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Chemical & Biological Weapons - A Tutorial Frank W Meissner, MD, MS, FACP, FACC, FCCP, CPHIMS [email protected]

ChemBio Tutorial

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Tutorial on Chemical and Biological Warfare - Presented at The 1st Annual Symposium On Seaport Security given in Houston Texas Y2003

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Page 1: ChemBio Tutorial

Terrorist Use of Chemical & Biological Weapons -

A Tutorial Frank W Meissner, MD, MS, FACP, FACC, FCCP, CPHIMS

[email protected]

Page 2: ChemBio Tutorial

Terrorist - The Official Definition

FBI Definition - The unlawful use of force against persons or property to intimidate or coerce a government, the civilian population, or any segment thereof, in the furtherance of political or social objectives.”

Page 3: ChemBio Tutorial

Why Terrorists Might Use

"Weapons of Mass Destruction"

Classically, terrorism was the act of making Political statement via violence

Political act designed to influence an audience

Levels of violence carefully calculated Draw attention but not so violent as too

Alienate supporters Trigger overwhelming response

Page 4: ChemBio Tutorial

Why Terrorists Might Use "Weapons of Mass Destruction”

Classical Terrorists have had substantively rational goals, e.g.,

Attaining national autonomy (Morocco)

Establish representative government (Palestinians)

Protest government policies & actions (Weatherman)

Page 5: ChemBio Tutorial

Why Terrorists Might Use "Weapons of Mass Destruction”

Candidates for use of Chem/Bio weapons represent the intersection of three sets of Groups

A B

C

A - Groups that want to use the agents despite the political risksB - Groups that can acquire the agent & dissemination technologyC - Groups whose organizational structure allows for covert delivery

Page 6: ChemBio Tutorial

Why Terrorists Might Use "Weapons of Mass Destruction”

Motivational Factors - Gaining Attention Bio-weapons ARE

Mysterious

Unfamiliar

Indiscriminate

Uncontrollable

Inequitable

Invisible

Factors that heighten FEAR, the Terrorists Goal State

Page 7: ChemBio Tutorial

Why Terrorists Might Use "Weapons of Mass Destruction”

Motivational Factors - Economic Damage Attack Crop, Livestock, Pharmaceuticals

Attack Corporate interests Potentially massive costs of clean up of a Bio-war attack

Recall that the Soviets lost the Cold War because we outspent them!

Could non-state Terrorists causes us to outspend our resources?

Page 8: ChemBio Tutorial

Why Terrorists Might Use "Weapons of Mass Destruction”

Motivational Factors - MillenarianismThe Millenarian idea- The present age is corrupt & a

new age will dawn after a cleansing apocalypseOnly a Chosen few (usually selected on the basis of adherence to doctrine or ritual) will survive the end

of time and experience paradisePrime motivator for some “ Domestic” Terrorists

Page 9: ChemBio Tutorial

Why Terrorists Might Use "Weapons of Mass Destruction”

Motivational Factors - Exacting Revenge or Creating Chaos

Politically motivated terrorists desire to change societies rather than destroy them

Thus avoid killing very large numbers of people Political costs exceed the benefits

Some terrorists wish to annihilate enemies or demolish societal order Ramzi Yousef, organizer of World Trade Center bombing, claimed he was exacting revenge

against the United States William Pierce, leader of neo-Nazi organization National Alliance, aims to initiate a worldwide

race war & establish an Aryan state Leon Czolgosz, assassin who shot President William McKinley was an anarchist, i.e., espoused a

political philosophy that believes all forms of governments are oppressive

Page 10: ChemBio Tutorial

Why Terrorists Might Use "Weapons of Mass Destruction”

Motivational Factors - Mimicking GodCreate an aura of divine retribution

Gods 5th plague on the Pharaoh in Exodus was murrain, a group of cattle diseases that includes anthrax

5th chapter of Samuel I, God turned against the Philistines and "smote them with emerods"

• Emerods=Bubo’s a symptom of bubonic plague

Page 11: ChemBio Tutorial

Why Terrorists Might Use "Weapons of Mass Destruction”

Motivational Factors - “Copycat” PhenomenaIncreased interest in Chem/Bio-weapons among

domestic extremists after Aum Shinrikyo incident

Surge in Anthrax hoaxes after both Aum Shinrikyo & Anthrax letters post-9/11

Page 12: ChemBio Tutorial

Why Terrorists Might Use "Weapons of Mass Destruction”

Motivational Factors - Technical AvailabilityWeapons of mass destruction & components are easier to acquire since Fall

of Soviet GovernmentFormer Soviet weapons experts may be providing biological weapons & expertise to Iran

Judith Miller and William J. Broad, "Bio-Weapons in Mind, Iranians Lure Needy Ex-Soviet Scientists," New York Times, 8 November 1998, A1; Miller and Broad, "Germ Weapons: In Soviet Past or in the New Russia's Future?" New York Times, 28 December 1998, A1.

South African biological weapons scientists have offered their expertise to Libya

19James Adams, "Gadaffi Lures South Africa's Top Germ Warfare Scientists," Sunday Times, 26 February 1995; Paul Taylor, "Toxic S. African Arms Raise Concern; US Wants Assurance `80s Program is Dead," Washington Post, 28 February 1995.

Page 13: ChemBio Tutorial

Why Terrorists Might Use

"Weapons of Mass Destruction"

In Summary, Postmodern or Super-terrorism

May aim to maximize number of casualties

Levels of violence carefully calculated Reflects a shift in the goal of terrorists

Maximizing damage to the target

This can become the end itself

Page 14: ChemBio Tutorial

Questions?

Is this terrorism?

Or is it asymmetrical warfare?

What exactly is a War on Terrorism?

Page 15: ChemBio Tutorial

Carl Von Clausewitz

Vom Kriege (On War) - 1832“War is Merely The Continuation of

Policy By Other Means”Can a state be at war with a non-state

actor?Or are we talking about Police actions?Can a War on Terrorism lead to a Police

State?

Page 16: ChemBio Tutorial

Hx of Chemical Warfare

Pre-WWI1000 BC - Chinese used arsenical smokes 600 BC - Solon of Athens put hellebore roots in the drinking water of Kirrha Thucydide's History of Peloponnesian War

429 & 424 BC, Spartans & Allies used noxious smoke and flame against Athenian-allied cities

660 AD Kalinkos invented "Greek Fire” Technical innovation extensively used by the Naval Fleet

of the Byzantine Empire for over 200 years Destroyed the naval fleet of Igor, Prince of Keiv, 941 AD

Page 17: ChemBio Tutorial

Hx of Chemical Warfare

Pre-WWI15th Century Leonardo da Vinci proposed military use of a powder of sulfide of arsenic and verdigris1618-48 - Thirty Years War - Toxic smoke projectiles designed & used 1899-1902 - Boer War - British troops fired picric acid-filled shells - munitions had little effect on the outcome of combat 1904-1905 - Russo-Japanese War - Japanese soldiers threw arsenal rag torches into Russian trenches

Page 18: ChemBio Tutorial

WWI

November 1914 - Dr. Hans von Tappen - designed 150-mm howitzer shell containing 7 lb of xylyl bromide and a burster charge for splinter effect

Operational tests of 18,000 of the shells at Russian positions near Bolimov - op failure 2° weather conditions

Tested again at Western front at Nieuport - March 1915 - also abysmal failure

Page 19: ChemBio Tutorial

WWI

Ypres, Belgium - 22 April 1915- 1st successful German chemical attack

Success of the attack was not capitalized upon by the Germans

July 1917- Germans introduced mustard agent

persistent vesicant that attacked the body in places not protected by gas masks

Page 20: ChemBio Tutorial

Intra-war period

Italian-Ethiopian War3 October 1935 - Benito Mussolini -invasion of Ethiopia from Eritrea, an Italian colony, and Italian Somaliland

Italians dropped mustard bombs and occasionally sprayed it from airplane tanks

Page 21: ChemBio Tutorial

Intra-war period

Japanese Invasion of China - 1937By 1939 Japanese were using mustard agent & Lewisite

Very effective against the untrained & unequipped Chinese troops

Chinese reported that their troops retreated whenever the Japanese used just smoke, thinking it might be a chemical attack

Page 22: ChemBio Tutorial

WWII

President Roosevelt established a “No-First-Use” policy

Germans in fact had manufactured & stored 1/4 million tons of chemical agents

Germans developed Nerve Agents Tabun (GA) & Sarin (GB) production beginning 1939

Page 23: ChemBio Tutorial

Korea & Cold War

Continuation of “No-First-Use” Policy

1950 - Full-scale Sarin production complex @ Edgewood Arsenal

Multiple types of Munitions Developed

Page 24: ChemBio Tutorial

Honest John Rocket - Chem Warhead & Sarin Bomblet

Page 25: ChemBio Tutorial

Vietnam

Extensive use of Chemical agents“Non-lethal” riot control agents

“Defoliants” (Agent Orange)

Re-defined chemical weapons to exclude this category of agents

Page 26: ChemBio Tutorial

Yemen Civil War 1962-1970

Yemeni dissidents overthrew monarchyRoyalist forces aided by Saudi Arabia & Jordan engaged in Civil WarEgyptians supported dissidents Egyptian Air Force used chemical weapons

Jan 1967 - Yemeni village of Kitaf95% population & all animals in village died within 10-50 min of attack Agent used was mixed mustard & nerve gas

Page 27: ChemBio Tutorial

1967 Arab-Israeli War

Both sides were prepared to use Chemical & Biological agents

Neither side used agents

Probably due to the speed of tactical operations

Page 28: ChemBio Tutorial

1973 Arab-Israeli War

No use of agents

But Israeli captured Arab equipment of Soviet design/origin demonstrated sophisticated Chem Defense & Offensive capabilities

Sparked renewed interest in Chem Defense in US Military

Page 29: ChemBio Tutorial

Afghanistan War

Extensive use of Chemical weapons by Soviet’s against Afghanistan civilians & mujahedeen (Arabic and or Persian mujhidn, pl. of mujhid, one who fights in a jihad (Holy War))

Page 30: ChemBio Tutorial

Iran-Iraq WarIraq trained & influenced by Soviet military advisors used chem agents against Iranian military forcesPrincipally used mustard & Tabun delivered by bomb from aircraft Also delivered agents by artillery shells & chemical rocket systems

Approximately 5% Iranian casualties from chem attack

Immediately after war used Chem agents against Kurds

Page 31: ChemBio Tutorial

1st Persian Gulf War

Frequent chemical alert alarms - all originally felt to be false alarms

4 Mar 91 - Kamisiyah arsenal - US Army 37th Engineer Battalion - blew munitions storage bunkers Probably Sarin- & Mustard-agent munitions

Wind shift @ start of battle prevented effective use by Iraqi forces Speed of advance may also have prevented effective deployment of chemical agents Fear of nuclear retaliation

Page 32: ChemBio Tutorial

Aum Shinrikyo Attacks

27 June 1994 - Sarin gas used in subway attack - killing 7 & injuring 500

19 March 1995 - Tokyo attack - killing 12 & injuring 3800

Page 33: ChemBio Tutorial

Chemical Agent: Definition (FM 8-285)

“A chemical substance…intended for use in military operations to kill, seriously injure, or incapacitate humans (or animals) through its toxicological effects.”

Page 34: ChemBio Tutorial

Chemical Agent: Definition (FM 8-285)

“A chemical substance…intended for use in military operations to kill, seriously injure, or incapacitate humans (or animals) through its toxicological effects.”

Excluded by FM 8-285

Riot-control agents (CS, CN, DM)

Chemical herbicides (e.g.. Agent Orange)

Smoke and flame materials

Page 35: ChemBio Tutorial

Excluded Agents: Riot-control Agents

Irritant agents (lacrimators) CS (“tear gas”) CN (Mace©) CA CR

Vomiting agents DM (Adamsite) DA DC

Page 36: ChemBio Tutorial

Riot-control Agents

Local irritants with high safety ratio

Short onset (seconds to minutes)

Short duration (15-30 minutes)

In low concentrations, cause intense painand lacrimation (tearing) with (Adamsite only)or without vomiting

Page 37: ChemBio Tutorial

Excluded Agents: Herbicides (Defoliants)

Agent Blue (cacodylic acid)

Agent Orange (1:1 mixture of 2.4.5-T and 2.4-D)

Contaminant: TCDD (Dioxin)

Agent White (4:1 mixture of 2.4-D and picoram)

Paraquat

Page 38: ChemBio Tutorial

Excluded Agents: Smokes

Petroleum oil smokes (fog oil=SGF)

Diesel fuel

HC

RP (RED phosphorus) in butyl rubber

WP (WHITE phosphorus)

FS

FM

Page 39: ChemBio Tutorial

Classification of “Official” Chemical Agents

TOXIC AGENTS (producing injury or death)LUNG-DAMAGING AGENTS (choking agents)

Chlorine (CL), phosgene (CG) [smokes] [vesicants]

“BLOOD” AGENTS (cyanogens): AC and CK

BLISTER AGENTS (vesicants) Mustard (H), Lewisite (L), phosgene oxime (CX), [T-2 mycotoxin]

NERVE AGENTS (anticholinesterases) GA,GB,GD,GF,VX

INCAPACITATING AGENTS (producing temporary effects) BZ, Agent 15, [riot-control agents]

Page 40: ChemBio Tutorial

Lung-damaging Agents

Chlorine (CL)

Chloropicrin (PS)

Phosgene (CG)

Diphosgene (DP)

[Mustard (HD, H) Lewisite (L)]

[Smokes] [isocyanates] [PFIB] [oxides of nitrogen]

Page 41: ChemBio Tutorial

Chemical-agent Damage to Respiratory System

Central effects (in larynx, trachea, and bronchi) predominate

Mustard (H, HD)Lewisite (L)[Chlorine (CL)]

Peripheral effects (in small airways and alveoli) predominate

Phosgene (CG)Perfluoroisobutylene (PFIB)Nitrogen oxides (NOx)HC smoke, isocyanates, many others

Page 42: ChemBio Tutorial

“Blood” Agents (Cyanogens)

Hydrogen cyanide (AC)

Cyanogen chloride (CK)

Page 43: ChemBio Tutorial

Blister Agents (Vesicants)

Sulfur mustard (H, HD)

Nitrogen mustard (HN1, HN2, HN3)

Lewisite = chlorovinyldichloroarsine (L)

Mustard / Lewisite mixtures (HL, HT, TL)

Phosgene oxime (CX)

[Riot-control agents]

[T-2 mycotoxin]

Page 44: ChemBio Tutorial

Nerve Agents (Anticholinesterases)

Tabun (GA)

Sarin (GB)

Soman (GD)

GF

VXAcetylcholineAcetylcholine

receptorreceptor

PPrreessyynnaappttiicc

AchAch

Ach

-est

eras

eA

ch-e

ster

ase

Ach

-est

eras

eA

ch-e

ster

ase

Cholinesterase inhibitorCholinesterase inhibitor

PralidoximePralidoxime

Atr

opin

eA

trop

ine

Page 45: ChemBio Tutorial

“Official” Chemical Agents: Incapacitating Agents

Purpose: Temporary incapacitation

CNS stimulants Amphetamines, cocaine, caffeine, nicotine, strychnine, metrazole

CNS depressants Barbiturates, opioids, antipsychotics, benzodiazepines

Psychedelics LSD-25, psilocybin, ibogaine, harmine, MDMA (“ecstasy”), PCP

Deliriants Anticholinergic glycolates (BZ, Agent 15)

Page 46: ChemBio Tutorial

Physical Forms of Chemical Agents

Solid

Liquid

Gas

Vapor

Aerosol

Page 47: ChemBio Tutorial

Persistence

Dependent on several factorsAgent volatility (determined by chemical structure)

Temperature

Wind

Agent-surface interactions

“Nonpersistent” agents (usually gone within 24 hours)GA, GB, GD, CL, CG, AC, CK

“Persistent” agentsVX, L, HL, “thickened” nerve and blister agents (e.g., TGD, THD)

Page 48: ChemBio Tutorial

Exposure and Absorption

Exposure (contact with agent) does not necessarily lead to absorption (penetration of epithelial barriers)

Two types of effects from exposure and absorption:Local

(effects are at the site of contact)

Systemic (absorption and subsequent systemic distribution

produce effects at sites distant from contact site)

Page 49: ChemBio Tutorial

Routes of Exposure & Absorption

Absorption through skin (percutaneous absorption)

Absorption through lungs (inhalational absorption)

Absorption through eyes (ocular absorption)

Absorption through the gut (enteral absorption)

Absorption by injection (parenteral absorption)

Intravenous absorption

Intramuscular absorption

Page 50: ChemBio Tutorial

Toxicity (Potency) of Liquid Agents

ED50: Effective Dose for 50% of exposed individuals

ID50: Incapacitating Dose for 50% of exposed individuals

LD50: Lethal Dose for 50% of exposed individuals

ID50 for liquid HD(mustard) : 770 mg for a 70-kg man

LD50 for liquid HD: 3000-7000 mg for a 70-kg man

Page 51: ChemBio Tutorial

Toxicity of Vapors or Gases

The Ct concept: Concentration x time

1 mg / m3 x 8 min = 8 mg-min / m3

8 mg / m3 x 1 min = 8 mg-min / m3

4 mg / m3 x 2 min = 8 mg-min / m3

2 mg / m3 x 4 min = 8 mg-min / m3

Page 52: ChemBio Tutorial

Toxicity of Vapors or Gases

ECt50: Effective Ct for 50% of exposed individuals

ICt50: Incapacitating Ct for 50% of exposed individuals

LCt50: Lethal Ct for 50% of exposed individuals

Ct50 assesses external dose, not internal dose

ICt50 and LCt50 therefore affected by

Route of exposure

Respiratory rate and depth, skin moisture, etc.

Page 53: ChemBio Tutorial

Toxicity of HD(Mustard) Vapor

HD vapor in eyes:ICt50: 200 mg-min / m3

Inhaled HD vapor:ICt50: 200 mg-min / m3

HD vapor on skin:ICt50: 1000-2000 mg-min / m3

Page 54: ChemBio Tutorial

Toxicity of HD (Mustard) Vapor

HD vapor in eyes:Permanent injury: > 800 mg-min/ m3

Inhaled HD vapor:LCt50: 1000-1500 mg-min / m3

HD vapor on skin:LCt50: 10,000 mg-min / m3

Page 55: ChemBio Tutorial

Comparative Toxicity - CW Agents

0

1000

2000

3000

4000

5000

6000

CL CG AC H GB VX BZ CSAGENT

(L) (L)(L)(L)(L) (E)(E)(L)

Ct50

(mg-min/m3)

Page 56: ChemBio Tutorial

Precursors to Chemical Weapons - Dual Use Technology & Agents

Ammonium bifluoride 1341-49-7

Civilian Uses CW Agent

Ceramics

Disinfectant for food equipment

Electroplating

Etching glass

Sarin (GB)

Soman (GD)

GF

Page 57: ChemBio Tutorial

Precursors to Chemical Weapons - Dual Use Technology & Agents

Diethylphosphite 762-59-2

Civilian Uses CW Agent

Organic synthesis

Paint solvent

Lubricant additive

VG

Sarin (GB)

Soman (GD)

GF

Page 58: ChemBio Tutorial

Precursors to Chemical Weapons - Dual Use Technology & Agents

Diethylamine 124-40-3

Civilian Uses CW Agent

Organic synthesis

Pharmaceuticals

Detergents

Pesticides

Gasoline additive

Missile fuels

Vulcanization of rubber

Tabun (GA)

Page 59: ChemBio Tutorial

Precursors to Chemical Weapons - Dual Use Technology & Agents

Diethylphosphite 762-59-2

Civilian Uses CW Agent

Organic synthesis

Paint solvent

Lubricant additive

VG

Sarin (GB)

Soman (GD)

GF

Page 60: ChemBio Tutorial

Precursors to Chemical Weapons - Dual Use Technology & Agents

Hydrogen Fluoride

Civilian Uses CW Agent

Fluorinating agent chemical reactions

Catalyst - alkylation & polymerization

Additives to liquid rocket fuels

Uranium refining

Sarin (GB)

Soman (GD)

Ethyl sarin (GE)

GF

Page 61: ChemBio Tutorial

Precursors to Chemical Weapons - Dual Use Technology & Agents

Methylphosphonous difluoride 753-59-3

Civilian Uses CW Agent

Organic Synthesis VX

VM

Sarin (GB)

Soman (GD)

GF

Page 62: ChemBio Tutorial

Precursors to Chemical Weapons - Dual Use Technology & Agents

Phosphorous oxychloride 10025-87-3

Civilian Uses CW Agent

Organic synthesis

Plasticizers

Gasoline additives

Hydraulic fluids

Insecticides

Dopant for semiconductors grade silicon

Flame retardants

Tabun (GA)

Page 63: ChemBio Tutorial

Precursors to Chemical Weapons - Dual Use Technology & Agents

Phosphorous trichloride 7719-12-2

Civilian Uses CW Agent

Organic synthesis

Insecticides

Gasoline additives

Plasticizers

Surfactants

Salt process

Dye stuffs

VG

Tabun (GA)

Sarin (GB)

Soman (GD)

GF

Page 64: ChemBio Tutorial

Precursors to Chemical Weapons - Dual Use Technology & Agents

Sulfur monochloride 10025-67-9

Civilian Uses CW Agent

Organic synthesis

Pharmaceuticals

Sulfur dyes

Insecticides

Rubber vulcanization

Polymerization catalyst

Hardening of soft woods

Sulfur Mustard (HD)

Page 65: ChemBio Tutorial

Precursors to Chemical Weapons - Dual Use Technology & Agents

Thionyl chloride 7719-09-7

Civilian Uses CW AgentOrganic synthesis

Chlorinating agent

Catalyst

Pesticide

Engineering plastics

Sarin (GB)

Soman (GD)

GF

Sulfur mustard (HD)

Sesqui mustard (Q)

Nitrogen mustard (HN-1,HN-2,HN-3)

Page 66: ChemBio Tutorial

Chemical Weapons Deployment Principles

Critical Variables in Agent DeploymentVolatility of agent

Persistence of agent

Rate of agent contact with target population

Desired level of geographic coverage

Page 67: ChemBio Tutorial

Chemical Weapons Deployment Principles - Volatility

Most CW agents liquids

Transformation of liquid to gas Add heat to cause enhanced vaporization

Explosive force - exploding munitions

Mechanical spray device

Transformation liquid => gas - major operational problem

Non-facilitated (room temperature) vaporization inadequate to develop LCt50 concentrations

Page 68: ChemBio Tutorial

Some agents gases under temperate conditions

Phosgene

Cyanogen chloride

Hydrogen cyanide

Chemical Weapons Deployment Principles - Volatility

Page 69: ChemBio Tutorial

More volatile = less persistency

Persistency = length of time agent remains liquid

Persistent by definition > 24 hr in liquid form

Nonpersistent < 24hr in liquid form Agent persistency - most to least

Vx - Tabun - Mustard - Lewisite - Sarin - Hydrogen Chloride - Cyanogen Chloride - Phosgene - Chlorine

Chemical Weapons Deployment Principles - Persistency

Page 70: ChemBio Tutorial

Sarin - nonpersistent agentEvaporates within 2 hr on sandy soil @ 50°F (10°C)

Evaporates under 1 hr on sandy soil @ 110°F (43°C)

On chemical resistant surface 15 min @ 50°F (10°C)

On chemical resistant surface 12min @ 100°F (43°C)

Vesicant mustard - persistent agentEvaporates 100 hr on sandy soil @ 50°F (10°C)Evaporates 7 hr on sandy soil @ 110°F (43°C)On chemical resistant surface 12 hr @ 50°F (10°C)On chemical resistant surface 1 hr @ 100°F (43°C)

Chemical Weapons Deployment Principles - Persistency

Page 71: ChemBio Tutorial

Chemical Weapons Deployment Principles - Rate of Agent

Contact With Target Population

(E)(L) (L)(L)(L)(L) (E)(L)

Ct50

(mg-min/m3)

0

1000

2000

3000

4000

5000

6000

CL CG AC H GB VX BZ CS

Page 72: ChemBio Tutorial

ƒ( , )

Chemical Weapons Deployment Principles - Desired level of

Geographic Coverage

(E)(L) (L)(L)(L)(L) (E)(L)

Ct50

(mg-min/m3)0

1000

2000

3000

4000

5000

6000

CL CG AC H GB VX BZ CS

Quantity of Agent & Method of Delivery

Page 73: ChemBio Tutorial

Weaponization

Stabilizers -prevent degradation of product Thickeners - increase viscosity & persistence of

liquid agents Transformation of bulk munitions payload of

agent into weaponized form of agent• Microscopic droplets (target - respiratory absorption)• Liquid spray droplets (target - cutaneous absorption)

Page 74: ChemBio Tutorial

Weaponization

Military grade munitions generate• Vapors

– Aerosol (1-7 microns)– Micro-climate height (6-10’)

• Liquids– Coarse spray that coats ground

Page 75: ChemBio Tutorial

Likely Terrorist delivery systems more primitive

Agricultural sprayersCrop dusting aircraft efficient vehicles

Orchard pesticide sprayer mounted on truck

Atomizers/spray cans

Paint sprayers

Aerosol generators

Fans

Page 76: ChemBio Tutorial

Methods Of Target Engagement

Least EfficientEasiest Technically

Highly EfficientDifficult Technically

Page 77: ChemBio Tutorial

Meteorological Effects -

Weapon Efficiency Temperature

Liquid mustard @ concentration 30 gm/m2

Persistence several d’s T <50°F (10°C) Persistence 1-2 d @ T 80°F (26°C)

HumidityHigh relative humidity enlarges aerosols

Wind speed & directionAffects @risk target populationHigh winds disperse aerosols Optimal steady wind @ 4 kts/hr

PrecipitationLight rain disperses & spreads chemical agentHeavy rains dilutes & disperses agent

Page 78: ChemBio Tutorial

Nature of Buildings & Terrain

Greater turbulence of primary weapons cloud in woodland & hilly terrain

Urban targets may result in enhanced persistence of agent by absorption by porous building materials

Persistence increased 3X by sandy Vs clay soil

Page 79: ChemBio Tutorial

Potential Targets

Point source targets - buildings Vulnerability is due to accessibility Entry areas for agent - ventilation & elevator systems Defenses

Surveillance of roof, mechanical rooms, elevator shafts, utility chases

Improved locking & access systems to these resources

Page 80: ChemBio Tutorial

Agent Indicator Matrix

A = Nerve agentsB= Blister agentsC= Cyanide D= Choke agentsE= Riot Control

Unchecked boxes = N/A A B C D E

CardiovascularSlow heart rate X X X XFast heart rate X

Digestive SystemDefecation X X XNausea X

Subtotal (this page)

To use the agent indicator matrix: Put a check in each row where the indicator is presentAt the bottom of the matrix -

total all check marks in each column Total all marks from each page - The column with the

highest % of checks is most probable agent

Page 81: ChemBio Tutorial

Agent Indicator Matrix

A = Nerve agentsB= Blister agentsC= Cyanide D= Choke agentsE= Riot Control

Unchecked boxes = N/A A B C D E

AppearanceProstration X X XTwitching X X XConvulsions X X XComa X X XBleeding from mouth X X XCoughing XSneezing X XVomiting XFasciculations X X X X

SkinCyanosis X X XGray area of dead skin X X X XPain, irritation XClammy X X XSweating, localized or generalized X X X X

Subtotal (this page)

Page 82: ChemBio Tutorial

Agent Indicator Matrix

Unchecked boxes = N/A A B C D E

EyesSmall pupils X X X XNormal, large pupilsInvoluntary closing X X XTearing XBurning, irritation XHeadache, pain around eye X X X XDim vision X X X XBlurred vision X X X XBurning pain in eyes XRedness X X X

RespiratoryCoughing XRunny nose XTight chest (short of breath) XBurning, irritation in nose X

Total (this page)

A = Nerve agentsB= Blister agentsC= Cyanide D= Choke agentsE= Riot Control

Page 83: ChemBio Tutorial

Agent Summary Chart

Agent Sym onset Syms Signs Decon Route & Rx

Nerve Vapor- sec

Liquid-min/hr

Muscle cramps, runny nose,difficulty breathing, eye pains, visual disturbance, sweating, diarrhea, LOC, flaccid paralysis, seizures

Pinpoint pupils (miosis)

Fasciculation's

Sweating

Hyper-salivation

Diarrhea

Seizures

Apnea

Rapid

Disrobing

Water &

Wash with soap

& shampoo

Inhalation &

Dermal

Atropine 2-6 mg IV + 2-PAMCL 600-1800 mg IV or 1gm IV over 20-30 min

Additional Atropine prn & additional 1 gm infusion of 2-PAMCL

Page 84: ChemBio Tutorial

Agent Summary Chart

Agent Sym onset Syms Signs Decon Route & Rx

Cyanide Secs to minutes

Dizziness, nausea, headache, eye irritations, LOC

Nonspecific findings - hyperventilation,

Convulsions, apnea

Rapid

Disrobing

Oxygen,

Amyl nitrate,

Sodium nitrite (300 mg IV) & sodium thiosulfate (12.5 gm IV)

Page 85: ChemBio Tutorial

Agent Summary Chart

Agent Sym onset Syms Signs Decon Route & Rx

Blister Agents

(Sulfur Mustard)

2-48 hr Burning, itching, or red skin, mucosal irritation (tearing, burning, redness of eyes), shortness of breath, N&V

Skin erythema, blistering, conjunctivitis & lid swelling, upper airway sloughing, pulmonary edema, marrow suppression with lymphocytopenia

Rapid

Disrobing, Flush with copious amounts of water

Inhalation, dermal absorption, oral ingestion

Thermal burn Rx

Supportive care

For Lewisite

BAL

Page 86: ChemBio Tutorial

Agent Summary Chart

Agent Sym onset Syms Signs Decon Route & Rx

Pulmonary agents

(phosgene)

1-24 hr Dyspnea, chest tightness, wheezing, mucosal & dermal irritation & redness

ARDS None usually needed

Inhalation

Supportive care

Specific Rx dependent on agent

Page 87: ChemBio Tutorial

Agent Summary Chart

Agent Sym onset Syms Signs Decon Route & Rx

Ricin (Castor bean toxin)

18-24 hr Ingestion - N&V, diarrhea, fever, abdominal pain

Inhalation - chest tightness, coughing, weakness, nausea, fever

ARDS, circulatory collapse, shock

Clothing removal, water rinse

Inhalation & ingestion

Supportive care

For ingestion charcoal lavage

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Agent Summary Chart

Agent Sym onset Syms Signs Decon Route & Rx

T-2 mycotoxin

2-4 hr Dermal & mucosal irritation; blistering, necrosis, blurred vision, N&V & diarrhea, ataxia, coughing & dyspnea

Mucosal erythema & hemorrhage, red skin, blistering, tearing, salivation, pulmonary edema, seizures, & coma

Clothing removal, water rinse

Inhalation & dermal contact

Supportive care

For ingestion charcoal lavage

Possibly high dose steroids

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Biological Warfare - History I

190 BC - Hannibal hurled venomous snakes onto enemy ships of King

Eumenes II of Pergamum @ Eurymedon

400 BC Scythian archers used arrows dipped in blood & manure or

decomposing bodies

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Biological Warfare - History II

1340 ADAttackers catapulted dead horses & other animals at the castle of Thun L'Eveque in Hainault (northern France)Defenders

”The stink & the air were so abominable...they could not long endure"

Negotiated a truce

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Biological Warfare - History III1346 AD

Tartars siege of Caffa (Port on the Crimean peninsula in the Black Sea)Tartars suffered an outbreak of plagueBefore abandoning their attack, they sent the infected bodies of their comrades by catapult over the walls of the cityFleeing residents carried the disease to ItalySecond major epidemic "Black Death" in Europe

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Biological Warfare - History IV

1422 ADAt Karlstein (in Bohemia)

Attacking forces launched the decaying cadavers of men killed in battle over the castle walls

They stockpiled animal manure in hope of spreading illness

The defense held fast, siege was abandoned @ five months

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Biological Warfare - History IV

1763 - British Gen Jeffery Amherst

Ft Pitt, Pennsylvania Ordered blankets & handkerchiefs taken from smallpox patients in the fort's infirmary & given to Delaware Indians at a peace-making parley

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WWI

1915 - German covert BioWar operations

Glanders - Disease horses/mules - German saboteurs used against military horses/mules

1917- Only real success infection - 4,500 mules Mesopotamia

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Biological Warfare - Intra-war & WWII

Japan’s Unit 731 (1932 - 1945)

BW research unit - Ping Fan, Manchuria3000 scientists & techs occupying >150 bldgPossibly 10,000 prisoners died - BW experimentation1,000 autopsies on prisoners infected with anthrax

11 Chinese cities attacked using anthrax, cholera, salmonella, shigella, plague

15 million Plaque infected fleas dropped A/C1940 - Chuhsien in Chekiang province - 1st episode of plaque ever seen in the province

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Post WWII - Accusations

British used BioWeapons in Oman - 1957

Brazilian landowners deliberate infection Amazonian tribes - 1960’s

China accused US - Cholera epidemic in Hong Kong 1961

Egyptian accusations against US of BioWar in Middle East, specifically Cholera in Iraq in 1966

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Post WWII

Ricin toxin assassinations - 1978Successful attack by Bulgarian Agents

Georgi Markov - Bulgarian dissident in exile

Unsuccessful attack 10 d’s prior Valdimir Kostov - Bulgarian dissident in exile

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Post WWII

3 April 1979 - Soviet Institute of Microbiology & Virology

Sverdlovsk - accidental release of Anthrax

66 confirmed deaths

Animal cases seen > 50-km from the site of release

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Post WWII

1970's- "Yellow Rain" - T-2 Mycotoxin

Controversial results - government sponsored research's

Possible use of agents Asia & Afghanistan

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1st Desert War

7 August 1995 - Defection of Iraqi General Hussein Kamal Iraq had loaded BioWar agents into

166 Bombs (100 botulinum toxin, 50 anthrax, 16 aflatoxin)25 SCUD/A1 Hussein missile warheads (13 botulinum toxin, 10 anthrax, 2 aflatoxin)122-mm rockets filled with anthrax, botulinum, aflatoxinSpray tanks capable of being fitted to fighter/bomber aircraft - 2000 L capacity

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US Offensive Bioweapons Program

April 1942 - creation US top-secret BioWar program All offensive programs ended 25 November 1969

Nixon administration Executive order

1972 - US signed Biological Weapons Convention

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US Offensive Bio-weapons Program

E-120 BiologicalBomblet

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Domestic Bioterrorism

1984 - Rajneesh cult contaminated salad bars with salmonella - 751 cases

of infection

1998 Anthrax spore hoaxes in Cincinnati, Louisville, Indianapolis

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Anthrax incidents in US – 1992-1999

Source: Historical Trends Related to Bioterrorism: An Empirical Analysis -Jonathan B. Tucker, Chemical and Biological Weapons Nonproliferation Project, Center for

Nonproliferation Studies, Monterey Institute of International Studies

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Aum Shinrikyo Attacks

1993- 1995 conducted up to 10 subway attacks

No casualties Poor manufacturing technique

Avirulent strain

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9-11 Anthrax attacks

1 week after 9-11 Tom Brokaw (NBC News) Anthrax tainted letterIdentical letter to office of New York TimesSenator Tom Daschle - Washington DCDecember 2001

18 patients infected 5 deaths Mass disruption

• Not mass destruction

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Potential deadly/incapacitating effects susceptible populations

Self-replicating capacity of some bio-agents to continue to proliferate

Relatively low cost of producing bio-weapon

Insidious symptoms can mimic endemic diseases

Difficulty in immediate detection – bio-weapon use

Sparing of property & physical surroundings

Advantages - Biological Weapons

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Disadvantages - Biological Weapons

Bio-war weapon could impact health aggressor forcesDependence on prevailing winds & other weather conditions for effective dispersionEffects of temperature, sunlight, & desiccation on survivability of some infectious organisms Environmental persistence of some agents (e.g., anthrax spores) can make region uninhabitable for long periodsPossibility of generation of secondary aerosols generated by troops moving through areaUnpredictability of morbidity secondary to biological attackRelatively long incubation period of many agentsPublic's aversion to use of biological warfare agentsTraceable

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Biological Weapons Properties

Toxins

Organisms

Spontaneous regeneration Epidemic organisms

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Requirements For Ideal Biological Warfare Agent

Availability or ease of production

Incapacitation and lethality

Appropriate particle size in aerosol

Ease of dissemination

Stability after production

Susceptibility and Non-susceptibility of Target & Attacking Populations

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Biological Weapons Deployment Principles

4 Components - Biological Warfare StrikeThe Agent

The Munitions

Delivery System

Meteorological Conditions @ Target Area

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Agent

Toxin - short incubation period - limited effectivenessBacterial or viral organism with longer incubation

period - causalities over 100’s of square kilometersAgent may be Incapacitating Vs Lethal

Agent characteristicsInfectivity

Manufacturability (Quantity)Stability after manufactureStability during deployment

Stability post-release

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Physical Attributes of Infective Agent

Liquids Simple to produce but difficult to disseminate

Dried FormComplex production but readily disseminated

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Physical Appearance of Selected Agents

Liquid agentsDerived from fermentation technology, tissue culture, & embryonated chicken eggs

Liquid agents can include bacteria, bacterial toxins, viruses and rickettsiae

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Physical Appearance of Selected Agents

However all have similar physical characteristics Viscosity - 5-15 centipoises Total solid content of the liquid between 5-20%

This MEANS - liquid is significantly thicker than water & less thick than light pancake syrup

Think slightly less viscous than whole milk

Color of liquids vary dramatically Bacterial agents & toxins derived from fermentation -

opaque amber to brown colored Egg-derived liquid agents color of egg yolk (if whole egg

processed) to slightly pink to red (if only embryo has been processed)

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Dried Agents

If actor is able to produce agents via tissue culture technology

Then has technology to produce dried agents

Consistency of bath powderIdeal dried agent has free flowing properties

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Dried Agents

Color of agent reflects the liquid from which derived Dried bacterial agents tend to be amber to brown Viral agents derived from tissue culture off-whiteViral & rickettesia from embroynated chicken eggs either brown to yellow to pink to redHowever, color of powders can easily be altered with dyes

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Physics of Primary Aerosol

Aerosol equilibration - time interval between release & full aerosolization of liquid/powderLarge particles (≥ 15 microns) do not remain in the air but quickly fall to ground Within a minute - aerosol comes to equilibrium with atmosphereAerosol is now composed of particles of 1-5 microns - behaves like a gas - Primary Aerosol Primary Aerosol formation is essential for efficient release of agent

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Physics of Primary Aerosol

Primary Aerosol can traverse heavily forested areas without degradation Similarly for a ‘victim’

Aerosol will permeate the atmosphere about the individual

Few if any particles will stick to person’s clothing or objects in aerosol path

Infectivity is high since ‘victim” will exchange 10-20 l/min

Conversely encountering a 15-20 micron particles will not result in high attack rates of illness

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Secondary Aerosol

Re-aerosolization of infectious particles Fell to ground from primary aerosolForced onto ground by disseminating deviceDeliberately sprayed or layered onto groundGenerated by people or vehicles stirring up particlesIn fact are difficult to generate & require extremely sophisticated techniques to manufacture into agents physical properties

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Biological Decay in Aerosols

Aerosol decay occurs through physical decay (fall out of particles) & biological decay Respiratory virulence & biological decay most important factors determining how far downwind bacterial aerosol will be infective Biological decay is expressed in terms of % death per minute of aerosol age & follows a geometric progression

ie, Biological decay of 20% per minute implies that total viable content of aerosol is halved every 3.5 minutes of age

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Munitions

Sophisticated munitions can result in ‘point-source’ or ‘line-source’

Beyond capabilities of even most organized terrorist groups

Terrorists most likely will employ liquid agent

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Munitions

Crud bomb could disseminate liquid/dry agent using explosive energy

Explosion will kill a large percentage of agent

Gaseous energy best way to generate high agent concentrations in aerosol but technically challenging

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Terrorist deployments

Liquid agentSingle-fluid nozzle efficiency - 600 PSI

Two-fluid nozzle efficiency - 90 PSI

Dried agent - requires high sophistication High agent concentration

Small particle size

Absence of electrostatic charge

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Weaponization

However, payoff is equally high - efficient dissemination from any number of devices using little energy

ABC fire extinguisher placed upwind of intended target or air intake of a building can produce large number of infections

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Delivery Systems

ANYTHING that can cause aerosol

Truck-mounted sprayer

Crop Dusters

2-gallon garden sprayer or fire extinguisher

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Meteorological Conditions Critical For ”Open-air" Targets

Aerosolized weapon maximum effectiveness @ 3-15 ftThermal inversion represents ideal environment

Inversion most likely @ night, daybreak, sundown

Sunlight highly destructive to most BW agentsToxins & spores of Bacillus anthracis & Coxiella burnetii

Wind also important factor for aerosol attackOptimal 5-25 mph< 5-mph limited spread>25-mph aerosol disintegrates

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Liquid & Dry agents Can Be Disseminated Over Wide Temps & Environments

Many BW experts expect terrorist use against non-open air targets

Buildings

Subway stations

Interstate tunnels

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Alternative Delivery Methods

Oral route - not very efficient - dilution & diffusion factors + chlorination makes public water sources poor targets Contamination of foods & fruits @ point of manufacture & along distribution pathways Dermal exposure not effective means of dissemination Vector transmission - logistically difficult to carry out

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Agent Summary ChartAgent Sym onset Syms Signs Rx

Anthrax 2-6 d

Range 1 d to 8 wks

Inhalation

Flu-like syndrome, N&V, abd pain, fever, respiratory distress

Cutaneous

Itching papule, fever

Inhalation

Fever followed by ARDS, confusion, widened mediastinum on CXR, bloody pleural effusions, atypical pneumonia

Cutaneous

Itching papule, 1-3 cm painless ulcer then necrotic center, lymphadenopathy

Mechanical ventilation

Antibiotic therapy

CIPRO 400 mg IV Q 8-12 hr or Doxycycline 200 mg IV initial then 100 mg IV Q 8-12 hr PLUS Rifampin 10/mg/kg/d

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Agent Summary ChartAgent Sym onset Syms Signs Rx

Botulism 12-72 hr

Range

2 hrs - 8 ds

Difficulty swallowing or speaking, symmetric descending weakness Respiratory dysfunction

No sensory dysfunction

Dilated or un reactive pupils, drooping eyelids (ptosis), doubled vision, slurred speech (dysarthria), descending flaccid paralysis, intact mental state

Mechanical ventilation

Parental nutrition

Trivalent botulinum antitoxin

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Agent Summary ChartAgent Sym onset Syms Signs Rx

Plague 1-3 d’s

by inhalation

Sudden onset fever, chills, headache, myalgia

Pneumonic - cough, chest pain, dyspnea, fever

Bubonic - painful lymph nodes

Pneumonic - Hemoptysis, radiographic pneumonia--patchy, cavities, confluent, consolidation, hemoptysis, cyanosis

Bubonic - painful, enlarged lymph nodes in groin, axilla,& neck

Streptomycin 30mg/kg/d in 2 divided doses X 14 ds

Gentamycin 3-5 mg/kg/d IV/IM Q8hr

TCN 2-4 gm per day,

CIPRO 400 mg IV Q 12 hr

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Agent Summary ChartAgent Sym

onsetSyms Signs Rx

Tularemia

“Pneumonic”

2-5 d’s

Range

1-21 d’s

Fever, cough, chest tightness, pleuritic pain, hemoptysis (rarely)

Community-acquired atypical pneumonia,

Radiographic bilateral patchy pneumonia with hilar adenopathy (TB like pleural effusions)

Diffuse, varied skin rash, may be rapidly fatal

Streptomycin 30mg/kg/d in 2 divided doses X 14 ds

Gentamycin 3-5 mg/kg/d IV/IM Q8hr

CIPRO 400 mg IV Q 12 hr (Change to PO after clinical improvement) X 10-14 d’s

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Agent Summary ChartAgent Sym

onsetSyms Signs Rx

Smallpox 12-14 d’s

Range

7-17 d’s

High fever & myalgia, itching, abdominal pain, delirium, rash on face, extremities, hands, feet, confused with chickenpox which has less uniform rash

Maculopapular then vesicular rash - 1st on extremities (face, arms, palms, soles, oral mucosa), Rash with hard, firm pustules (intradermal blisters), RASH IS SYNCHRONOUS on various segments of body

Supportive care

Vaccinate care-givers

Experimental

Cidofovir

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Initial Discovery Procedures

Put on Personal Protective Equipment Meissner’s 1st Law of Combat Medicine - Don’t Become A Causality Yourself

Stay upwind/stay uphillIf PPE not available maintain distance of 300 feet from scene If PPE is available maintain distance 75 feet

Until Agent & concentration determined

Exercise extreme caution IFBiological attack

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Initial Discovery Procedures

Observe & annotate the following Exact location of incident Wind direction & weather conditions Plume direction if visible (generally not visible)Orientation of victimsNumber of victims Suggested safe access routes & staging areas

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Gross Decontamination Procedures

If vapor attack Place outside in breeze

May only require removal of outer clothing

Liquid contamination Remove outer clothing

Flush victim with water &/or hypochlorite & water

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Site Set-Up Procedures

3 Zones Hot (Exclusion ) Zone

Warm (Contamination reduction ) Zone

Cold (Support) Zone

All zones - upwind & uphill from other zones

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Hot Zone

Adjacent to incident scene Rescuer or EOD personnel only in this zone All personnel in protective gearSingle Entry Control Point (ECP) Total accountability for personnel in zone ECP minimum of 25 meters upwind from source Minimal medical treatment

AirwayHemorrhage controlAdminister antidote

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Warm Zone

Upwind & uphill from hot zoneRescue, medical, & decontamination personnel in this zone - all in PPEEntry to Warm Zone from Hot Zone via ECPExit is via separate patient transfer pointAll personnel entering/exits & all patient exits must be logged Zone is minimum of 15’ (5 m) wideWarm triage point is where rapid triage of victims takes place

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Warm Zone

Immediate category patients go through liter decontaminationAmbulatory victims & warm zone personnel go through ambulatory decontamination Patients exit Warm Zone via patient transfer point No contaminated material enters Cold Zone

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Cold Zone

Upwind & uphill from Warm Zone All personnel have protective equipment @ hand (wind shift or improper decontamination)Patients enter via patient transfer point & go through cold triage point

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Casualty Decontamination Center

1

2

3

3 4

45

6

1 TRIAGE2 EMT3 CLOTHING REMOVAL4 SKIN DECON5 CLEAN EMT6 DISPOSITION

CONTAMINATEDDUMP 75M

ARRIVAL POINT

30M

PREVAILING WINDS

SHUFFLE PIT

HOT LINE

MTF60M

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Casualty Decontamination Center

Arrival Triage / EMT Decon Clean Treatment

Ambulatory Decon

Litter Decon

ArrivalPoint(dirty)

TriageStation

DirtyDisposition

AreaEMT

Station

Clean Treatment

Area

CleanDisposition

Area

Dirty Clean

Evacuate (clean)

Evacuate (dirty) or return to duty

(Dirty dump)

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Agent Removal

Two methods of agent removalPhysical & ChemicalPhysical Methods

Simply scraping off visible agent - highly effective

Copious flushing with water - problems containing waste water & thermal protection

Absorbent materials such as earth, dry soap powder, Fuller’s earth, or flour

Water/soap mixture can be highly effective

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Agent Removal

Chemical methods 5% chlorine solution for decontamination of

equipment• 48 ounces (1.4 kg) calcium hypochlorite to 5 gallons

(19 liters) H20 • If necessary 5% solution can be used for skin,

however, must rinse off within 10’ of application 0.5% chlorine solution for decontamination of

skin or wounds• 6 ounces (170 gm) calcium hypochlorite to 5 gallons

(19 liters) H20

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Decontamination Equipment

Chlorox™ bleach 5.25% hypochlorite solution & can be used directly from the bottle

Calcium hypochlorite available as dry swimming pool/spa chlorine

Plastic garbage can (50-60 gallon (190-230 liter)

Sponges, brushes, & pressurized garden sprayers

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Care and Decontamination of Litter Patients

Remove gross contamination

Transfer to decontamination prep litterCut away all clothes & remove personal property

Transfer to decontamination litter

Decontaminate patient with 0.5% hypochlorite (blotted)

Shower with copious amounts of water

Transfer to patient treatment area

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Decontamination Pointers

Contaminated clothing dump @ least 240’ downwind of decontamination station

Rub, Scrub, & Flush

Efficient technique is to use small commercial above-ground pools

Careful use of chlorine in enclosed spaces

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Threat Analysis

Multiple technical drawbacks to CBW Toxins/pathogens/toxic chemicals need

Sophisticated handling, storage, delivery

Weaponized shelf life is short unless stored in controlled environment Clandestine production is difficult

Basic techniques for production simpleDual use technologies heavily scrutinized Use of missiles expensive per pound of payload/lethalityClimate critical for efficacy

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Threat Analysis

Seaport targets Attractive from military standpoint

Classical ‘Choke Points’Majority of combat logistics & troop movements still use

seaborne lanes of communicationDisrupt transportation of goods & foodstuffs

Difficult to control access to seaportTerrorist does not have to physically penetrate the US

immigration proceduresAbility to concentrate large quantities of weaponized

agent Traditionally has poor security

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Threat Analysis

Seaport targets Have sophisticated & criminal elements used to subverting custom &

security measures Drug smugglers

Illegal alien transporters

DownsidesMeteorological conditions poor for attack

Usually have significant winds that preclude adequate aerosol production Immersed in the ultimate & universal solvent - H20

Has large workforce available for effective disaster response Has sophisticated machinery available for decontamination procedures

Large storage facilities ideal for decontamination operations