Biological disasters

P.Nagarjuna Reddy
 Introduction
• Causative of process or phenomenon of organic origin or conveyed by biological
vectors
• Includes exposure to pathogenic micro-organisms, toxins and bioactive substances
• May cause loss of life, injury, illness or other health impacts, property damage, loss
of livelihoods and services, social and economic disruption, or environmental
damage.      
• These are referred to as poor man's nuclear bomb as they are easy to manufacture,
transport and have the ability to kill hundred and thousands of people. They have
ability to generate immediate effects.
 Examples

• Outbreaks of epidemic diseases

• Plant or animal contagion,
• Insect or other animal plagues and infestation.    
 Forms of biological disasters

• Epidemic 
• Affects large number of individuals within a population, community, or region at the same time
• Examples : Cholera, Plague, Japanese Encephalitis (JE)/Acute Encephalitis  Syndrome (AES)

• Pandemic 
• Epidemic that spreads across a large region, that is, a continent, or even worldwide of existing,
emerging or reemerging diseases and pestilences.
• Example : Influenza H1N1 (Swine Flu).
 Biological Agents as Causes of mass
destruction
• Highly virulent agents have the potential of infecting large numbers -
infectious chains.
• The potential of some infectious agents is nearly as great as that of
nuclear weapons
• Weapon of Mass Destruction (WMD): Nuclear, Biological and Chemical
(NBC).
 TRENDS FAVORING BIOLOGICAL WEAPONS

• Low cost and widespread availability

• More efficient in terms of coverage /Kg of payload
• Advances in biotechnology have made production easy
• Agents are largely natural pathogens and simulate existing diseases.
• Have an unmatched destructive potential
• Technology for dispersing biological agents - sophisticated.
• The lag time between infection and appearance of symptoms is longer than with chemical
exposures.
• Lethal biological agents can be produced easily and cheaply.
 Sources of Biological Agents

• Any human, animal or plant pathogen can cause an epidemic or

biological weapon.
• The deliberate intention/action to cause harm - biological attack.
• Incident in the USA where members of a religious cult caused
gastroenteritis by the use of Salmonella typhimurium (Common natural
pathogen)
 Methods of dissemination/delivery

• Aerosols - biological agents are dispersed into the air, forming a fine mist
that may drift for miles.
• Animals – fleas, mice, flies, mosquitoes, and livestock.
• Food and water contamination - some pathogenic organisms and toxins
may persist in food and water supplies.
• Person-to-person : Smallpox, Plague, and the Lassa viruses.
 Types of Biological Agents

• There are three categories of biological agents potential enough to cause

mass casualties (Center for Disease Control & Prevention).
• Category A, B & C
• Those in category A have the greatest potential for fear and disruption and
most significant public health impacts.
 CATEGORY A
• Easily disseminated or transmitted person-to-
person
• High mortality
• Require special action for public health preparedness
• Viruses: Variola major (smallpox), Filo viruses (Ebola,
Marburg), Arenaviruses (Lassa, Junin)
• Bacteria: Bacillus anthracis (anthrax), Yersinia pestis
(plague), Francisella tularensis (tularemia)
• Toxins: Clostridium botulinum toxin (botulism)
CATEGORY B

• Moderately easy to disseminate

• Moderate morbidity and low mortality
• Require improved diagnostic capacity & enhanced surveillance
• Viruses: Alphaviruses

• Bacteria: Coxiella burnetii (Q fever), Brucella spp. (brucellosis),

Burkholderia mallei (glanders)
• Toxins: Rinus communis (caster beans) ricin toxin, Clostridium perfringe
episolon toxin, Staphylococcus enterotoxin B
• Food/waterborne pathogens: Salmonella spp., Vibrio cholerae,
• E. coli O157:H7, Shigella dysenteriae, Cryptosporidium parvum,
 CATEGORY C

• Viruses: Nipah, hantaviruses, tick borne hemorrhagic fever viruses, tick

borne encephalitis viruses, yellow fever
• Bacteria: Multi-drug resistant Mycobacterium tuberculosis
 Interesting facts

• Certain characteristics need to be present for an organism -

potential biological agent for warfare or terrorist attack.
• Anthrax, smallpox, plague, tularemia, brucellosis and botulinism
toxin- leaders in the field.
• Use of agents that target livestock and crops could be as devastating
as human pathogens -probable economic impact on the community.
 History: Major Events across the Globe

• Biological warfare has a long history of mass destruction- epidemic and pandemic
diseases.
• Limited biological warfare is reported to have been carried out by Japan during
World War-II
• Mycotoxins have been reported to be used in Afghanisthan
• The Red Indians in North America were given the smallpox infected blankets
• 2001, the USA experienced biological attacks involving the intentional distribution of
bacillus anthracis spores through the postal system.
 Documented Intentional Use of Biologicals

• Japan used plague bacilli in China during 1932-1945 causing 260,000 deaths
• Dispersal of anthrax spores due to accident in production unit in USSR (Sverdlovsk) caused
68 deaths in 1979
• In 1984, Osho followers used Salmonella typhimurium in salad in a restaurant in Oregaon,
USA leading to 751 cases
• Shigella dysenteriae Type 2 employed in Texas, USA in 1996
• Anthrax spores through postal envelopes in USA in Oct-Nov 2001 leading to 22 cases and
5 deaths
 Present status in India and progress
• India accorded significant priority – control & elimination of diseases - major public health burden.
• Eradication of smallpox in 1975 that accounted for majority of deaths in 18th and 19th centuries.
• Malaria is another major public health problem - fall in economic production with over 75 million cases
annually in the early 1950s, which has now been successfully brought down to two million cases annually

• Plague, which had assumed epidemic proportions in the early to mid 19 th and 20th centuries, has nearly been
eliminated.
• Plague outbreak in Surat (1994) with over 1,000 suspected cases and 52 deaths - widespread panic and mass
exodus of people
• SARS outbreak in 2003 caught the attention of the world - spread of a disease from a single hospital case to a
global pandemic in less than three months.Though India reported only three, the panic created by the media was
unprecedented.
• Similarly, the outbreak of avian influenza among poultry in Nandurbar and Jalgaon districts of Maharashtra and
adjoining districts of Gujarat and Madhya Pradesh (2006) saw the poultry industry plummet.
 Present status in India and progress
• A still greater threat – possibility of avian influenza (H5N1) to become a pandemic virus that
may kill millions. The 1918 influenza pandemic killed an estimated 7 million people in India.
• Slow, evolving epidemics such as HIV/AIDS - socio- economic disruption
• Emerging and reemerging diseases, notably SARS, avian influenza, Nipah virus, leptospirosis,
dengue, Chikungunya and Rickettsial, are also posing serious threats.
• Among the eight to ten globally recognised, most harmful trans-boundary Animal Diseases
five are existing in the country, e.g., FMD, PPR, Newcastle disease, hog cholera and
bluetongue.
• India has been successful recently in eradicating rinderpest
• Highly Pathogenic Avian Influenza (HPAI) (bird flu) has already invaded the country on two
occasions in successive years 2006 and 2007.
• Through timely intervention – control the potential for a human pandemic
 Impact of Biological Disasters

• Bioweapons - ‘the poor man’s nuclear bomb’

• Large scale operation may cost
• $ 2,000 per sq. km with conventional weapons,
• $ 800 with nuclear weapons,
• $ 600 with nerve gas weapons and
• $ 1 with biological weapons.
 Impact of Biological Disasters
• Dispersal experiments have been attempted using non- pathogenic Bacillus globigii
• An attack on the New York subway system would kill at least 10,000 people.
• WHO studies show that a 50 kg dispersal on a population of 500,000 would result in up to 95,000
fatalities.
• In case of smallpox, the emergence of secondary cases at the rate of 10 times the number of primarily.
• Inevitably, epidemics would break out and social chaos would ensue.
• The economic impact of BT would be a major burden
• Use of Bacillus anthracis would cause losses of $26.2 billion per 100,000 persons exposed, while a less
lethal pathogen, e.g., Brucella suis would cause $477.7 million.
• A BT attack on agriculture can cause as much economic loss as an attack on human beings.
• The spread of the Parthenium hysterophorus weed - late 1950s along with imported wheat, affected the
yield of fodder crops and became a crop pest
 Prevention of Biological Disasters
a) Vulnerability Analysis and Risk Assessment
b) Environmental Management
• Water supply
• Personal hygiene
• Vector control
• Burial/disposal of the dead
c) Prevention of Post-disaster Epidemics
d) Integrated Disease Surveillance Systems
e)Pharmaceutical Interventions: Chemoprophylaxis,
• Immunization and Other Preventive Measures
f)Non-pharmaceutical Interventions
• Social Distancing Measures
• Disease Containment by Isolation and Quarantine Methodologies
g)Biosafety and Biosecurity Measures
 Action plan

• Plan for Family Biological Disaster Plan.

• Preparation by ensuring Prevention measures
• Take a First Aid and Cardio-Pulmonary Resuscitation (CPR) training.
• Subscribe to a Medical Insurance Plan.
 Preparation by ensuring Prevention measures
• Personal cleanliness - daily bath, don’t grow long nails and wear clean clothes.
•  Hand Hygiene (Wash hands with soap and water before preparing food or eating, after passing
stools, coughing or sneezing). 
•  Eat nutritious and balanced food.
• Immunization state should be upto date.
• Prevent overcrowding.
• Good ventilation.
• Protect from hot and cold weather.
• Health Education.
•  Surveillance.
 DIARRHOEAL GROUP OF DISEASES
(CHOLERA)
 Do’s
• Hand Hygiene.
• Encourage drinking of water from a safe source or water that has been disinfected (chlorinated). Add bleaching powder in all
community wells at regular intervals. Use water pumped out from India Mark II hand pumps, if installed in the village/community.
• Drink boiled potable water in an emergency that has been boiled for at least 15 minutes and consumed it the same day.
• Promote storage of water in narrow mouthed container.
•  Cook food thoroughly especially meat, poultry, eggs and seafood until it is steaming and eat it while it is still hot.  
• Ensure cooked meat and poultry is safe and no part of the meat discoloured or foul smelling, or in the case of egg, their shells are not
cracked.                                                 
•  If food is not eaten immediately, reheat cooked until it is steaming hot prior to serving.
• Keep food items covered.
• Increase fluid intake as soon as diarrhoea starts by drinking ORS solution or home-made preparation of Table Salt 5 grams (1 teaspoon)
in and 20 grams (4 teaspoons) of Sugar dissolved in 1 litre of drinking water.
• Encourage banana eating, which provides potassium.
• Continue feeding children when they are sick and to continue breastfeeding if the child is being breast fed. 
• Refer the diarrhoea case to the nearest health facility in case of the following : Child is irritable, restless or lethargic or unconscious:
eating or drinking poorly; child has marked thirst; child has fever or blood in stool.
 Don’ts

• Do not drink water from unsafe sources.

• Do not eat uncooked food unless it is peeled or shelled. 
• Do not leave cooked food at room temperature longer than 2 hours.
• Do not consume cut fruits from vendors.
• Do not defecate in open area.
• Do not give access to rats and houseflies in your premises.
  RESPIRATORY GROUP OF DISEASES
(TUBERCULOSIS, INFLUENZA, CHICKENPOX,
MENINGITIS)
 Precautions
•  Avoid close contact with people who are having respiratory illness.
•  The sick person should stay at home, and avoid going into the community,
school/office, public places for at least 24 hours after symptoms have resolved.
• Sick persons at home should keep distance from others. 
• Respiratory Hygiene/Cough Etiquette:-
• Cover the nose/mouth with a handkerchief/ tissue paper when coughing or sneezing which
should be disposed off in dustbins;
• Perform hand hygiene (e.g., frequent hand washing with soap and water, alcohol-based hand
rub, or antiseptic hand wash) and thoroughly dried preferably using disposable tissue/ paper/
towel after contact after having contact with respiratory secretions and contaminated
objects/materials.
 Precautions
• Triple layer surgical Mask of standard and certified make should be worn by Suspected/
probable/confirmed cases of influenza or by the care provider in home care settings and close
family contacts of such cases undergoing home care. 
• Get plenty of sleep, be physically active, manage your stress, drink plenty of fluids, and eat
nutritious food.
• Avoid smoking.
• Persons who have difficulty breathing or shortness of breath should seek immediate medical
attention and report to the nearby hospital.
• If sick persons must go into the community (e.g., to seek medical care), then they should wear a
face mask or use a handkerchief or tissues to cover any coughing and sneezing so as to reduce the
risk of spreading the infection in the community.
• Immunization status should be upto date as per National Universal Immunization Programme.
MOSQUITO BORNE DISEASES
(MALARIA, DENGUE, FILARIA,
CHIKUNGUNYA)
 Do’s

• Follow “sun-down sleeves-down” approach. Wear clothes that cover arms and legs.
• Prevent water collections on ground and other places to prevent malaria breeding.
• Empty water containers at least once a week.
• Remove water from coolers from time to time.
• Cover and seal any septic tanks.
• Use Mosquito Nets preferably Insecticide Treated Bed Nets (ITBN).
• Apply insect repellants while sleeping to keep away mosquitoes.      
• Seek medical advice in case of rashes, mental irritation or unconsciousness..
 Don’ts

• Do not encourage children to wear shorts and half sleeved clothing.

• Do not allow water to stagnate.
• Do not allow discarded items to accumulate such as tires, tubes, empty
coconut shells, household items and objects wherein water may collect.
• Do not bathe in village ponds and allow cattle to take bath in the same
pond.