NUR 113: DISASTER NURSING

STUDENT ACTIVITY SHEET BS NURSING / FOURTH YEAR

Session # 16

Materials:
LESSON TITLE: Bioterrorism
Book, pen and notebook
LEARNING OUTCOMES:
Upon completion of this lesson, the nursing student can:
References:
1. Define Bioterrorism Veenema, T.G. (2019) Disaster Nursing and
2. Identify the pathogens used with bioterrorism. Emergency Preparedness for Chemical,
3. Determine the emergency nursing interventions for Biological, and Radiological Terrorism and other
patients who were exposed to biological agents. Hazards 4th Edition
4. Describe the management for person who were
exposed to biological agents

LESSON PREVIEW/REVIEW (5 minutes)

Instruction: List the vulnerable and susceptible populations.

1.
2.
3.
4.

MAIN LESSON (40 minutes)

BIOTERRORISM
The act of biological terrorism (bioterrorism) involves the deliberate use of microbial pathogens or toxins.

Like other threat agents, Bio-Agents can cause disease by inhalation, ingestion, or skin contact. But unlike other agents,
biological agents can also be contagious among people, and between people and animals. Bio-Agents may also incubate
and multiply in the body for days to weeks before symptoms are seen and a person knows they are sick.

For some Bio-Agents, no vaccines are available, so infected people must be quarantined. When left in the
environment, some biological agents can be dormant but potent for periods of weeks to years, depending upon both the
specific agent, and on the environmental conditions.

Pathogens used in Bioterrorism

1. Bacterial Agents
• Single-celled organisms
• Can reproduce
• Antibiotic treatment
2. Viral agents
• Live inside cells
• Need host to reproduce
• Vaccine and antiviral treatments
3. Toxins
• Non-living (can’t reproduce)
• Produced by organisms
• Antidote treatment

Delivery of Bioterrorism Agents

This document and the information thereon is the property of PHINMA

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 • Form of delivery, or method of dispersion, effects both agent spread and response. Attacks may be either overt or
covert. In an overt attack, the delivery method is obvious, such as release from an airplane or bomb. While the
use of a bio-agent may not be immediately known, testing can quickly confirm the presence of microorganisms.
But, determination of the name of the bio-agent can several days. For a biotoxin, as with any chemical,
identification is much quicker.
• In a covert attack, the delay in identification of the bio-agent may be even longer because the attack may not be
recognized until after people have become obviously sick, which may take days. Covert attacks may include
contamination of a building or subway HVAC system, food, water, or other surfaces. For contagious agents, the
presence of an infected individual in a large crowd can effectively spread a bio-agent. However, for most
diseases, people are obviously sick, and bed-ridden during the most contagious stages. An unrecognized attack
using a contagious agent with several days delay until symptoms are seen can allow further dispersion of infected
people and spread the agent. In a worst-case-scenario, an epidemic may occur before a biological attack is
recognized.

1. Overt -- Provides notice, creates panic

• aircraft, bombs, missiles
2. Covert -- NO notice; spread may be unchecked for days!
• Spray fine mist (e.g., into HVAC)
• Spread on food, water, surfaces (e.g., mail, vehicles)
• Contagious people and animals

Bio-Agent Dose
• Inhalation of 1 to 500 bacteria or virus can cause sickness and death.
– 100,000 bacteria fit on a pin head
– 400 million virus fit on a pin head
• Inhalation of 0.000002 to 4.8 micro grams of a biotoxin can cause sickness
– A sand grain weighs 170 to 13,000 micrograms

Bio-Agent Detection
Bio-agents are detected through symptoms of infection and through time-consuming tests. Bio-agents cannot be detected
by the human senses, although high amounts of mist or powder can be seen and may be early indications of the presence
of bio-agents (e.g., powder in envelopes). There are some instruments that can rapidly detect an increase of biological
organisms in the air, but these instruments cannot identify the organism. An organism’s ability to cause harm is not
certain until it is identified. Tests for identifying bio-agents typically take days because they require growing the organism
in a culture before it can be identified.

Bio-Agent Indications
• Many patients with same illness at the same time
• Symptoms unusual for age
• Type of infection rare to region
• Dead animals before humans

Bio-Agent Response
• Identify: Bio-Agent(s), source, area affected, population exposed
• Notify local medical facilities
• Isolate and contain affected areas and population
• Treat - provide vaccine or medications to the affected population
• Decontaminate affected areas and population
• Follow-on Treatment - continue medical treatment as appropriate

Bio-Agent Decontamination
• Physical removal-HEPA vacuum
• Liquid decontamination
• Foam decontamination
• Emulsions
• Fumigants

Different approaches for different situations,

and multiple approaches for most situations.

This document and the information thereon is the property of PHINMA

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CHECK FOR UNDERSTANDING (10 minutes)
You will answer and rationalize this by yourself. This will be recorded as your quiz. One (1) point will be given to correct
answer and another one (1) point for the correct ratio. Superimpositions or erasures in you answer/ratio is not allowed.
You are given 10 minutes for this activity:

Multiple Choice
1. All but one is correct about Bio-Agent Response:
a. Identify: Bio-Agent(s), source, area affected, population exposed
b. Notify local medical facilities
c. Isolate and contain unaffected areas and population
d. Treat -- provide vaccine or medications to the affected population
ANSWER: ________
RATIONALE:_______________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________

2. One advantage of a biological weapon is

a. It is odorless, colorless, and tasteless
b. It has a small attack area
c. It will immediately result in massive cases of human illness
d. It will kill the perpetrator of the release
ANSWER: ________
RATIONALE:_______________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________

3. The difference between the cost of biological weapons and other types of weapons is
a. Biological agents cost much more but can impact a much larger area making them cheaper overall
b. Biological agents cost about as much as chemical agents
c. Biological agents are about half the cost of other types of weapons
d. Biological agents are several hundred times less expensive than other weapons
ANSWER: ________
RATIO:____________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________

4. Which of the following is the worst-case scenario for a biological release?

a. Particle size 1 to 5 microns
b. Weather pattern includes a thermal inversion
c. Aerosol release
d. All of the above
ANSWER: ________
RATIO:____________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________

5. One disadvantage of a biological weapon is that

a. It is not easy to control
b. It is too easy to disperse and may leak prior to delivery
c. It is difficult to use due to International restrictions
d. None of the above
ANSWER: ________
RATIO:____________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________

RATIONALIZATION ACTIVITY (THIS WILL BE DONE DURING THE FACE TO FACE INTERACTION)
The instructor will now rationalize the answers to the students. You can now ask questions and debate among yourselves.
Write the correct answer and correct/additional ratio in the space provided.

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1. ANSWER: ________
RATIO:_______________________________________________________________________________________
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2. ANSWER: ________
RATIO:_______________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________
3. ANSWER: ________
RATIO:_______________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________
4. ANSWER: ________
RATIO:_______________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________
5. ANSWER: ________
RATIO:_______________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________

LESSON WRAP-UP (5 minutes)

You will now mark (encircle) the session you have finished today in the tracker below. This is simply a visual to help you
track how much work you have accomplished and how much work there is left to do.

You are done with the session! Let’s track your progress.

AL Activity: CAT: 3-2-1

Instructions:
1. As an exit ticket at the end of the class period
2. After the lesson, have each student record three things he or she learned from the lesson.
3. Next, have them record two things that they found interesting and that they’d like to learn more about.
4. Then, have students record one question they still have about the material.
5. Review the students’ responses. You can use this information to help develop future lessons and
1. determine if some of the material needs to be taught again.

Three things you learned:

1. ______________________________________
2 ______________________________________
3. ______________________________________

Two things that you’d like to learn more about:

1. ______________________________________
2. ______________________________________

One question you still have:

1. ______________________________________

This document and the information thereon is the property of PHINMA

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