Epidemiology - Final 3

drraythe's version from 2016-02-15 12:05

Biological Disasters

Question Answer
What are the 3 kinds of biological disasters?(1) Naturally occurring
(2) Accidental
(3) Intentional in origin (bioterrorism & agroterrorism)
Of naturally occurring biological disasters, what are the 2 subgroups of this?Non-emerging & emerging
Explain emerging vs non-emerging biological disasters (2 types of naturally occurring BDs)(1) Non-emerging: Plague is endemic in parts of the US
(2) Emerging: Incidence has either ↑ in the past 2 decades or threatened to ↑ in the near future (pandemic H1N1)
What are some of the consequences of naturally occurring dzs?(1) Economic devastation
(2) Psychological impact
(3) Improved preparedness
What’s an example of an Accidental disaster?E. coli contamination of beef products over the last 10 years
What are the 3 consequences of accidental disasters?(1) Economic devastation
(2) Psychological impact
(3) Improved preparedness (same as the naturally occurring ones)
What’s more likely? The naturally occurring, accidental, or intentional biological disasters?Accidentally & natural are WAY MORE COMMON
What is AGROTERRORISM?The intent is to indirectly attack persons by destruction of the plant & animal infrastructure
What is Bioterrorism?The intent is to threaten people directly w/ biological organisms
What are some clues which would indicate that the biological disaster might have been intentional?(1) Clustering of dz (temporally or geographically, in healthy animals or people)
(2) Dz occurring outside of normal season
(3) Dz occurs in a different spp to the expected
(4) Dissemination may cover large area very quickly (airborne)
(5) Acute morbidity/mortality depending on the agent
Effectiveness of Agents/Attack of an intentional biological disaster is dependent upon...(list some stuff)Category of Agent used & mechanisms of action
Dose reqd for infxn: [morbidity vs mortality] → cz economic/psychological/physical devastation, Inexpensive, easy to obtain & produce
Biological characteristics → environmental stability, Tx availability, target chosen, method of dispersal
Quality of emergency response plans
What’s the CDC definition of a bioterrorism attack?A bioterrorism attack is the deliberate release of viruses, bacteria, or other (agents) used to cz illness or death in people, animals, or plants
The list of the select agents were determined based on what 5 criteria?(1) The public health impact
(2) The delivery potential to large populations
(3) Potential for person-person xmission
(4) The public perception as related to public fear
(5) The special public health preparedness needs
Explain category A, B & CCategory A is the HIGHEST priority
B is the 2nd highest
C is the 3rd highest
The A list Inclds high-priority agents that pose a risk to national security bc they can:Be easily disseminated/xmitted person-person
Hav high mortality rates → major public health impact
Cz public panic
Need special action for preparedness
What are Category A agents? Point out the 2 most virulent formsThe most virulent forms incld Inhalational Anthrax & Pneumonic Plague [aerosol]

(Ann & Ebony Bought a Small Place, Tula likes it)
Describe what makes something a Category B list & give 5 examplesThey are moderately easy to disseminate, have moderate morbidity but low mortality & req. enhanced diagnostic capacity & surveillance.
The 5 category Bs she mentioned were Brucella spp, Coxiella burnetii, Salmonella, E. coli 0157, Shigella

(Bruce & Sal Eat Cox at Shiggy's)
Describe what makes something a Category C list & 2 examplesThere are Emerging pathogens that could be engineered for future mass dissemination bc of:
Ease of production & dissemination
Potential for high morbidity/mortality
Major public health impact

(Nipah was Hantaed)
What route of entry is of the greatest concern out of the bioterror agents?Aerosol: Inhalation into the lungs = route of greatest concern, since all Category A agents can be effectively disseminated via aerosol [anthrax 2001]
(Primary) Pneumonic Plague - What is super important to know about this?Most likely form to be used as a bioterror agent! Pneumonic form czs high mortality & is rapidly spread via aerosol xmission. W/o Tx, it's 100% fatal. Develops as a result of inhaling infectious droplets from an infected cat or human
What is the vet's role in public health matters?They are to educate owners & educate high risk groups. Notify state public health & animal health officials; Federal → human cases. IT IS NOT THE VETS ROLE TO TREAT HUMANS, ONLY TO ADVISE them to seek help from their MD
What does CDC stand for? What is their focus?Centers for Dz Control & Prevention. Focus: Protecting human health
What is Agroterrorism?The malicious use of plant or animal pathogens to cz dz in the agricultural sector – plants or animals OR The deliberate introduction of an animal or plant dz w/ the goal of generating fear over the safety of food, causing economic loss and/ or undermining social stability
What is "Tier 1" ?Tier 1 added to both HHS & USDA-APHIS select agents, a category that presents the greatest risk of deliberate misuse w/ the greatest potential for mass casualties/devastation to the economy, infrastructure or public confidence.
****Examples of APHIS – SPECIFIC Select agents: more likely to be used as agroterrorism agent (5)FMD (highest priority)
Classical swine fever
Newcastle dz
Vesicular Stomatitis
Highly Pathogenic Avian Influenza
(In addition, other agents categorized on the CDC (A-C) used to infect animals)
Why might a terrorist pick agroterrorism?Not the animal/crops but the people who rely on them for food & jobs thus Agroterrorism = Economic Terrorism. Attacks on plants or animals less emotionally sensitive than attacks on humans. Often delay in recognition, making “get away” easier, Agriculture is a sleeping target, not yet fully recognized for its vulnerability/not yet fully protected.
Why is agroterrorism so difficult to deal w/?Multiple points of entry
Multiple possible delivery methods
Natural (Accidental) vs intentional
Real vs hoax
In Agroterrorism, explain direct vs indirect modes of xmissionDirect Xmission: Essentially, immediate transfer of infectious agents (Eg. Introduction of animals carrying FMD [aerosol])
Indirect Xmission: Vehicle-borne-fomites, clothing... (FMD), Vector-borne-unreliable (insects)
What is the vet's role when it comes to agroterrorism?Be observant - Animals as sentinels of dz! Quick Dx, quarantine, depopulation of animals
Ongoing Surveillance - Track baseline dz prevalence & incidence
Encourage biosecurity on the farm & you, the vet, Report to proper authorities in a timely manner & Encourage teamwork to deal w/ existing disasters
What is the HHS?Department of Health & Human Services
What is the USDA-APHIS?US Department of Agriculture - Animal & Plant Health Inspection Service
What is the FDA?Food & drug administration
What is the EPA?Environmental Protection Agency
What is the role of USDA-APHIS?The lead federal agency in safeguarding American livestock & poultry health & in responding to a foreign animal, emerging or reemerging dz is the: U.S. Department of Agriculture's (USDA) Animal & Plant Health Inspection Service (APHIS) - Veterinary Services Division. There is also an Emergency programs division & National Vet. Labs


Question Answer
Bacillus anthracisA, Anthrax
Clostridium botulinum (toxin)A, Botulism
Yersinia pestisA, The plague
Variola majorA, Smallpox
Francisella tularensisA, Tularemia
Filoviruses & ArenavirusesA, Viral Hemorrhagic Fever, (Ebola & Lyssa Viruses)
Brucella sppB, Brucellosis
Burkholderia malleiB, Glanders
Burkholderia pseudomalleiB, Melioidosis
Chlamydophila psittaciB, Psittacosis
Coxiella burnettiB, Q-Fever
Rickettsia prowazekiiB, Epidemic Typus Fever
AlphavirusesB, Encephalitis (Western, Eastern & Venezuelan Equine Encephalitis Viruses)
Toxins (Ricin & Staphylococcal enterotoxin B)B, Toxic syndromes
Food safety threats (list some)B, Salmonella & E. coli (0157:H7)
Water safety threats (list some)B, Cryptosporidium & Vibrio cholerae
Nipha virusC (Emerging threat)
HantavirusC (Emerging threat)