Chemical and Biological Terrorism Preparedness

Bacterial, viral or toxic agents could be used as weapons against human beings. Although these agents are difficult to deliver into an unsuspecting population, it is still a remote possibility. This web site was created to provide you with basic information about biological agents that could be used, and what you can do to prepare yourself for any act of this kind in your community.

Here is an introduction to a few of the key preparedness activities for responding to incidents of this nature:

  • The Washtenaw County Emergency Medical Services Commission created a Bioterrorism Committee in April of 2000. This committee was charged with reviewing all available information pertaining to acts of domestic and international terrorism; reviewing the potential of health and safety impacts on the citizens of Washtenaw County; identification of all pertinent response resources; and developing a local bioterrorism response procedure. This committee has met numerous times since inception. It has completed and submitted the Department of Justice Weapons of Mass Destruction Risk and Needs Assessment, and continues to update local response procedures.
  • The Michigan Department of Community Health has in place a Bioterrorism Preparedness Project that has been funded through a three-year grant of approximately $1.5 million per year from the Centers for Disease Control and Prevention (CDC) for stronger public health preparedness for bioterrorism.
  • Michigan has been preparing for how to respond in the event of a Bioterrorism attack and much work has already been completed across the state. All county Emergency Management and Public Health departments have been working cooperatively with the Michigan State Police, Federal Bureau of Investigation, Michigan National Guard, Emergency Medical Services, Poison Control Centers, area physicians and hospitals, and the Michigan Department of Community Health to focus on this extremely important issue. Priority has been given to community response. This includes coordinating emergency management activities, enhancing disease detection and reporting, improving biological and chemical laboratory capacity, and enhancing Michigan's health alert network. Washtenaw County has a full Hazardous Materials Response Team in place, comprised of highly trained personnel from many local agencies. The team is on-call twenty four hours a day for response to any major hazardous incident. The team director has met numerous times with the other members of the Bioterrorism Committee to coordinate bioterrorism response.
What is the Risk?

Washtenaw County has a low likelihood of experiencing a terrorist attack. Obviously it is not impossible, but the risk is low. The main reason for this is that we have no major targets of international political debate or controversy that known international terrorists have targeted before or have ever shown interest in targeting. The World Trade Center and the Pentagon were well known and extremely high visibility targets. Terrorists groups have consistently denounced what these national symbols represent.  The risk, though it is very low, does still exist.

"Bioterrorism"

Bioterrorism is the intentional or threatened use of viruses, bacteria, fungi or toxins from livining organism to produce death or disease in humans, animals or plants. There are over 400 agents listed as possible agents of bioterrorism. The four agents most likely to be used are Smallpox (Variola major), Anthrax (Bacillus anthracis), Botulism (botulinum toxin) and Plague (Yersinia pestis).

Smallpox

- Smallpox is a disease caused by the variola virus; there are two types, variola minor and the more deadly variola major. Smallpox is spread from one person to another by coming into direct contact with infected saliva droplets from a person ill with the disease. Persons with smallpox are most contagious during the first week of the illness because that is when a large amount of virus can be found in the saliva. However, transmission can occur until all the lesions have completely healed (all scabs have fallen off). The incubation period is about twelve days (range: 7-17 days) following exposure to the virus. Early symptoms include a high fever, fatigue, and head & back aches. A characteristic rash appears two to three days later; this rash is concentrated on the face, arms and legs. It starts with flat, red lesions that progress at the same rate; they become pus-filled and begin to crust early in the second week (8th-9th day). Scabs develop, separate and then fall off after about three to four weeks. The majority of patients do recover, but death can occur in up to 30% of those who become ill. Deaths usually occur late in the first week or the second week of illness.

The last case of smallpox on Earth occurred in Somalia, in 1977. In 1980 the World Health Organization certified that smallpox had been eradicated from the planet. Currently, the only known remaining samples of smallpox virus are held in secure facilities at the Centers for Disease Control and Prevention in Atlanta, GA, and the Institute for Viral Preparations in Koltsovo, Russia.

Although destruction of all remaining samples of smallpox virus has been proposed, the United States government has decided to permanently store its samples of smallpox virus. Allegations and rumors of smallpox virus stocks in other locations have not been verified.

As a result of the successful eradication program, smallpox vaccine was removed from the commercial market in 1983, and is no longer a licensed product in the United States. The United States Public Health Service maintains an emergency stockpile of approximately 15 million doses.

At the present time, smallpox vaccine is supplied only to certain laboratory workers who are at risk of infection with smallpox-like viruses as a result of their occupation. The Centers for Disease Control and Prevention is authorized to release the vaccine only to these workers under an Investigational New Drug (IND) permit from the Food and Drug Administration (FDA). The IND does not allow us to release smallpox vaccine to any other person for any reason.

The Federal Government, including the Centers for Disease Control and Prevention, is concerned about the threat of bioterrorism. Plans for a response to such an event are being developed at many levels of the Government. These plans do not include wide spread use of smallpox vaccine at this point. The benefits and risks of reintroduction of smallpox vaccine are continuing to be examined. Current outbreak prevention efforts include the development and production of a new type of smallpox vaccine.

For more information about smallpox, visit the Centers for Disease website for  "Smallpox and Bioterrorism" . You may also wish to view the Public Health Service's " Recommendations on Smallpox Vaccination ."

Anthrax

- Anthrax is a disease caused by a spore-forming bacterium called Bacillus anthracis. It is most commonly found in animals and sometimes in humans who handle infected animals. Anthrax is not contagious, which means it is not spread from person to person. Healthy people who come into contact with persons sick with anthrax cannot "catch" the disease. There are three ways an individual may become infected: 1) by breathing 8,000-30,000 anthrax spores down into the lungs (inhalation), 2) by handling contaminated animals/animal products, or other contaminated objects, where spores can enter a cut, or abrasion on the skin (cutaneous), and 3) by eating contaminated meat/food (intestinal). Symptoms vary depending on how the spores entered the body, but usually occur within seven days (incubation period). However, current recommendations are for 60 days of preventative antibiotic therapy for those individuals who have a confirmed exposure to this bacterium. Cutaneous anthrax symptoms begin with a raised itchy bump that looks like an insect bite which develops into a blister-like lesion (1-2 days), which then becomes a painless ulcer with a blackened center. About 20% of untreated cutaneous anthrax patients die. Early symptoms of intestinal anthrax include nausea, loss of appetite, vomiting and fever; these are followed by abdominal pain, vomiting of blood and severe diarrhea. Approximately 25% to 60% of patients with intestinal anthrax die from the disease. Inhalational anthrax symptoms resemble those of a common cold. After several days, the symptoms may progress to severe breathing problems and shock. If treatment is not started soon enough, generally before symptoms appear, inhalation anthrax infection is usually fatal.

Anthrax can be found all over the world. It is usually more common in developing countries or countries without preventative veterinary programs. Certain regions of the world report more anthrax in animals than in others (South and Central America, Southern and Eastern Europe, Asia, Africa, the Caribbean and the Middle East). The disease usually occurs in wild and domestic warm-blooded animals such as, cattle, goats, sheep, camels, antelopes and other herbivores.

When a case of anthrax is identified and reported, local, state and federal health authorities quickly conduct an investigation, determine the time and place of the exposure and identify those individuals who need treatment with antibiotics. The Centers for Disease Control and Prevention have stockpiled the appropriate antibiotics needed to effectively treat large numbers of people; these supplies can be transported within hours; distribution would be coordinated via state health departments. The Washtenaw County Public Health Department is monitoring local antibiotic inventories and supplies to improve immediate response capability.

Anthrax vaccine for humans is not currently available to the general public and is not recommended for children under the age of 18. Six doses of the vaccine are needed to complete the initial series (day 0, 2 & 4 weeks, 6, 12 & 18 months) and yearly boosters are recommended to sustain adequate protection. Vaccines licensed for use in animals should not be used in humans.

For more information about anthrax, check the Centers for Disease Control website for  "Anthrax and Bioterrorism" .  You may also wish to view the Public Health Service's " Recommendations on Anthrax Vaccination ".

Botulism

- Botulism is a muscle-paralyzing disease caused by a toxin produced by a bacterium called Clostridium Botulinum. Botulism is not spread from person to person. There are three main kinds of botulism: 1) Food borne, 2) Wound and 3) Infant. Food borne botulism occurs when an individual ingests pre-formed toxin that leads to illness within a few hours to a few days. Improperly prepared or home-canned foods are the most frequent cause of this illness and can affect any age group. Infant botulism occurs in a small number of susceptible infants each year. For unknown reasons, this bacterium is able to grow in the intestines of these infants. Wound botulism is caused when open wounds become infected with the living bacteria; toxin is produced which results in paralysis. In the United States, injecting drug users are the group most at risk for this form of the disease. The incubation period for food borne botulism is six hours to two weeks (usually between 12-36 hours) after ingesting contaminated food or water. Symptoms include double vision, blurred vision, drooping eyelids, slurred speech, difficulty swallowing, dry mouth and muscle weakness. This weakness always moves down the body: first the shoulders, then upper arms, then lower arms, then thigh, calves, etc. Paralysis of the muscles that control breathing can cause death, unless assistance via mechanical ventilation is provided. Infants with botulism appear very lethargic (sleepy, difficult to wake up), feed poorly (unable to suck effectively), are constipated, have a weak cry and lax (poor) muscle tone.

The CDC maintains a supply of antitoxin against botulism. The antitoxin is effective in reducing the severity of symptoms if administered early in the course of the disease. Most patients in the U.S. (more than 90%) recover after a few weeks to several months of supportive care.

For more information about botulism, view the Centers for Disease Control website on "Botulism and Bioterrorism" .

Plague

- Plague is an infectious disease caused by the bacterium Yersinia pestis, it is found in rodents and their fleas in many areas of the world. There are two types of infection, bubonic and pneumonic. Naturally acquired disease usually presents as bubonic plague which is caused by flea bites; the pneumonic form is caused by breathing in the organism. The pneumonic form can spread from person to person via respiratory droplets, however, a person must have direct and close (within 6 feet) contact with an infected individual to be exposed to the disease. The incubation period is from one to seven days for bubonic plague and from one to four (usually short) for pneumonic plague. Early symptoms of plague include fever, headache, weakness, cough with bloody or watery sputum, shortness of breath and chest pain; nausea, vomiting abdominal pain and diarrhea may also occur. Within two to four days the pneumonia quickly leads to septic shock (infection of the entire body). Without early antibiotic treatment (within 24 hours of the first respiratory symptoms) most pneumonic plague patients die.

There is no vaccine against plague; however preventative antibiotic treatment for seven days will protect individuals who have had face-to-face (close, direct) contact with infected persons.

Yersinia pestis is very sensitive to sunlight and does not survive long outside the body of an infected host (flea, rodent, human). The bacterium may survive however, for several weeks, in water, moist food or grains.

For more information about plague, view the Centers for Disease Control website for "Plague and Bioterrorism" .

To find out more about Bioterrorism, try these sites:


Chemical Attack

Chemicals are an enormous part of our every-day lives. Without the advancements made in chemistry, physics and technology in general, we would still be living in the middle ages. Without the hazardous properties found in fuels, corrosives, solvents, alchohols and other chemicals, we would find ourselves without automobiles, well constructed homes, and effective health care systems, just to name a few.

These technological advancements come with a risk. Accidental hazardous materials spills and releases do occur. When they do happen, highly trained "HazMat" teams are quickly activated and the spill is mitigated. Because of recent events, the risks are heightened because chemicals may be available to criminals who intend harm for the sake of making political or social change through an act of terrorism.

Because there are so many chemicals available in North America, it is simply impossible to list what could be used and how it would affect you if it were released. For that reason, it is important to educate yourself about the procedures that are already in-place in your community for responding to hazardous materials accidents.

You would find out about the appropriate emergency procedure to follow by listening to your local Emergency Alert System radio station. In Washtenaw County, those stations are WEMU 89.1 FM and WAAM 1600 AM

. If your area is affected by a chemical emergency, there are two basic emergency procedures that you may be asked to follow. They are "Shelter in Place" or "Evacuation" . Shelter-in-Place:

Authorities may decide to shelter you "in-place" for your protection. It is important to stay calm, listen carefully to the radio to make sure the "shelter-in-place" order applies to you, and follow the following instructions:

  • Take your children and pets indoors immediately. While gathering your family, you can provide a minimal amount of protection to your breathing by covering your mouth and nose with a damp cloth.
  • Close all windows in your home.
  • Turn off all fans, heating and air conditioning systems.
  • Close the fireplace damper.
  • Go to an aboveground room (not the basement) with the fewest windows and doors.
  • Take your Family Disaster Supplies Kit with you.
  • Wet some towels and jam them in the crack under the doors. Tape around doors, windows, exhaust fans or vents. Use the plastic garbage bags to cover windows, outlets, and heat registers.
  • If you are told there is danger of explosion, close the window shades, blinds, or curtains. To avoid injury, stay away from the windows.
  • Stay in the room and listen to your radio until you are told all is safe or you are told to evacuate.

Evacuation:

Authorities may decide to evacuate an area for your protection. Again, it is important to stay calm, listen carefully and follow all instructions. If you are told to evacuate, listen to your radio to make sure the evacuation order applies to you and to understand if you are to evacuate immediately or if you have time to pack some essentials. Do not use your telephone. If you are told to evacuate immediately:

  • Move quickly and calmly and take the following with you:
    • Your Family Disaster Supplies Kit and medications
    • A change of clothing for each member of the family
    • Medication, eyeglasses, hearing aids or dentures, or things like canes and walkers
    • Personal items such as toothbrushes, deodorant, etc.
    • Items for your baby such as diapers, formula, or baby food
    • Books, puzzles or cards and games for entertainment
    • Close and lock your windows
    • Shut off all vents
    • Lock the door
  • Do not assume that a shelter will have everything you need. In most cases, the shelters will provide only emergency items such as meals, cots, and blankets. You do not need to turn off your refrigerator or freezer, but you should turn off all other appliances and lights before locking your home as you leave.
  • Check on neighbors to make sure they have been notified, and offer help to those with disabilities or other special needs. If you need a ride, ask a neighbor. If no neighbor is available to help you, listen to the emergency broadcast station for further instructions.
  • Take only one car to the evacuation site. Close your car windows and air vents and turn off the heater or air conditioner. Do not take shortcuts because a shortcut may put you in the path of danger. For your safety, follow the exact route you are told to take.

As an added precaution during this heightened state of alert, the U.S. Environmental Protection Agency (EPA) in coordination with the U.S. Department of Transportation (DOT) and the Federal Bureau of Investigation (FBI) has suggested that those who manufacture, distribute, transport or store hazardous chemicals should be especially vigilant regarding the physical security of those chemicals. The EPA has also recommended that these businesses review "Chemical Accident Prevention: Site Security" .


What You can do to be Prepared

All families should be prepared to sustain themselves for a minimum of a full 72 hours... for any community emergency that may happen.  Consider taking a few minutes today to prepare your family or business for the next crisis before it happens.

The Washtenaw County Homeland Security Task Force has developed the  Community Emergency Preparedness Workbook & Guidelines to help you.   This booklet is designed to inform you about many of the systems that are inplace and ready to respond, but most importantly it contains valuable information about what you can do to help your family, friends, and co-workers survive.  The time you invest today will be well worth the effort.


If you would like more information, please contact:

Washtenaw County Public Health Department
Disease Control Unit
Weekdays, 8:30 a.m. - 5:00 p.m.
Phone (734) 544-6759

Washtenaw County Emergency Management Division
Weekdays, 8:30 a.m. - 5:00 p.m.
Phone (734) 973-4900


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