B-NICE Overview. Types of WMD Agents. Types of WMD Agents. Types of WMD Agents. Job Aid Version 1.0 and 2.0. CDC & Prevention

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1 B-NICE Overview Types of WMD Agents Biological Nuclear Incendiary Chemical Explosive Types of WMD Agents Job Aid Version 1.0 and 2.0 Chemical Biological Radiological Nuclear Explosive Types of WMD Agents CDC & Prevention Biological Nuclear Incendiary Chemical Explosive Ranks bioterrorism organisms into 3 categories based on ability to: 1. Be easily disseminated or transmitted. 2. Cause high mortality & present a major public health problem. 3. Cause panic & social disruption. 4. Require special attention of public health preparedness. 1

2 Biological Agents Microscopic organisms capable of causing illness and/or death in human populations Biological Agents 1. Bacteria Single-celled organisms capable of independent growth 2. Viruses Very small organisms that are incapable of independent growth, require living cells to replicate 3 Categories of Bio-organisms A-B-C List A - List Anthrax (Bacillus anthracis) Plague (Yersinia pestis) Smallpox (Variola major) Tularemia (Francisella tularensis) Botulism (Clostridium botulinum toxin) Viral hemorrhagic fevers (Ebola, Marburg, Yellow fever) Usually due to direct contact with contaminated wool, hides, or tissues Onset of symptoms begins 3-5 days after exposure Ulcerated sores develop within 24 to 36 hours Cutaneous Anthrax Cutaneous Anthrax Intestinal Anthrax Sores may develop into systemic infections if untreated Readily treatable with antibiotics Relatively low fatality rate if treated Occurs following ingestion of spores Signs/symptoms: Nausea, loss of appetite, vomiting, and fever followed by abdominal pain, bloody vomit, and severe diarrhea 25 to 60% fatal with treatment Almost 100% fatal without treatment 2

3 Inhalation Anthrax Inhalation Anthrax Caused by inhalation of Bacillus anthracis spores Begins with sudden onset of flu-like symptoms from 1 to 7 days after exposure Over next 2 to 4 days patient exhibits respiratory distress, exhaustion, tachycardia, cyanosis, and terminal shock Patient experiences shortness of breath, gasping cough, sweating, chills, and fever Definitive sign: widened middle part of chest (mediastinum) Hypothetical Scenario Estimated 130,000 to 3 million deaths would follow release of 100 kg (220 lbs.) of aerosolized anthrax over Washington D.C. Est. economic impact of $26.2 billion per 100,000 people exposed Poor mans atomic bomb Yersinia pestis transmitted from rodents to humans by infected fleas Aerosolized for biowarfare by Russians Plague Plague Bubonic Plague Types: Bubonic Pneumonic Septicemic Incubation period 2 to 10 days Targets lymph system Malaise, high fever, tender swollen lymph nodes result 50% fatal if untreated 3

4 Pneumonic Plague Septicemic Plague Incubation period 2 to 3 days Targets respiratory system High fever, chills, headache, muscle pain, cough with bloody sputum, SOB, cyanosis 90 to 100% fatal if untreated Communicable through respiratory droplets Generalized infection Occurs when bubonic or pneumonic form spreads beyond initial target to bloodstream Leads to tissue necrosis, skin lesions, and gangrene Often fatal Vaccines are available for bubonic plague but not pneumonic plague Antibiotic therapy and supportive treatment can reduce fatality rate Plague Vaccines and Treatment Options Key points Route of entry Signs and symptoms Patient treatment Tularemia Tularemia Video Clip Viruses Smallpox Venezuelan Equine Encephalitis Viral Hemorrhagic Fever 4

5 Smallpox Smallpox Key points Route of entry Signs and symptoms Patient treatment Likely disseminated by aerosol Incubation period 5 to 12 days Very contagious through respiratory system Smallpox Mortality rate 30% to 40% Fully MCE capable Treatment: supportive therapy for symptoms Vaccine available VEE Vector Transmitted Viruses VEE Vector Transmitted Viruses Key points Route of entry Signs and symptoms Patient treatment 5

6 Viral Hemorragic Fever (VHF) VHF Video Clip Key points Route of entry Signs and symptoms Patient treatment Toxins Substances of natural origin Produced by animal, plant or microbe Ricin Botulism Derived from castor bean plant Extremely toxic in very low concentrations Routes: Inhalation, Ingestion, Injection Onset of symptoms in 8 to 24 hours Death occurs in 36 to 72 hours due to pulmonary edema No known antidotes or vaccines Ricin Castorbean Plant (Ricinus communis) Toxins Assassination 1978: A BULGARIAN EXILE WAS INJECTED WITH RICIN, USING THE END OF A DEVICE DISGUISED TO LOOK LIKE AN UMBRELLA. HE DIED 4 DAYS LATER. 6

7 Assassination Weapon Botulinum Clostridium botulinum produces one of the most potent toxins known Routes: Inhalation, Ingestion Likely used to contaminate food or water or as aerosol agent Symptoms progress to paralysis of muscles leading to respiratory failure and death Botulinum Mortality rates of 20% with prompt treatment and 60% or higher without treatment Patient treatment consists of respiratory support and other supportive therapy Nuclear or Radiological Hazards Conventional Nuclear Devices Large Expensive Difficult to develop Very low probability of use by terrorists Radiological Nuclear or Radiological Hazards November Cases, lost, stolen, abandoned radiological sources Radiological Dispersal Device (RDD) Uses conventional explosives to scatter radioactive source High probability of occurrence 7

8 Briefcase RDD This is where the RDD detonates This is the area of physical damage This is the area of contamination Incendiary Incendiary Case History February, 2003 at Daegu, South Korea Milk container of gasoline ignited in subway car 189 people died 8

9 Incendiary Weapons Mechanical Materials Flammable gases Flammable/ combustible liquids Oxidizer enhanced Electrical 20 gallons of gasoline Five Classes of Chemical Agents Five Classes of Chemical Agents 1. Nerve Agents -Sarin, Soman, Tabun, VX 2. Blood Agents Hydrogen Cyanide, Cyanogen Chloride 3. Choking Agents Chlorine, Phosgene 4. Blister Agents- Mustard, Lewisite 5. Irritant Agents-Pepper Spray, Tear Gas, Mace HCN 1. Nerve Agents - Sarin, Soman, Tabun, VX 2. Blood Agents Hydrogen Cyanide, Cyanogen Chloride 3. Choking Agents Chlorine, Phosgene HCN 9

10 Nerve Agents MARK I Auto-injector Kit S- salivation L- lacrimation U- urination D- defecation G- gastric distress E- emesis M- miosis Five Classes of Chemical Agents Hydrogen Cyanide Antidote Kit 2. Blood Agents Hydrogen Cyanide, Cyanogen Chloride 3. Choking Agents Chlorine, Phosgene HCN Five Classes of Chemical Agents, continued Five Classes of Chemical Agents, continued 4. Blister Agents Mustard, Lewisite 5. Irritant Agents - Pepper Spray, Tear Gas, Mace 10

11 Pepper Spray Video Clip Explosives Case History: Murrah Federal Building Oklahoma City 4800 pounds of ANFO used in truck bomb 10 story concrete/steel building destroyed 168 people killed Motive reportedly revenge for Branch Davidians siege Emergency Response to Terrorism Job Aid FEMA USFA NFA US DOJ 11