Chemical, Biological, Radiological, Nuclear And Explosive Issues

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<ul><li>1.Chemical, Biological, Radiological, Nuclear and Explosive Issues CBRNEfor Veterinary Professionals Module 3 Colorado Veterinary Medical Reserve Corps</li></ul> <p>2. CO VMRC Training Program </p> <ul><li>Unit 1:Overview of animal emergency management for veterinary professionals </li></ul> <ul><li>Unit 2:Biodefense and biological risk management </li></ul> <ul><li>Unit 3: Overview of CBRNE Hazards for Veterinary Professionals </li></ul> <ul><li>Unit 4:Personal preparedness and contingency planning </li></ul> <p>Each module lasts approximately 90 minutes, with 15 minute breaks and 1 hour for lunch 3. Learning objectives </p> <ul><li>Define CBRNE and terrorism </li></ul> <ul><li>Describe the potential impacts of CBRNE events on animals/agriculture </li></ul> <ul><li>Identify the classes of chemical hazards </li></ul> <ul><li>Identify antidotes for nerve agents </li></ul> <ul><li>Identify Biological hazards </li></ul> <ul><li>Identify radiological and nuclear threats</li></ul> <ul><li>List the classes of radioactive particles </li></ul> <ul><li>List key challenges related to animals in radiological events </li></ul> <ul><li>List basic animal decontamination needs and challenges </li></ul> <p>4. Objectives, continued </p> <ul><li>Identify the basic physiology of explosive blast injuries </li></ul> <ul><li>List the four levels of personal protective equipment</li></ul> <ul><li>Briefly describe foreign animal disease threats </li></ul> <ul><li>Identify the key operational branches in a FAD response </li></ul> <ul><li>Describe the basic biosecurity concerns for FAD emergency responders</li></ul> <ul><li>Describe how to don and doff basic biological PPE</li></ul> <ul><li>List the core issues for use of respiratory PPE </li></ul> <p>5. CBRNE </p> <ul><li>C hemical </li></ul> <ul><li>B iological </li></ul> <ul><li>R adiological </li></ul> <ul><li>N uclear </li></ul> <ul><li>E xplosive </li></ul> <p>6. Terrorism </p> <ul><li>The unlawful use of force or violence committed by a group or individual against persons or property to intimidate or coerce a government, the civilian population, or any segment thereof, in furtherance of political or social objectives. </li></ul> <ul><li>--U.S. Department of Justice </li></ul> <p>7. Terrorism: animal impacts </p> <ul><li>Secondary animal/ag impacts in general attack </li></ul> <ul><li>Primary attack on livestock/animals </li></ul> <ul><li>Attack on a specific company or industry </li></ul> <ul><li><ul><li>Domestic terrorism </li></ul></li></ul> <ul><li>Targeting animal or human food supply in a covert attack </li></ul> <ul><li><ul><li>Public health threats </li></ul></li></ul> <ul><li><ul><li>Public confidence in food supply </li></ul></li></ul> <ul><li><ul><li>Economic impacts </li></ul></li></ul> <ul><li><ul><li>Illustrated in general by recent pet food contamination incident </li></ul></li></ul> <p>8. Chemical threats </p> <ul><li>Military chemical weapons </li></ul> <ul><li><ul><li>Nerve agents </li></ul></li></ul> <ul><li><ul><li><ul><li>Tabun, Sarin, VX, </li></ul></li></ul></li></ul> <ul><li><ul><li>Vesicant or blistering agents </li></ul></li></ul> <ul><li><ul><li><ul><li>Mustard gas, Lewisite </li></ul></li></ul></li></ul> <ul><li><ul><li>Blood agents (cyanide compounds) </li></ul></li></ul> <ul><li>Industrial/other chemicals </li></ul> <ul><li><ul><li>Chlorine, phosgene, ammonia, cyanide, nitric acid </li></ul></li></ul> <ul><li><ul><li>Pesticides </li></ul></li></ul> <ul><li>Misc. </li></ul> <ul><li><ul><li>Methamphetamine byproducts, mace, tear gas </li></ul></li></ul> <p>1 2 4 9. Tokyo subway attack, 1995 </p> <ul><li>Sarin (nerve agent) </li></ul> <ul><li>AUM Shinrikyo group </li></ul> <p>Shoko Asahara </p> <ul><li>12 deaths </li></ul> <ul><li>990 treated </li></ul> <ul><li>9000 panic </li></ul> <p>10. Treatment of OP Poisoning </p> <ul><li>Antidotes </li></ul> <ul><li><ul><li>Atropine </li></ul></li></ul> <ul><li><ul><li>2-PAM Cl </li></ul></li></ul> <ul><li><ul><li>Diazepam </li></ul></li></ul> <p>11. Canine nerve agent antidotes </p> <ul><li>Atropine: </li></ul> <ul><li><ul><li>0.2 - 2 mg/kg IM.</li></ul></li></ul> <ul><li><ul><li>30 kg (66#) canine, IM = 6 to 60 mg </li></ul></li></ul> <ul><li><ul><li>Mark I injector containsonly2 mg! </li></ul></li></ul> <ul><li>2-PAM Chloride: </li></ul> <ul><li><ul><li>10 - 20 mg/kg IM </li></ul></li></ul> <ul><li><ul><li>30 kg canine = 300 to 600 mg.</li></ul></li></ul> <ul><li><ul><li>The Mark I injector contains 600 mg (The LD50 for dogs is 190 mg/kg, so the injector dose should be relatively safe for dogs over 10kg) </li></ul></li></ul> <ul><li>Diazepam: </li></ul> <ul><li><ul><li>0.2 - 2 mg/kg IV for seizure control, used to effect.</li></ul></li></ul> <ul><li><ul><li>The CANA injector contains only 2 mg for IM use </li></ul></li></ul> <ul><li><ul><li>IM diazepam in dogs unpredictably absorbed </li></ul></li></ul> <p>12. Chemical agents: Agriculture </p> <ul><li>Wisconsin 1996 </li></ul> <ul><li>National By-Products, Inc. </li></ul> <ul><li>Deliberate contamination of product with chlordane (insecticide) </li></ul> <ul><li>Perpetrator was a business rival </li></ul> <p>13. Natural CBRNE-like event Wyoming/CO border, 2004 </p> <ul><li>600 elk dead or dying with signs of paralysis </li></ul> <ul><li>No other species </li></ul> <ul><li>Eventual ID as: </li></ul> <ul><li><ul><li>Xanthoparmelia chlorochroa</li></ul></li></ul> <ul><li><ul><li>Lichen intoxication</li></ul></li></ul> <p>Walter Cook, Merl Raisbeck, Todd Cornish, Elizabeth Williams, Benge Brown, Greg Hiatt, and Terry Kreeger (in press): Paresis and death in elk ( Cervus elaphus ) due to lichen intoxication in Wyoming.Journal of Wildlife Diseases 14. Melamine ??? </p> <ul><li>Wednesday, May 23, 2007</li></ul> <ul><li>On March 16, 2007, Menu Foods recalled more than 60 million cans and pouches of pet food that it are marketed under a variety of brand names.</li></ul> <ul><li>The company acted after receiving reports from owners that their pets had become ill. </li></ul> <p>New York Times 15. Should you enter a building with this on the door? 3 1 0 16. National Fire Protection Association NFPA Hazardous Material Diamond 17. Material Safety Data Sheets </p> <ul><li>MSDS forms contain the following: </li></ul> <p>Section 16 - Other InformationSection 8 - Exposure Controls &amp; Personal ProtectionSection 15 - Regulatory InformationSection 7 - Handling and StorageSection 14 - MSDS Transport InformationSection 6 - Accidental Release MeasuresSection 13 - Disposal ConsiderationsSection 5 - Fire Fighting MeasuresSection 12 - Ecological InformationSection 4 - First Aid MeasuresSection 11 - Toxicological InformationSection 3 - Hazards Identification Including Emergency OverviewSection 10 - Stability &amp; Reactivity DataSection 2 - Composition/Information on IngredientsSection 9 - Physical &amp; Chemical PropertiesSection 1 - Product and Company Identification 18. Anhydrous Ammonia 3 1 0 19. Biological Agents 20. History of bio-warfare: examples </p> <ul><li>Examples </li></ul> <ul><li><ul><li>1346:Caffa (Crimea) human plague cadavers catapulted into castle under siege </li></ul></li></ul> <ul><li><ul><li>Infected defenders fled, helped to trigger Black Death 1763:Fort Pitt, Pennsylvania, smallpox infected blankets given to Delaware Indians </li></ul></li></ul> <ul><li><ul><li>WWII: Japanese test anthrax, typhoid, cholera and plague as weapons in China </li></ul></li></ul> <ul><li><ul><li>US (2001):Use of anthrax spores through the mail </li></ul></li></ul> <p>21. </p> <ul><li><ul><li>WWI:German use of glanders against 3500 horses in US bound for Europe </li></ul></li></ul> <ul><li><ul><li>Afghanistan (1980s):Soviet Union suspected of using glanders against Mujaheddin horses </li></ul></li></ul> <p>Livestock Disease Agents as Bioweapons 22. Bio-weapons programs </p> <ul><li>United States:Discontinued offensive program in 1969 </li></ul> <ul><li><ul><li>1972:US and 100+ nations sign treaty banning biological weapons </li></ul></li></ul> <ul><li>Former Soviet Union </li></ul> <ul><li><ul><li>Massive program </li></ul></li></ul> <ul><li>Iraq (?) </li></ul> <ul><li>Al Qaeda in Afghanistan </li></ul> <ul><li><ul><li>200+ documents found in caves related to bioterrorism </li></ul></li></ul> <p>Pandora (Dante Gabriel Rossetti, 1869) 23. Animal agricultural vulnerabilities </p> <ul><li>Pre-production </li></ul> <ul><li><ul><li>Water, medications </li></ul></li></ul> <ul><li><ul><li>Feed, fertilizers </li></ul></li></ul> <ul><li>Production </li></ul> <ul><li><ul><li>Farms &amp; ranches </li></ul></li></ul> <ul><li><ul><li>Concentrated operations </li></ul></li></ul> <ul><li>Exhibits </li></ul> <ul><li>Transportation and markets </li></ul> <ul><li>Processing </li></ul> <p>24. Significant disease agents </p> <ul><li>Foot and Mouth Disease </li></ul> <ul><li>Bovine Spongiform Encephalopathy </li></ul> <ul><li>Classical Swine Fever </li></ul> <ul><li>Rift Valley Fever </li></ul> <ul><li>Burkholderia (Glanders, melioidosis) </li></ul> <ul><li>Highly Pathogenic Avian Influenza </li></ul> <ul><li>Exotic Newcastle Disease </li></ul> <p>25. Foot and Mouth Disease </p> <ul><li>Cloven-hoofed animals (ungulates) </li></ul> <ul><li><ul><li>Cattle, sheep, pigs, goats, wildlife </li></ul></li></ul> <ul><li>Virus:One of the most contagious diseases known </li></ul> <ul><li><ul><li>Incubation 4-5 days </li></ul></li></ul> <ul><li><ul><li>Fever, vesicles (blisters) </li></ul></li></ul> <ul><li><ul><li>Mouth, nose, teats, feet </li></ul></li></ul> <p>26. FMD outbreaks </p> <ul><li>Great Britain, 2001 </li></ul> <ul><li><ul><li>Over 3 million animals culled </li></ul></li></ul> <ul><li><ul><li>Over 8000 infected premises </li></ul></li></ul> <ul><li><ul><li>Cost over $5 billion US + tourism impacts </li></ul></li></ul> <ul><li>Uruguay, 2000 </li></ul> <ul><li><ul><li>6900 animals culled </li></ul></li></ul> <ul><li><ul><li>24 million doses of vaccine used </li></ul></li></ul> <ul><li><ul><li>Costs of $247 million US </li></ul></li></ul> <ul><li>Taiwan, 1997 </li></ul> <ul><li><ul><li>$1.4 billion US, entire swine industry </li></ul></li></ul> <p>27. Bovine Spongiform Encephalopathy </p> <ul><li> Mad Cow Disease </li></ul> <ul><li>Prion (protein) agent </li></ul> <ul><li>Spread by cattle feeds with bovine proteins added </li></ul> <ul><li>Prevention by feed bans </li></ul> <ul><li>Over 150 human cases </li></ul> <ul><li><ul><li>Mostly UK and European nations </li></ul></li></ul> <p>28. The Cow that stole Christmas </p> <ul><li>Christmas Eve 2003 </li></ul> <ul><li>1 positive cow in Washington State </li></ul> <ul><li><ul><li>Canadian origin </li></ul></li></ul> <ul><li><ul><li>Older than feed ban </li></ul></li></ul> <ul><li><ul><li>No human exposure </li></ul></li></ul> <ul><li>Over 3 Billion in trade impacts </li></ul> <ul><li>Additional cases found </li></ul> <p>29. Classical Swine Fever(Hog Cholera) </p> <ul><li>Viral agent </li></ul> <ul><li>Swine </li></ul> <ul><li>Acute and chronic infections </li></ul> <ul><li>Acute: </li></ul> <ul><li><ul><li>Fever, loss of appetite </li></ul></li></ul> <ul><li><ul><li>Erythema of skin </li></ul></li></ul> <ul><li><ul><li>Staggering, weakness, death </li></ul></li></ul> <ul><li>Great Britain:2000 </li></ul> <ul><li><ul><li>16 infected premises </li></ul></li></ul> <p>30. Rift Valley Fever </p> <ul><li>Signs in animals:</li></ul> <ul><li><ul><li>Fever, diarrhea, jaundice, loss of appetite, nasal discharge, death </li></ul></li></ul> <ul><li>Highly infectious for people </li></ul> <ul><li><ul><li>Varies from mild signs to hemorrhagic fever, meningioencephalitis, ocular disease, jaundice, and death. </li></ul></li></ul> <ul><li>Viral agent, direct and vector spread </li></ul> <ul><li>Sheep, goats, cattle, buffalo, rodents, and many other species </li></ul> <p>31. Burkholderia</p> <ul><li>Burkholderia mallei (Glanders) </li></ul> <ul><li><ul><li>Horses, carnivores, people </li></ul></li></ul> <ul><li>Burkholderia pseudomallei (Melioidosis)(Whitmores disease) </li></ul> <ul><li><ul><li>Cattle, sheep, goats, people </li></ul></li></ul> <ul><li>Respiratory and abscessation disease </li></ul> <p>32. Avian Diseases </p> <ul><li>Highly Pathogenic Avian Influenza </li></ul> <ul><li>Exotic Newcastle Disease </li></ul> <p>33. =Extremely sick/dead birds 34. 35. Exotic Newcastle Disease </p> <ul><li>All birds </li></ul> <ul><li><ul><li>Often sub-clinical in wild birds and psittacine birds (parrots, etc.) </li></ul></li></ul> <ul><li>Domestic poultry very susceptible </li></ul> <ul><li>Hemorrhagic GI lesions </li></ul> <ul><li>Neurological and respiratory signs </li></ul> <ul><li> mortality and sudden death </li></ul> <p>36. END Outbreak, U.S. 2002-2003 </p> <ul><li>4 million poultry destroyed </li></ul> <ul><li>Over $150 million in direct costs </li></ul> <ul><li>15,000 response personnel </li></ul> <ul><li><ul><li>Up to 2500 at one time </li></ul></li></ul> <ul><li>Smuggled parrots?</li></ul> <ul><li><ul><li> fighting fowl</li></ul></li></ul> <ul><li><ul><li> backyard poultry</li></ul></li></ul> <ul><li><ul><li> commercial </li></ul></li></ul> <ul><li>Biosecurity standards correlated to infection rates </li></ul> <p>37. 38. Highly Pathogenic Avian Influenza </p> <ul><li>Virus:Influenza A </li></ul> <ul><li>Severe in chickens and turkeys </li></ul> <ul><li>Less severe in ducks/wild birds</li></ul> <ul><li>Depression,appetite,thirst </li></ul> <ul><li>Diarrhea, respiratory disease, death </li></ul> <ul><li>Some strains are zoonotic </li></ul> <p>39. Potential of weaponized agents </p> <ul><li>Increased virulence </li></ul> <ul><li>Resistance to antimicrobials </li></ul> <ul><li>Environmental durability </li></ul> <ul><li>Increase host range </li></ul> <ul><li><ul><li>People </li></ul></li></ul> <ul><li><ul><li>Animals </li></ul></li></ul> <ul><li> Known disease behavior may not apply! </li></ul> <p>40. Weaponization </p> <ul><li>Genetic selection </li></ul> <ul><li><ul><li>Serial passage of microbial stains to select for desired characteristics </li></ul></li></ul> <ul><li>Genetic engineering </li></ul> <ul><li><ul><li>Mixing pathogen genes </li></ul></li></ul> <ul><li><ul><li>Adding resistance factors </li></ul></li></ul> <ul><li><ul><li>Potentially VERY DANGEROUS </li></ul></li></ul> <ul><li><ul><li><ul><li>OpeningPandoras Box </li></ul></li></ul></li></ul> <p>41. Bio-toxins </p> <ul><li>Non-living agents from a biological source: </li></ul> <ul><li><ul><li>Clostridial toxins</li></ul></li></ul> <ul><li><ul><li><ul><li>Botulinum neurotoxin </li></ul></li></ul></li></ul> <ul><li><ul><li><ul><li>Perfringens epsilon toxin </li></ul></li></ul></li></ul> <ul><li><ul><li>Staphyloccocal enterotoxins </li></ul></li></ul> <ul><li><ul><li>Mycotoxins </li></ul></li></ul> <ul><li><ul><li><ul><li>Aflatoxins, T-2 toxin </li></ul></li></ul></li></ul> <ul><li><ul><li>Shigatoxin (E. coli) </li></ul></li></ul> <ul><li><ul><li>Others (Ricin) </li></ul></li></ul> <ul><li>Use more like a chemical attack </li></ul> <p>42. Hoaxes &amp; false alarms: </p> <ul><li>Commodity markets are driven by investorperceptions </li></ul> <ul><li>Publicperception drives consumer markets </li></ul> <ul><li>Impacts of credible threats and false alarms may be initially similar to actual events </li></ul> <ul><li> Proving the negativemay be a tremendous challenge </li></ul> <p>43. Kansas FMD scare:3-12-02 </p> <ul><li>Holton Livestock Market </li></ul> <ul><li>Veterinarian reported lesionspotentiallyconsistent with FMD </li></ul> <ul><li><ul><li>Precautionary action </li></ul></li></ul> <ul><li><ul><li>Nothighly suspect </li></ul></li></ul> <ul><li>Rumor of 9 infected cowsspread quickly (hours) </li></ul> <ul><li>Estimated market impactof 50 million dollars </li></ul> <p>44. Radiological threats </p> <ul><li>Radiological dispersion device </li></ul> <ul><li><ul><li>Dirty bomb </li></ul></li></ul> <ul><li>Intentional radiological contamination of people, animals, food, water or the environment </li></ul> <ul><li>Accidental contamination </li></ul> <p>Alexander Litvinenko 45. Radiological agents 46. Nuclear threats </p> <ul><li>Military attacks </li></ul> <ul><li>Terrorist/criminal attacks </li></ul> <ul><li>Impacts </li></ul> <ul><li><ul><li>Mass casualties </li></ul></li></ul> <ul><li><ul><li>Catastrophic infrastructure damage </li></ul></li></ul> <ul><li><ul><li>Incident of national significance </li></ul></li></ul> <p>47. Radiological/Nuclear Animal/Ag impacts </p> <ul><li>Direct casualties </li></ul> <ul><li>Companion animals </li></ul> <ul><li><ul><li>Evacuation </li></ul></li></ul> <ul><li><ul><li>Decontamination </li></ul></li></ul> <ul><li><ul><li>Sheltering </li></ul></li></ul> <ul><li><ul><li>Search &amp; Rescue </li></ul></li></ul> <ul><li>Livestock </li></ul> <ul><li><ul><li>Decon vs euthanasiaand disposal </li></ul></li></ul> <ul><li><ul><li>Food safety issues </li></ul></li></ul> <ul><li>Resource prioritization! </li></ul> <p>48. Radiation Protection Principles </p> <ul><li>Time </li></ul> <ul><li>Distance </li></ul> <ul><li>Shielding </li></ul> <ul><li>Quantity </li></ul> <ul><li>Route </li></ul> <ul><li><ul><li>External vs internal </li></ul></li></ul> <p>49. Explosive attacks </p> <ul><li>Examples </li></ul> <ul><li><ul><li>Oklahoma City </li></ul></li></ul> <ul><li><ul><li>NY, DC, PA </li></ul></li></ul> <ul><li><ul><li><ul><li>9-11-01 </li></ul></li></ul></li></ul> <ul><li>Primary </li></ul> <ul><li><ul><li>Targeting persons at the site </li></ul></li></ul> <ul><li>Secondary device </li></ul> <ul><li><ul><li>Targeting responders </li></ul></li></ul> <p>Alfred P. Murrah Building, Oklahoma City, 1995 50. Blast Physics and Physiology </p> <ul><li>Blast Pressure Wave </li></ul> <ul><li>(Friedlander wave form) </li></ul> <ul><li><ul><li>Detonation. </li></ul></li></ul> <ul><li><ul><li>Blast Overpressure (BOP). </li></ul></li></ul> <ul><li><ul><li>Exponential decay. </li></ul></li></ul> <ul><li><ul><li>Positive Pressure Phase. </li></ul></li></ul> <ul><li><ul><li>Negative Pressure Phase. </li></ul></li></ul> <p>51. Blast Physics and Physiology </p> <ul><li>Associated PSIs with injury </li></ul> <ul><li><ul><li>2 5 - Tympanic membrane rupture. </li></ul></li></ul> <ul><li><ul><li>15- Lung damage threshold. </li></ul></li></ul> <ul><li><ul><li>30 - 40 - Lethality threshold.</li></ul></li></ul> <ul><li>Blast Winds </li></ul> <ul><li><ul><li>Generated by the rapidly expanding gases displacing air. </li></ul></li></ul> <ul><li><ul><li>Maximum speeds &lt; 1500 mph. </li></ul></li></ul> <p>52. Blast injuries </p> <ul><li>Primary:from blast wave injury to tissues </li></ul> <ul><li><ul><li>Mainly affects organ systems with a high air to fluid ratio (auditory, pulmonary and GI.) </li></ul></li></ul> <ul><li>Secondary injuries:from bomb fragments or flying debris </li></ul> <ul><li>Tertiary:victim propelled into stationary objects </li></ul> <ul><li>Other:Burns, smoke, radiation </li></ul> <p>53. Principles of Veterinary Triage </p> <ul><li>General medical triage nomenclature </li></ul> <ul><li><ul><li>Green:Minor (walking wounded) </li></ul></li></ul> <ul><li><ul><li>Yellow: Delayed treatment OK </li></ul></li></ul> <ul><li><ul><li>Red:Needs immediate care </li></ul></li></ul> <ul><li><ul><li>Black:Dead/going to die </li></ul></li></ul> <ul><li>Veterinary professionals would triage for animals and potentially could triage people in catastrophic situations. </li></ul> <p>54. Decontamination ?? 55. Decontamination zones WIND HOT ZONE Incident WARM ZONE Evacuation and decontamination Cold Zone Safe area 56. Decontamination: Equipment and vehicles </p> <ul><li>Two step process </li></ul>


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