Neurological aspects of chemical and biological terrorism: guidelines for neurologists

Comparing the top 100 attacks in the Global Terrorism Database: high injury rate versus high fatality rate attacks

BACKGROUND

Terrorist attacks have the potential to be mass casualty events, causing multiple injuries and deaths. High injury rate attacks will particularly place a high burden on emergency medical systems. This study aimed to assess if there is a difference between attacks with high injury rates and high fatality rates.

METHODS

The top 100 terrorist events causing the highest number of fatalities versus the highest number of injuries were selected from the Global Terrorism Database. Analyses were performed on temporal factors, location, target type, attack and weapon type, and perpetrator type.

RESULTS

The 9/11 attacks caused the highest number of both fatalities and injuries. With regards to injury rates, the sarin attacks in Tokyo, Japan ranked second. Events with high fatality rates were overrepresented in Sub-Saharan Africa, whereas events with high injury rates were predominant in the Middle East & North Africa. High fatality rates were most often associated with armed assaults and hostage takings. Bombings were responsible for the highest number of injuries. CBRN attacks were overrepresented in the top 100 injuries, and accounted for 11% of the incidents.

CONCLUSION

High injury rate incidents place a heavy burden on the health care system as the number of injuries is nearly ten times as high as the number of injuries in high fatality rate incidents. Epidemiological analysis of high impact terrorist events may contribute to counter-terrorism preparedness, to an increased focus on dealing with CBRN-events, and thus to a proper medical response to future terrorist events.

A Turn-On and Colorimetric Probe Based on Isophorone Skeleton for Detecting Nerve Agent Mimic Diethyl Chlorophosphite

A new turn-on probe (SWJT-20) based on isophorone fluorophore for the detection of nerve agent mimic diethyl chlorophosphite (DCP) was designed and synthesized. SWJT-20 could rapidly respond to DCP within 2 s using UV-Vis or fluorescent spectra, accompanied by a significant change in the solution color under visible light or UV light, which could be observed by the naked eyes. The detection limit of SWJT-20 to DCP was as low as 8.3 nM, which is lower than those of most reported fluorescent probes for DCP detection. Additionally, SWJT-20 could quantitatively measure DCP using ratio changes in A₄₂₇/A₆₄₅ in absorption spectra. Furthermore, facile paper as sensors with the visualization of colorimetric/fluorometric responses based on SWJT-20 has been fabricated. Notably, this probe could detect DCP vapor through gas diffusion experiments.

Health Care Organizations: Soft Target during COVID-19 Pandemic

Health care organizations have been challenged by the coronavirus disease 2019 (COVID-19) pandemic for some time, while in January 2020, it was not immediately suspected that it would take such a global expansion. In the past, other studies have already pointed out that health care systems, and more specifically hospitals, can be a so-called “soft target” for terrorist attacks. This report has now examined whether this is also the case in the context of the COVID-19 pandemic.

During the lockdown, hospitals turned out to be the only remaining soft targets for attacks, given that the other classic targets were closed during the lockdown. On the other hand, other important factors have limited the risk of such attacks in hospitals. The main delaying and relative risk-reducing factors were the access control on temperature and wearing a mask, no visits allowed, limited consultations, and investigations.

But even then, health care systems and hospitals were prone to (cyber)terrorism, as shown by other COVID-19-related institutions, such as pharmaceuticals involved in developing vaccines and health care facilities involved in swab testing and contact tracing. Counter-terrorism medicine (CTM) and social behavioral science can reduce the likelihood and impact of terrorism, but cannot prevent (state-driven) cyberterrorism and actions of lone wolves and extremist factions.