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Coudron L, McDonnell MB, Munro I, McCluskey DK, Johnston ID, Tan CK, Tracey MC. Fully integrated digital microfluidics platform for automated immunoassay; A versatile tool for rapid, specific detection of a wide range of pathogens. Biosens Bioelectron 2019; 128:52-60. [DOI: 10.1016/j.bios.2018.12.014] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Revised: 11/29/2018] [Accepted: 12/11/2018] [Indexed: 11/17/2022]
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2
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Ahn JH, Chung JW, Kim CW, Lee DH. Preparedness of Young Male Physicians for Biological Terrorism and Warfare in South Korea. HONG KONG J EMERG ME 2017. [DOI: 10.1177/102490791201900104] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Introduction The events of 11th September 2001, and the subsequent anthrax attacks in the United States brought the threat of bioterrorism to the forefront of concern for public health departments. Moreover, the rising confrontation between North and South Korea emphasizes the possibility of aggression with biological weapons and our vulnerability to bioterrorism. While the importance of physicians' interests and management ability is becoming more critical, no studies have yet been undertaken in Korea to assess whether primary care physicians are well informed and capable of managing bioterrorism. This study evaluates the awareness and response of young male physicians to potential bioterrorism in South Korea. Method A total of 692 young male physicians completed the knowledge and awareness survey during the education period of military service on 9th April 2005. Results Forty-five percent of the participants responded that the possibility of biological warfare in Korea was high. The level of bioterrorism knowledge, however, was low. Eighty-seven percent acknowledged the necessity of education and training for bioterrorism, and 69.9% were willing to accept education and training in bioterrorism preparedness. Conclusion These findings suggest that young physicians should receive continuous education and training to improve preparedness for biological terrorism and warfare in South Korea.
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Affiliation(s)
- JH Ahn
- Chung-Ang University Hospital, Department of Internal Medicine, Chung-Ang University College of Medicine, 224-1, Heukseok-dong, Dongjak-gu, 156-757, Seoul, Korea
| | - JW Chung
- Chung-Ang University Hospital, Department of Internal Medicine, Chung-Ang University College of Medicine, 224-1, Heukseok-dong, Dongjak-gu, 156-757, Seoul, Korea
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3
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Deliberately Contaminated Food. Food Saf (Tokyo) 2014. [DOI: 10.1128/9781555816186.ch13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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4
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Zhang J, Li Z, Zhang H, Wang J, Liu Y, Chen G. Rapid detection of several foodborne pathogens by F0F1-ATPase molecular motor biosensor. J Microbiol Methods 2013; 93:37-41. [PMID: 23361046 DOI: 10.1016/j.mimet.2013.01.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2012] [Revised: 01/20/2013] [Accepted: 01/20/2013] [Indexed: 11/16/2022]
Abstract
F0F1-ATPase within chromatophore was constructed as a molecular motor biosensor through ε-subunit antibody-biotin-streptavidin-biotin-AC5-Sulfo-Osu system. Based on probe-DNA specific binding, DNA of several foodborne pathogens Listeria monocytogenes, Salmonella typhimurium, Vibrio parahaemolyticus and Vibrio cholerae was specifically captured by F0F1-ATPase molecular motor biosensors. Loads of DNA decreased the rotation rate of F0F1-ATPase, and led to the decrease of ATP synthesis. The detection of pathogens based on proton flux change driven by ATP-synthesis of F0F1-ATPase, which was indicated by F-DHPE, was monitored by a fluorescence spectrometer. The results demonstrate that the F0F1-ATPase molecular motor biosensor can specifically detect bacterial DNA at low concentration level, and will be a convenient, quick, and promising tool for detecting pathogens.
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Affiliation(s)
- Jie Zhang
- Beijing Entry-Exit Inspection and Quarantine Bureau, Beijing, China
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5
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Powell V, Din FM, Acharya A, Torres-Urquidy MH. Broader Considerations of Medical and Dental Data Integration. HEALTH INFORMATICS 2012. [PMCID: PMC7177026 DOI: 10.1007/978-1-4471-2185-5_4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Valerie Powell
- Robert Morris University, Moon Township,, Moon Township, 15108-1189 USA
| | - Franklin M. Din
- Medical Informatics Center of Excellence, Camp Hill, 25403 USA
| | - Amit Acharya
- MCRF/BIRC, Marshfield, WI, USA, Marshfield, 54449 Wisconsin USA
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6
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Bourgeois SL, Doherty MJ. Bioterrorism and biologic warfare. Oral Maxillofac Surg Clin North Am 2009; 17:299-330, vii. [PMID: 18088788 DOI: 10.1016/j.coms.2005.04.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Biologic agents have been used throughout history to influence battles. Recently, biologic agents have been used as terrorist weapons. A review of the history of biologic weapons and a medical overview of the Centers for Disease Control and Prevention Category A and B agents is provided, including history, pathogenesis, clinical presentation, microbiology/virology, diagnosis, treatment, and each agent's use or potential use as a weapon. Background information on public health issues surrounding bioterrorism and the role of oral and maxillofacial surgeons in a bioterrorist event also is provided.
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Affiliation(s)
- Sidney L Bourgeois
- Department of Oral and Maxillofacial Surgery, National Capital Consortium, National Naval Medical Center, 8901 Wisconsin Avenue, Bethesda, MD 20889, USA.
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7
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York J, Spetzler D, Xiong F, Frasch WD. Single-molecule detection of DNA via sequence-specific links between F1-ATPase motors and gold nanorod sensors. LAB ON A CHIP 2008; 8:415-419. [PMID: 18305859 DOI: 10.1039/b716744j] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
We report the construction of a novel biosensing nanodevice to detect single, sequence-specific target DNA molecules. Nanodevice assembly occurs through the association of an immobilized F1-ATPase molecular motor and a functionalized gold nanorod via a single 3',5'-dibiotinylated DNA molecule. Target-dependent 3',5'-dibiotinylated DNA bridges form by combining ligation and exonucleation reactions (LXR), with a specificity capable of selecting against a single nucleotide polymorphism (SNP). Using dark field microscopy to detect gold nanorods, quantitation of assembled nanodevices is sufficient to distinguish the presence of as few as 1800 DNA bridges from nonspecifically bound nanorods. The rotary mechanism of F1-ATPase can drive gold nanorod rotation when the nanorod is attached via the DNA bridge. Therefore, rotation discriminates fully assembled devices from nonspecifically bound nanorods, resulting in a sensitivity limit of one zeptomole (600 molecules).
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Affiliation(s)
- Justin York
- Molecular and Cellular Biology Graduate Program, Faculty of Biomedicine and Biotechnology, School of Life Sciences, Arizona State University, Tempe, AZ 85287-4501, USA
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8
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Staats HF, Alam SM, Scearce RM, Kirwan SM, Zhang JX, Gwinn WM, Haynes BF. In vitro and in vivo characterization of anthrax anti-protective antigen and anti-lethal factor monoclonal antibodies after passive transfer in a mouse lethal toxin challenge model to define correlates of immunity. Infect Immun 2007; 75:5443-52. [PMID: 17709410 PMCID: PMC2168269 DOI: 10.1128/iai.00529-07] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Passive transfer of antibody may be useful for preexposure prophylaxis against biological agents used as weapons of terror, such as Bacillus anthracis. Studies were performed to evaluate the ability of anthrax antiprotective antigen (anti-PA) and antilethal factor (anti-LF) neutralizing monoclonal antibodies (mAbs) to protect against an anthrax lethal toxin (LeTx) challenge in a mouse model and to identify correlates of immunity to LeTx challenge. Despite having similar affinities for their respective antigens, anti-PA (3F11) and anti-LF (9A11), passive transfer of up to 1.5 mg of anti-PA 3F11 mAb did not provide significant protection when transferred to mice 24 h before LeTx challenge, while passive transfer of as low as 0.375 mg of anti-LF 9A11 did provide significant protection. Serum collected 24 h after passive transfer had LeTx-neutralizing activity when tested using a standard LeTx neutralization assay, but neutralization titers measured using this assay did not correlate with protection against LeTx challenge. However, measurement of LeTx-neutralizing serum responses with an LeTx neutralization assay in vitro employing the addition of LeTx to J774A.1 cells 15 min before the addition of the serum did result in neutralization titers that correlated with protection against LeTx challenge. Our results demonstrate that only the LeTx neutralization titers measured utilizing the addition of LeTx to J774A.1 cells 15 min before the addition of sample correlated with protection in vivo. Thus, this LeTx neutralization assay may be a more biologically relevant neutralization assay to predict the in vivo protective capacity of LeTx-neutralizing antibodies.
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Affiliation(s)
- Herman F Staats
- Department of Pathology, Box 3712, DUMC, Durham, NC 27710, USA.
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9
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Affiliation(s)
- David McD Taylor
- Department of Emergency Medicine, Austin Hospital, Heidelberg, Victoria 3084, Australia
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10
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Mattix ME, Zeman DH, Moeller R, Jackson C, Larsen T. Clinicopathologic aspects of animal and zoonotic diseases of bioterrorism. Clin Lab Med 2006; 26:445-89, x. [PMID: 16815461 DOI: 10.1016/j.cll.2006.03.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
We live in an era of emerging infectious diseases and the threat of bioterrorism. Most of the infectious agents of modern concern, from plague to avian influenza H5N1, are zoonotic diseases: infectious agents that reside in quiet animal reservoir cycles that are transmitted occasionally to humans. The public health, health care, and veterinary communities have an enormous challenge in the early recognition, reporting, treatment, and prevention of zoonotic diseases. An intimate understanding of the natural ecology, geographic distribution, clinical signs, lesions, and diagnosis of these diseases is essential for the early recognition and control of these diseases.
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Affiliation(s)
- Marc E Mattix
- Regional Western Pathologies, 6941 Bristol Lane, Bozeman, MT 59715, USA.
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11
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Clarke L, Chess C, Holmes R, O'Neill KM. Speaking with One Voice: Risk Communication Lessons from the US Anthrax Attacks. JOURNAL OF CONTINGENCIES AND CRISIS MANAGEMENT 2006. [DOI: 10.1111/j.1468-5973.2006.00491.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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12
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Jamieson DJ, Ellis JE, Jernigan DB, Treadwell TA. Emerging infectious disease outbreaks: old lessons and new challenges for obstetrician-gynecologists. Am J Obstet Gynecol 2006; 194:1546-55. [PMID: 16731070 PMCID: PMC7093849 DOI: 10.1016/j.ajog.2005.06.062] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2005] [Revised: 05/13/2005] [Accepted: 06/14/2005] [Indexed: 12/21/2022]
Abstract
OBJECTIVE The purpose of this study was to summarize 3 recent high-profile infectious disease threats that have affected the United States: severe acute respiratory syndrome, West Nile virus, and anthrax. STUDY DESIGN A systematic review was conducted with the use of Medline searches, searches of the Centers for Disease Control and Prevention website, and review by experts at the Centers for Disease Control and Prevention. RESULTS The 3 emerging infectious diseases pose very different threats: Severe acute respiratory syndrome is a newly identified pathogen that caused an international pandemic; the West Nile virus investigation involved an old pathogen that was identified in a new location; and the anthrax attacks involved the intentional introduction of a pathogen. CONCLUSION All 3 outbreaks highlight the importance of obstetrician-gynecologists keeping current with new information as it emerges. In this global environment, it is likely that novel disease threats will continue to emerge in the United States.
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Affiliation(s)
- Denise J Jamieson
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA.
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13
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Herrmann JE, Wang S, Zhang C, Panchal RG, Bavari S, Lyons CR, Lovchik JA, Golding B, Shiloach J, Lu S. Passive immunotherapy of Bacillus anthracis pulmonary infection in mice with antisera produced by DNA immunization. Vaccine 2006; 24:5872-80. [PMID: 16790303 DOI: 10.1016/j.vaccine.2006.04.065] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2006] [Revised: 04/24/2006] [Accepted: 04/25/2006] [Indexed: 10/24/2022]
Abstract
Because of the high failure rate of antibiotic treatment in patients with anthrax there is a need for additional therapies such as passive immunization with therapeutic antibodies. In this study, we used codon-optimized plasmid DNAs (DNA vaccines) encoding Bacillus anthracis protective antigen (PA) to immunize rabbits for producing anti-anthrax antibodies for use in passive immunotherapy. The antisera generated with these DNA vaccines were of high titer as measured by ELISA. The antisera were also able to protect J774 macrophage cells by neutralizing the cytotoxic effect of exogenously added anthrax lethal toxin, and of the toxin released by B. anthracis (Sterne strain) spores following infection. In addition, the antisera passively protected mice against pulmonary challenge with an approximate 50 LD50 dose of B. anthracis (Sterne strain) spores. The protection in mice was obtained when the antiserum was given 1h before or 1h after challenge. We further demonstrated that IgG and F(ab')2 components purified from anti-PA rabbit hyperimmune sera retained similar levels of neutralizing activities against both exogenously added B. anthracis lethal toxin and toxin produced by B. anthracis (Sterne strain) spores. The high titer antisera we produced will enable an immunization strategy to supplement antibiotic therapy for improving the survival of patients with anthrax.
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Affiliation(s)
- John E Herrmann
- Antibody Science, Inc., 80 Webster Street, Worcester, MA 01603, USA.
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14
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Hitchcock PJ, Mair M, Inglesby TV, Gross J, Henderson DA, O'Toole T, Ahern-Seronde J, Bahnfleth WP, Brennan T, Burroughs HEB, Davidson C, Delp W, Ensor DS, Gomory R, Olsiewski P, Samet JM, Smith WM, Streifel AJ, White RH, Woods JE. Improving Performance of HVAC Systems to Reduce Exposure to Aerosolized Infectious Agents in Buildings; Recommendations to Reduce Risks Posed by Biological Attacks. Biosecur Bioterror 2006; 4:41-54. [PMID: 16545023 DOI: 10.1089/bsp.2006.4.41] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The prospect of biological attacks is a growing strategic threat. Covert aerosol attacks inside a building are of particular concern. In the summer of 2005, the Center for Biosecurity of the University of Pittsburgh Medical Center convened a Working Group to determine what steps could be taken to reduce the risk of exposure of building occupants after an aerosol release of a biological weapon. The Working Group was composed of subject matter experts in air filtration, building ventilation and pressurization, air conditioning and air distribution, biosecurity, building design and operation, building decontamination and restoration, economics, medicine, public health, and public policy. The group focused on functions of the heating, ventilation, and air conditioning systems in commercial or public buildings that could reduce the risk of exposure to deleterious aerosols following biological attacks. The Working Group's recommendations for building owners are based on the use of currently available, off-the-shelf technologies. These recommendations are modest in expense and could be implemented immediately. It is also the Working Group's judgment that the commitment and stewardship of a lead government agency is essential to secure the necessary financial and human resources and to plan and build a comprehensive, effective program to reduce exposure to aerosolized infectious agents in buildings.
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15
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Hitchcock PJ, Mair M, Inglesby TV, Gross J, Henderson DA, O'Toole T, Ahern-Seronde J, Bahnfleth WP, Brennan T, Burroughs HEB, Davidson C, Delp W, Ensor DS, Gomory R, Olsiewski P, Samet JM, Smith WM, Streifel AJ, White RH, Woods JE. Improving Performance of HVAC Systems to Reduce Exposure to Aerosolized Infectious Agents in Buildings; Recommendations to Reduce Risks Posed by Biological Attacks. Biosecur Bioterror 2006. [DOI: 10.1089/bsp.2006.4.ft-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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16
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Jamieson DJ, Jernigan DB, Ellis JE, Treadwell TA. Emerging infections and pregnancy: West Nile virus, monkeypox, severe acute respiratory syndrome, and bioterrorism. Clin Perinatol 2005; 32:765-76. [PMID: 16085032 PMCID: PMC7119112 DOI: 10.1016/j.clp.2005.04.008] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
As new infectious diseases, such as West Nile virus, monkeypox, and severe acute respiratory syndrome (SARS) are recognized in the United States, there are critical questions about how these infectious diseases will affect pregnant women and their infants. In addition, the implications of bioterrorist attacks for exposed pregnant women need to be considered. In this article, the authors address the following questions for a number of infectious disease threats: (1) does pregnancy affect the clinical course of these novel infectious diseases?, (2) what are the implications for prophylaxis and treatment of exposed or infected pregnant women?, and (3) are these novel infectious diseases transmitted during pregnancy, labor and delivery, or breastfeeding?
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Affiliation(s)
- Denise J Jamieson
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 4770 Buford Highway, Atlanta, GA 30341, USA.
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Abstract
OBJECTIVE Disaster medicine and disaster medical response is a complex and evolving field that has existed for millennia. The objective of this article is to provide a brief review of significant milestones in the history of disaster medicine with emphasis on applicability to present and future structures for disaster medical response. RESULTS Disaster medical response is an historically necessary function in any society. These range from response to natural disasters, to the ravages of warfare, and most recently, to medical response after terrorist acts. Our current disaster response systems are largely predicated on military models derived over the last 200 yrs. Their hallmark is a structured and graded response system based on numbers of casualties. In general, all of these assume that there is an identifiable "ground zero" and then proceed with echelons of casualty retrieval and care that proceeds rearward to a hospital(s). In a civil response setting, most civilian models of disaster medical response similarly follow this military model. This historical approach may not be applicable to some threats such as bioterrorism. A "new" model of disaster medical response for this type of threat is still evolving. Using history to guide our future education and planning efforts is discussed. CONCLUSION We can learn much from an historical perspective that is still applicable to many current disaster medical threats. However, a new response model may be needed to address the threats of bioterrorism.
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Affiliation(s)
- Saqib I Dara
- Division of Pulmonary and Critical Care Medicine, Mayo Clinic College of Medicine, Rochester, MN 55905, USA
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18
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Howell JM, Mayer TA, Hanfling D, Morrison A, Druckenbrod G, Murphy C, Cates R, Pauze D. Screening for Inhalational Anthrax Due to Bioterrorism: Evaluating Proposed Screening Protocols. Clin Infect Dis 2004; 39:1842-7. [PMID: 15578409 DOI: 10.1086/426080] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2004] [Accepted: 08/10/2004] [Indexed: 11/03/2022] Open
Abstract
Eleven known cases of bioterrorism-related inhalational anthrax (IA) were treated in the United States during 2001. We retrospectively compared 2 methods that have been proposed to screen for IA. The 2 screening protocols for IA were applied to the emergency department charts of patients who presented with possible signs or symptoms of IA at Inova Fairfax Hospital (Falls Church, Virginia) from 20 October 2001 through 3 November 2001. The Mayer criteria would have screened 4 patients (0.4%; 95% CI, 0.1%-0.9%) and generated charges of 1900 dollars. If 29 patients (2.6%; 95% CI, 1.7%-3.7%) with >or=5 symptoms (but without fever and tachycardia) were screened, charges were 13,325 dollars. The Hupert criteria would have screened 273 patients (24%; 95% CI, 22%-27%) and generated charges of 126,025 dollars. In this outbreak of bioterrorism-related IA, applying the Mayer criteria would have identified both patients with IA and would have generated fewer charges than applying the Hupert criteria.
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Affiliation(s)
- John M Howell
- Department of Emergency Medicine, Inova Fairfax Hospital, Falls Church, VA 22042-3300, USA.
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19
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McCurdy LH, Larkin BD, Martin JE, Graham BS. Modified Vaccinia Ankara: Potential as an Alternative Smallpox Vaccine. Clin Infect Dis 2004; 38:1749-53. [PMID: 15227622 DOI: 10.1086/421266] [Citation(s) in RCA: 67] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2003] [Accepted: 01/07/2004] [Indexed: 11/03/2022] Open
Abstract
Despite the declaration of smallpox eradication in 1980, the existence of variola stockpiles and the threat of bioterrorism demand that immunity to smallpox through vaccination be maintained. Although the currently available vaccine was used for the most successful medical intervention ever accomplished, it also is associated with side effects that are difficult to accept in a vaccine for a disease that has not been present for >25 years. Herein, we review alternative approaches to maintaining immunity to smallpox through vaccination with attenuated poxviruses, and we suggest modified vaccinia Ankara (MVA) as a leading candidate for an alternative smallpox vaccine.
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Affiliation(s)
- Lewis H McCurdy
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland 20892-3017, USA
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Abstract
Little is known about contemporary physicians' sense of preparedness for bioterrorism, willingness to treat patients despite personal risk, or belief in the professional duty to treat during epidemics. In a recent national survey few physicians reported that they or their practice are "well prepared" for bioterrorism. Still, most respondents reported that they would continue to care for patients in the event of an outbreak of "an unknown but potentially deadly illness," although only a narrow majority reported believing in a professional duty to treat patients in epidemics. Preparing physicians for bioterrorism should entail providing practical knowledge, preventive steps to minimize risk, and reinforcement of the profession's ethical duty to treat.
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Affiliation(s)
- G Caleb Alexander
- Division of General Internal Medicine, MacLean Center for Medical Ethics, University of Chicago Hospitals, USA
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21
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Hobbs J, Kittler A, Fox S, Middleton B, Bates DW. Communicating health information to an alarmed public facing a threat such as a bioterrorist attack. JOURNAL OF HEALTH COMMUNICATION 2004; 9:67-75. [PMID: 14761834 DOI: 10.1080/10810730490271638] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
Considerable literature exists on the communication of risk to the public through channels such as television, radio, and newspapers. However, little has been written on the communication of risk through less traditional communication forms, such as the Internet. The purpose of this study was to investigate the role of the Internet as an additional source of health information to that provided by the traditional news media in managing the public's response to an emerging health risk such as a bioterrorist attack. Despite some of the Internet's advantages over traditional media, including the depth and speed in which information can be conveyed to different audiences, the Internet was underutilized during fall 2001, when it became important to convey information on the risks of anthrax. A number of developments are required if the health care system is to capitalize on the Internet's potential as a risk communication device. These developments include research into public Internet searching behavior and further development in the role of search engines and government agencies in organizing quality health information.
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Affiliation(s)
- John Hobbs
- Department of Medicine, Brigham and Women's Hospital, Boston, MA 02115, USA
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22
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Shieh WJ, Guarner J, Paddock C, Greer P, Tatti K, Fischer M, Layton M, Philips M, Bresnitz E, Quinn CP, Popovic T, Perkins BA, Zaki SR. The critical role of pathology in the investigation of bioterrorism-related cutaneous anthrax. THE AMERICAN JOURNAL OF PATHOLOGY 2003; 163:1901-10. [PMID: 14578189 DOI: 10.1016/s0002-9440(10)63548-1] [Citation(s) in RCA: 62] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Cutaneous anthrax is a rare zoonotic disease in the United States. The clinical diagnosis traditionally has been established by conventional microbiological methods, such as culture and gram staining. However, these methods often yield negative results when patients have received antibiotics. During the bioterrorism event of 2001, we applied two novel immunohistochemical assays that can detect Bacillus anthracis antigens in skin biopsy samples even after prolonged antibiotic treatment. These assays provided a highly sensitive and specific method for the diagnosis of cutaneous anthrax, and were critical in the early and rapid diagnosis of 8 of 11 cases of cutaneous anthrax during the outbreak investigation. Skin biopsies were obtained from 10 of these 11 cases, and histopathological findings included various degrees of ulceration, hemorrhage, edema, coagulative necrosis, perivascular inflammation, and vasculitis. Serology was also an important investigation tool, but the results required several weeks because of the need to test paired serum specimens. Other tests, including culture, special stains, and polymerase chain reaction assay, were less valuable in the diagnosis and epidemiological investigation of these cutaneous anthrax cases. This report underscores the critical role of pathology in investigating potential bioterrorism events and in guiding epidemiological studies, a role that was clearly demonstrated in 2001 when B. anthracis spores were intentionally released through the United States postal system.
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Affiliation(s)
- Wun-Ju Shieh
- Infectious Disease Pathology Activity, Division of Bacterial and Mycotic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA
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23
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D'Amelio R, Biselli R, Natalicchio S, Lista F, Peragallo MS. Vaccination programmes in the Italian military. Vaccine 2003; 21:3530-3. [PMID: 12922079 DOI: 10.1016/s0264-410x(03)00380-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Raffaele D'Amelio
- Aeronautica Militare, Comando Logistico, Viale dell'Università 4, 00185 Rome, Italy.
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Mayer TA, Morrison A, Bersoff-Matcha S, Druckenbrod G, Murphy C, Howell J, Hanfling D, Cates R, Pauze D, Earls J. Inhalational anthrax due to bioterrorism: would current Centers for Disease Control and Prevention guidelines have identified the 11 patients with inhalational anthrax from October through November 2001? Clin Infect Dis 2003; 36:1275-83. [PMID: 12746773 DOI: 10.1086/374843] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2002] [Accepted: 01/27/2003] [Indexed: 11/03/2022] Open
Abstract
A panel of 10 physicians used the nominal group technique to assess the ability of the Centers for Disease Control and Prevention (CDC) interim guidelines for clinical evaluation of persons with possible inhalational anthrax (IA) to retrospectively identify the 11 patients with IA seen during the October 2001 bioterrorism outbreak. The guidelines would not have identified 10 of 11 of these patients, primarily because the guidelines were designed to address only those patients with a known history of exposure or clearly identified environmental or occupational risk. The panel suggested revisions to the guidelines, primarily consisting of broadening the criteria for evaluation to include either known exposure or environmental occupational risk, or to include clinical symptoms consistent with IA. These extensions of the guidelines retrospectively identified 8 of 11 of the patients with IA from October 2001.
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Affiliation(s)
- Thom A Mayer
- Department of Emergency Medicine, Inova Fairfax Hospital, Falls Church, Virginia 22042, USA.
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Meyer J. The role of the anaesthestist during biological, chemical or nuclear incidents. SOUTHERN AFRICAN JOURNAL OF ANAESTHESIA AND ANALGESIA 2003. [DOI: 10.1080/22201173.2003.10872988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Abstract
The fears and predictions of attacks with biological weapons, which were increasing at the close of the twentieth century, were transformed into reality not long after September 11, 2001, when several anthrax-laden letters were sent through the U.S. postal system. The attack challenged our medical preparedness and scientific understanding of the epidemiology of biothreat agents. It is fortunate that this was not a massive aerosol release that could have exposed hundreds of thousands. Rapid diagnoses and medical treatments limited casualties and increased survival rates, but tragically some individuals died of inhalational anthrax. Even as physicians tested new treatment regimes and scientists employed new ways of detecting anthrax and decontaminating the mail, new predictions were made for potentially even more devastating attacks with anthrax, smallpox, plague, tularemia, botulism, or hemorrhagic fever viruses. Fear gripped the nation. Law enforcement sought to find the villain(s) who sent the anthrax letters and to deter future bioterrorist attacks. The biomedical community began to seek new ways of protecting against such future threats of bioterrorism.
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Affiliation(s)
- Ronald M Atlas
- Department of Biology, University of Louisville, Kentucky 40292, USA.
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Rose MA, Larrimore KL. Knowledge and Awareness Concerning Chemical and Biological Terrorism: Continuing Education Implications. J Contin Educ Nurs 2002; 33:253-8. [PMID: 12442873 DOI: 10.3928/0022-0124-20021101-05] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND A survey on knowledge and awareness concerning chemical and biological terrorism was used to assess the knowledge base of health care providers at an urban medical center in preparation for developing a workshop on domestic terrorism preparedness. A second survey assessing domestic terrorism preparedness of infection control personnel and nurse educators also was conducted. METHOD A total of 291 nurses, physicians, nursing students, and medical students completed the knowledge and awareness survey. A total of 24 infection control personnel and nurse educators completed the second survey on domestic terrorism preparedness. FINDINGS The knowledge scores of the respondents were low, with less than one fourth of the knowledge questions answered correctly. In addition, less than 23% of the respondents reported confidence to provide health care in a hypothetical chemical terrorism situation. CONCLUSION These findings indicate a need for nurses in continuing education and staff development to develop, implement, and evaluate innovative domestic terrorism preparedness programs.
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Affiliation(s)
- Molly A Rose
- Community Systems Administration, Thomas Jefferson University, Jefferson College of Health Professions, Department of Nursing, Philadelphia, PA 19107, USA
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Cunha BA. Anthrax, tularemia, plague, ebola or smallpox as agents of bioterrorism: recognition in the emergency room. Clin Microbiol Infect 2002; 8:489-503. [PMID: 12197871 DOI: 10.1046/j.1469-0691.2002.00496.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Bioterrorism has become a potential diagnostic consideration in infectious diseases. This article reviews the clinical presentation and differential diagnosis of potential bioterrorist agents when first presenting to the hospital in the emergency room setting. The characteristic clinical features of inhalation anthrax, tularemic pneumonia, plague pneumonia, including laboratory and radiographic finding, are discussed. Ebola vieus and smallpox are also discussed as potential bioterrorist-transmitted infections from the clinical and epidemiologic standpoint. In addition to the clinical features of the infectious diseases mentioned, the article discusses the infectious disease control and epidemiologic implications of these agents when employed as bioterrorist agents. The review concludes with suggestions for postexposure prophylaxis and therapy.
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Affiliation(s)
- B A Cunha
- Infectious Disease Division, Winthrop-University Hospital, Mineola and State University of New York School of Medicine, Stony Brook, New York 11501, USA
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Wallace MR, Hale BR, Utz GC, Olson PE, Earhart KC, Thornton SA, Hyams KC. Endemic infectious diseases of Afghanistan. Clin Infect Dis 2002; 34:S171-207. [PMID: 12019465 DOI: 10.1086/340704] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
The current crisis in Afghanistan has resulted in an influx of Western military personnel, peacekeepers, humanitarian workers, and journalists. At the same time, unprecedented numbers of internally displaced persons and refugees have overwhelmed much of the already fragile infrastructure, setting the stage for outbreaks of infectious diseases among both foreigners and local populations. This review surveys the literature concerning the infectious diseases of Afghanistan and south-central Asia, with particular emphasis on diseases not typically seen in the Western world.
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Concern About Anthrax Among Adults With Respiratory Illnesses. INFECTIOUS DISEASES IN CLINICAL PRACTICE 2002. [DOI: 10.1097/00019048-200206000-00007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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