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Food Animal Veterinarian Presentation

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					Bioterrorism
Awareness:
Protection of
Human and Animal
Health
Food animal
veterinarians
          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
                                     Center for Food Security and Public Health
                                             Iowa State University 2005
                Biological Attack
•   Bioterrorism attacks of 2001
    •   Anthrax in postal system
        •   22 cases
        •   5 deaths
•   U.S. public health realm changed
    forever



                                   Center for Food Security and Public Health
                                           Iowa State University 2005
    Preparedness Responsibilities:
            Veterinarians
• Anticipate outbreaks on the local level
• Collect and label samples
• Know the agents
• Know the typical signs of diseases
    −   Animals and human
• Know how to report suspected cases
• Disseminate knowledge


                                  Center for Food Security and Public Health
                                          Iowa State University 2005
              Overview
•   Bioterrorism
•   Zoonoses and bioterrorism
•   Disease control and biosecurity
•   U.S. Government agencies involved
•   Bioterrorism agents/diseases
•   Your role and responsibility


                             Center for Food Security and Public Health
                                     Iowa State University 2005
                       Terrorism
Agroterrorism        Bioterrorism                     Other
Biological,                                      Conventional,
chemical, or         Biological agents           radiological,
radiological         targeting humans,           nuclear,
agents targeting     animals, or plants          chemical,
agriculture or its                               cyber
components
                                                       •Typically
  •Livestock
                                                       direct
  •Food supply
                                                       human
  •Crops
                                                       targeting
  •Industry
  •Workers
                                          Center for Food Security and Public Health
                                                  Iowa State University 2005
         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


                              Center for Food Security and Public Health
                                      Iowa State University 2005
Infectious Disease Outbreak
               Exposure

                                  Symptoms

                                              Seek Care
No. Affected




                    Time (Days)
                                         Center for Food Security and Public Health
                                                 Iowa State University 2005
    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                       Center for Food Security and Public Health
                                         Iowa State University 2005
    Many Agents are Zoonotic
• Disease may be seen in animals
  before humans
• Animals are sentinels
    −   Pets, livestock,
        wildlife




                               Center for Food Security and Public Health
                                       Iowa State University 2005
       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

                               Center for Food Security and Public Health
                                       Iowa State University 2005
             Disease Control:
             Client Education
•   Disinfect/clean up areas
    contaminated with animal waste
    − Livestock,   pets, wildlife, rodents
•   Basic hygiene
    − Wash  hands
    − Child supervision




                                      Center for Food Security and Public Health
                                              Iowa State University 2005
          Zoonoses Control:
           Client Education
•   Proper pet selection
•   Use caution at petting zoos
•   Cook food properly
•   Control strays
•   Communication with physician and
    veterinarian
•   Follow guidelines for
    immunocompromised people

                                 Center for Food Security and Public Health
                                         Iowa State University 2005
        Biosecurity Education
           for 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
                               Center for Food Security and Public Health
                                       Iowa State University 2005
        Biosecurity Education
           for 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
                               Center for Food Security and Public Health
                                       Iowa State University 2005
      Biosecurity Education
         for the Producer
• Maintain healthy herd
   − Vaccinations
   − Proper hygiene for
     animals and handlers
• Purchase from
  reputable sources
• Quarantine newly
  purchased animals
• Separate sick animals

                            Center for Food Security and Public Health
                                    Iowa State University 2005
    Biosecurity: Veterinarians
• Disinfect your clothes, boots, equipment
  between farms
• Avoid vehicle contamination
• Follow biosecurity guidelines set forth by
  species-specific associations




                                  Center for Food Security and Public Health
                                          Iowa State University 2005
U.S. Agencies

Dealing with terrorism
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

                                     Center for Food Security and Public Health
                                             Iowa State University 2005
     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    Center for Food Security and Public Health
                                             Iowa State University 2005
    Centers for Disease Control
          and Prevention
•   CDC's Mission
    − Promote  health and quality
    of life by preventing and
    controlling disease, injury,
    and disability
• Preparing for bioterrorism since 1998
• One of the first agencies to respond to
  anthrax incidents of 2001

                                  Center for Food Security and Public Health
                                          Iowa State University 2005
Strategic National Stockpile


•   12-hour Push Package
    −   Complete package of
        medical materials




•   Vendor Managed Inventory
    −   Tailored to suspected agents


                                       Center for Food Security and Public Health
                                               Iowa State University 2005
Insert Your State’s Info Here




                     Center for Food Security and Public Health
                             Iowa State University 2005
            Preparing Iowa
•   Iowa’s Homeland
    Security
    − Administered by
      Iowa Emergency
      Management
      Division
    − Works with public
      and private         www.iowahomeland
                          security.org
      partners

                                Center for Food Security and Public Health
                                        Iowa State University 2005
            Preparing 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

                                     Center for Food Security and Public Health
                                             Iowa State University 2005
Category ABC
Agent Overview
             Classification
•   Prepared by the CDC’s Bioterrorism
    Preparedness and Response Office
•   Category A: highest priority
•   Category B: second highest priority
•   Category C: third highest priority




                               Center for Food Security and Public Health
                                       Iowa State University 2005
    “Weaponization” of Agents
•   Alter characteristics of a pathogen to
    make it a more effective weapon
    − Enhance    transmission
    − Increase virulence
    − Resistant to antibiotics
    − Evade vaccine protection
    − Alter clinical signs



                                 Center for Food Security and Public Health
                                         Iowa State University 2005
           Note 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.



                                     Center for Food Security and Public Health
                                             Iowa State University 2005
Category A : Agents/Diseases
•   Anthrax
•   Botulism
•   Plague
•   Smallpox
•   Tularemia
•   Viral hemorrhagic fevers


                               Center for Food Security and Public Health
                                       Iowa State University 2005
         Anthrax: The Agent
•   Bacteria: Bacillus anthracis
•   Forms spores
•   Human disease
    − Skin
    − Intestinal
    − Pulmonary

•   Animal disease
    − Septicemia   and rapid death
                                     Center for Food Security and Public Health
                                             Iowa State University 2005
     Anthrax: The Bioweapon
•   History
•   Available & easily
    produced
•   Spores infective
•   Aerosolization
•   Low lethal dose
•   High mortality
•   Person-to-person transmission rare
                              Center for Food Security and Public Health
                                      Iowa State University 2005
      Anthrax: The Response
•   Vaccine
    − Humans
    − Animals

•   Antibiotics
    − Treatment
    − Prophylaxis

•   Disinfection
    − Sporicidal   agents, sterilization
                                      Center for Food Security and Public Health
                                              Iowa State University 2005
        Botulism: 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
                              Center for Food Security and Public Health
                                      Iowa State University 2005
     Botulism: The Bioweapon
•   Used by Aum Shinrikyo
    cult in Japan
•   Aerosolized
•   Easy to produce and
    transport
•   Potent and lethal
•   Most poisonous substance
    known
                               Center for Food Security and Public Health
                                       Iowa State University 2005
      Botulism: The Response
•   Toxoids for high risk people
•   Antitoxin available
    − Case-by-case   basis
•   Botulinum toxins are easily
    inactivated with many
    disinfectants and heat



                                  Center for Food Security and Public Health
                                          Iowa State University 2005
             Plague: 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

                                     Center for Food Security and Public Health
                                             Iowa State University 2005
      Plague: The Bioweapon

•   WHO estimate
    − 50kg agent: City population 5 million
    − 150,000 cases pneumonic plague
    − Potential mortality: 100,000

•   Available
•   Person-to-person transmission
•   Pneumonic form ~ 100% fatal if
    untreated
                                   Center for Food Security and Public Health
                                           Iowa State University 2005
       Plague: The Response
•   Antibiotics generally effective if given
    early
•   Killed vaccine available
•   Isolation of sick individuals
•   Susceptible to a number of common
    disinfectants



                                 Center for Food Security and Public Health
                                         Iowa State University 2005
        Smallpox: The Agent
•   Variola virus, Orthopoxvirus
•   Eradicated from the world in 1977
•   Narrow host range: Humans only
•   Transmission: Person-to-person,
    fomites, aerosols
•   Clinical signs
             progressive skin
    − Flu-like,
     eruptions
                                Center for Food Security and Public Health
                                        Iowa State University 2005
    Smallpox: The Bioweapon
•   Used historically
•   Disease signals a bioterrorism event
    − Susceptible   population
•   Easy to produce large scale
•   Aerosolization
•   Secondary spread
    − Person-to-person
    − Fomites
•   Mortality approximately 30%
                                  Center for Food Security and Public Health
                                          Iowa State University 2005
     Smallpox: The Response
•   No specific treatment
•   Vaccinia virus vaccination
•   Vaccinia Immune Globulin
•   Isolation of infected individuals
•   Ring vaccination program
•   Disinfection of environment, clothing
    with various chemicals, boiling or
    autoclaving
                               Center for Food Security and Public Health
                                       Iowa State University 2005
       Tularemia: The Agent
•   Francisella tularensis
•   Transmitted by ingestion,
    inhalation, vectors, direct
    contact through skin
•   Six clinical forms in humans




      Glandular       Ulceroglandular
                                   Center for Food Security and Public Health
                                           Iowa State University 2005
        Tularemia: 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

                                     Center for Food Security and Public Health
                                             Iowa State University 2005
    Tularemia: The Bioweapon
•   Stable
•   Aerosolized
•   Low infective dose via inhalation
•   Case fatality: 30-60% (untreated )
•   WHO estimation: 1970
    − 50 kg agent: City population 5 million
       250,000 ill
       19,000 deaths


                                   Center for Food Security and Public Health
                                           Iowa State University 2005
     Tularemia: The Response
•   Person-to-person transmission not
    documented
•   Antibiotics effective if early or
    prophylactic
•   Vaccine
    − For high risk individuals
    − Unknown efficacy
      against inhalational
      tularemia
                                  Center for Food Security and Public Health
                                          Iowa State University 2005
     Viral Hemorrhagic Fevers:
             The Agents
•   Ebola, Marburg, Lassa, Machupo
•   Human clinical presentation
    − Early: Fever, fatigue
    − Severe: Bleed from internal
      organs, body orifices
    − Progression to shock &
      seizures                            Vincent Massey



•   Animals: Only non-human
    primates susceptible
                                    Center for Food Security and Public Health
                                            Iowa State University 2005
       VHF: The Bioweapons
•   Aerosolized
•   Not readily available, require
    specialized production
•   Person-to-person and nosocomial
    transmission occur
•   Untreated fatality rate variable
    − Humans:25-90%
    − Non-human primates: 50-100%

                              Center for Food Security and Public Health
                                      Iowa State University 2005
         VHF: The Response
•   Intensive supportive care
•   Ribavirin has shown some efficacy
•   Susceptible to bleach solutions,
    phenolic disinfectants, and UV light




                                Center for Food Security and Public Health
                                        Iowa State University 2005
Category B: Agents/Diseases
•   Brucellosis   •   Typhus fever
•   Glanders      •   Viral encephalitis
•   Melioidosis   •   Toxins
•   Psittacosis   •   Food Safety Threats
•   Q Fever       •   Water Safety Threats




                                 Center for Food Security and Public Health
                                         Iowa State University 2005
       Brucellosis: The Agent
•   Gram-negative bacteria
•   Ingestion, inhalation, or
    direct contact
•   Clinical signs
    − Humans:    Cyclic fever and
      flu-like symptoms
    − Animals: Reproductive signs




                                    Center for Food Security and Public Health
                                            Iowa State University 2005
     Brucellosis: The Agent
                                          Human
 Species          Natural Host
                                         Pathogen
                 Cattle, bison, elk,
B. abortus                                        Yes
                       horses
B.melitensis    Goats, sheep, cattle              Yes
               Swine, hares, reindeer,
  B. suis                                         Yes
                  caribou, rodents
  B. canis       Dogs, other canids               Yes
  B. ovis              Sheep                       No



                                         Center for Food Security and Public Health
                                                 Iowa State University 2005
    Brucellosis: The Bioweapon
•   History
•   Highly infectious
•   Easily aerosolized
•   Stable
•   Prolonged incubation period
    − May   make diagnosis difficult
•   Person-to-person unlikely

                                       Center for Food Security and Public Health
                                               Iowa State University 2005
    Brucellosis: The Response
•   Long term antibiotics generally
    effective
•   Vaccinate calves, no human vaccine
•   Eliminate reservoir
•   Standard precaution
    to avoid exposure
•   Thorough disinfection

                              Center for Food Security and Public Health
                                      Iowa State University 2005
         Glanders: The Agent
•   Burkholderia mallei: Gram-negative
•   Transmission by
    ingestion, inhalation, or
    direct contact
    − Animal-to-human
      transmission is inefficient
•   Clinical signs
    − Humans & horses: Cutaneous &
      pulmonary lesions, rapidly fatal illness
                                     Center for Food Security and Public Health
                                             Iowa State University 2005
     Glanders: The Bioweapon
•   History
    − WWI Russian horses
    − WWII Chinese civilians, horses, POW’s

•   Easy to produce
•   Aerosolized, highly infectious
•   Mortality high in chronic form
    − 50-70%

•   Person to person transmission: Rare
                                  Center for Food Security and Public Health
                                          Iowa State University 2005
      Glanders: The Response
•   No vaccine
•   Antibiotic therapy likely effective
•   Destroyed by various chemicals




                                 Center for Food Security and Public Health
                                         Iowa State University 2005
        Melioidosis: The Agent
•   Burkholderia pseudomallei:
    Gram-negative
•   Transmission: Contact,
    ingestion, inhalation
•   Clinical signs: Humans,
    sheep, goats, and pigs
    − Asymptomatic to
     pneumonia, lung and
     wound abscesses
                                 Center for Food Security and Public Health
                                         Iowa State University 2005
    Melioidosis: The Bioweapon
•   Easy to produce
•   Available
•   Aerosolization
•   High mortality: 90%
•   Person-to-person (rare)
•   Animal-to-person (rare)


                              Center for Food Security and Public Health
                                      Iowa State University 2005
    Melioidosis: The Response
•   Long-term, multiple
    antibiotics effective
•   Vaccines available:
    Not in U.S.
•   Easily destroyed by
    disinfectants



                            Center for Food Security and Public Health
                                    Iowa State University 2005
       Psittacosis: The Agent
•   Chlamydophila psittaci
    − Gram-negative

•   Occurs worldwide
•   Reportable in U.S.
•   Clinical disease in humans and birds
    − Asymptomatic
    − Systemic   illness with severe pneumonia


                                   Center for Food Security and Public Health
                                           Iowa State University 2005
    Psittacosis: The Bioweapon
•   Easily obtained
•   Aerosolized
•   Stable in the
    environment
•   Person-to-person
    transmission rare
•   Low mortality

                        Center for Food Security and Public Health
                                Iowa State University 2005
     Psittacosis: The Response
•   Antibiotics
    generally effective
•   Decontamination
    possible with most
    disinfectants




                          Center for Food Security and Public Health
                                  Iowa State University 2005
           Q Fever: The Agent

•   Coxiella burnetii
•   Transmission: Inhalation,
    direct contact, ingestion, ticks
•   Disease symptoms
    − Humans:
         Acute: Flu-like + pneumonia & hepatitis
         Chronic: Endocarditis, osteomyelitis
    − Animals:    Most asymptomatic
         Sheep, cattle and goats: Abortions
                                        Center for Food Security and Public Health
                                                Iowa State University 2005
     Q Fever: The Bioweapon
•   History
•   Easily accessible
•   Environmentally
    resistant
•   Highly infectious
•   Aerosolization
    − Travel   ½ mile by wind
•   Low mortality- chronic morbidity
                                Center for Food Security and Public Health
                                        Iowa State University 2005
      Q Fever: The Response
•   Often self-limiting disease
•   Antibiotic therapy may limit
    complications
•   Vaccine developed, not available in
    U.S.
•   Variable susceptibility to
    disinfectants


                               Center for Food Security and Public Health
                                       Iowa State University 2005
     Typhus Fever: The Agent
• Rickettsia prowazekii: Rickettsial organism
• Endemic in Eastern Europe, Middle East,
  and parts of Africa
• Transmitted in feces of              human
  body louse
• Clinical signs: Humans
    −   Fever, headache, macular                   J. Kalisch


        eruptions, and petechial rash
•   Not seen in domestic animals

                                        Center for Food Security and Public Health
                                                Iowa State University 2005
            Typhus Fever:
            The Bioweapon
•   WHO estimation: 1970
    − 50 kg agent; 5 million people in city
    − 125,000 ill
    − 8,000 deaths

•   Available
•   Can be aerosolized
    in lice feces
                                U.S. Typhus Commission




                                        Center for Food Security and Public Health
                                                Iowa State University 2005
Typhus Fever: The Response
•   Antibiotics are generally effective
•   Vaccine, not commercially available




                               Center for Food Security and Public Health
                                       Iowa State University 2005
Viral Encephalitis: The Agent
•   The Alphaviruses: EEE, WEE, and VEE
•   Transmitted via mosquito
•   Clinical signs
    − Humans,     horses, donkeys,
      mules: Often asymptomatic
      to flu-like
    − Encephalitis in small proportions

•   Birds are asymptomatic carriers, act
    as sentinels
                                   Center for Food Security and Public Health
                                           Iowa State University 2005
         Viral Encephalitis:
          The Bioweapon
•   Easy to produce
•   Aerosolization
•   High rate of infection
•   Person-to-person transmission
    possible




                              Center for Food Security and Public Health
                                      Iowa State University 2005
         Viral Encephalitis:
           The Response
•   Supportive care        •   Virus unstable in
•   Vaccine                    environment
    − Equine
    − Human:   High risk




                                      Center for Food Security and Public Health
                                              Iowa State University 2005
         Toxins: The Agents
•   Staphylococcal
    enterotoxin B (SEB)
•   Ricin toxin from
    castor plant
•   Clostridium
    perfringens epsilon
    toxin


                          Center for Food Security and Public Health
                                  Iowa State University 2005
               SEB: The Agent
•   Staphylococcal enterotoxin B (SEB)
•   A common cause of food poisoning
•   Clinical signs: Humans
    − Fever, chills, headache, myalgia
    − Non-productive cough if inhaled
    − GI signs if swallowed

•   Animals: Likely similar to human

                                   Center for Food Security and Public Health
                                           Iowa State University 2005
              Ricin: The Agent
•   Ricin toxin from bean of castor plant
•   Available worldwide
•   Clinical signs
    − Acuteonset of fever,
     chest tightness, cough,
     dyspnea, nausea



                                Center for Food Security and Public Health
                                        Iowa State University 2005
     Epsilon 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
                                   Center for Food Security and Public Health
                                           Iowa State University 2005
      Toxins: The Bioweapon
•   History
•   Aerosolized: SEB, ricin
•   Available worldwide
•   Easy to produce, stable
•   Many species affected
•   No person-to-person transmission


                             Center for Food Security and Public Health
                                     Iowa State University 2005
       Toxins: The Response
•   Supportive care
•   No vaccines currently available for
    SEB or ricin
•   Vaccines for animals for clostridial
    disease
•   Toxins are inactivated with common
    disinfectants


                               Center for Food Security and Public Health
                                       Iowa State University 2005
        Food Safety Threats
•   Campylobacter species
•   Salmonella species
•   E. coli 0157:H7
•   Viruses, parasites,
    chemicals, toxins
•   Ingestion of
    contaminated food
•   Gastrointestinal upset
                             Center for Food Security and Public Health
                                     Iowa State University 2005
           Food Safety Threats:
             The Bioweapon
•   1984, The Dalles, Oregon
    − Bagwan Shree Rajneesh cult
    − Contaminated salad bars
         Salmonella typhimurium
    − Goal:Incapacitate voters
    − 751 people ill




                                   Center for Food Security and Public Health
                                           Iowa State University 2005
        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



                                Center for Food Security and Public Health
                                        Iowa State University 2005
       Water Safety Threats
•   53% of US drinking
    water is from ground
    water
•   Cryptosporidium
    parvum- protozoa
•   Vibrio cholerae-
    bacteria


                           Center for Food Security and Public Health
                                   Iowa State University 2005
    Cryptosporidium: The Agent
•   Cryptosporidium parvum- protozoa
•   Transmission: Inhalation, ingestion
•   Clinical signs: Humans, calves,
    others
    − Acute   gastroenteritis
•   Dogs, cats, horses, pigs: Resistant



                                Center for Food Security and Public Health
                                        Iowa State University 2005
    Vibrio cholerae: The Agent
•   Vibrio cholerae- Gram-
    negative bacteria
•   Transmission: Fecal-
    oral, contaminated
    shellfish
•   Clinical signs, humans
    − Acute,mild diarrhea
    − 5% severe disease
•   Animals are resistant to
    disease
                               Center for Food Security and Public Health
                                       Iowa State University 2005
           Water Safety:
     Public Health Significance
•   1993: Municipal water supply
    contaminated in Milwaukee
    − Cryptosporidum   parvum
    − 40,000   ill
•   1997: Decorative water fountain at
    the Minnesota Zoo
    − C.parvum
    − 369 cases
    − Mostly young children

                                Center for Food Security and Public Health
                                        Iowa State University 2005
       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
                                      Center for Food Security and Public Health
                                              Iowa State University 2005
              Category C
•   Nipah virus
•   Hantavirus




                           Center for Food Security and Public Health
                                   Iowa State University 2005
      Nipah Virus: The Agent
•   Paramyxovirus
•   Fruit bat reservoir
•   Clinical signs
    − Humans:  Encephalitis
    − Pigs: Respiratory, neurological
    − Dogs and cats: “Distemper”




                                   Center for Food Security and Public Health
                                           Iowa State University 2005
    Nipah Virus: The Bioweapon
•   Aerosolization
    potential
•   Wide host range
•   No person-to-person
    transmission
    expected
•   High morbidity and
    mortality
                          Center for Food Security and Public Health
                                  Iowa State University 2005
    Nipah Virus: The Response
•   Avoid contact with all
    infected animals and
    fluids
•   Vaccine being researched
•   Call authorities
    immediately



                               Center for Food Security and Public Health
                                       Iowa State University 2005
      Hantavirus: 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
                               Center for Food Security and Public Health
                                       Iowa State University 2005
    Hantavirus: The Bioweapon
•   Aerosolized
•   Hospitalization
•   Unexpected disease
    in the U.S.
    − HFRS limited to
     Asia/Europe to date




                           Center for Food Security and Public Health
                                   Iowa State University 2005
    Hantavirus: The Response
•   Supportive care
•   Limit exposure to
    rodent excrement
    − Wear   gloves, face
      mask
•   Virus is deactivated
    with bleach


                            Center for Food Security and Public Health
                                    Iowa State University 2005
          Other Important
             Diseases
•   Transmissible Spongiform
    Encephalopathy (TSE)
•   Rift Valley Fever
•   Hendra Virus
•   West Nile Virus
•   Foot and Mouth Disease
•   Monkeypox

                               Center for Food Security and Public Health
                                       Iowa State University 2005
     Transmissible Spongiform
    Encephalopathy: The Agent
•   Prions
    − Proteinaceous infectious particles
    − Mutated proteins

•   Very long incubation period
•   Neurological signs in all species
•   No treatment available



                                   Center for Food Security and Public Health
                                           Iowa State University 2005
            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
                                       Center for Food Security and Public Health
                                               Iowa State University 2005
         TSE: 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
                                      Center for Food Security and Public Health
                                              Iowa State University 2005
    Rift Valley Fever: The Agent
•   Phlebovirus in family Bunyaviridae
•   Transmission: Mosquito, inhalation,
    contact with infected body fluids
•   Clinical signs
    − Humans:      Flu-like, fever,
     headache
         Severe disease: Retinitis,
          hemorrhagic fever
    − Animals:    Abortions, death in neonates
                                       Center for Food Security and Public Health
                                               Iowa State University 2005
           Rift Valley Fever:
            The Bioweapon
•   WHO estimate: 1970
    − 50 kg of virus aerosolized
    − 35,000 incapacitated
    − 400 deaths (1% mortality)

•   Stable at most temperatures
•   Inactivated by various chemicals



                                   Center for Food Security and Public Health
                                           Iowa State University 2005
             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
                                   Center for Food Security and Public Health
                                           Iowa State University 2005
        Hendra 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
                                                Center for Food Security and Public Health
                                                        Iowa State University 2005
    Hendra Virus: The Response
•   Little is known about disease
•   Highest level of security to work with
    the agent
•   Potentially serious consequences
    − High mortality rate
    − Lack of treatment




                                Center for Food Security and Public Health
                                        Iowa State University 2005
    West 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”
                                      Center for Food Security and Public Health
                                              Iowa State University 2005
          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
    − 4,554cases
    − 40% of ill result in death

•   Method of introduction to U.S.
    unknown
                           *data current as of 1/30/04

                                      Center for Food Security and Public Health
                                              Iowa State University 2005
Spread of WNV in the U.S.:
        1999-2002




                    Center for Food Security and Public Health
                            Iowa State University 2005
               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




                                    Center for Food Security and Public Health
                                            Iowa State University 2005
Foot 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
                               Center for Food Security and Public Health
                                       Iowa State University 2005
    FMD: 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

                                     Center for Food Security and Public Health
                                             Iowa State University 2005
          FMD: The Response
•   USDA upgrading safeguarding
    measures
•   Strict biosecurity
•   Notify authorities immediately
•   Response and recovery plans
    − Quarantine
    − Depopulation
    − Disinfection
•   Vaccination – complex decision
                                Center for Food Security and Public Health
                                        Iowa State University 2005
         Monkeypox: 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
    conjunctivitis
•   Humans: Flu-like, rash,
    pustules, lymphadenopathy


                                            Center for Food Security and Public Health
                                                    Iowa State University 2005
            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
                                                   Center for Food Security and Public Health
                                                           Iowa State University 2005
    Monkeypox: 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

                                       Center for Food Security and Public Health
                                               Iowa State University 2005
The Veterinarian’s
Responsibility
        Opportunities for the
        Veterinary Profession
•   Integrate into the public health
    system
    − Be aware, contribute, assist in
      development of surveillance programs
    − Report trends in disease and clinical
      signs
    − Be involved with emergency response
      plans at all levels


                                  Center for Food Security and Public Health
                                          Iowa State University 2005
          The Veterinarian’s
            Responsibility
•   Guardian of animal and public health
•   Sharpen awareness of potential
    bioterrorism
•   Alert officials early
•   You are the expert
            leadership and input to clients
    − Provide
     and community


                                  Center for Food Security and Public Health
                                          Iowa State University 2005
     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
                               Center for Food Security and Public Health
                                       Iowa State University 2005
                Contacts
•   Phone numbers to know
    − State Veterinarian
    − State Public Health
      Veterinarian
    − APHIS- Area Veterinarian
      in Charge
    − Public Health Officials




                                 Center for Food Security and Public Health
                                         Iowa State University 2005
               Summary
•   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
                               Center for Food Security and Public Health
                                       Iowa State University 2005
               Summary
•   Prevention, recognition, and
    response involves everyone
•   Report any suspicious activity,
    unexplained behavior or death loss
    in your clients’ herd or flock
•   You play a critical role



                              Center for Food Security and Public Health
                                      Iowa State University 2005
     Conclusion


“The best prescription,
    is knowledge.”

             Dr. C. Everett Koop
             Former U.S. Surgeon General




                       Center for Food Security and Public Health
                               Iowa State University 2005
Acknowledgments
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.


                 Center for Food Security and Public Health
                         Iowa State University 2005
             Acknowledgments
Author:      Danelle Bickett-Weddle, DVM, MPH


Reviewers:   Radford Davis, DVM, MPH
             Gayle Brown, DVM, PhD
             Jean Gladon, BS




                                       Center for Food Security and Public Health
                                               Iowa State University 2005

				
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