bioterrorism awareness: protection of human and animal health food animal producers
TRANSCRIPT
Bioterrorism Awareness:Protection of Human and Animal HealthFood animal producers
Center for Food Security and Public Health Iowa State University 2005
Why Are We Here?Why Are We Here?
• September 11, 2001 changed many things−Worst terrorist act in U.S.
history−More than 3,000 presumed
dead−Occurred on American soil− Increased sense of
vulnerability
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Biological AttackBiological Attack
• Bioterrorism attacks of 2001• Anthrax in postal system
• 22 cases• 5 deaths
• U.S. public health realm changed forever
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OverviewOverview
• Bioterrorism• Zoonoses and bioterrorism• Disease control and biosecurity • U.S. Government agencies involved• Bioterrorism agents/diseases• Your role and responsibility
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Biological agents targeting humans, animals, or plants
Biological, chemical or radiological agents targeting agriculture or its components
•Livestock•Food supply•Crops•Industry•Workers
TerrorismTerrorism
BioterrorismAgroterrorism Other
Conventional, radiological, nuclear, chemical,cyber
•Typically direct human targeting
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Characteristics of a Biological Attack
Characteristics of a Biological Attack
• Difficult to detect release• Dissemination may cover large area• Possible secondary spread • Recognition of agent may be delayed
days to weeks• Difficulties in catching perpetrator
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Time (Days)
No.
Aff
ecte
d
Exposure
Symptoms
Seek Care
Infectious Disease OutbreakInfectious Disease Outbreak
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Clues Suggesting Biological Agent Release
Clues Suggesting Biological Agent Release
• Clustering of morbidity or mortality−Temporally or geographically−Large numbers of animals and/or people−Atypical symptoms
• Normally healthy people affected • Unusual symptoms for area• Unusual age distribution• Disease occurring outside typical
season
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Many Agents are ZoonoticMany Agents are Zoonotic
• Zoonotic means a disease transmitted from animals to humans
• Disease may be seen in animals before humans
• Animals are sentinels− Pets, livestock, wildlife
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Factors That Promote Transmission of Zoonoses
Factors That Promote Transmission of Zoonoses
• Frequent contact with domestic or wild animals
• Overlap with wildlife habitat• Intensive livestock production• Poor animal sanitation• Poor personal hygiene• Poor animal health
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Routes of TransmissionRoutes of Transmission
• Direct contact − Gel, liquid, powder− Scratches− Droplet spray onto mucous membranes
• Indirect: Ingestion, injection− Contaminated food, water− Vector
• Aerosol
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Disease Control: Client EducationDisease Control: Client Education
• Disinfect/clean up areas contaminated with animal waste−Livestock, pets, wildlife, rodents
• Basic hygiene−Wash hands−Child supervision
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Zoonoses ControlZoonoses Control
• Proper pet selection• Use caution at petting zoos• Cook food properly• Control strays• Visit and communicate with physician
and veterinarian • Follow guidelines for
immunocompromised people
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Biosecurity Educationfor the Producer
Biosecurity Educationfor the Producer
• Develop and implement a biosecurity plan
• Train employees to help maintain the plan
• Post signs restricting access to areas of the farm and control traffic flow
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Biosecurity Educationfor the Producer
Biosecurity Educationfor the Producer
• Regulate visitors• Keep visitors sanitary
−Clean clothing, boots−Disposable plastic shoe/boot
covers
• Implement insect, bird and animal control
• Secure water, feed, and nutrient sources
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Biosecurity Educationfor the Producer
Biosecurity Educationfor the Producer
• Maintain healthy herd−Vaccinations−Proper hygiene for
animals and handlers• Purchase from
reputable sources• Quarantine newly
purchased animals• Separate sick animals
U.S. Agencies
Dealing with terrorism
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Public Health Security and Bioterrorism Preparedness Response Act of 2002
Public Health Security and Bioterrorism Preparedness Response Act of 2002
• June 12, 2002• Improve ability of the U.S. to prevent,
prepare for, and respond to bioterrorism and other public health emergencies
• $4.3 billion to various federal, state and local agencies−Upgrade facilities, enhance security, etc
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Department of Homeland Security (DHS)
Department of Homeland Security (DHS)
• Established January, 2003• Mission
−Prevent, protect, and respond to acts of terrorism on U.S. soil
• Established four policy directorates −Responsibilities for coordinating HHS and
USDA−Guard borders and airports, coordinate the
response for future emergencies, analyze threats and intelligence, protect our critical infrastructure
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Centers for Disease Control and Prevention (CDC)
Centers for Disease Control and Prevention (CDC)
• CDC's Mission−Promote health and quality
of life by preventing and controlling disease, injury and disability
• Preparing for bioterrorism since 1998• One of first agencies to respond to anthrax
incidents of 2001
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Strategic National StockpileStrategic National Stockpile
• 12-hour Push Package− Complete package of
medical materials
• Vendor Managed Inventory− Tailored to suspected agents
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Insert Your State’s Info HereInsert Your State’s Info Here
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Preparing IowaPreparing Iowa
• Iowa’s Homeland Security −Administered by
Iowa Emergency Management Division
−Works with public and private partners
www.iowahomelandsecurity.org
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Preparing IowaPreparing Iowa
• Iowa Department of Public Health www.idph.state.ia.us/odedp
• Iowa Department of Agriculture and Land Stewardship− Highly infectious animal disease program− IRVIN: Iowa Rapid Veterinary Information
Network
• CFSPH training veterinarians to educate others
Category ABC Agent Overview
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ClassificationClassification
• Prepared by the CDC’s Bioterrorism Preparedness and Response Office
• Category A: Highest priority• Category B: Second highest priority• Category C: Third highest priority
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“Weaponization” of Agents“Weaponization” of Agents
• Alter characteristics of an agent, allowing it to cause a more serious disease−Enhance transmission− Increase virulence−Resistant to antibiotics−Evade vaccine protection −Alter clinical signs
Harder to diagnose
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Note to presenterNote to presenter
• As time allows select diseases you would like to review.
• If you have limited time you should focus on the Category A agents.
• The disease coverage is brief. If you would like more information on a disease, refer to the fact sheet or to the disease specific presentation.
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Category A : Agents/DiseasesCategory A : Agents/Diseases
• Anthrax• Botulism• Plague• Smallpox• Tularemia• Viral hemorrhagic fevers
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Anthrax: The AgentAnthrax: The Agent
• Bacteria: Bacillus anthracis • Forms spores• Human disease
−Skin− Intestinal− Inhalation
• Animal disease−Spreads through the body−Rapid death
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Anthrax: The ResponseAnthrax: The Response
• Vaccine−Humans−Animals
• Antibiotics−Treatment−Prevention
• Hardy in environment −Difficult to disinfect
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Botulism: The AgentBotulism: The Agent
• Clostridium botulinum – Gram pos, spore-forming bacteria
• 7 different neurotoxins −Types A-G
• Clinical signs−Flaccid paralysis−Pigs, dogs and cats
fairly resistant
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Botulism: The ResponseBotulism: The Response
• Toxoids for high risk people• Antitoxin available
−Case-by-case basis
• Spores destroyed by moist heat
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Plague: The AgentPlague: The Agent
• Yersinia pestis−Gram neg, transmitted by fleabites,
aerosol, direct contact• Symptoms: Humans
−Bubonic, septicemic, pneumonic• Symptoms: Animals
−Cat: Similar to human−Dogs, livestock: Somewhat
resistant
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Plague: The ResponsePlague: The Response
• Antibiotics generally effective if given early
• Killed vaccine available • Isolation of sick individuals• Susceptible to a number of common
disinfectants
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Smallpox: The AgentSmallpox: The Agent
• Variola virus• Eradicated from the world in 1977• Narrow host range: Humans only• Transmission: Person-to-person,
contaminated items• Clinical signs
−Flu-like, progressive skin eruptions
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Smallpox: The ResponseSmallpox: The Response
• No specific treatment• Vaccine has side effects• Vaccination of health care personnel• Isolation of infected individuals• Disinfection of clothing etc. with
steam, fire or bleach
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Tularemia: The AgentTularemia: The Agent
• Francisella tularensis• Transmitted by ingestion,
inhalation, vectors, direct contact through skin
• Six clinical forms in humans
UlceroglandularGlandular
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Tularemia: The AgentTularemia: The Agent
• Sheep, young pigs, horses, dogs, cats• Sudden fever, lethargy, stiffness,
prostration and death
• Wildlife• Usually find dead• Rabbits behave strangely
• Cattle, older pigs resistant
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Tularemia: The ResponseTularemia: The Response
• Person-to-person transmission not documented
• Antibiotics effective if early or preventative
• Vaccine−For high risk individuals−Unknown effectiveness against inhalation tularemia
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Viral Hemorrhagic Fevers:The Agents
Viral Hemorrhagic Fevers:The Agents
−Early: Fever, fatigue−Severe: Bleed from internal
organs, body orifices−Progression to shock,
seizures
• Animals: Only non-human primates susceptible
• Ebola, Marburg, Lassa, Machupo • Human clinical presentation
Vincent Massey
Center for Food Security and Public Health Iowa State University 2005
VHF: The ResponseVHF: The Response
• Intensive supportive care• Antiviral medications have shown
some efficacy • Susceptible to various disinfectants
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Category B: Agents/DiseasesCategory B: Agents/Diseases
• Brucellosis• Glanders• Melioidosis • Psittacosis • Q Fever
• Typhus fever• Viral encephalitis• Toxins• Food Safety Threats • Water Safety Threats
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Brucellosis: The AgentBrucellosis: The Agent
• Bacteria: Brucella spp.• Transmission by
− Ingestion− Inhalation−Direct contact
• Clinical signs−Humans: Cyclic fever
and flu-like symptoms−Animals: Reproductive signs
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Brucellosis: The ResponseBrucellosis: The Response
• Long term antibiotics generally effective
• Vaccinate calves, no human vaccine• Eliminate reservoir• Standard precaution to
avoid exposure• Thorough disinfection
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Glanders: The AgentGlanders: The Agent• Bacteria: Burkholderia mallei • Transmission by ingestion,
inhalation or direct contact−Animal-to-human transmission
is inefficient
• Clinical signs−Humans & horses: Cutaneous &
pulmonary lesions, rapidly fatal illness
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Glanders: The ResponseGlanders: The Response
• No vaccine • Antibiotic therapy likely effective• Destroyed by various chemicals
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Melioidosis: The AgentMelioidosis: The Agent
• Bacteria: Burkholderia pseudomallei
• Transmission: Contact, ingestion, inhalation
• Clinical signs: Humans, sheep, goats and pigs−No symptoms to pneumonia,
lung and wound abscesses
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Melioidosis: The ResponseMelioidosis: The Response
• Long-term, multiple antibiotics effective
• Vaccine not available in U.S.
• Easily destroyed by disinfectants
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Psittacosis: The AgentPsittacosis: The Agent
• Bacteria: Chlamydophila psittaci • Occurs worldwide• Reportable in U.S.• Clinical disease
−Humans and birds: Ranges from no symptoms to systemic illness with severe pneumonia
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Psittacosis: The ResponsePsittacosis: The Response
• Antibiotics generally effective
• Decontamination possible with most disinfectants
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Q Fever: The AgentQ Fever: The Agent
• Bacteria: Coxiella burnetii • Transmission: inhalation, direct
contact, ingestion, ticks• Disease symptoms
− Humans: Acute: Flu-like, pneumonia, liver disease Chronic: Heart complications, bone inflammation
− Animals: Most have no signs Sheep, cattle and goats: Abortions
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Q Fever: The ResponseQ Fever: The Response
• Antibiotic therapy may limit the disease
• Vaccine developed, not available in U.S.
• Some disinfectants are effective
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Typhus Fever: The AgentTyphus Fever: The Agent
• Bacteria: Rickettsia prowazekii• Endemic in Eastern Europe, Middle
East, and parts of Africa• Transmitted in feces of
human body louse • Clinical signs: Humans
−Fever, headache, red blotches, and a red-dot rash
• Not seen in domestic animals
J. Kalisch
Center for Food Security and Public Health Iowa State University 2005
Typhus Fever: The ResponseTyphus Fever: The Response
• Antibiotics are generally effective• Vaccine, not commercially available
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Viral Encephalitis: The AgentViral Encephalitis: The Agent• Viruses causing EEE, WEE, and VEE• Transmitted via mosquito• Clinical signs
• Birds do not become ill but are carriers; act as sentinels
−Humans, horses, donkeys, mules: Often no signs to flu-like illness
−Brain inflammation in some patients
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Viral Encephalitis:The Response
Viral Encephalitis:The Response
• Supportive care• Vaccine
−Equine−Human: high risk
• Virus cannot live in environment
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Toxins: The AgentsToxins: The Agents
• Staphylococcal enterotoxin B (SEB)
• Ricin toxin from castor plant
• Clostridium perfringens epsilon toxin
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SEB: The AgentSEB: The Agent
• Staphylococcal enterotoxin B (SEB)• A common cause of food poisoning • Clinical signs: Humans
−Fever, chills, headache, aches−Non-productive cough if inhaled−GI signs if ingested
• Animals: Likely similar to human
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Ricin: The AgentRicin: The Agent
• Ricin toxin from bean of castor plant • Available worldwide• Clinical signs
−Acute onset of fever,chest tightness, cough,
dyspnea, nausea
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Epsilon Toxin: The AgentEpsilon Toxin: The Agent
• Clostridium perfringens type B and D• Increases intestinal and vascular
permeability, liver and neurological damage
• Clinical signs−Calves: Diarrhea, abdominal pain,
listlessness, neurologic−Sheep, goats: Watery to bloody
diarrhea, neurologic−Humans: Little information
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Toxins: The ResponseToxins: The Response
• Supportive care• No vaccines currently available for
SEB or ricin• Vaccines for animals for clostridial
disease• Toxins are inactivated with common
disinfectants
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Food Safety ThreatsFood Safety Threats• Campylobacter species• Salmonella species• E. coli 0157:H7 • Viruses, parasites,
chemicals, toxins• Ingestion of
contaminated food• Gastrointestinal upset
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Food Safety Threats: The Response
Food Safety Threats: The Response
• Constant vigilance to improve food safety
• Food irradiation at processing plants
• Wash hands and utensils frequently
• Proper cooking temperature and storage
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Water Safety ThreatsWater Safety Threats
• 53% of US drinking water is from ground water
• Cryptosporidium parvum- protozoa
• Vibrio cholerae- bacteria
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Cryptosporidium: The AgentCryptosporidium: The Agent
• Cryptosporidium parvum- protozoa• Transmission: Inhalation, ingestion• Clinical signs: Humans, calves,
others−Acute gastroenteritis
• Dogs, cats, horses, pigs: Resistant
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Vibrio cholerae: The AgentVibrio cholerae: The Agent
• Vibrio cholerae- bacteria• Transmission: fecal-oral,
contaminated shellfish• Clinical signs: humans
−Acute, mild diarrhea−5% severe disease
• Animals are resistant to disease
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Water Safety: Public Health Significance
Water Safety: Public Health Significance
• Cryptosporidum parvum −1993: Municipal water supply
contaminated in Milwaukee−40,000 ill−1997: Decorative water fountain at the
Minnesota Zoo−369 cases −Mostly young children
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Water Safety Threats: The Response
Water Safety Threats: The Response
• Government has laws to protect our water supply
• Treatment facilities are equipped and will likely inactivate most organisms
−Chlorination, filtration, ozone
• Dilution factor
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Category CCategory C
• Nipah virus• Hantavirus
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Nipah Virus: The AgentNipah Virus: The Agent
• Fruit bats• Clinical signs
−Humans: Brain inflammation−Pigs: Respiratory; neurological−Dogs and cats: “Distemper”
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Nipah Virus: The ResponseNipah Virus: The Response
• Avoid contact with all infected animals and fluids
• Vaccine being researched• Call authorities
immediately
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Hantavirus: The AgentHantavirus: The Agent• Bunyaviridae family• Asymptomatic reservoir: Rodents• Transmission: Inhalation,
ingestion, direct contact• Human clinical signs
−Fever, myalgia, headache−Hantavirus Pulmonary Syndrome −Hemorrhagic Fever with Renal Syndrome
• Not seen in domestic animals
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Hantavirus: The ResponseHantavirus: The Response
• Supportive care• Limit exposure to
rodent excrement• Virus is
deactivated with bleach
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Other Important Diseases
Other Important Diseases
• Transmissible Spongiform Encephalopathy (TSE)
• Rift Valley Fever• Hendra Virus• West Nile Virus• Foot and Mouth Disease• Monkeypox
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Transmissible Spongiform Encephalopathy: The AgentTransmissible Spongiform
Encephalopathy: The Agent• Prions
−Proteinaceous infectious particles−Mutated proteins
• Very long incubation period• Neurological signs in all species• No treatment available
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Bovine Spongiform Encephalopathy
Bovine Spongiform Encephalopathy
• “Mad cow disease”• Incubation: 2 to 8 years• 1995, United Kingdom
−vCJD−People exposed to BSE
Before bovine offal ban in 1989
• Active U.S. surveillance since 1990
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TSE: The ResponseTSE: The Response
• Very resistant−Heat, sterilization and disinfectants
• Early identification not possible −Lack of host immune response−Long incubation period
• No effective treatment or vaccine • Surveillance program• Import restrictions
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Rift Valley Fever: The AgentRift Valley Fever: The Agent
• Virus• Transmission: mosquito, inhalation,
contact with infected body fluids• Clinical signs
−Humans: Flu-like, fever, headache Severe disease: Vision complications,
bleeding with fever−Animals: Abortions, death in newborns
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Rift Valley Fever: The Response
Rift Valley Fever: The Response
• Vaccinate ruminants in endemic areas
• Control mosquitoes• Avoid contact with
infected tissues & blood−Wear protective clothing
• No person-to-person transmission
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Hendra Virus: The AgentHendra Virus: The Agent
• Newly discovered− Australia
• Fruit bats• Transmission: Urine, body fluids• Incubation: 6-18 days• Humans
− Flu-like illness, respiratory failure
• Horses, cats− Acute respiratory signs, nasal discharge,
fever, encephalitis, sudden death
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Hendra Virus: The ResponseHendra Virus: The Response
• Little is known about disease• Potentially serious consequences
−High death rate−Lack of treatment
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West Nile Virus: The AgentWest Nile Virus: The Agent
• Flavivirus• Transmission
− Mosquitoes: Culex species− Blood transfusion, organ
donation, breast feeding• Animals: Horses, birds,
mammals and reptiles• Humans
− Duration: 3-6 days− 80% have no signs− 20% develop “West Nile Fever”
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West Nile Virus: Public Health Significance
West Nile Virus: Public Health Significance
• Human illness in U.S. in 2003−9,100 cases, 222 deaths
• Horses illness in U.S. in 2003−4,554 cases−40% of ill result in death
• Method of introduction to U.S. unknown
*data current as of 1/30/04
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Spread of WNV in the U.S.: 1999-2002
Spread of WNV in the U.S.: 1999-2002
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West Nile Virus: The Response
West Nile Virus: The Response
• Treatment: Supportive care• Vaccine available for horses, not humans• Source elimination
− Mosquito larval habitats• Personal protection
− Reduce time outdoors− Wear long pants and sleeves− Use mosquito repellent
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Foot and Mouth Disease: FMDFoot and Mouth Disease: FMD
• Picornavirus• Transmission: Direct contact,
aerosol, fomites• Species: Cloven-hooved
animals (not horses)• Signs: Fever, vesicles,
salivation, lameness• Extremely rare, mild
symptoms in people
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FMD: Agroterrorism ThreatFMD: Agroterrorism Threat
• Most important livestock disease in the world
• U.S. agriculture as a target−One sixth of the U.S. domestic
product is tied to agriculture− Immunologically naive population
• Vulnerabilities− Increased travel, poor biosecurity
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FMD: The ResponseFMD: The Response• USDA upgrading safeguarding
measures• Strict biosecurity• Notify authorities immediately• Response and
recovery plans−Quarantine−Depopulation−Disinfection
• Vaccination – complex decision
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Monkeypox: The AgentMonkeypox: The Agent• Orthopoxvirus, related to
smallpox• Transmission
− Reservoir may be African squirrel
− Bites, aerosol, direct contact− Zoonotic, animal-to-animal,
person-to-person• Animals: Fever, rash, pustules,
red eyes• Humans: Flu-like, rash,
pustules, swollen lymph nodes
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Monkeypox: Public Health Significance
Monkeypox: Public Health Significance
• 2003 U.S. Outbreak− Zoonotic disease− 6 Midwestern states
• Animal illness− Suspect cases: 93− Confirmed cases: 10
• Human illness− Suspect cases: 72− Confirmed cases: 37
All had contact with infected prairie dogs
• Potential bioweapon
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Monkeypox: The ResponseMonkeypox: The Response
• Treatment: Supportive care• Smallpox vaccination
− Moderately protective (85% of cases)− 30 individuals in 2003, no adverse events
• Infection Control− EPA registered detergent disinfectant− 0.5% sodium hypochlorite (bleach)
• Embargo• Euthanasia of animals• Quarantine for 6 weeks
Conclusion
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What to do if bioterrorism is suspected
What to do if bioterrorism is suspected
• Stay informed and remain calm• Response is event specific• Response is everyone's responsibility• Follow the advice of public health
officials • Follow federal and state guidelines• Movement restrictions may be
necessary
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ContactsContacts
• Phone numbers to know−Local veterinarian−Local physician−Public health officials
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SummarySummary
• Bioterrorism is a real threat • Public health infrastructure is being
strengthened• Many bioterrorism agents are
zoonotic• Awareness education is an important
component of preparedness and protection
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SummarySummary
• Prevention, recognition and response involves everyone
• Report any suspicious activity, unexplained behavior or death loss in your herd or flock
• You play a critical role
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ConclusionConclusion
“The best prescription,is knowledge.”
Dr. C. Everett KoopFormer U.S. Surgeon General
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AcknowledgmentsAcknowledgments
Development of this presentation was funded by a grant from the Centers for Disease Control and Prevention to the Center for Food Security and Public Health at Iowa State University.
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AcknowledgmentsAcknowledgments
Authors:
Reviewers:
Danelle Bickett-Weddle, DVMJamie Snow, DVM
Radford G. Davis, DVM, MPHGayle B. Brown, DVM, PhDJean Gladon, BS