Bioterrorism Attack To The US - Research Paper Example

Bioterrorism Attack To The US Abstract The utilization of biological agents particularly as weapons of distracting set up structures, for instance, huge urban populations and governments has been common throughout history. Subsequent to the anthrax letters posted to different government officers in the fall of 2001, America has been at the forefront of massive investment in surveillance, prevention as well as preparation for a possible bioterrorism attack. Supplementary funding authorized from 2002 has helped the Centers for Disease Control and Prevention, the Environmental protection Agency as well as Health and Human Services department, invest in preventive research measures and preparedness programs like Bio watch, Hospital Preparedness Program and Laboratory Response. With such programs as epidemiological surveillance and systems like sentinel monitoring in place for majority of metropolitan regions, the instant danger of a great-scale bioterrorist assault may be quite limited. Nevertheless, early detection is an important factor to start instant response measures aimed at preventing further spread in case of circulation of a biological agent. An interagency technique particularly in rural areas to raise attentiveness for the ordinary people and to educate health care employee still remains basic tasks and is also a continuing challenge. Techniques for risk management in responding to circulation of biological agents in addition to suitable decontamination measures which minimize the possibility of additional contamination have been offered, and imply additional investments in surveillance and preparedness. Continuing efforts to enhance response and preparedness to a bioterrorist assault are significant to further minimize mortality, morbidity as well as economic effect on public health. Keywords: risk management, public health policy, bioterrorism, community preparedness Introduction Basically, bioterrorism assault involves an intentional release of bacteria, viruses or other agents such as germs that can lead to death or illness in human beings, plants or animals. Normally, these agents are naturally found, however it is also possible that they can be altered to enhance their capacity to cause illness, be resistant to modern drugs, or maximise their capability to be spread via air, water or food (Mellehovitch, 2004). Terrorists may make use of biological agents since they are exceptionally hard to identify and do not lead to sickness for many hours even to a number of days. Bioterrorism agents such as smallpox virus can be passed from one individual to another and others like anthrax however, cannot. There are three categories of bioterrorism depending on how readily they can be spread as well as the harshness of sickness or death they lead to. These categories are Category A, B and C. Category A agents are high-priority ones that comprise of toxins or organisms that pose the maximum danger to not only national security but also general public. Category B agents are reasonably simple to spread and lead to moderate sickness as well as death rates. Finally Category C are 3rd maximum priority agents and comprise of up-and-coming pathogens which possibly could be engineered for future mass spread since they are readily produced, available, as well as spread. Background In the past 20 years there has been a considerable increase in utilization of biological agents for the intention of circulating such substances for public harm. Even though frequently referred to as “bioterrorism”, the intentions of such attacks as those are not essentially anticipated to threaten recognized government frameworks, however, they can also be provoked by political, ecological or religious ideologies. Similarly, not all occurrences involving threatened or actual dispersion of biological agents ought to be categorized as works of terrorism, since they can also be carried out by common criminals not in any way linked to or with terrorists’ organization (Mellehovitch, 2004). A sum of 153 cases of threatened or actual using of biological agents have been reported since 1990 to 1999.This is over 5 times the accounted cases for the period spanning from 1990-1989.In this context “threatened use” refers to investigations by federal agents that resulted in seizing of biological agents purposed for being used against citizens within America, both by radicalized individuals or antigovernment groups. This considerable rise in biological agents has been accredited to an increase in terrorist organizations seeking to intentionally inflict mass casualties as well as use threatening tactics, criminal groupings having extreme radical, religious, ecological or political motives that want to create awareness of a particular cause, or some regimes that in the past have used biological agents to threaten specific or minorities sections of their population both outside or within their boundaries(Heinrich,2001). The other phrase that is oftenly connected with bioterrorism as well as biological agents deployed to inflict fatalities is weapons of mass destruction (WMDs).Inspite of the likelihood of inflicting mass fatalities, up to now there have been no accounted occurrences where biological agents have been causatively associated to be deployed as WMDS. Nevertheless, not all accounted incidents concerning biological agents are connected with a WMD which is aiming bigger regions and intended to lead to several fatalities. Additionally, a WMD is not restricted to the using of biological agents, but however covers the using of a nuclear, radiological, biological or chemical weapon aimed at inflicting destruction to a big population or destroying structures. Thus the largest concern for using of a biological agent possibly as a WMD is associated with aerosol dissemination that can be attained if the size of the particle spans 1-5 micrometer that can go through the lung bronchioles. Scientists estimate that an anthrax (Bacillus anthracis) or plague (Yersinia pestis) dissemination of aerosol over Washington DC would cause 1-3 million deaths of people provided the right environmental conditions are maintained. Other dissemination route such as food and water supply are less prone because of frequent monitoring and considerably high quantities of the biological agent needed to cause death or harm. The complication of a possible bioterrorism danger needs consideration of several various aspects. Wide categorization of these aspects comprise of risk evaluation involving surveillance and monitoring, risk management, comprising of preparing, preventing and decontaminating as well as risk communication on the basis of existing public health policy in addition to available resources(Mellehovitch, 2004). Literature review America is susceptible to a terrorist attack. An attack such as that one may involve use of biological, chemical, nuclear or radiological weapons. America has not been well equipped to effectively deal with such a challenge. Thus, biological terrorism could inflict profound demands on the country’s public health as well as health care structures. Normally, the public health structure comprises the 1st line of defense in case there is failure of prevention or deterrence bioterrorism. There are many programs that are ongoing so as to enhance the medical and health dimensions of national reaction to the danger posed by bioterrorism. In addition there has been inadequate means of evaluating the effectiveness of existing programs. Consequently, the advancement and application of a tactical structure is required(Mellehovitch, 2004). Thus the Centers for Disease Control (CDC) ought to come up with a program for advancing a countrywide health surveillance structure capable of offering early warning of any incidents related to bioterrorism. Such surveillance systems ought to institute as well as incorporate automatic systems for disease reporting, syndromic surveillance as well as automatic data reporting ones. Doctors must also be persuaded to take cultures in plus requesting for laboratory analyses on a more regular basis so as to ensure that nothing unusual is underway. In addition, localities ought to develop treatment and prophylaxis arrangements that are broken or phased into escalatory sections. Proper training of public health, medical as well as emergency personnel is significant to an all inclusive and wide-ranging detection, evaluation as well as response structure. Local, state and federal agencies require enhanced information cooperation and infrastructure. Government ought to establish an alliance with the private sector as far as bioterrorism preparedness plans are concerned (Heinrich, 2001). Main focus Throughout history, there have been various reports regarding the deployment of biological agents for purposes of warfare. Their use ranged from use of cadavers in spoiling enemy water supplies or catapulting plague-infected carcasses across walls targeting mass exodus from a city that was besieged. Whereas pathogens are living viable organisms, such as viruses and bacteria, toxins are derived and isolated from living organisms and are much more toxic than agents of chemical warfare. Pathogens are capable of reproducing and thus even tiny amounts can lead to a considerable danger to a bigger population, whereas toxins frequently need inhalation or ingestion in considerable quantities so as to affect an individual (Grundmann, 2014).Going by the US Center for Disease Control and Prevention categorization, category A agents, consisting of the plague and anthrax are a key concern for risk management as well as planners, because they are readily produced as well as dispensed. For instance, anthrax spores are easily accessible from either lawful or unlawful sources, whereas ricin is commonly taken out of the plant’s seeds itself. Currently, anthrax poses the greatest danger on the basis of the models that replicate its spreading in a crowded urban region with a million occupants. On the basis of a model by the WHO around 180,000 people risk being exposed to anthrax spores together with around 30,000 becoming debilitated, whereas over 95,000 deaths taking place. The subsequent destructive agent would be the plague leading to 36,000 incapacitations plus 44,000 anticipated deaths. Numbers such as those may not reflect the present situation of more uptown living conditions (Grundmann, 2014). Preparedness Over the past 20 years there has been increased use of biological agents leading to increasing need for risk evaluation, monitoring as well as surveillance. Normally, risk evaluation comprises of modeling techniques that are on the basis of particular assumptions. The 4 fundamental assumptions that can result in actual bioterrorism assault are that terrorists have; first and foremost accessibility to agents, secondly the capabilities and science to manufacture as well as securely store the agents in adequate amounts, thirdly the capability to weaponize the agent for spreading and fourthly the actual intention to make use of the agent; something that needs an organizational leadership. Risk evaluation as well as observation of biological agent dangers is more difficult and intricate than for other weapon such as chemical ones; because the commencement of symptoms can be deferred for a few hours, days or even weeks, in addition to particular symptoms for certain toxins and pathogens being rather unspecific and general, thus delaying an early diagnosis (Khardori, 2006). Apart from surveillance as well as monitoring of a possible future bioterrorism assault, preparedness continues to be a key objective that needs continuous enhancement not only on local but also regional as well as national levels. A US General Accounting Office report starting 2005 shows that in 2000 a sum of 141.2 million dollars were used on research endeavors associated with terrorism and bioterrorism, of which the National Institutes of Health and CDC got the biggest amounts; 43 and 48.2 million dollars respectively. Nevertheless, 2001 saw the federal budget rise to 156.8 million dollars .This provision took place prior to World Trade Center 11 September 2001, terrorist attacks, which was followed by anthrax letters soon afterwards. Due to the devastating incidents of September 11, there was a considerable increase in the funding following the enactment of 2002 bioterrorism Act which aimed at providing the CDC with extra resources to assist health care system and states prepare adequately for a possible biological agent spreading (Heinrich, 2001). In 2002, the Department of Defense was allocated funds for biological and chemical defense program amounting to 856 million dollars, which comprised of 507 million dollars to be used in research and development as well as 348 million dollars for purposes of procurement. The Health Resources as well as Services administration was instituted in 2002, as a response to anthrax letters as well as other possible biological threats and was funded to the tune of 460 million dollars in 2006, so as to set up a countrywide response and preparedness network amongst hospitals in partnership with the CDC. In addition, 2006 saw funding for CDC considerably increased further so as to cater for additional resources towards surveillance and bioterrorism preparedness with a 766 million dollars budget (Heinrich, 2001). Up to today bioterrorism preparedness attack continues to be a challenge both at state as well as federal levels mostly because of resources coordination and instituting of network that maximizes state together with federal resources to enable them to rapidly and adequately respond to an occurrence. Many federal as well as state agencies have instituted their own response plans in addition to implementing new resources in preparation for a possible bioterrorism assault with the direction of Health Resources and Services Administration together with CDC. Instances of such programs comprise of hospital staffs training to enable them identify in addition to responding to a possible exposure to a biological agent and avoid more contamination amongst the people at risk (Heinrich, 2001). Primarily, this therefore entails a statewide reaction to endorse a quick communication and possible quarantine for the individuals exposed, while at the same time permitting the state governor to announce a public health crisis. It is this step that set offs federal agencies to provide extra resources, like vaccines, extra testing in addition to epidemiological support ,as well as medical assistance. The National Preparedness Guidelines was set up by the Federal Emergency Management Agency in 2007, so as to respond to a possible danger including plague, aerosolized anthrax as well as food contamination like biological assaults and several others. Consequences of a bioterrorist attack A bioterrorist attack leads to psychiatric morbidity. Those at the highest exposure risk may become sick with PTSD, alcohol abuse, and depression. Several millions of ordinary affected people may experience a changed feeling of safety as well as hyper vigilance. In addition, there will be development of other trauma-linked disorders that will be experienced first in initial care situations. These comprise of unexplained somatic signs and symptoms, panic disorder, generalized nervousness disorder, depression as well as increased nicotine, alcohol or other substance intake, in addition to family violence and conflict (Hall & Norwood, 2002). Economically, the impact of a bioterrorist assault may range from 477.7 million dollars per 100,000 individuals exposed to 26.2 billion dollars per 100,000 individuals exposed to brucellosis and anthrax scenario respectively. There are other indirect costs involved such as loss of income when one is hospitalized as well as loss of productive time and labor. There is also a lot of money that is spent in improving the response capabilities of public health system to bioterrorism (Kaufmann &Meltzer, 1997). Suggestions for Improvement and Future Implications On the basis of past experiences particularly with mass-casualty incidents as well as the using biological agents in bioterrorism assaults, present observation and preparedness ought to continue as the focal point of extra enhancement and research. Early dissemination detection assists in quicker response time in addition to low mortality and morbidity rates. Nevertheless, this needs a considerable awareness by both public health care workers and departments in addition to frequent training so as to offer enough symptom assessment and treatment techniques (Grundmann, 2014). With the key objective of prevention focused on plague, anthrax, tularemia and smallpox, all of which are category A agents, it is very important to inform the public as well as health care workers regarding other agents’ potential for instance ricin ,that can readily be disseminated. Even though anthrax vaccine exists, it is linked with several side effects and therefore needs 6 to 7 doses for adequate immunity, hence limiting its use in vaccination of the public. Currently, SNS includes 10 million anthrax vaccine doses in readiness for any extensive anthrax bioterrorism assault. Preventive measures aside, plague and anthrax treatment techniques comprise of antibiotics which are also an aspect of the SNS aimed at preventing infection. Another very important point is intravenous antibiotics availability particularly for treating acutely sick persons following a biological or an anthrax assault (Grundmann, 2014). In future it is important to continue being vigilant in regard to potential bioterrorism assaults as well as considering both reactive and proactive measures. It was only after the 2001 anthrax letters that the US together with other countries realized what present limitations exist, necessitating considerable investment which has been done to cure some of them via increased awareness, surveillance as well as preparedness. Nevertheless majority of the present measures are on the basis of occurrences restricted to a particular region, like the metropolitan dissemination which would be solved via harmonization amongst a small number of state as well as federal agencies (Grundmann, 2014). Widespread observation via biosensoring technology is turning out to be a more pragmatic as well as financially feasible objective that ought to be followed at not only regional but also state as well as federal levels. Collecting samples and reporting results therefore may be essential in particular instances (such as sporting events, whereby dissemination could result in secondary infections distant from the initial source) to avoid secondary contaminations. Currently there are movable rapid-screening units that are accessible which permit first round detection of biological agents. In future, such devices will soon become regularly used (Grundmann, 2014). Eventually emerging biological toxins and pathogens are yet to be resolved. The CDC’s category A agents continue to be the mainly disseminated currently ,with little being known regarding new viruses or bacterial strains, which could be used by large organizations against a given population or country. The international community ought to be aware and constantly keep an eye on such prospective developments, because presently we lack efficient response or capacity of detecting other kinds of these agents (Grundmann, 2014). References Read More