Anthrax is a potentially fatal disease. Anthrax can be acquired through the inhalation, ingestion, or by contact with skin.1 The effect of exposure varies by type of initial infection. Inhalation can lead to flu symptoms, while ingestion can lead nausea from a gastrointestinal response, and finally blisters if skin was exposed to anthrax.2 Anthrax has been used in war and by terrorists. The first account of anthrax dates back to the Roman Empire.3
In the past there have been numerous attacks and threats of anthrax use against the public, and political or military personnel. Some of the largest and most recognized attacks include the American textile incident of the 1990’s; the Soviet outbreak at a military microbiology facility (the largest to date); the terrorist attacks in the United States by mail during the months of October to November, 2001.4
Developmental Milestones/Developments to Date:
Major developments with regard to anthrax include vaccinations for human immunization, and antibiotic medication after infection.5 Studies were published describing the possibility of birth defects in newborns of women injected during their pregnancy.6 These studies show little statistical evidence or substantial support of the claim; only when alternative referent groups were used was there a relationship including the women vaccinated in the first trimester.7 The vaccination is widely used in the United States military for all deporting soldiers in high risk situations.
Current Assessment/State of the Field:
Anthrax is currently considered a public health threat by means of bioterrorism and on the CDC scale from A to C is considered A, the highest for a bioterrorism risk.8 The nature of this substance allows for easy and unnoticeable transmission in a public space. Anthrax is a constant agent being utilized in hoax threats (non lethal, white powdered substances) and attacks on predominant individuals often by specifically addressed mail.9
A major challenge concerning anthrax is the development of a vaccine to be readily available for public consumption in case of emergency.10 Vaccinations are also a challenge by distribution of the vaccine much like the challenges faced with the Swine Flu vaccine of 2009. Delayed development, expected necessary vaccines, distribution to most vulnerable individuals, and timely response are among those problems and challenges.6
Another challenge concerns use of anthrax by terrorists in powder form–the best way to infect a lage population. The amount needed to infect a large population is small and easily portable, but for the time being there remains challenges in spreading the spores over a wide area. Regardless, high density locations need to be prepared for an attack. An aersolized anthrax attack would present with unique problems since symptoms would present well after initial exposure.11 Attempts to implement early detection devices are incomplete.12*( See below for works cited)
See Biosurveillance for detection advancements on anthrax and related proposals.
Henderson, D., A., “Bioterrorism as a Public Health Threat,” Emerging Infectious Diseases, vol. 4, No. 3, July-Sept 1998.
- Admonition & historical accounts.
Benjamin, Georges C. “Chemical and Biological Terrorism: Planning for the Worst” Physician Executive Volume 26 Issue 1. 80. January/February 2000.
- Chemical or biological terrorism is the use of pathogenic microbes or toxins derived from plants, animals, microbes, or chemical agents to achieve terror.” – page 80
- ”Chemical and biological weapons, like nuclear weapons, are categorized as weapons of mass destruction (WMD) because of the high number of potential victims that can result from their use.” – page 80 *
- ”While any chemical can be weaponized, the chemical agents traditionally of concern fall into four categories: nerve agents like sarin, which create an anticholinergic-like syndrome; vesicants like mustard gas, that cause a blistering or burn-like syndrome; cyanide, which interrupts aerobic metabolism; and riot control agents such as mace, which generally cause incapacitation.” – page 80
- ”Biological agents act like chemical agents but have a slower onset of action. Agents of concern include Ricin.” – page 81
- ”The ideal bioweapon is hard to detect from the usual microbial flora, has person-to-person spread, and is easy to aerosolize. There are two groups of organisms of public health concern: those that cause a high morbidity or a high mortality.” – page 81
- ”Examples of high morbidity organisms include salmonella, cholera, or E. coli. The number of highly toxic organisms is fortunately quite low and includes anthrax, smallpox, and the viruses that cause hemorrhagic fevers, plague, brucellosis, and tularemia.” – page 81
- “Clues that biological terrorist events have occurred include an unexplained increase in respiratory cases or deaths, or dead and dying animals. Epidemiological clues include diseases with the wrong mode of transmission, which occur in an inappropriate geographic distribution or infect a new or novel population.” – page 81
- “Components of a biological/chemical terrorism disaster plan: plan how to identify the threat; develop an effective public health disease surveillance system; link the public health system and the traditional medical care delivery system; develop command and control systems; determine hospital bed availability; define disease containment, isolation, and quarantine procedures; plan how to obtain extra life support equipment such as respirators; plan how to train clinical staff to identify high-risk unusual diseases; ensure non-clinical staff are trained on the management of suspicious packages and mail; identify experts; plan simple handling and transport; plan how to communicate high risk information; manage medical examiner cases; and maintain a crime scene.” – page 81
- ”Effective disease control strategies such as case finding, decontamination, prophylaxis and vaccination, and quarantine must be defined.” – page 82
Chemical, WMD, Bioterrorism, Public Health, Military, Sarin, Japan, Ricin, E. coli, Cholera, Salmonella, Anthrax, Smallpox, Hemorrhagic fever, Plague, Brucellosis, Tularemia, Prophylaxis, Vaccination, Quarantine
Vergano, Dan, “Bioterrorism defense under fire Doctors say military plans are wrong approach”. USA TODAY. June 21, 2000.
- “At a recent briefing sponsored by the American Medical Association, infectious-disease specialists argued that military planners have botched the nation’s bioterrorism defenses and ignored the doctors who would form the leading lines of defense against terrorists wielding diseases to kill.”
- “”It’s not the military who will respond to a biological event, but biologists,” says AMA briefing speaker Michael Osterholm of the Minneapolis-based Infection Control Advisory Network, an infectious-disease consulting firm. A former state health official, he warns “it’s just a matter of time” before a bioterrorist attack occurs. He estimates an anthrax attack could cause 3 million deaths.”
- “Osterholm criticizes the federal government’s allocation of funds as already too military-oriented, with about $ 121 million sent to the Centers for Disease Control and Prevention to combat bioterrorism, out of about $ 10 billion in the 1999 federal counterterrorism budget”
- “Biological weapons pose a unique public threat. Unlike explosives or gunfire, microbes overwhelm people slowly, spreading through the populace with symptoms that can mimic more benign maladies, like the flu.”
- “Lab analysis, vaccines and drugs, “disease detectives,” and quarantine are all tools that can be directed toward a biological disaster by the CDC director without the involvement of any other federal agency, Lillibridge says. ‘We anticipate the rest of the government catching up with us.’”
- “Instead of funding military bioterrorism response teams, he says, the government should bulk up disease surveillance efforts staffed by physicians”
- “Most bioterrorism planning revolves around worst-case scenarios,” says terrorism expert Bruce Hoffman, who heads the Washington, D.C., office of RAND, a military and public policy think tank. Terrorists desire terror, he suggests, a goal achieved far more easily and cheaply with a gun or a bomb than with microbes.”
Schwartz, Morton, N., “Recognition and Management of Anthrax — An Update,” NEJM, v. 345, No. 22, P. 1621, Nov. 29, 2001.
“Review Article, Bactereriology, Pathogenesis, epidemiology, clinical features, treatment.”
Fauci, Anthony, S., NEJM, Editorial, “Smallpox Vaccination Policy—The Need for Dialogue,” Vol. 346, No.17, pg. 1319.
Powers, Michael and Ban, Jonathan, “Bioterrorism: Threat and Preparedness“, National Academy of Engineering. Spring 2002 http://www.nae.edu/Publications/Bridge/EngineeringandHomelandSecurity/BioterrorismThreatandPreparedness.aspx
- Therefore, rather than planning for a narrow range of least-likely, high-consequence contingencies or focusing only on additional mailborne anthrax attacks, we must plan for a variety of future incidents–including incidents that cause mass casualties and mass disruption.”
- “The incidents aroused significant fear and disruptions but not mass casualties. Based on these attacks, some analysts have suggested that terrorists would not be able to orchestrate mass-casualty attacks using biological weapons. Others have considered these attacks as demonstrations of terrorists’ ability to acquire high-quality anthrax”
- “Rather than focusing on vulnerability to a particular organism or looking to history to determine what is to come, policy makers and scientists must recognize that the bioterrorist threat is not uni-dimensional. We must consider four key elements of the threat: the who (the actor), the what (the agent), the where (the target), and the how (the mode of attack).”
- “We do not know how “massive” an attack would have to be to overwhelm the response system, instill fear and panic, or cause serious political or economic fallout.”
“Every dollar spent preparing for a specific agent, such as building stocks of smallpox or anthrax vaccine or purchasing antidote for botulinum toxin, is a dollar that cannot be spent on preparedness for other organisms.
- Given the variety of combinations among actors, agents, targets, and dissemination techniques, a public health system must be capable of rapidly and accurately detecting and assessing a large number of bioterrorism scenarios and addressing most contingencies.”
- “planning should be based on developing the capability of effectively and efficiently responding to a variety of bioterrorist contingencies”
- “We must strike a better balance between hedging our defenses against high-end, mass-casualty events and building a “system of systems” capable of addressing both a wider range of bioterrorist contingencies and natural outbreaks of infectious disease.”
- “In addition, accurate and timely information will be the backbone of the decision making process in times of crisis and will provide credible and consistent information to the general public to reduce panic.”
- “A national surveillance system to provide an early warning of unusual outbreaks of disease, both natural and intentional, will be a critical component of our preparedness. This system will depend on an information infrastructure that includes electronic data networks connecting local public health departments and area health care providers and providing regular analyses of the data for the presence of unusual trends that could indicate a bioterrorist attack”
Hodge, James, “Bioterrorism Law and Policy: Critical Choices in Public Health” Journal of Law, Medicine & Ethics, 2002.
- “However, in many states, existing legal standards for response are absent, antiquated, or insufficient. Prior to September 11, many state health departments did not address bioterrorism in their emergency response plans.’^ Recently, public health lawyers and scholars at the Center for Law and the Public’s Health at Georgetown and Johns Hopkins Universities were asked by the Centers for Disease Control and Prevention and a series of national partners (i.e., the National Governors Association, the National Conference of State Legislatures, the Association of State and Territorial Health Officials, the National Association of City and County Health Officers, the National Association of Attorneys General, and the Turning Point Public Health Statute Modernization National Collaborative) to develop a model act for states to respond to public health emergencies.” (Pg. 1-2)
- “…gives state and local public health authorities a modern series of powers to track, prevent, and disease threats resulting from bioterrorism or other public health emergencies. These powers include measures (e.g., isolation, quarantine, treatment, and vaccination requirements) that may temporarily compromise individual civil liberties (e.g., rights to due process, speech, assembly, travel, and privacy) to protect the public’s health. To date, thirty-two states have introduced legislative bills based on the Model Act.” (Pg. 2)
- “Bioterrorists may infect individuals through multiple routes: (1) intentional spread of contagious diseases through individual contact; (2) airborne dissemination of some infectious agents; or (3) contamination of water, food, controlled substances, or other widely distributed products. The equipment needed to manufacture biological weapons is easy to obtain and conceal.” (Pg. 3)
- “The Model Act broadly defines a “public health emergency” as: an occurrence or imminent threat of an illness or health condition that: (1) is believed to be caused by bioterrorism or the appearance of a novel or previously controlled or eradicated infectious agent or biological toxin; and (2) poses a high probability of any of the following harms: (a) a large number of deaths in the affected population; (b) a large number of incidents of serious permanent or long term disability in the affected population; or (c) widespread exposure to an infectious or toxic agent that poses a significant risk of substantial future harm to a large number of people in the affected population.” (Pg. 3-4)
- “First, the federal government has greater financial resources at its disposal to respond to a bioterrorism threat. Second, it may be in a better position to negotiate the price of needed vaccines, drugs, or supplies, or to suspend the patent rights of high-demand medications. These techniques were recently used by President George Bush and DHHS in negotiations with the German drug company Bayer, concerning the sale of Cipro, the antibiotic used to treat anthrax. Third, most significant bioterrorism threats will exceed the boundaries of any single state, thus requiring a national, coordinated response.” (Pg. 5)
Glass, Thomas A. and Monica Schoch-Spana, “Bioterrorism and the People: How To Vaccinate a City against Panic,” Clinical Infectious Diseases, 34:217-23 (Jan 15, 2002)
- [Glass and Schoch-Spana propose a five point model for community participation in response bioterror attacks, especially epidemics]: 1. “treat the public as a capable ally,” 2. “enlist civic organizations,” 3. “anticipate the need for home-based patient care and infection control,” 4. “invest in public outreach and communication strategies,” and 5. “ensure that planning reflects the values and priorities of affected populations.”
- The public has generally been discounted as an effective means of defense against bioterrorism; this attitude is not based on experience, as the authors claims “natural and technological disasters and disease outbreaks indicate a pattern of generally effective and adaptive collective actions.”
- “Collective behavior changes over time and in relation to external events. This suggests that, in times of disaster, panic may be ‘iatrogenic’: that is, the actions of emergency managers may determine the extent and duration of he panic, to the extent that it exists.”
Inglesby, Thomas, V., et. al., “Anthrax as a Biological Weapon, 2002: Updated Recommendations for Management,” JAMA, May 1, 2002. vol. 287, No. 17, p. 2236.
Shapiro, Daniel, S., & Schwartz, Donald, R., “Exposure of laboratory workers to Francisella tularensis despite a bioterrorism procedure,” J. of Clinical Microbiology, June 2002, pp. 2278-2281. PubMed http://www.ncbi.nlm.nih.gov/pubmed/12037110 last checked 12/16/15
- ”A rapidly fatal case of pulmonary tularemia in a 43-year-old man who was transferred to a tertiary care facility is presented. The microbiology laboratory and autopsy services were not notified of the clinical suspicion of tularemia by the service caring for the patient. Despite having a laboratory bioterrorism procedure in place and adhering to established laboratory protocol, 12 microbiology laboratory employees were exposed to Francisella tularensis and the identification of the organism was delayed due to lack of notification of the laboratory of the clinical suspicion of tularemia. A total of 11 microbiology employees and two persons involved in performing the patient’s autopsy received prophylactic doxycycline due to concerns of transmission. None of them developed signs or symptoms of tularemia. One microbiology laboratory employee was pregnant and declined prophylactic antibiotics. As a result of this event, the microbiology laboratory has incorporated flow charts directly into the bench procedures for several highly infectious agents that may be agents of bioterrorism. This should permit more rapid recognition of an isolate for referral to a Level B laboratory for definitive identification and should improve laboratory safety.” P. 2278.
- ”Despite the presence in the clinical microbiology laboratory of a written procedure for working with agents of bioterrorism, including F. tularensis, the identification of F. tularensis isolated from a fatal case of pulmonary tularemia was delayed, resulting in the manipulation of the organism at the bench by laboratory workers, many of whom subsequently began taking prophylactic antibiotics.” 2278
- ”Although tularemia is rare, with approximately 200 cases annually in the United States, in Pike’s study of 3,921 cases of laboratory-associated infections, it ranked second in the United States as a cause of laboratory-associated infections, behind only brucellosis, and third worldwide, behind brucellosis and typhoid (15).” P. 2278
- ”Although the medical service caring for this patient was concerned enough about the possibility of tularemia to give him intramuscular streptomycin, the microbiology laboratory and the autopsy service were not informed of this clinical suspicion. As a result, there was both a delay in sending the clinical isolate for definitive identification and an increased risk to the microbiology staff. Although a specific bioterrorism procedure was in place in the microbiology laboratory, it was separate from, and had not been sufficiently integrated into, the specific bench procedures for the workup of blood, respiratory, and sterile body fluid cultures. As a result, technologists working with the isolate on these benches did not suspect F. tularensis. It has been the standard procedure in our microbiology laboratory to subculture all positive blood cultures within a biological safety cabinet. This procedure, which involves a broth culture, is one that can potentially result in the production of an infectious aerosol.” P. 2280
- ”The clinical microbiology laboratory at Boston Medical Center is currently designated a Level A laboratory. This classification means that the laboratory should not attempt the identification of potential bioterrorism agents such as F. tularensis, but it does require the ability to rapidly rule out such agents and to forward those isolates which cannot be ruled out to a Level B laboratory (12, 13).” P. 2280
- ”The misidentification or preliminary identification of F. tularensis as a Haemophilus species has been noted in a number of published reports (2, 11, 18). F. tularensis is characteristically isolated as small, poorly staining gram-negative rods seen mostly as single cells which yield mostly pinpoint colonies on chocolate agar and often on sheep agar at 48 h, do not grow on either MacConkey or eosin-methylene blue agar, are oxidase negative, and have a weakly positive or a negative catalase test.” P. 2280
- ”Although Yersinia pestis and Bacillus anthracis, two agents that have been classified as a Category A critical biological agents, have only rarely been reported to cause laboratory infections, we have incorporated flow charts for the identification of these organisms into our procedures in order to prevent a delay in their identification. In the clinical virology laboratory, we have incorporated a flow chart for those situations in which cytopathic effect is seen and which is consistently demonstrated upon passage but cannot be identified with our standard laboratory procedures.” P. 2280
- ”The role of performing autopsies in the possible detection of cases of bioterrorism is an important one (14). Under ideal circumstances, autopsies in cases of suspected bioterrorism should be performed in a specially designated morgue rather than in a routine hospital-based setting to minimize the risk of transmission of exotic agents, such as those causing viral hemorrhagic fevers.” P. 2281
Johnston, D, Broad, WJ, “Anthrax in Mail was Newly Made, Investigators Say,” New York Times, June 23, 2002, pg.1.
Sternbach, G., “The history of anthrax,” J Emerg Med. (4): 463-7. 2003 May, 24
- [A general history of the emergence and latest concerns about Anthrax.]
Weber, David, J. et al., “Efficacy of Selected Hand Hygiene Agents Used to Remove Bacillus atrophaeus (a Surrogate of bacillus anthracis) From contaminated hands.” JAMA, March 12, 2003, no 10, pg. 1274-1277.
- “handwashing with soap and water containing, 2% chlorhexidine gluconate, or chlorine containing towels reduced the amount of ”B atrophaeus” spore contamination, whereas use of waterless rub containing ethyl alcohol was not effective in removing spores.”
Davis, Jim, “The Looming Biological Warfare Storm” Air & Space Power Journal, Volume 17, Issue 1. 57. Spring 2003.
- ”Until very recently, the lack of focus on this subject (biological warfare) has resulted in a lack of appropriate funding and accountability.” – page 58
- ”Unless we focus appropriate dollars and develop a coherent national plant to prepare for and prevent such actions, the United States will likely suffer an enormous economic loss that could even lead to our demise as a superpower.” – page 58
- ”A belief in one or more of at least six false assumptions or myths helps explain why individuals, including senior civilian and military leaders, do not believe that a mass-casualty biological warfare (BW) attack will occur.” – page 58
- ”Myth one: there never really has been a significant BW attack” – page 58
- ”Even before the fall 2001 anthrax terrorism in the United States, incidents of BW and bioterrorism have occurred on multiple occasions.” – page 58
- ”Today, more countries have active biological warfare programs than at any other time in history, which increases the likelihood that BW will be used again in the future.” – page 58
- ”Myth two: The United States has never been attacked by a BW agent” – page 59
- ”Myth three” you have to be extremely intelligent, highly educated, and well-funded to grow, weaponized, and deploy a BW agent” – page 59
- ”Dr. Tara O’Toole, deputy director for the Center for Civilian Biodefense Studies at Johns Hopkins University, believes we have probably crossed over the threshold from ‘too difficult’ to accomplish to ‘doable by a determined individual or group’” – page 59
- “Much of the technical information is readily available on the internet, in libraries, and through mail order channels that provide ‘how-to’ manuals.” – page 59
- ”Myth four: biological warfare must be too difficult because it has failed when it has been tried” – page 59
- ”Myth five: there are moral restraints that have kept and will keep BW agents from being used” – page 60
- ”Morality can be marshaled as a reason both to limit BW use and to advocate mass killings – depending on the decision maker’s values and perspectives” – page 60
- ”Myth six: the long incubation period required for BW agents before onset of symptoms makes BW useless to users” – page 60
- ”There have already been multiple BW attacks, and to a savvy weaponeer, the incubation period can be used as an advantage rather than a disadvantage.” – page 60
- ”There are two primary motivations that might drive an adversary to attack the United States with a BW agent. The first motivation is to gradually ‘erode US influence’ as a world superpower. The second is categorized as ‘revenge or hate’” – page 61
- ”The author believes that there are three most likely BW scenarios the United States and its allies might face in the future: an agroterrorist event against the United States, a BW attack on United States and allied troops in the Middle East, and/or a bioterrorist attack against a large population center in the United States or an allied state.” – page 61
- ”Such myths continue to inhibit the adequate funding of US and allied biodefense” – page 66
Atlas, Ronald, “National Security and the Lab” Medical Laboratory Observer, Volume 35, Issue 9. 52. September 2003.
- ”The aftermath of anthrax attacks following the horrific 9/11 events increased fear that terrorists could acquire deadly pathogens from legitimate U.S. laboratories, which led to a series of laws and regulations directly impacting clinical microbiology laboratories.” – page 52
- ”Enhancement of clinical and public health laboratories is key to the nation’s biodefense capabilities, so the American Society for Microbiology (ASM) worked with the Centers for Disease Control and Prevention (CDC) to develop protocols for diagnostic laboratories to recognize and handle major biothreat agents.” – page 52
- ”Since clinical labs have been the sources of the agents used in prior acts of bioterrorism or biocrimes, (e.g., the 1989 use of salmonella by the Rajneesh cult in Dalles, OR), they must exercise appropriate oversight as to who is given access to any pathogen which can be misused to cause harm.” – page 52
- ”Clinical labs wishing to retain select agents as clinical specimens or reference standards must meet all of the registration requirements of the Biopreparedness Act, including imposing strict biosecurity procedures and obtaining Department of Justice clearance for all individuals with access to the select agents.” – page 52
- ”The CDC and USDA must maintain accurate tracking of the acquisition, transfer and possession of these select agents, and must establish safeguards and biosecurity procedures to be followed by institutions possessing select agents.” – page 52
- ”The FBI is responsible for conducting security risk assessments of individuals seeking access to listed agents and toxins, and individuals or entities seeking to register under the Act.” – page 52
- ”The Biopreparedness Act, a new regulatory burden, should have minimal impact. The greatest impact is likely to be on the labs in the western United States where plague, tularemia, and coccidioidomycoses occur.” – page 52
Editors, “The Thomas Butler Case: Some Unreported Information and Reasons for the Department of Justice’s Prosecution,” THE SUNSHINE PROJECT, October 28, 2003, http://www.sunshine-project.org/publications/pr/pr281003.html
- [Butler] “prompted a national bioterrorism scare”
- [worked in a] “large and secretive biodefense program supported by the US Army”
- “focus on US biodefense investigating anthrax letters in 2001, led to security concerns when vials went missing”
- “need to prevent sensitive research from the public eye”
- “a leak at a sensitive biodefense project isn’t just a potential health or terrorism threat. An accident could be an international liability.”
Editors, “Assesing The Threat of BW Terrorism” NTI. 2004. http://www.nti.org/h_learnmore/bwtutorial/chapter04_01.html
- “With the exception of the smallpox virus, most bioterrorism threat agents can be isolated from natural sources such as diseased animals, patients, or even contaminated soil in the case of anthrax spores. Nevertheless, more than 85 different strains (varieties) of anthrax bacteria have been identified in nature, and only a few of these strains are highly virulent, or capable of causing disease.”
- “Once terrorists acquired a “seed culture” of a virulent pathogen, they would need to cultivate the agent in laboratory glassware or a small stainless steel fermentation tank.”
- “The goal of weaponization is to convert the agent into a form in which it can be dispersed as an aerosol cloud of microscopic particles, ranging in size from one to five microns (thousandths of a millimeter). Only particles with these dimensions are small enough to lodge in the tiny air sacs of the victims’ lungs to cause infection.”
- “Anthrax spores can survive for decades in soil and for hours in an airborne aerosol. Furthermore, anthrax spores can survive environmental contaminants and potentially become re-aerosolized.”
Hobbes, John,“Communicating Health Information to an Alarmed Public Facing a Threat Such as a Bioterrorist Attack”. Journal of Health Communication. 2004.
- “The Internet revealed much potential for effective and interactive communication in a sensitive and complex situation such as a bioterrorist attack.” (Pg. 1)
- “Yet, ultimately, investigation revealed that only four letters containing anthrax had been distributed through the postal system (Broad, 2002), demonstrating the ease with which a relatively small-scale bioterrorist attack could disrupt a population.” (Pg. 2)
- Finally, poor communication between the various healthcare workers and researchers, namely, public health officials, physicians, and field workers (both at the federal and state levels) resulted in a much slower response to the emerging risks than would be desirable.” (Pg. 3)
- “A key advantage the Internet has over traditional media is that the Internet provides multiple branches of information, all accessible almost simultaneously, and which the user can easily maneuver between. During the anthrax threat, the Internet also allowed for innovative communication devices such as interactive tutorials on anthrax self-care” (Pg. 5)
- “In the two days after the terrorist attacks, one out of four Internet users went online in addition to monitoring television and radio reports” (Pg. 5)
- “This is especially salient given that during the height of the bioterrorist threat many people were likely afraid to travel away from home. In some cases, when a number of cities issued warnings of potential threat, people preferred to stay at home or close to home; one survey published on September 15 found that ‘‘about 9% of Americans say that in the first two days after the terror attacks they cancelled some travel Plans”” (Pg. 5)
- “An advantage of this mode of communication is that it allows for more targeted information to be quickly distributed to patients from a trusted medical practitioner. However, although there is a demand from patients for e-mail communication with doctors (Deering, 2001), physicians are somewhat hesitant to adopt this practice. Through agencies such as the CDC, the government could help medical professionals by e-mailing them key messages, links to approved sites, and indicators of emerging risks.” (Pg. 6)
- “Search engines play a key role in organizing information for the public during a bioterrorist attack. The Internet industry in cooperation with the government should develop transparent protocols for organizing key information during emergency situations so that credible and validated sites are called up first when people search for information.” (Pg. 7)
- “However, there is some evidence that health information on the Internet does affect people’s management and response to health risk. The Pew Internet & American Life Project has found that 61% of those who searched online for health information—or about 43 million Americans—said that the information they found on the web improved the way they take care of themselves” (Pg. 7)
- “Wider use of e-mail from medical practitioners to patients could provide significant benefits in getting targeted messages on risks and suggested behavioral changes to patients, building on assumed trust between patient and physician. Finally, greater use and integration of shared electronic medical records made possible through Internet technology will provide considerable benefit in tracking emerging risks.” (Pg. 8)
Kyriacou, Demetrios, “Clinical predictors of bioterrorism-related inhalational Anthrax“. Lancet 2004.
- “Unfortunately, clinical manifestations include a nonspecific prodrome of fever, cough, and chest discomfort that also characterizes other types of acute respiratory infections”
- “As a result, inhalational anthrax might not be recognized until the onset of respiratory distress and shock.”
- “The US Centers for Disease Control and Prevention (CDC) issued guidelines to differentiate between inhalational anthrax, community-acquired pneumonia, and influenza-like illness.”
- “For inhalational anthrax cases, clinical and pathological characteristics of the patients at the time of the assessment that resulted in the diagnosis of inhalational anthrax were abstracted from published accounts.”
- “The mortality rate was 94•4% for naturally occurring cases and 45•5% for bioterrorism-related cases.”
- “In particular, nausea, vomiting, pallor or cyanosis, diaphoresis, altered mental status, and raised haematocrit seemed to predict inhalational anthrax. The most accurate predictor was mediastinal widening or pleural effusion on chest radiograph. This finding was 100% sensitive (95% CI 84•6–100) for inhalational anthrax.”
Casadevall, Arturo, and Liise-anne Pirofski, “The Weapon Potential Of A Microbe,” TRENDS IN MICROBIOLOGY, Volume 12, No. 6, June 2004.
- “The weapon potential of a microbe is a function that includes such variables as its virulence, time to disease, and suceptibility of possible target populations.”
Santora, Marc, “City Opens a Secure Lab To Counter Bioterrorism,” 14 July 2004, New York Times http://query.nytimes.com/gst/fullpage.html?res=9807E4DA163AF937A25754C0A9629C8B63&scp=3&sq=bioterrorism&st=cse Last Checked 20 February 2011.
- “Opening of a $16 million high-security laboratory to help detect and deal with future threats.”
- “Today New York faces a different kind, a more dangerous kind, of biohazard: bioterrorism.”
- “The laboratory here, which is testing for bioterrorism, also greatly upgrades our ability to test rapidly, say, for tuberculosis.'”
- “In the new lab, more than 100 technicians and scientists will be able to work at one time if required.'”
- “…secure Level 3 section. Those areas, which hold dangerous pathogens, feature filtered air, sealed doors and negative air pressure, which prevent germs from leaking out.”
- “Since Sept. 11, 2001, universities, states and the federal government have greatly expanded their financing for Level 3 facilities, raising concern about ensuring the security of the pathogens being studied.”
Smith, Stephen, “Bioterror Research Spurs Ideas In Medicine,” Knight Ridder Tribune Business News, pg. 1, Jul 21, 2004.
- “Boston-area scientists are developing a sensor capable of sounding an early alarm about acts of bioterrorism, a paperback-sized device that would be integrated into ventilation systems to detect trace amounts of Anthrax, Ricin, and other potentially lethal toxins.”
- “In an illustration of scientific cross-pollination becoming more common in Boston and nationally, the same technology is about to be tested as a way to diagnose disease.”
- “Brigham and Women’s Hospital plans to begin a study this summer of whether the sensor can pinpoint when patients are suffering from diabetes, a heart attack, a lung infection, or some other medical condition by analyzing gases in their breath.”
- “The device samples air drawn through heating and cooling systems. Fine, airborne particles are broken down into their molecular building blocks, with electrical charges placed on those molecules so that they can be recognized by the detector. Then, the charged components travel across a tiny electrical field tuned to allow only potentially threatening agents to reach the end.”
- “When one of the suspect molecules makes it through, the sensor compares it with molecular fingerprints of rogue agents stored in its computer. If a match is made, an alarm sounds.”
- “The scientists working on the sensor said tests show it can successfully identify three harmless strains of bacteria that are cousins of anthrax.”
- “Stoto questioned the practicality of sensor systems, arguing that a terrorist could circumvent them. Instead, he advocated investing in surveillance networks to swiftly identify outbreaks of unusual illness in patients by monitoring every cough, sniffle, and stomachache reported to emergency rooms and physician offices.”
King, Warren, “Washington State Bioterror Monitoring Expands To Animals,” Knight Ridder Tribune Business News, pg. 1, Aug 30, 2004.
- “State health officials are expanding their early warning system for a bioterrorist attack by employing the help of rabbits, squirrels, mice and other critters.”
- “As part of the state’s biological-warfare defense, state veterinarians recently began monitoring unusual small-animal deaths for evidence of tularemia, plague or other diseases that could be cause by lethal agents.”
- “Small animals likely would show symptoms and die faster than humans after being exposed to a lethal biological agent.”
- “In the animal reporting system, plague and tularemia are receiving special emphasis because they are considered among the highest risks for an attack and can infect both animals and humans. Anthrax, often mentioned as a threat, also could be detected in animals, especially cattle, sheep and goats, where it occurs naturally.”
- “Plague, tularemia and anthrax…can be easily disseminated or transmitted person to person, can cause many deaths, and can cause panic.”
- “Plague is usually fatal unless treated with antibiotics within 24 hours of onset. Typically, those who are infected experience fever, weakness and rapidly developing pneumonia.”
- “If inhaled, tularemia bacteria can cause abrupt fever, headache, muscle aches and potentially fatal pneumonia, if not treated quickly with antibiotics.”
- “The new surveillance looks for ‘die-offs’ of vulnerable animals — a group of wild animals dying quickly without apparent explanation.”
- “Establishing a database of information on wildlife deaths will help veterinarians to determine quickly which infections are natural and which might be from bioterrorism.”
- “Unusual, unexplained symptoms may indicate the introduction of a disease from abroad, such as with the monkeypox outbreak a year ago.”
- “The Center’s latest solicitation releases in June specifically sought technology submissions that addressed antiterrorism applications such as force protection, port and obrder defense, and security and maritime and land logistics security.”
- “Another will help 20/20 GeneSystems develop a second-generation of its BioCheck hazardous substance analyzer…to extend capabilities of the BioCheck kit used by first responders to screen suspicious powders suspected of containing anthrax and other bioterror agents.”
- “An individual researcher received…grant to develop a rapid bioluminescent bioassay system that assesses toxicity in water and sediments. The QwikLite technology…measures toxins within 24 hours. Conventional sediment testing usually requires up to 13 days to yield results.”
Shane, Scott, “Anthrax Inquiry Draws Criticism From Federal Judge,” NYT, A23, Oct. 8, 2004.
- Judge reviewed classified update from FBI.
- Hatfill civil suit for being called a “person of interest.”
Rose, Laura, “Chlorine Inactivation of Bacterial Bioterrorism Agents“. Applied and Environmental Microbiology. Pg. 566-568, Vol. 71, No.1
- “Currently, chlorination is the most common method of disinfecting drinking water in the United States. (Pg. 1)
- “The Bacillus anthracis spores were less susceptible to cholorine disinfection than the gram-negative organisms.” (Pg. 1)
KAREN T. MORR, [the Acting Assistant Secretary for Office of Information Analysis in DHS] Statement, ”HEARING BEFORE THE SUBCOMMITTEE ON EMERGENCY PREPAREDNESS, SCIENCE, AND TECHNOLOGY OF THE COMMITTEE ON HOMELAND SECURITY HOUSE OF REPRESENTATIVES, ONE HUNDRED NINTH CONGRESS”, FIRST SESSION JULY 12, 2005. “PROJECT BIOSHIELD: LINKING BIOTERRORISM THREATS AND COUNTERMEASURE PROCUREMENT TO ENHANCE TERRORISM PREPAREDNESS.”
- “Al-Qa’ida documents recovered from a training camp in Afghanistan show interest in a variety of biological agents and mentioned plague, anthrax, cholera and tularemia.”
- “To determine threat, we examine an actor’s capability and intent. We assess capability based on factors such as the actor’s level of skill or knowledge, their ability to acquire a biological agent, the materials necessary to grow the agent and their capacity to effectively disseminate a biological agent. For intent, in addition to the actor’s desire to simply use biological weapons, we discern which agents they are more likely to pursue, their preferred method of deployment and which targets they intend to attack.”
- “Last month one of our analysts provided some of the Committee members with a classified briefing on the specifics of the current bioterrorist threat to the Homeland. I will not be able to revisit this classified threat assessment in this open forum but we would be happy to provide this information to additional members in a closed session.”
- “On occasion, we require quick access to information that does not reside within IA. In these cases, our analysts are supported to the Biodefense Knowledge Center (BKC)—a 24×7 support cell based at Lawrence Livermore National Laboratory and sponsored by the S&T Directorate. The BKC possesses vast repositories of biological technical information and is able to access SMEs from around the country, such as the U.S. Army Medical Research Institute of Infectious Diseases (USAMRIID), the U.S. Army Medical Research Institute for Chemical Defense (USAMRICD), and the Armed Forces Medical Intelligence Center (AFMIC), in support of a tasking from IA. The BKC compiles the appropriate information and relays it to our analysts who integrate the information into their finished intelligence analysis.”
- “Our analysts regularly collaborate with other intelligence agencies, particularly NCTC, DIA, FBI, and CIA. We also work with experts from government, academic, and private institutions and partner with scientists who keep us abreast of their potential areas of concern and the trends they see. Interaction with outside public and private sector institutions keeps us well-informed of new and emerging technology that may be exploited or misused by malicious actors. For example, IA recently hosted a workshop on emerging biotechnologies and the future biological threat. This provided a forum for non-governmental experts to provide IA with information of which they believe we should monitor.”
- “Our analysts are broadly focused and access a wide array of information in gathering source material for our assessments. They use all-source intelligence, scientific and technical information, terrorist profiles, historical trends, and open source information such as media reports and scientific journal articles.”
- “We keep current on foreign State biological weapons program developments as these activities may have implications for future terrorist events. We look at the intent of the enemy, their capabilities, potential scenarios, and attack vectors. Working with counterterrorist experts in the Community, we develop link charts on potential associates here in the United States of operatives abroad who may have received training in WMD capabilities or have knowledge of WMD programs.”
- “we assessed the implications of the H2N2 influenza shipment in which a U.S. contractor sent a highly virulent strain of influenza to hundreds of laboratories worldwide. We also recently published an Information Bulletin advising State and local Law Enforcement officials of
indicators of covert anthrax production. Generally, our products fall into two categories: threat assessments and feasibility assessments.”
- “Threat Assessments. Threat assessments are written on known actors and are based on specific intelligence. To determine threat, we examine an actor’s capability and intent. We calculate capability based on factors such as a particular actor’s level of skill or knowledge; their ability to acquire a biological agent and the materials necessary to grow the agent; and their capacity to effectively disseminate a biological agent. For intent, we consider more than just an actor’s desire to use biological weapons. We attempt to discern which agents they are more likely to pursue, their preferred method of deployment, and which targets they intend to attack.”
- “Feasibility Assessments. Intelligence is never complete or all-knowing and we cannot wait until intelligence is received in order to consider plausible scenarios or the impact of a particular technique or technology on a bioterrorist’s capability. To move beyond this limitation, IA, in partnership with S&T, conducts assessments of biological processes, emerging technologies, and techniques and determines their feasibility for use in a bioterrorism event. These assessments include indicators that will help to identify if a particular scenario begins to unfold so we can prevent or disrupt events before they occur. In conjunction with the feasibility assessment, we are producing unclassified excerpts with the indicators which are distributed widely to local, State, Federal officials as well as the private sector to enhance awareness in the field and to increase suspicious activity reporting and trigger investigations where necessary.”
- “IA also has produced several bioterrorism-specific ‘‘red team’’ products, which explore issues from a terrorist’s perspective using nongovernmental experts and creative thinkers. These topics have included terrorist use of genetically modified food and recombinant DNA technologies to damage the U.S. food supply; possible terrorist exploitation of a U.S. flu vaccine shortage; and the safety and security impacts of a pandemic influenza outbreak.
- “Under the BioShield legislation, DHS is charged with assessing current and emerging threats of chemical, biological, radiological, and nuclear agents; and determining which of such agents present a material threat against the United States population. S&T, supported by IA, has been conducting Material Threat Assessments (MTAs) and Material Threat Determinations (MTDs) in order to guide near term BioShield requirements and acquisitions.”
- “MTAs … are speculative and represent a best estimate of how an adversary may create a high-consequence event using the agent/weapon in question. Currently, MTAs are drafted by the S&T and IA provides comments on the assessment before it is provided to HHS. In our review, we ensure that the assessment reflects what IA assesses is the general capability of terrorist groups that are pursuing biological weapons.”
- “MTAs result in an estimate of the number of exposed individuals, the geographical extent of the exposure, and other collateral effects. If these consequences are of such a magnitude to be of significant concern to our national security, the Secretary of DHS then issues a formal Material Threat Determination to the Secretary of HHS, which initiates the BioShield process. To date, one MTA has been completed for anthrax and MTAs for plague, botulinum toxin, tularemia, radiological devices and chemical nerve agents are underway and an MTA for viral hemorrhagic fevers will be initiated next month. MTDs have been approved for four agents: smallpox, anthrax, botulinum toxin, and radiological/nuclear devices.”
- “IA, in cooperation with NCTC and the FBI, is providing WMD outreach briefings around the country. These briefings outline the terrorist WMD threat, including descriptions of the types of weapons used and indicators and warnings aimed at increase awareness and reporting. In the near future, we hope to expand these briefings to other audiences such as academia and the private sector to further increase awareness and reporting.”
- “IA will be playing a key role in supplying current intelligence to the National Biosurveillance Integration System (NBIS) operations center once it begins operation later this summer. NBIS will fuse information on human, plant, and animal health with environmental monitoring of air, food, and water systems. This information will be integrated with threat and intelligence information to provide real-time situational awareness and identify anomalies or trends of concern to the Homeland Security Operations Center.”
Knauss, Tim, “U.N. to Get Bioterror Agent Decontamination Systems” NTI. Dec. 13, 2005.
- “Two $60,000 machines capable of cleansing mail of anthrax and other biological agents were completed”
- “BioDefense said independent tests confirm that the system, which was created after the September 2001 al-Qaeda attacks, is capable of eliminating anthrax, smallpox, ricin, HIV, influenza, botulism and the plague”
Sabelnikov, A et. al, “Airborne exposure limits for chemical and biological warfare agents: Is everything set and clear?” International Journal of Environmental Health Research, 16(4), 241-253. August, 2006.
- “In the case of a radiological terrorist event, emergency response guidelines (ERG) have been worked out.”
- “In the case of a terrorist event with the use of chemical warfare (CW) agents the situation is not that clear, though the new guidelines and clean-up values are being generated based on re-evaluation of toxicological and risk data.”
- “For biological warfare (BW) agents, such guidelines do not yet exist.”
- “In the case of a terrorist event with the use of chemical warfare (CW) agents, the situation is not that clear, because airborne exposure limits (AELs), obtained by extrapolation of toxicological data among animal species and from animals to humans has proven to be unreliable for many chemical agents (Johnson 2003).”
- “The Emergency Response Planning Guidelines (ERPG) developed by the American Industrial Hygienist Association (AIHA) (AIHA 2003) define three risk/exposure levels: level one is defined as ‘‘the maximum airborne concentration of toxic chemical below which, it is believed, nearly all the individuals could be exposed for up to 1 h without experiencing more than mild, transient adverse health effects or without perceiving a clearly defined objectionable odor.”
- “Research on man was not and is not possible, because of ethical reasons, and the most, if not all, the information on military tests and research in this area including animal models is classified (Johnson 2003 is one of the few exceptions).”
- “With regard to CW agents, it is suggested that in spite of the fact that the new, revised exposure limits were proposed or recommended by the Centers for Disease Control and Prevention, CDC, and the US Army, further research is still needed.”
Hsu, Spencer, “Costly Weapon-Detection Plans Are In Disarray, Investigators Say,” The Washington Post, A-Section, Pg. A15, July 16, 2008.
- “Bush administration initiatives to defend the nation against a smuggled nuclear bomb or a biological outbreak or attack remain poorly coordinated, costing billions of tax dollars while basic goals and policies remain incomplete.”
- “Separately, a five-year-old program to detect the airborne release of biological warfare agents such as anthrax, plague and smallpox in more than 30 major U.S. cities still lacks basic technical data to help medical officials determine how to respond to an alert triggered by the sensors.”
Hsu, Spencer, “Modest Gains Against Ever-Present Bioterrorism Threat; An Attack Could Be Hard To Predict With Current Tools,” The Washington Post, A Section, Pg. A10, Aug 3, 2008.
- “The result: modest gains, at best, toward preventing another attack similar to the one in 2001, in which anthrax bacteria killed five people and sickened 17.”
- “‘The potential for something to happen is much greater now than it was in 2001, simply because of developments of technology and education.’”
- “The government has not developed a general-use anthrax vaccine. A new generation of sensors that would sniff out threats more quickly has been delayed. A coordinated plan to respond to a widespread outbreak still doesn’t exist. And the rapid increase in the number of researchers registered to work with biological agents, now 15,000 people, has come without enough oversight.”
- “A significant bright spot…is the dramatic improvement in government preparations to respond to threats such as smallpox, botulism (botulinum), plague and other biological agents.”
- “The Strategic National Stockpile, a emergency cache of critical pharmaceuticals that can be sent within 12 hours to counter outbreaks, has been greatly expanded.”
- “The stockpile…has 60 million treatment courses of antibiotics for anthrax and pneumonic plague. About 300 million doses of smallpox vaccine can also be shipped.”
- “Officials say that the government is retooling efforts to encourage drug companies to invest in BioShield projects. and that the effort is paying off in new antitoxins for anthrax and botulism.”
- “All 50 states now can receive urgent disease reports around-the-clock and conduct year-round surveillance for diseases such as influenza.”
- “But the nation still lacks plans and an organized structure to respond to a massive disease outbreak with thousands of victims.”
Margaret A. K., Ryan, et al. “Birth Defects among Infants Born to Women Who Received Anthrax Vaccine in Pregnancy.” American Journal of Epidemiology 168, no. 4 (August 15, 2008): 434. Academic Search Premier, EBSCOhost (accessed April 30, 2010).
- A review using statistics to determine the probable birth defects in anthrax vaccinated womens’ new born children.
- The study finds a small correlation in those vaccinated in the first trimester only when a referent group was used.
Law, Tina, “Detector Passes Tests,” The Press (Christchurch, New Zealand) — Business; Business day; pg. 7, June 26, 2009
- “A Christchurch manufacturer of a hand-held device that detects lethal anthrax spores is bracing itself for a barrage of sales after strong test results in the United States.”
- “Veritide’s ‘Ceeker’ scanner accurately identified 100 per cent of the anthrax samples used over two weeks of testing at the Midwest Research Institute in Florida. The company said it was also correct in 95 per cent of tests involving hoax substances.”
- “The technology was first developed at the University of Canterbury and provided test results in a few minutes compared to existing products and technologies that could take 30 minutes to three days. The United States Department of Defence was one customer and had bought several machines for use across the US.”
- “The results are being presented today in Baltimore in the United States at Biodetection Technologies 2009, an international conference for experts in detection and identification of biological and chemical threats.”
Dow, Jay “NYPD: Tests Suggest Powder Scare Not A Threat: First Round Of Tests Show No Danger In White Powder, But Emergency Response Was Very Real,” WCBS TV http://wcbstv.com/topstories/powder.envelopes.nyc.2.1302723.html Nov. 10, 2009.
- “Fire officials say someone sent three envelopes filled with white powder to three foreign consulates. They were all postmarked from Dallas and contained at least one note referencing al-Qaida. But investigators now say initial field tests suggest they’re a hoax.”
Kuomikakis, Bill, Ho, Jim and Duncan, Scott, “Anthrax Letters: Personal Exposure, Building Contamination, and Effectiveness of Immediate Mitigation Measures,” Journal of Occupational and Environmental Hygiene, 7:2, 71-79. First Published on December 15, 2009.
- “This report is the first detailed and quantitative study of potential mitigation procedures intended to deal with anthrax letters using a simulated anthrax letter release within an actual office building.”
- “Several scenarios were devised to examine the effects of personnel movement on these characteristics as well as determining the effects of some potential mitigation techniques and published response guidelines for anthrax letters.”
- “Following each trial, all samplers as well as the table and chair at the release point were cleaned with 10% household bleach solution. At the completion of each scenario, extensive decontamination was performed.”
- “Opening a spore-containing letter at the release point resulted in a rapid increase in the spore aerosol concentration in less that 1 min after beginning to open the letter.”
- “The strategies tested in this study all proved to be ineffective, clearly demonstrating the extreme difficulties posed in attempting to respond to anthrax letter incidents.”
- “The rapid spread of spores outside the office where the letter was opened would make it difficult to devise a practical quick response protocol to prevent the spread.”
- “Based on this work we believe that existing response guidelines should be reassessed to provide a scientific basis on whether the procedures achieve the intended mitigation.”
Rees, Nick, “U.S. Postal Service to be in charge of drug delivery in the event of a bioattack,” BioPrepWatch http://www.bioprepwatch.com/news/211476-us-postal-service-to-be-in-charge-of-drug-delivery-in-the-event-of-a-bioattack December 31, 2009.
- “Following an executive order released Wednesday, the U.S. Postal Service will be put in charge of delivering drugs and other medical aid to Americans in the event of a large-scale biological weapon attack.”
- “President Obama’s order states that the postal service will be in charge of dispensing “medical countermeasures” for biological weapons in the event of an attack because of its ability to deliver to U.S. citizens rapidly.”
- “Federal agencies are required to develop a response plan within 180 days including possible law enforcement escorts for postal service workers under the order, which cites anthrax as a primary threat consideration. The order would see local law enforcement supplemented by local federal law enforcement officers.”
Nyamathi, Adeline, “Computerized Bioterrorism Education and Training for Nurses on Bioterrorism Attack Agents” SLACK Incorporated. 2010.
- “Compared with other potential biological agents, anthrax spores are stable in the environment and the aerosolized form has a high mortality rate.” (Pg. 1)
- “Achieving the goal of bioterrorism preparedness is directly linked to comprehensive education and training that enables first-line responders, such as nurses, to diagnose infectious agents rapidly and assess and deal with risks appropriately to avoid widespread contamination, illness, and death. In the same way that the threat of biological attack is continuous and constantly evolving, bioterrorism education and training must take advantage of newer technologies and must be sustained and not limited to occasional seminars or a one-time symposium” (Pg. 2)
- “Fewer than 50% of the nurses were able to correctly differentiate anthrax from an upper respiratory infection or smallpox from chickenpox. Furthermore, nurses scored lower than physicians on all 12 of the knowledge-based questions. Of the respondents, only 20% reported having previous bioterrorism training and fewer than 15% believed that they could respond efficiently to a bioterrorism event.” (Pg. 2)
- “In a larger study of 651 physicians, an online program was used to train participants to diagnose and manage cases of smallpox, anthrax, botulism, and plague (Cosgrove, Perl, Song, & Sisson, 2005). Pretest/posttest scores for correct diagnosis increased from 47% to 79%, whereas scores for correct management increased from 25% to 79%. Thus, web-based, case-oriented programs were effective in educating physicians about agents of bioterrorism. (Pg. 2)
- “This didactic module, which was adapted for nurses, included a background on bioterrorism, encompassing a brief history of bioterrorism and the reasons why biological agents could be used as weapons and an overview of the category A bioterrorism agents, including the differential diagnosis, diagnostic methods, and treatment.” (Pg. 4)
- “Participants in the computerized bioterrorism education and training program were more likely to solve the cases critically without reliance on expert consultants. However, participants in the standard bioterrorism education and training program reduced the use of unnecessary diagnostic tests” (Pg. 10)
Public Health, Anthrax, Smallpox, Emergency Response, Bioterrorism, Biosecurity
Rees, Nick, “UDT provides analysis of Alabama anthrax scare,” http://www.bioprepwatch.com/news/211527-udt-provides-analysis-of-alabama-anthrax-scare January 6, 2010.
- “’Interesting enough, over the past two-years, the FBI has responded to over 900 of these threat letters,’ said FBI spokesman Rich Kolko. ‘Even sending a hoax letter is a serious crime.'”
Tinder, Jay, “Fears rise that Scotland anthrax outbreak spreading,” http://www.bioprepwatch.com/news/211557-fears-rise-that-scotland-anthrax-outbreak-spreading, January 8, 2010.
- “The anthrax outbreak among intravenous drug users in Scotland has now caused six deaths and infected a total of 12 people, health officials have revealed.”
- “‘It is highly probable that the contamination of heroin by anthrax is accidental,” Gordon Meldrum, director general of the Scottish Crime and Drug Enforcement Agency, said in a statement. “Production processes (of heroin) can be basic and often be conducted in areas where there is contamination from animal carcasses or feces.”
PharmAthene, Inc. “Data Show Valortim(R) Anthrax Anti-Toxin May Augment Immune System’s Ability to Destroy Anthrax Bacteria,” http://www.prnewswire.com/news-releases/data-show-valortimr-anthrax-anti-toxin-may-augment-immune-systems-ability-to-destroy-anthrax-bacteria-85189772.html, PR Newswire, February 24, 2010.
- “Valortim® is a fully human anti-toxin monoclonal antibody being developed for the prevention and treatment of inhalational anthrax. Preclinical studies suggest that Valortim® has the potential to provide protection against anthrax infection when administered prophylactically (prior to the emergence of symptoms of anthrax infection) and also may increase survival when administered therapeutically (once symptoms become evident).”
- “Valortim® appears to augment the immune system’s ability to kill anthrax bacilli by enhancing the human dendritic cell response to a challenge with anthrax spores.”
- “Studies indicate that it may also assist in enhancing the adaptive immune response to anthrax, which may lead to a reduction and clearance of the bacteria in the host organism.”
Anthrax, Vaccination, Biodefense
Andreson, Teresa, “Bill Will Launch Review of Anthrax Investigation,” http://www.securitymanagement.com/news/bill-will-launch-review-anthrax-investigation-006828, SECURITY MANAGEMENT, February 26, 2010.
- “An amendment to the 2010 Intelligence Authorization Act (H.R. 2701) will require that the government investigate and issue a report on the anthrax attacks of 2001 to determine whether the attacks originated from outside the United States.”
- “The investigation will be conducted by the Inspector General and, according to the act, will include raw intelligence and should attempt to establish whether there is any credible evidence to connect the anthrax attacks to a foreign entity.”
- “”This investigation was botched at multiple points, which is why reexamining it is so important,”Holt commented while introducing the amendment, . Given that the samples of the strain of anthrax that was used in the attacks may have been supplied to foreign laboratories, we think it is prudent to…examine whether or not evidence of a potential foreign connection to the attacks was overlooked, ignored, or simply not passed along to the FBI.””
Baccini, Michela, et al., “Multiple Imputation in the Anthrax Vaccine Research Program,” http://www.springerlink.com/content/1q54165h36533m48/, CHANCE, Number 1, Volume 23, March, 2010.
- “Since 2000, the CDC has been planning and conducting a clinical trial, the Anthrax Vaccine Research Program (AVRP), to evaluate a reduced AVA schedule and a change in the route of administration in humans.”
- “The AVA trial is a 43-month prospective, randomized, double-blind, placebo-controlled trial for the comparison of immunogenicity (i.e., immunity) and reactogenicity (i.e., side effect) elicited by AVA given by different routes of administration and dosing regimens.”
- “Administration is subcutaneous (SQ) versus intramuscular(IM).”
- “The AVA study has been significant because, as a result of the interim analysis, the FDA approved the change in the routeof AVA administration from SQ to IM. However, as with other complex experimental and observational data, the AVRP data creates various challenges for statistical evaluation.”
- “During the last two decades, multiple imputation (MI) has become a standard statistical technique for dealing with missing
- “A practically more important task is to address missing measurements not intended to be obtained in this study— these values are the survival status of the human subjects if, after the vaccination, they had been exposed to anthrax.”
- “For predicting this survival, there is little information from the human study alone because exposing humans to lethal anthrax doses is not ethical, given the risks of such exposure. For this reason, in parallel to the study with humans, CDC has been conducting a study with macaques.”
Handley, Alison, “Being Alert to Anthrax,” Nursing Standard (Royal College of Nursing), Great Britain, March 10-16; Vol. 24, pp. 21
- “To date 19 cases of anthrax have been confirmed in Scotland and three in England since December 2009. Similarities suggest that heroin, or a contaminated cutting agent mixed with it, is the likely source of an infection that has already claimed ten lives in the UK.”
- “The cases represent the first known outbreak of anthrax to have occurred in conjunction with drug use.”
- “UK health authorities are working on the assumption that all heroin in circulation carries a risk.”
- “The outbreak has been varied in terms of the initial signs, symptoms and severity, although infection at the injection site has been the most common presentation.”
- “Health Protection Scotland nurse consultant Lisa Ritchie says: ‘Nurses should be aware of the symptoms and presentations of anthrax among heroin users. They need to ensure that standard infection control policies are followed rigorously. Potentially, the greatest risk of contamination within the hospital environment would occur from unrecognised anthrax cases in drug users.’”
Bouri, Nidhi & Franco, Crystal, “Environmental Decontamination Following a Large-Scale Bioterrorism Attack: Federal Progress and Remaining Gaps,” Biosecurity and Bioterrorism: Biodefense Strategy, Practice, and Science, Volume 8, Number 2, 2010. April 7, 2010.
- “The process of environmental decontamination is a key step in a successful response to a large-scale attack involving a biological agent. Costs for the decontamination response following the 2001 anthrax attacks were estimated in the hundreds of millions of dollars, and some facilities could not be reopened for more than 2 years.”
- “However, a large-scale biological attack would likely result in an even greater amount of contamination, more areas that need to be cleaned and made safe, and a much greater cost to the American public.”
- “The Select Biological Agents (biological organisms of particular concern) can be categorized along a continuum of decontamination difficulty, ranging from not problematic to very problematic, with a range of difficulty in between. Factors influencing the difficulty of decontamination for a particular agent following a biological attack would include both the natural stability of the agent in the environment and added man-made stability through weaponization.”
- “Bacillus anthracis, the causative agent of anthrax, is considered to be the most problematic agent of concern. Anthrax is both a threat to human health and extremely hardy in the environment. Thus, anthrax requires extensive environmental decontamination following a release.”
- “The main purpose of this analysis is to identify the gaps in decontamination policy and technical practice at the federal level, including safety standards, that must be addressed in order to facilitate a successful response to a large-scale attack involving a biological agent.”
- “The U.S. intelligence community, including the Central Intelligence Agency (CIA), the Defense Intelligence Agency (DIA), the Department of State, the National Intelligence Council, and the Defense Science Board, has assessed the threat of an attack on the U.S. using biological weapons, and they have determined that the threat of a biological attack on the U.S. is current and real.14 Yet, as noted by the Com- mission on the Prevention of Weapons of Mass Destruction Proliferation and Terrorism (the Commission) in their World at Risk report released in December 2008, the U.S. remains vulnerable and unprepared to deal with such an attack.”
- “Decontamination is the process of removing or inactivating a hazardous substance (in this case, a biological agent) from contaminated environments or surfaces, including skin, clothing, buildings, air, and water, in order to prevent adverse health events from occurring. Remediation fol- lowing an attack with a biological weapon will involve a number of different phases of response, including: Sampling, Testing, and Analysis; Containment and Mitigation; Decontamination, Confirmatory Sampling, and Testing”
- “Although efforts are underway and advancements have been made in the field of biological agent decontamination, there are a number of high-level policy and scientific questions that have not yet been resolved. These gaps will be major stumbling blocks to a successful decontamination response following a large bioterrorism attack. Gaps include challenges in leadership, research coordination, funding, and decontamination response.”
- “Numerous federal agencies have responsibility for portions of the decontamination response to a bioterrorism attack. Yet, federal plans do not sufficiently delineate decontamination leadership roles and responsibilities.”
- “Currently, the U.S. lacks a coordinated and sustained federal research program in biological decontamination.”
- “The federal government does not have the human resources to carry out a decontamination response on its own, even for a small biological event.”
- “The nation must be ready to effectively and efficiently respond to and recover from a large-scale bioterrorism attack, and the federal government must take steps now to ensure that the U.S. has the technical and operational capabilities necessary to re- cover after an attack.”
- “The DOD Chemical and Biological Defense Program (CBDP) strives to develop capabilities for decontamination research and response ‘‘that enable the quick restoration of combat power, maintain/recover essential functions that are free from the effects of CBRN hazards, and facilitate the return to pre-incident operational capability””(Pg. 3)
- “Investment now in biological decontamination research to improve technologies and methods has the potential to save the country tens of billions of dollars in clean-up costs for the next event” (Pg. 5)
- “The risks of secondary aerosolization are important to understand, because they will greatly affect decontamination methods and standards, as well as policy decisions surrounding evacuation, transportation, and population movement” (Pg. 6)
- “The federal government does not have the human resources to carry out a decontamination response on its own, even for a small biological event” (Pg. 7)
Ramasamy, S., et al., “Principles of antidote pharmacology: an update on prophylaxis, post-exposure treatment recommendations and research initiatives for biological agents,” Review, British Journal of Pharmacology, Defence Science & Technology Organisation, Human Protection and Performance Division, Fishermans Bend, Vic., Australia; April 20, 2010.
- “Antibiotics are still recommended as the mainstay treatment following exposure to anthrax, plague, Q fever and melioidosis.”
- “There are two licensed anthrax vaccines available (Little, 2005; Wang and Roehrl, 2005). The US anthrax vaccine adsorbed is extracted from a cell-free culture filtrate of an unencapsulated, toxin-producing strain of Bacillus anthracis (V770-NP1R). The UK vaccine (Health Protection Agency) is prepared from a similar strain called Sterne 34F2. Both vaccines contain the protective antigen (PA) adsorbed to aluminium hydroxide and contain small amounts of lethal factor (LF) and oedema factor (EF). The vaccines are both effective against anthrax infection when administered prophylactically, although the vaccination protocols differ.”
- “Although current human anthrax vaccines are effective against anthrax, they still suffer from batch-to-batch variation in composition, require multiple doses and yearly booster injections and have been associated with occasional adverse reactions.”
- “Protection against anthrax via current anthrax vaccines is mediated largely by antibody (humoral) responses to the protective antigen (PA); however, cellular immunity has been shown to also play an important role.”
- “Previous studies have shown that whole spore-based vaccines are more effective against virulent strains of B. anthracis than the current PA-based vaccines.”
- “The FDA recommends that ciprofloxacin, doxycycline or amoxicillin be used for a period of 60 days post exposure to B. anthracis (http://www.fda.gov/).”
- “The most significant novel therapy has been the development of antibody-based passive immuno-therapy against anthrax toxin components, primarily PA and to a lesser extent LF. This has been made possible through significant funding from the US government to support the development and commercialization of antibody-based therapy.”
Editors, “Senators Oppose Looming Bioshield Funding Cuts” 23 July 2010, Global Security Newswire http://gsn.nti.org/gsn/nw_20100723_7284.php Last Checked 20 February 2011.
- “Three U.S. senators this week led the charge against a move to cut as much as $2 billion from the coffers of a program intended to promote development of countermeasures to biological agents and other WMD materials.”
- “Legislation passed July 1 in the House of Representatives would reallocate money from the Project Bioshield Special Reserve Fund or separate pandemic flu preparedness funding to pay for education assistance to states.”
- “To date Project Bioshield has reportedly bought about $2 billion worth of countermeasures for the U.S. Strategic National Stockpile.”
- “It has also already been stripped of hundreds of millions of dollars and has experienced some high-profile failures, including the cancellation of a contract for a new anthrax vaccine.”
- “Furthermore, the casualty potential of a biological attack is far greater than any terrorist attack we have seen to date. Yet, we still have no modern vaccine for anthrax and no countermeasures for dozens of other potential bioterror pathogens.”
- “The Project Bioshield rescission included in the House amendment, or any similar future rescission, would devastate the Bioshield program by cutting a majority of the program’s remaining funding, which is intended for the procurement of new vaccines and countermeasures.”
- “The Obama administration is preparing a method to better promote private production of vaccines and other countermeasures.”
- “‘Bioshield has demonstrated limited success in providing incentives for private-sector developers and has not provided a robust pipeline of medical countermeasures.”
Dilanian, Ken, “Senators deplore cuts in bioterrorism funds; A bipartisan group of 17 calls a drug-vaccine program vital to security,” Los Angeles Times, MAIN NEWS; National Desk; Part A; Pg. 18, July 23, 2010.
- “A bipartisan group of 17 senators has signed a letter denouncing an effort to cut billions in funds for drugs and vaccines intended to thwart bioterrorism.”
- “At issue is a House budget bill that would cut up to $2 billion from the Project BioShield special reserve fund to buy drugs and vaccines in the event of a biological attack. The funds were set aside as a guarantee to private companies that if they produced the medicines, government money would be available to buy them.”
- “Senator Joe Lieberman: “The catastrophic events of September 11th and the anthrax attacks that followed demonstrated that our government was ill prepared to deal with the kinds of terrorist attacks we may well face in the future,” “We still have no modern vaccine for anthrax and no countermeasures for dozens of other potential bioterror pathogens. The BioShield Program was meant to address these serious security shortcomings.”
- “Bioterrorism experts have called the cut an example of how the Obama White House is failing to thoroughly address the threat of a biological attack, which they say could kill 400,000 Americans and do $2 trillion in economic damage.”
- “White House spokesman Nick Shapiro said the government had been dissatisfied with Project BioShield and was redesigning a system creating incentives for private drug companies to produce drugs and vaccines faster.”
Jiao, Guan-Sheng, et. al, “Antidotes to anthrax lethal factor intoxication. Part 1: Discovery of potent lethal factor inhibitors with in vivo efficacy,” PanThera Biopharma, LLC, Aiea, HI & Laboratory of Bacterial Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, Bioorganic & Medicinal Chemistry Letters, Accepted 12 August 2010.
- “Three forms of the disease anthrax caused by Bacillus anthracis are characterized by the route of exposure. Infection of an open wound leads to cutaneous anthrax, and ingestion of contaminated food causes gastrointestinal anthrax.”
- “Sub-nanomolar small molecule inhibitors of anthrax lethal factor have been identified using SAR and Merck L915 (4) as a model compound. One of these compounds (16) provided 100% protection in a rat lethal toxin model of anthrax disease.”
- “Given the effectiveness of B. anthracis as a weapon of bioterrorism,5 the major role LF plays in the pathogenesis of anthrax, and validation of LF as a target for small molecule drug intervention,6 we began our search for an antidote to LF intoxication.”
- “The resulting SAR led to the identification of the 3,5-di- methyl-4-fluoroaniline analog as the most potent inhibitor possessing sub-micromolar inhibitory activity.”
- “One compound, the aniline 16, was capable of providing 100% protec- tion at this dose. Repeating this experiment with lower doses of 16 indicated that this compound was fully protective at both 5.0 and 2.5 mg/kg, although at the lowest dose the animals became ill approximately 3 h after treatment with LT but appeared fully recovered by 24 h post exposure (data not shown).”
- “In summary, we have identified sub-nanomolar inhibitors of anthrax lethal factor with potent in vivo efficacy.”
Editors, “83 Hippos DEAD From Anthrax At Queen Elizabeth National Park” The Huffington Post, August 16, 2010. Last checked September 18, 2010. http://www.huffingtonpost.com/2010/08/16/queen-elizabeth-national_n_682902.html 12.
- “Queen Elizabeth National Park is on alert after the death of 83 hippopotamuses from the poisoning which comes from bacteria living in the soil.”
- “This happened once in 2004 and more than 300 hippos died of poisoning.”
Thomas, Richard, et. al., “Influence of particle size on the pathology and efficacy of vaccination in a murine model of inhalational anthrax,” Journal of Medical Microbiology(2010), 59, 1415–1427, August 19, 2010.
- “Deposition of Bacillus anthracis endospores within either the lungs or nasal passages of A/J mice after aerosol exposure was influenced by different particle sized aerosols and resulted in different infection kinetics.”
- “Particle size-related deposition of B. anthracis endospores has previously been shown to increase MLD and mean time-to-death (MTD) in the guinea pig model (Druett et al., 1953). A murine model has not been reported for the investigation of particle size-dependent effects of inhalational anthrax and the subsequent assessment of therapeutics.”
- “Inhalation of greater numbers of endospores within 12 mm particles is required to induce infection.”
- “Immediately after aerosol deposition (0 h), endospores were primarily localized to either the lungs or nasal passages depending on the size of the inhaled particles (Fig. 2).”
- “Deposition in the nasal passages was significantly higher with the 12 mm particle aerosol and bacterial counts remained higher than those associated with the infection caused by the inhalation of 1 mm particle aerosols over the 96 h time-course.”
- “A subunit vaccine based on the rPA constituent of anthrax toxin has been developed. The rPA vaccine is efficacious against anthrax caused by the inhalation of endospores within a small-particle aerosol in murine and non-human primate models (Flick-Smith et al., 2005; Williamson et al., 2005).”
- “This study represents the first investigation of the effect of therapeutic intervention on respiratory anthrax infection caused by deposition of endospores within the URT.”
Emergent BioSolutions Inc. “Emergent BioSolutions Awarded NIAID Contract That Increases Potential Funding to Over $58 Million for Advanced Development of Third Generation Anthrax Vaccine,” http://www.marketwatch.com/story/emergent-biosolutions-awarded-niaid-contract-that-increases-potential-funding-to-over-58-million-for-advanced-development-of-third-generation-anthrax-vaccine-2010-09-01?reflink=MW_news_stmp, press release, BUSINESS WIRE, September 1, 2010.
- “Emergent BioSolutions Inc. announced today that it has signed a contract valued at up to $28.7 million with the National Institute of Allergy and Infectious Diseases (NIAID), an institute within the National Institutes of Health (NIH), for advanced development of the company’s third generation anthrax vaccine candidate.”
- “This product candidate, one of two third generation vaccines being developed as part of Emergent’s anthrax franchise, consists of BioThrax(R) (Anthrax Vaccine Adsorbed) in combination with a novel immunostimulatory compound, CPG 7909 (VaxImmune(TM)). “
- “Daniel J. Abdun-Nabi, president and chief operating officer of Emergent BioSolutions said ‘We believe our vaccine candidate addresses key criteria established by the government for a third generation anthrax vaccine. If successfully developed, we believe this product would strengthen the government’s portfolio of biodefense medical countermeasures.’”
- “The Phase II clinical trial is anticipated to begin in the first quarter of 2012, with preliminary data expected to be available in the second half of 2012.”
Brady, Rebecca, et al., “Analysis of Antibody Responses to Protective Antigen-Based Anthrax Vaccines through Use of Competitive Assays,” Clinical and Vaccine Immunology, vol. 17, no. 9, p. 1390-1397, September 2010.
- “In this study, we examined the antibody response in humans as well as nonhuman primates and rabbits, animal species that will be used to generate efficacy data to support the approval of new anthrax vaccines.”
- “We found that PA-based vaccines elicited IgC antibodies to each of the four PA domains in all three species.”
- “These findings provide information that will be useful when linking animal protection data to humans via an antibody bridge to establish efficacy of new anthrax vaccines.”
Greenberg, David, et. al., “Identifying experimental surrogates for Bacillus anthracis spores: a review,” Investigative Genetics 2010, 1:4, September 1, 2010.
- “The risks associated with surrogate use are of critical concern. Surrogates are typically used to replace a pathogen that, if used, would present a poten- tial threat to public health. B. anthracis is classified as a BSL-3 organism and work must be conducted under highly contained conditions not suitable for fate and transport experiments. Ideally, an attenuated strain of B. anthracis would be a good surrogate because it should behave similarly to the pathogenic strains and pose little risk.”
- “The results of these stu- dies indicate that B. anthracis is most closely related to B. cereus, B. thuringiensis and B. mycoides, which are grouped together as the B. cereus group (Figure 1). In contrast, B. subtilis, B. atrophaeus, B. megaterium, and Geobacillus are more distant relatives of B. anthracis. As their chromosomal genomes are very similar, some authors have suggested that B. cereus, B. thuringiensis and B. anthracis are actually a single species separated only by different plasmid composition .”
- “The exosporium can be highly vari- able, both among B. anthracis relatives [155-157] and within B. anthracis, as shown by differences between the Vollum and Sterne strains .”
- “Interestingly, dry spore density is simi- lar among the surrogates listed in Table 1, despite volume differences . Thus, the right choice of sur- rogate appears to depend on the dispersion medium under consideration.”
- “Our goal was to examine the various possible surrogates for B. anthracis, review the criteria for selecting an appropriate surrogate, compare the potential surrogates by these criteria and, ultimately, choose the most appro- priate surrogate for our purposes.”
- “After examination of the first criteria, safety of use, we are left with B. atro- phaeus, B. thuringiensis, B. megaterium and B. subtilis as potential surrogates. However, after further examina- tion of genetic relatedness and the consequential mor- phological differences, B. thuringiensis emerges as the most appropriate candidate for a B. anthracis surrogate.”
- “We recommend B. thuringiensis as the most appro- priate surrogate based upon existing empirical data. As a result of the phenotypic similarity within the B. cereus group it will be important to utilize a B. thurin- giensis strain that has a publically available genome sequence, such as B. thuringiensis serovar israelensis (ATCC 35646; GenBank No. AAJM01000000). This will allow for strain-specific markers to be identified [217,218] which can be used as the basis for assays that can readily detect this strain and distinguish it from con-specifics as well as near neighbour species.”
Merkel, Todd, et al., “Development of a highly efficacious vaccinia-based dual vaccine against smallpox and anthrax, two important bioterror entities,” PNAS Early Edition, Center for Biologics Evaluation and Research, Food and Drug Administration, Bethesda, MD, September 2, 2010.
- “A compelling need exists for a better vaccine against B. anthracis that can confer rapid immunity with an abbreviated immunization schedule that can be stored long term and deployed quickly in the event of a bioterror event.”
- “Having demonstrated the superiority in immunogenicity and attenuation of virulence of IL-15–integrated Wyeth vaccinia, we exploited our Wyeth/IL-15 platform to generate a dual vaccine effective against both smallpox and anthrax by integrating the PA gene of B. anthracis (Wyeth/IL- 15/PA) to overcome the problems of poor immunogenicity and apparent lack of immunological memory associated with the li- censed Biothrax/AVA vaccine.”
- “We believe our dual vaccine, Wyeth/IL-15/PA, which is effective against two of the most deadly pathogens, will help consolidate and simplify our national bio- terror counterefforts by streamlining the manufacture, stockpiling, and swift deployment of such vaccines should the need arise.”
- “In developing Wyeth/IL-15/PA, a dual vaccine that is effica- cious against two leading deadly pathogens with high bioterror potential, we integrated cytokine IL-15 into a licensed smallpox vaccine with the disruption of the single vaccinia gene hemag- glutinin—which does not play an appreciable role in viral path- ogenesis or replication (27)—primarily to attenuate the residual virulence of the Wyeth strain of vaccinia.”
- “It is important to emphasize that the vaccinia-based dual vac- cine with integrated IL-15 not only is superior in immunogenicity and efficacy in comparison with the currently licensed vaccines against smallpox and anthrax, but also remedies the inadequacies associated with such licensed vaccines.”
Soroka, Stephen D., et. al., “A two-stage, multilevel quality control system for serological assays in anthrax vaccine clinical trials,” The International Association for Biologicals, Elsevier, Microbial Pathogenesis and Immune Response (MPIR) Laboratory, Meningitis and Vaccine Preventable Diseases Branch, Division of Bacterial Diseases, Microbial Pathogenesis and Immune Response (MPIR) Laboratory, Meningitis and Vaccine Preventable Diseases Branch, Division of Bacterial Diseases, Accepted September 2, 2010.
- “A two-stage, multilevel assay quality control (QC) system was designed and implemented for two high stringency QC anthrax serological assays; a quantitative anti-PA IgG enzyme-linked immunosorbent assay (ELISA) and an anthrax lethal toxin neutralization activity (TNA) assay.”
- “A total of 57,284 human serum samples were evaluated by anti-PA enzyme-linked immunosorbent assay (ELISA) and 11,685 samples by anthrax lethal toxin neutralization activity (TNA) assay. The QC system demonstrated overall sample acceptance rates of 86% for ELISA and 90% for the TNA assays respectively.”
- “The purpose of the data generated by the Anthrax Vaccine Research Program (AVRP) was to inform significant public health decisions on the use and distribution of the only licensed anthrax vaccine in the US. The wide ranging impact of these decisions on vaccination and emergency preparedness policies, together with the long duration of the study, required that the biological assays used for primary and secondary endpoint determination were precise, accurate, sensitive, specific and validated [5e7].”
- “The overall performance of the ELISA Positive control concen- trations and the TNA assay reference standard ED50 demonstrated high precision and accuracy for both assays over time (Table 3).”
- “The system established in our laboratory for the monitoring assay performance provided an increased measure of confidence in the AVRP data obtained from these serological assays.”
- “The quality control system established here is an adaptable system for other types of serological assays and has since been applied effectively for use with influenza serological assays as part of the pandemic H1N1 emergency response in 2009 (Hancock, K., personal communication).”
Editors, “Suspect anthrax parcel discovered at Istanbul airport,” Xinhua, People’s Daily Online, September 03, 2010, Last Checked September 22 2010, http://english.peopledaily.com.cn/90001/90777/90853/7128877.html.
- “Unidentified powder found in a cargo packet resulted in an anthrax scare at Istanbul’s Ataturk airport here on Friday.”
- “Six Americans and one Turk working for NATO at the airport have been quarantined in an Istanbul hospital, according to a report by Dogan News Agency.”
- “The report said an American soldier received cargo that was shipped over from the U.S., when he encountered a packet containing a white powder.”
- “The Americans notified the Ataturk airport’s administration asking for assistance, and doctors of the Health Ministry immediately took action, the report said.”
- “The parcel containing the potential anthrax is being investigated and the vehicle carrying the potential anthrax has also been isolated, according to the report.”
Dema, Tashi, “Anthrax outbreak,” Kuensel Online, NEWS, Thursday, September 09, 2010. http://www.kuenselonline.com/2010/modules.php?name=News&file=article&sid=16659
- “An anthrax outbreak had killed about 29 cattle and infected eight people in Kaktong village in Panbang, Zhemgang as of September 2.”
- “Seven patients were treated in the BHU with antibiotics and injection, while one man with severe wounds was referred to Panbang BHU.”
- “Officials from the regional livestock development office in Zhemgang, who went to investigate the case after receiving the report last month, told Kuensel that the outbreak was caused by bacillus anthrax is, a bacteria which stays in the soil and spreads to animal during rainy seasons.”
- “The country was put on high alert on Sunday, September 5, as the bacterial disease continued to spread between animals and people, and killed 150 cattle.”
Habib, Haroon, “Anthrax spreads in Bangladesh,” The Hindu, NEWS / International, http://www.thehindu.com/news/international/article623516.ece, DHAKA, September 9, 2010.
- “Anthrax has already spread in many districts of Bangladesh, forcing the authorities issue a red alert.”
- “The Institute of Epidemiology, Disease Control and Research (IEDCR) confirmed on Thursday that 447 people in eight districts had been infected with anthrax in the last three weeks.”
- “Health Ministry officials initially said the northern Sirajganj district had the most number of infected, numbering 207.”
- “Officials also confirmed the disease spread after villagers consumed anthrax infected meat sold at low prices.”
Pharmaceutical Research and Manufacturers of America, “Medicines in Development for Infectious Diseases,” Report, Biopharmaceutical Research Continues Against Infectious Diseases with 395 Medicines and Vaccines in Testing, www.pharma.org, September 10, 2010.
- “America’s biopharmaceutical research companies are developing 395 medicines and vaccines to combat the many threats posed by infectious diseases. Each of these medicines in development is either in clinical trials or under review by the Food and Drug Administration.”
- “Among the medicines now being tested are 88 antibiotics/antibacterials for treating bacterial infections such as pneumonia and tuberculosis; 96 antivirals for treating such viruses as hepatitis, herpes and influenza; and 145 vaccines to prevent or treat diseases such as staph infections and pneumococcal infections. Not included in this report are medicines in development for HIV infection.”
- “Two combined monoclonal antibodies that bind to, neutralize, and destroy toxins caused by Escherichia coli infections.”
- “A medicine for the most common and difficult-to-treat form of hepatitis C that inhibits the enzyme essential for viral replication.”
- “An anti-malarial drug that has shown activity against Plasmodium falciparum malaria that is resistant to current treatments.”
- “A potential new class of antibiotics to treat methicillin-resistant Staphylococcus aureus (MRSA).”
- “A novel treatment that works by blocking the ability of the smallpox virus to spread to other cells, thus preventing it from causing disease.”
- “‘Included are several developments for anthax vaccines.’”
Editors, “Dhamrai residents get anthrax vaccine,” Savar, NEWS, September 13, 2010. Last Checked Tuesday, September 14, 2010. http://bdnews24.com/pdetails.php?id=173263.
- “Though the deaths of birds and animals in Dhamrai area were not caused by anthrax, the local residents have nonetheless been given anthrax vaccine, livestock and health officials say.”
- “Dhamrai health and family planning officer Sukumar Sarker on Monday said the locals were given anthrax vaccine as a precaution, though no anthrax affected people was identified or admitted to hospitals.”
- “Upazila livestock official Habibur Rahman told bdnews24.com that a temporary camp has been set up in the area. ‘Three hundred cows of Kayetpara have been given anthrax vaccine.’”
- “Over 50 birds and animals – including several ducks, chickens, pigeons, crows, dogs and cats – were found dead in the area on Saturday noon.
- “Until Monday, there have been 495 people found to be infected by anthrax in nine districts. Of them, 208 in Sirajganj, 57 in Pabna, 46 in Kushtia, 26 in Tangail, 67 in Meherpur, eight in Manikganj, one in Satkhira, 75 in Lalmonirhat and seven in Rajshahi.”
Bigongiari, Jeffrey, “Multiple bioagent vaccines in the pipeline,” Bioprepwatch, NEWS, September 13 2010, http://www.bioprepwatch.com/news/215388-multiple-bioagent-vaccines-in-the-pipeline Last Checked September 23 2010.
- “Scientists in the United States are working on a number of vaccines intended to lessen the threat posed by agents of bioterrorism.”
- “There are currently ten separate treatments in development by biopharmaceutical companies to treat the devastating disease anthrax, according to BusinessWire.”
- “Increasingly, attention is being paid to bioterror agents and “super bugs” that are resistant to known treatments. In the United States alone, 2 million drug-resistant infections are reported every year, costing a total of $34 billion annually, according to the Infectious Disease Society.”
AFP, “Bangladesh human anthrax infections cross 500,” AFP, DHAKA, September 14, 2010. Last checked Tuesday, September 14, 2010. http://www.google.com/hostednews/afp/article/ALeqM5i13ISrs35cZiSrGd3uAOupEHEWkA
- “Ten districts have confirmed outbreaks of anthrax in humans and cattle, with the total number of people infected rising to 508 across the country, health ministry director Mahmudur Rahman told AFP.”
- “No humans have died because the cases of human infection consist of cutaneous, or skin, anthrax — which causes wound-like lesions but is not fatal if treated properly.”
- “Thirteen new cases of human anthrax have been reported in the last 24 hours.”
- “According to health ministry director Mahmudur Rahman, ‘The vaccination programme for cattle is having an impact.’”
Editors, “Anthrax spreads to nearly one sixth Bangladesh districts,” Xinhua News Agency, DHAKA, September 14, 2010. Last Checked Tuesday, September 14, 2010. http://www.istockanalyst.com/article/viewiStockNews/articleid/4496560
- “Anthrax cases among humans have so far spread to nearly one sixth districts of Bangladesh since the South Asian country recorded the first virus-infected patient on Aug. 18.”
- “The latest figures, released by Bangladesh’s Institute of Epidemiology, Disease Control and Research (IEDCR) on its website on Tuesday, showed the disease spread to 10 out of 64 districts of the country.”
- “Following the quick spread of anthrax to more new districts, the Bangladeshi government last week announced red-alert across the country and formed committees in all the 64 districts to coordinate all efforts of anthrax prevention and treatment.”
Barrett, Devlin, “New Review of FBI’s Work in “Anthrax Letters Case,” Metropolis, The Wall Street Journal, September 15, 2010, http://blogs.wsj.com/metropolis/2010/09/15/new-review-of-fbis-work-in-anthrax-letters-case/, Last Checked September 22, 2010.
- “The investigative arm of Congress will take another look at the science the FBI used to determine who mailed deadly anthrax-laced letters in 2001.”
- “The Government Accountability Office has notified Rep. Rush Holt, a New Jersey Democrat, that the agency will review the science behind the FBI’s conclusions that Army scientist Bruce Ivins sent the letters that killed five people.”
- “The National Academy of Sciences is in the midst of a two-year-review of the scientific work that led the FBI to finger Dr. Ivins after spending years chasing other suspects. Dr. Ivins took a fatal overdose of pills in 2008 as a federal grand jury prepared to indict him for the anthrax mailings.”
- “In a letter to Holt, GAO officials said they would conduct their review once the NAS reaches its conclusions, which is expected later this year.”
Editors, “BARDA awards $51 million contract for next generation anthrax vaccine,” U.S. Department of Health and Human Services, hhs.gov, Friday, September 17, 2010. http://www.hhs.gov/news/press/2010pres/09/20100917c.html.
- “The U.S. Department of Health and Human Services’ Biomedical Advanced Research and Development Authority (BARDA) awarded a $51 million contract to Emergent BioSolutions, Inc., of Rockville, Md., for the development of a new anthrax vaccine using the protective antigen (rPA) to stimulate a protective immune response that neutralizes the anthrax toxins.”
- “This contract builds on HHS investments in antibiotics, antitoxins, and vaccine development for anthrax. It highlights the department’s commitment to develop a next-generation, recombinant anthrax vaccine.”
- “In the first two years of the contract, Emergent will develop the final vaccine formulation and test its stability.”
- “This advanced research and development contract was awarded using a flexible federal government contracting tool known as a Broad Agency Announcement. This Broad Agency Announcement (BAA-BARDA-09-34) provides a way to identify innovative and promising technologies for advanced development across the chemical, biological, radiological and nuclear research areas of interest.”
Kuddus, Ruhul, “Containing anthrax outbreak: Some suggestions,” The Daily Star, Saturday, September 18, 2010, http://www.thedailystar.net/newDesign/news-details.php?nid=154823, Last Checked September 22, 2010.
- “Authorities in Bangladesh, according to the information published in some daily news papers, stated that the government has sufficient reserve of anthrax vaccine. However, it is not clear what the authorities have actually done to contain the outbreak.”
- “The following measures could be helpful to achieve the goals: Quarantine all imported cattle, Test every imported cattle for anthrax before allowing the animals to enter the country, Test every cattle before it can be slaughtered, Restrict cattle slaughter in the permit-holding slaughterhouses, Isolate infected animals and treat the animals only if feasible. Many countries have laws that prohibit medical treatment of animals infected with anthrax because it may undermine animal vaccination. Ideally, confirmed infected animals are killed by lethal injection. Intravenous injection of ~10 ml of saturated solution (3.5 moles/litre) of potassium chloride would kill a large bull instantly without any suffering, Cover the dead animal with a plastic film if possible (before touching) and bury it under six feet of soil (incineration is ideal but not be practical in Bangladesh), Dispose of soil and water contaminated with exudates of the infected cattle in the same pit. Hay and other contaminated animal fodder should be burned, Enforce meat inspection uniformly, Restrict meat sale by licensed meat vendors only.”
- “The above steps are standard practices in the developed countries. In Bangladesh, those should be implemented at least in the affected areas. Such efforts would restore public confidence and actually bring the crisis to an end.”
Purlain, Ted, “Bangladesh announces plans to fight anthrax outbreak” Bioprepwatch, September 20, 2010, http://www.bioprepwatch.com/news/215727-bangladesh-announces-plans-to-fight-anthrax-outbreak, Last Checked September 22, 2010.
- “The Fisheries and Livestock Minster of Bangladesh, Latif Abdul Biswas, announced on September 19 plans to fight an outbreak of anthrax before the end of the Ramadan fasting period, including the creation of a National Steering Committee.”
- “The committee plans to meet immediately following an inter-ministerial meeting composed of 25 representatives from the ministries of livestock, health, the environment, domestic and foreign affairs and the Dhaka City Corporation, according to TheDailyStar.net.”
- “The committee’s function will be to ensure that the various ministries can function together properly to fight the anthrax outbreak by properly dealing with the importation of cattle and the management of disease in the absence of direct control from the livestock ministry.”
- “Since August 18, 583 people in 12 administrative districts have been reported to have been infected with anthrax according to the Institute of Epidemiology, Disease Control and Research.”
Editors, “ANTHRAX UNDER CONTROL IN BANGLADESH WITH NO NEW CASE SINCE SEPT 18,” Newswire, Nationwide International News, DHAKA, Asia Pulse, September 23, 2010.
- “Bangladesh’s Fisheries and Livestock Minister Abdul Latif Biswas Wednesday claimed in Parliament that anthrax is now under control in the country in the wake of timely steps by the government.”
- “In a statement, the Minister informed the House that no new case of Anthrax has been detected in the country since September 18.”
- “He informed the House that the government is actively considering providing compensation to the affected cattle farmers.”
- “The Minister criticized some media for creating panic over anthrax, saying one media broadcast that 300 cows were infected with anthrax at Haimchar in Chandpur district.”
Fasanella, A., “New anthrax study results from A. Fasanella et al described,” Newsletter, Medical Letter on the CDC & FDA, Expanded Reporting, pg.12, September 23, 2010
- “The potential role of insects in the spread of B. anthracis to humans and domestic animals during an anthrax outbreak has been confirmed by many studies.”
- “Among insect vectors, the house fly Musca domestica is considered a potential agent for disease transmission. In this study, laboratory-bred specimens of Musca domestica were infected by feeding on anthrax-infected rabbit carcass or anthrax contaminated blood, and the presence of anthrax spores in their spots (faeces and vomitus) was microbiologically monitored. It was also evaluated if the anthrax spores were able to germinate and replicate in the gut content of insects. These results confirmed the role of insects in spreading anthrax infection.”
- “This role, although not major, given the huge size of fly populations often associated with anthrax epidemics in domestic animals, cannot be neglected from an epidemiological point of view and suggest that fly control should be considered as part of anthrax control programs.”
Editors, “Emergency declared in south Russian village over Anthrax outbreak,” RIA Novosti, Kransodar, Russia, September 29, 2010.
- “A state of emergency has been declared in a village in south Russia’s Krasnodar Territory over an anthrax outbreak.”
- “Anthrax was detected in cows at a local dairy farm, and the region’s emergencies service reported earlier in the day that at least two employees had contracted the potentially lethal disease. “
- “‘A state of local-scale emergency was declared on the territory of the Uspenskaya Village. The outbreak was localized and the disease was prevented from spreading,’ Alyona Vnukova said.”
- “The farm has been placed under quarantine, and vets are checking to see if privately kept cows contracted the infection.”
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”’…, Ellen and …, Alison”’, “Decontamination Options for Bacillus anthracis-Contaminated Drinking Water Determined from Spore Surrogate Studies,” Lawrence Livermore National Laboratory, …
*”Hydrogen peroxide at a concentration of 5% and Dichlor or sodium hypochlorite at a concentration of 2% were highly effective at spore inactivation regardless of spore type tested, spore exposure time, or spore concentration evaluated.”
*”This is the first reported study of Dichlor as an effective decontaminant for B. anthracis spore surrogates. Dichlor’s desirable characteristics of …excellent alternative.” *[[Anthrax]], [[Decontamination]]
”’…, Maggie”’, “Researchers combine smallpox, anthrax vaccines,”
…developed for use in people.”
*[[Anthrax]], [[Smallpox]], [[Vaccination]]
”’…, Pat”’, “…e and ability to degrade into non-toxic products.” .
”’…, Ashton”’, “Bangladesh livestock minister blames anthrax panic on …behind the anthrax scare.”
”’…, Jeffery”’, “Emergent BioSolutions, Inc.’s inhalational anthrax treatment receives …on a rolling basis.”
”’Editors”’, “NIH Funds Advanced Development of Three Biodefense Vaccines: …could amount to $23.8 million over the next nine years.” .
*[[Anthrax]], [[Vaccination]], [[Biodefense]], [[Dengue]]
”’Chris …”’, “Researches Tout Combination Anthrax-… ability to protect nonhuman primates against inhalation anthrax and intravenous monkeypox — a disease similar to smallpox.”
*[[Anthrax]], [[Smallpox]], [[Vaccination]]
”’Editors”’, “Country Rid of Anthrax… like nitrofuran and chloromphenicol.”
”’…, James, and …, Anbarasan”’, “Anthrax outbreak hits Bangladesh leather and meat sectors,” BBC, News, Business, …could spell disaster for a Bangladeshi industry worth some $500m to the impoverished country.”
”’…, Ted”’, “Experts discover how anthrax toxins disrupt cell mechanisms… from bioterrorist threats.”
*[[Anthrax]], [[Biodevelopment]], [[Biodefense]] ”’
…, Annabell, et.al.”’, “Anthrax toxins cooperatively inhibit endocytic recycling by the …2010.
*”It has been speculated that additional host targets may con- tribute to mediating the lethal effects of anthrax toxins7 and inter- actions between the two toxins remain poorly understood.”
*”In summary, …
*”The reduction in Dl/Notch levels in response to anthrax toxin treat- ment requires further analysis with respect to potential consequences.”
*[[Anthrax]], [[Biodevelopment]], [[Biodefense]]
”’Editors,”’ “Scientists closer to a safer anthrax vaccine” Homeland Security Newswire …The next step in the Einstein research will be to inject the peptides into an animal model to see if the peptides can protect against anthrax infection.”
*[[Anthrax]], [[Vaccination]], [[Biodefense]]
”’…, Ted”’, “Expert decries potential burning of anthrax vaccine,”…
… He is currently the CEO of the Weapons of Mass Destruction Center.”
”’…, Tim”’, “Outbreak of deadly anthrax claims lives of 13 heroin users,” The Daily Record,.'”
”’… Ashton”’, “Arizona congressman receives hoax anthrax letter,” …by midday the following day.” *[[Anthrax]]
”’…, Bryant”’, “Airmen Given Expired Anthrax Vaccines,” Military… requires troops assigned to high-threat areas to be inoculated against a potential infection.”
*[[Anthrax]], [[Vaccination]], [[Oversight]]
”’…, Gaobing, et. al.”’, “A Chimeric Protein that Functions as both an Anthrax Dual-Target Antitoxin and a Trivalent Vaccine,” Journal, Antimicrobial Agents and Chemotherapy, Volume …for both pre-exposure and post-exposure vaccination.” *”Overall, we have developed a novel and dually functional reagent for the prophylaxis and treatment of anthrax.”
*[[Anthrax]], [[Vaccination]], [[Prophylaxis]], [[Biodevelopment]]
”’Daigle, Ashton”’, “Minnesota man pleads guilty to anthrax hoax,” ….face up to five years in prison for the charge.”
”’…., Jazmyn”’, “Northwestern students’ discovery could detect cancer or anthrax in moments,” …on an envelope is anthrax.”
”’…, Helemul”’, “Cattle traders hope for loss recovery,” …infected animals and humans.” *[[Anthrax]], [[Asia]]
”’…, Josh,”’ “Uganda Seen as a Front Line in Bioterrorism.”
…creates a security risk.
* [[Biodefense]], [[Ebola]], [[Bioterrorism]], [[Lab Safety]], [[Public Health]], [[Marburg]], [[Biosafety]], [[Africa]]
”’H…., Steven”’, “Lax Security at Ugandan Anthrax Labs Poses …World Cup, has captured American attention and concern about the region.”
*[[Lab Safety]], [[Biosafety]], [[Africa]], [[Anthrax]], [[Ebola]]
”’…, Keith”’, “Anthrax Toxins-Roadblocks for exocytic Trafficking,” Developmental Cell, Volume 19, Number 5, November 16, 2010. *”Anthrax toxins cause vascular dysfunction, in part by …additional novel insights into the biological activities of anthrax toxins.” *[[Anthrax]], [[Biodevelopment]]
”’P., Elaine”’, “Letter Carriers Add anthrax must take the medication for ….” *[[Anthrax]], [[Emergency Response]]
”’Editors”’, “NIH scientists show how anthrax bacteria impair immune response…the level of anthrax bacteria increased rapidly in the 48 hours following infection, and all the mice died within six days.” *[[Anthrax]], [[Vaccination]], [[Biodevelopment]]
”’…, Kenneth & LeVine, Steven”’, “Anthrax Toxin Delivers a One-Two Punch,” Cell Press, Cell Host & Microbe 8, Elsevier Inc., November 18, 2010. …represent a powerful tool to address such questions and will quicken the pace of research aimed at under- standing of the physiologically relevant roles of toxin in anthrax.” *[[Anthrax]], [[Biodevelopment]]
”’M…, Martin”’, “U.S Will Expand Biosecurity Work to Africa… *[[Biosecurity]], [[Biosafety]], [[Bioterrorism]], [[Anthrax]], [[Ebola]] ‘
”K…, P., Budowole, B., Ravel, J.”’, “Microbial Forensic Investigation of the Anthrax-Letter Attacks,” Microbial Forensics, Elsevier, …, such as next-generation sequencing.” *[[Anthrax]], [[Biotechnology]]
”’P E.,”’ “Letter Carriers…, “we should be able to expand it to other cities.”” *[[Anthrax]], [[Biodefense]]
”’…, Ted”’, “New data discovered about early-stage anthrax infections… may become the key in treating and preventing anthrax.” *[[Anthrax]], [[Biodevelopment]]
”…, Megan”’, “Amerithrax experts debate FBI findings, …the FBI originally thought the letters were mailed.” *[[Anthrax]], [[Dual Use]]
”’A… Press”’, “Researcher tells how anthrax may have been made… killed himself as investigators closed in.” *[[Anthrax]], [[Dual Use]], [[Misconduct]]
== 2011 ==
…Expert Panel Is Critical of …that it was capable of producing the anthrax powder in the mailings.”
[[Anthrax]], [[Law Enforcement]], [[al-Qaeda]], [[Afganistan]], [[Personnel Reliability]]
”’…, Jerry”’, “Anthrax report casts doubt on scientific evidence in FBI case against Bruce Ivins…was inconsistent, and it called for further review.”
*[[Biosecurity]], [[Bioterrorism]], [[Anthrax]]
”’… Scott”’, “Panel on Anthrax Inquiry Finds Case Against Ivins Persuasive,” …and touched off a national panic about the danger posed by invisibly tiny anthrax spores.”
*[[Anthrax]], [[Personnel Reliability]], [[Law Enforcement]]
”’R, Rudy”’, “Anthrax continues to haunt farms, livestock in southern Italy… allow anthrax bacteria to form spores.” *[[Anthrax]], [[Zoonotic]]
”’Editors”’, “Debate Flares Over Testing Anthrax Vaccine on Children spores that could re-emerge over a period of time.” *[[Anthrax]], [[Public Health]], [[Bioterrorism]], [[Biotechnology]]
”’Editors”’, “Boosting “Natural Killer” Cells May Counteract Anthrax… of blood-borne anthrax bacteria than their counterparts.”
*[[Anthrax]],[[Public Health]], [[Vaccination]], [[Synthetic Biology]], [[Decontamination]], [[Bioterrorism]], [[Biodefense]]
”’Quinlisk et. Al”’, “Challenges in the Use of Anthrax Vaccine Absorbed (AVA) in the Pediatric Population as a Component of Post-Exposure Prophylaxis (PEP),” National Biodefense Science Board,….” *“In the United States, AVA is used to protect military personnel, and at-risk laboratory.”
*[[Anthrax]], [[Vaccination]], [[Public Health]]
”’Editors”’, Science Insider, “Scientists Brace for Media Storm Around Controversial Flu Studies,” …the results show that those downplaying the risks of an H5N1 pandemic should think again, he says.”
*[[Open Science]], [[Classified]], [[Due Process Vetting]], [[Flu]], [[Dual Use]], [[NSABB]], [[Anthrax]], [[Netherlands]], [[Pandemic]][[Zoonotic]]
== 2012 ==
”’…, Jerry”’, “Case turns the Justice Dept. on itself…, but said ‘the Stevens case against Battelle was dismissed and the [criminal] investigation of Battelle has been closed.’” *[[Anthrax]], [[Law]], [[Law Enforcement]], [[Lab Security]], [[Attribution]]
== 2013 ==
”’…, Chris ”’, “Lab Prepares New Bioagent Infection Detector” …the instrument.” *[[Biodefense]], [[Biosecurity]], [[Emergency Response]], [[Anthrax]], [[Ricin]]
== 2014 ==
”’Wurtz,….”’ “Negative Impact of Laws Regarding Biosecurity and Bioterrorism on Real Diseases” Clinical Microbiology & Infection, …
*”Category B includes agents that are moderately easy to disseminate, cause moderate morbidity and low mortality, and require enhancement of diagnostic capacities and speciﬁc surveillance” – page 508 *” Category C includes emerging infectious agents that could be engineered for mass dissemination in the future because of their availability and ease of production and dissemination, as well as their potential to cause high rates of morbidity and mortality and to have a major health impact.” – page 508 … *”Workers and regulators must try to ﬁnd a balance between …for both biodefence and emerging pathogens.” – page 514
*[[Military]], [[Public Health]], [[Anthrax]], [[Bioterrorism]], [[CDC]]
”’J…, H. et al.”’ “Biological Warfare, Bioterrorism, and Biocrime” Clinical Microbiology & Infection, Volume…. *”Biological weapons achieve their intended target effects through the infectivity of disease-causing infectious agents.” – page 488 *”The Geneva Protocol, …
…as a BW agent improved by genetic engineering and weaponization processes.” –page 490 … to combat ‘regular’ infectious disease outbreaks and mitigate the effects of bioterrorist attacks. Such an approach is likely to be the most cost-effective” – page 495 *[[Military]], [[Public Health]], [[WMD]], [[Chemical]], [[BWC]], [[Bioterrorism]], [[Anthrax]], [[Ricin]], [[Drug Resistance]], [[CDC]]
”’Centers for Disease Control and Prevention, Media Statement”’, “…*” CDC announced today that approximately 75 Atlanta-based staff are being monitored or provided antibiotics because they may have been unintentionally exposed to live Bacillus anthracis (anthrax) after established safety practices were not followed.” …B. anthracis at the time samples were distributed to the other CDC laboratories.”
*[[Anthrax]], [[CDC]], [[ Lab Safety]], [[BSL]] ‘
”S…, Julie”’, “Exclusive: U.S. government scientists retrace events leading to anthrax breach,” …CDC this week conducting their own investigation.” *[[Anthrax]], [[Lab Safety]], [[CDC]], [[Oversight]], [[Select Agent]], [[BSL]]
Status brief works cited 1 http://www.bt.cdc.gov/agent/anthrax/needtoknow.asp
3 Sternbach, G., “The history of anthrax,” J Emerg Med. (4): 463-7. 2003 May, 24
4 Sternbach, G., “The history of anthrax,” J Emerg Med. (4): 463-7. 2003 May, 24
6 Margaret A. K., Ryan, et al. “Birth Defects among Infants Born to Women Who Received Anthrax Vaccine in Pregnancy.” American Journal of Epidemiology 168, no. 4 (August 15, 2008): 434. Academic Search Premier, EBSCOhost (accessed April 30, 2010).
7 Margaret A. K., Ryan, et al. “Birth Defects among Infants Born to Women Who Received Anthrax Vaccine in Pregnancy.” American Journal of Epidemiology 168, no. 4 (August 15, 2008): 434. Academic Search Premier, EBSCOhost (accessed April 30, 2010).
8 Glass, Thomas A. and Monica Schoch-Spana, “Bioterrorism and the People: How To Vaccinate a City against Panic,” Clinical Infectious Diseases, 34:217-23 (Jan 15, 2002) and http://www.bt.cdc.gov/agent/anthrax/needtoknow.asp
9 Dow, Jay, WCBS TV, “NYPD: Tests Suggest Powder Scare Not A Threat: First Round Of Tests Show No Danger In White Powder, But Emergency Response Was Very Real,”  Nov. 10, 2009.
10 Hsu, Spencer, “Modest Gains Against Ever-Present Bioterrorism Threat; An Attack Could Be Hard To Predict With Current Tools,” The Washington Post, A Section, Pg. A10, Aug 3, 2008.
11 Glass, Thomas A. and Monica Schoch-Spana, “Bioterrorism and the People: How To Vaccinate a City against Panic,” Clinical Infectious Diseases, 34:217-23 (Jan 15, 2002)
12 Hsu, Spencer, “Costly Weapon-Detection Plans Are In Disarray, Investigators Say,” The Washington Post, A-Section, Pg. A15, July 16, 2008.