and Containment Strategy 167
7. Patient management and infection control 168
8. Potential as a bioweapon 169
9. Prevention 172
9.1 Vaccination policy 173
10. Future direction 175
References 176
Chapter 6 182
Hemorrhagic Fever Viruses as Biological Weapons 182
1. Introduction 182
2. Epidemiology 186
2.1. Filoviridae: Ebola and Marburg viruses 188
2.2. Arenaviridae: Lassa, Junin, Machupo, Guanarito, and Sabia 190
2.3. Bunyaviridae: Rift Valley Fever and Crimean-Congo Hemorrhagic Fever 192
Patient Management 193
3.1. Clinical Recognition 193
3.2. Laboratory Diagnosis 193
3.3. Treatment 194
4. Vaccines 196
5. Public Helth Measures 197
5.1. Infection Control 197
5.2. Environmental Decontamination 198
6. Ongoing Research and Proposed Agenda 199
7. Conclisions 199
8. Acknowledgments 200
References 200
Chapter 7 205
Botulism as a Potential Agent of Bioterrorism 205
1. Introduction 205
2. History of Botulism 206
3. Botulinum Toxin as a Weapon 207
4. Diagnosis 210
5. Treatment 212
6. Management 213
References 214
Chapter 8 217
Ricin: A Possible, Noninfectious Biological Weapon 217
1. Introduction 217
2. History 217
2.1. The Story of a “Death Umbrella” 218
3. The Toxin 220
3.1. Toxicity 221
4. Ricin as a Potential Bloweapon 222
5. Clinical Presentation 223
5.1. Prognosis 224
5.2. Diagnosis 224
6. Treatment 224
7. Prevention and Vaccine 225
8. Medical Use of Ricin 226
9. Conclusion 226
Acknowledgments 226
References 227
Chapter 9 229
Bioterrorism Alert for Health Care Workers 229
1 Introduction 229
2. Step 1. Maintain a Healthy "Index of Suspicion" (Or,"How to Recognize Illness Due to Bilogical Weapons") 230
3. Setp2. Protect Thyself Frist 231
3.1. Physical Protection 232
3.2. Chemical Protection 232
3.3. Immunologic Protection (Including “Pros and Cons of Mass Vaccination”) 233
4. Step 3. Save the Patient's Life ("The Primary Assessment") 236
5. Step 4. Disinfect or Decontaminate as appropriate 236
6. Step 5. Establish a Diagnosis ("The secondary assessment") 238
7. Step 6. Provide Prompt Therapy 238
8. Step 7. Institute Proper Infection Control Measures 240
9. Step 8. Alert the Proper Authorities ("Which Agency should One Notify for Suspicious Cases?") 241
10. Step 9. Conduct an Epidemiologic Investigation (and Manage the Medical and Psychological Aftermath of Bioterror Attack) 244
11. Step 10. Maintain a Level of Proficiency 245
Acknowledgments 246
References 246
Chapter 10 249
The Economics of Planning and Preparingfor Bioterrorism 249
1. Introduction 249
2. How Many Resources?: Basic Concept 249
3. Refining the Basic Concept:Being More Realistic 250
3.1. Cost of Deploying a Planned Intervention 251
3.2. A Special Case: Optimal Amount for Pre-event Protective Interventions 251
3.3. Example 1: Annual “Premiums” for Pandemic Influenza Preparations 253
3.4. Example 2: Annual “Premiums” to Reduce Probabilityof Losses Due to Anthrax Attack 254
4. Categories of Interventions 256
4.1. Postevent Medical Interventions (Reaction Interventions) 258
4.2. Pre-event Medical Interventions (Reaction Interventions) 258
4.3. Pre-event Protective Interventions: Reducing the Probability of Attack 259
4.4. Calculating the Savings in Post-event Interventions Due to Pre-event Interventions 259
5. Selecting Interventions for Evalution for Funding 260
6. Calculating the Number of Casualties and Casualties Averted 261
6.1. Types of Mathematical Models 261
6.1.1. Increasing Complexity 262
6.1.2. Deterministic Mathematical Models 262
6.1.3. Stochastic Models 263
6.2. Model Limitations 263
6.2.1. Size of Attack 263
6.2.2. Numbers Initially Infected and Implicit Assumptions 264
6.2.3. Why Not Use “Worst Case?” 264
6.3. Realistic Expectations and Keeping It Simple 265
6.3.1. Sensitivity Analyses and Policy Levers 265
7. Calculating the Value of Casualties and Other Losses Averted 266
8. Probability of anEvent Occurring 267
9. Selecting Between the Options 268
10. Summary 268
References 269
Index 270

Produkt-Details

• Erscheint lt. Verlag: 18.3.2010
• Reihe/Serie: Emerging Infectious Diseases of the 21st Century
• Reihe/Serie: Emerging Infectious Diseases of the 21st Century
• Zusatzinfo: XVI, 273 p.
• Verlagsort: New York
• Sprache: englisch
• Themenwelt: Medizin / Pharmazie ► Gesundheitswesen
• Themenwelt: Medizin / Pharmazie ► Medizinische Fachgebiete
• Themenwelt: Studium ► 1. Studienabschnitt (Vorklinik) ► Biochemie / Molekularbiologie
• Themenwelt: Studium ► Querschnittsbereiche ► Epidemiologie / Med. Biometrie
• Themenwelt: Studium ► Querschnittsbereiche ► Infektiologie / Immunologie
• Themenwelt: Studium ► Querschnittsbereiche ► Prävention / Gesundheitsförderung
• Themenwelt: Naturwissenschaften ► Biologie ► Mikrobiologie / Immunologie
• Themenwelt: Sozialwissenschaften ► Politik / Verwaltung
• Themenwelt: Technik
• Schlagworte: bioterrorism • Controlling • emerging infectious • Healthcare • Infection • Infection control • Infections • Infectious • infectious disease • Infectious Diseases • IRA • terrorism • Vaccine
• ISBN-10: 1-4419-1266-5 / 1441912665
• ISBN-13: 978-1-4419-1266-4 / 9781441912664