History of Biological Warfare - Globally

• 1925 • 1972 Geneva Protocol Biological Weapons Convention » signed by 103 nations Geneva Conventions Ratified

• 1975

PROTOCOL FOR THE PROHIBITION OF THE USE IN WAR OF ASPHYXIATING, POISONOUS OR OTHER GASES, AND OF BACTERIOLOGICAL METHODS OF WARFARE Opened for signature: 17 June 1925, entered into force: 8 February 1928 Geneva Protocol

ПРОТОКОЛ О ЗАПРЕЩЕНИИ ПРИМЕНЕНИЯ НА ВОЙНЕ УДУШАЮЩИХ, ЯДОВИТЫХ ИЛИ ДРУГИХ ПОДОБНЫХ ГАЗОВ И БАКТЕРИОЛОГИЧЕСКИХ СРЕДСТВ Женева, 17 июня 1925 года

Biological Weapons Convention
Convention on the Prohibition of the Development, Production and Stockpiling of Bacteriological (Biological) and Toxin Weapons and on Their Destruction Signed at Washington, London, and Moscow April 10, 1972

Joint Statement by President George W. Bush and President Vladimir on Cooperation Against Bioterrorism November 13, 2001 At Shanghai, we resolved to enhance cooperation in combating new terrorist threats, including those involving weapons of mass destruction. We agree that, as a key element of our cooperation to counter the threat of terrorist use of biological materials, officials and experts of the United States and Russia will work together on means for countering the threat of bioterrorism, now faced by all nations, and on related health measures, including preventive ones, treatment and possible consequence management.

What role can Russia play in Combating Infectious Diseases And Bioterrorism Threats
The threat of biological weapons and their use in bioterrorism have increased. At the same time there are huge improvements in the knowledge of infectious diseases. How do we contain the threat of biological warfare (BW) and bioterrorism and continue to make progress in eliminating and treating infectious diseases?
S.V. Netesov, L.S. Sandakhchiev, VECTOR, Novosibirsk

In the past 20 years, more than 30 previously unknown infectious agents have been identified.
They causing such diseases as AIDS, hemorrhagic fevers, antibiotic resistant bacterial strains, hepatitis C, etc., A significant part of these infectious diseases result from the ability of microorganisms to mutate and adapt to humans and their medical treatment environment of medical prophylaxes and treatments. These properties, combined with increasing human mobility and migration and the increasing number of people with suppressed immunity, and several other factors, make the emergence of new diseases and variants more likely.

Biological Warfare Nonproliferation and Threat Reduction
The issues of nonproliferation and threat reduction of biological weapons based on infectious agents are different from other weapons of mass destruction (WMD). We believe that the major nonproliferation and threat reduction efforts should focus on already working with emerging pathogens research centers, which might present a source of expertise for potential bioterrorists.

Russia’s Role in Infectious Disease Research and International Cooperation
Russia has great potential in the area of infectious disease research, as well as in development and manufacture of therapeutic and prophylactic preparations at facilities of the Russian Ministry of Public Health, those of BIOPREPARAT and of local public health establishments. Two large State Research Centers of the Russian Ministry of Public Health — for Applied Microbiology (Obolensk, European region) and Virology and Biotechnology VECTOR (Koltsovo, eastern region) — were involved in biological defense programs of the former Soviet Union before 1990.

The State Research Center of Virology and Biotechnology VECTOR, operated by the Russian Ministry of Public Health, is a large research and production complex, whose primary activities are focused on basic and applied research in the theoretical virology, molecular biology, virology, immunology, aerobiology, epidemiology, and biotechnology. VECTOR also develops and manufactures preventive, therapeutical and diagnostic preparations.

VECTOR

VECTOR is one of two scientific and experimental facilities in Russia mainly focusing on virus infection research. The State Research Center for Applied Microbiology, Russian Ministry of Public Health (Obolensk, Moscow Oblast), is a similar scientific and experimental center, involved in bacterial infections research. VECTOR and Obolensk are the only institutions in both Russia and the rest of the CIS countries in which studies of highly dangerous pathogens can be done at an up-to-date level.

VECTOR’s research and production facilities amount to more than 250,000 m2 on over 8,000 hectares (19,768 acres). The research and experimental facilities at VECTOR are equipped for up-to-date scientific work with highly pathogenic human and animal viruses, under conditions of complete biosafety. Several buildings meet special biosafety requirements for high containment facilities (BSL 2, 3, and 4): an air-tight external perimeter, negative pressure in the working zone, complete sterilization (liquid, and solid) or reliable filtration (air) of all types of discharge.

VECTOR

VECTOR
The research and technical staff of the Center are highly qualified personnel, specializing in the field of genetic engineering, molecular biology, virology, theoretical virology, immunology, epidemiology, and ecology. The staff has extensive experience in highly dangerous viruses research and in production of diagnostic and prophylactic preparations for public health and veterinary needs.

The Collection of Cultures of Microorganisms in VECTOR contains over 10,000 deposit entries: various viral strains, including the national collection of variola virus strains and strains of BSL-4 viral pathogens; recombinant viral strains; strains of microorganisms, including producer strains. The Collection received international recognition in 1995 when it was affiliated with the European Culture Collection Organization (ECCO).

VECTOR

VECTOR also houses one of the two WHO Collaborating Centers for orthopoxvirus diagnosis and repository for variola virus strains and their DNA. The other WHO Collaborating Center for smallpox and other poxvirus infections is at the CDC in Atlanta, USA. As a WHO Collaborating Center, VECTOR preserves and studies the Russian collection of variola virus isolates. The research collaboration between these two Centers is promising in terms of basic science and confidence building.

VECTOR

VECTOR
VECTOR’s Breeding and Holding Facility for laboratory animals, which includes one of only two monkey breeding facilities operating in Russia, is used for testing therapeutic and diagnostic preparations. Facilities for the performance of preclinical and clinical trials of new medicinal preparations are available at VECTOR.

Possible research at the proposed International Center could focus on arboviruses, including tick-borne encephalitis virus that is endemic in Russia; HFRS virus, Omsk hemorrhagic fever virus – both endemic in Siberia; filoviruses: Marburg and Ebola; orthopoxviruses: smallpox virus, monkeypox, and cowpox viruses; viruses causing hepatitis A, B, C; paramyxoviruses, rabdoviruses, influenza viruses, etc. This list of viruses could be extended by bacteria and parasites, such as tuberculosis, which is increasing sharply now in Russia, and opisthorchiasis – human parasitic disease affecting the liver. The latter is endemic in Siberia, too.

VECTOR

The aims of the Federal Center of Hygiene and Epidemiology
• Sanitary and Epidemiological measures in case of situation with the outbreaks of infectious diseases or during disasters; • Statistical monitoring for control of infectious diseases at the federal level, reporting;

The structure of the Federal Center of Hygiene and Epidemiology
• Disaster department • Epidemiological department • Laboratory services

The period until 1991 Life expectancy (both sexes)
80 70 60 50 40 30 20 10 0 59 47 32 47 43 63 Russia France USA

1900

1938

The period until 1991 Life expectancy in 1965
80 70 60 50 40 30 20 10 0 64,3 67,3 66,8 73,4 74,7 73,7

Russia France USA

Men

Women

The health care principles upon which the Soviet health care system was to be based (Nikolai Semashko):

• • • • •

government responsibility for health universal access to free services a preventive approach to “social diseases” quality professional care a close relation between science and medical practice continuity of care between health promotion, treatment and rehabilitation.

• The health care system was under the centralized control of the state, which financed services by general government revenues as part of national social and economic development plans. • All health care personnel became employees of the centralized state, which paid salaries and provided supplies to all medical institutions. • The main policy orientation throughout this period was to increase numbers of hospital beds and medical personnel.

Next steps following the establishment of the “Semashko” model in 1918

Next steps following the establishment of the “Semashko” model in 1918 (cont.)
• Russia made massive strides in arresting the spread of infectious diseases. • Drastic epidemic control measures were implemented, particularly in the cases of tuberculosis, typhoid fever, typhus, malaria and cholera. • These involved community prevention approaches, routine check-ups, improvements in urban sanitation and hygiene, quarantines, etc.

Health crisis
• The diverging paths of Russia and other industrialized nations with respect to health status from the 1960s onward has been attributed to the failure of the Russian health care system to successfully respond to the epidemiological transition.

The leading causes of death in the Russia Federation
• Cardiovascular diseases with rates that are the highest in the European Region. • External causes of injury and poisoning • Cancer

CVD Injury

Cancer
Average for 19992001

WHY was prophylaxis with Ciprofloxacin extended to 60 days?

More on Sverdlovsk 

Source: New York Department of Health

BECAUSE in Sverdlovsk cases appeared more than 40 days after exposure, and because of data from animal experiments Source: New York Department of Health

Lidia Tretyakova looks at the tombstone of her father, Lazar Karsayev, at a cemetery in Yekaterinburg, Russia, Thursday, Oct. 18, 2001. A mysterious outbreak of anthrax killed at least 68 people, including Karsayev, 22 years ago in the Russian industrial center of Sverdlovsk, today known as Yekaterinburg. At the time, neither the victims

Laboratory workers at the Sverdlovsk regional epedemiological service put on the special suits they wear when working with anthrax and other dangerous bacteria in Yekaterinburg, Russia,

Terrorism
• Is an unlawful act of violence • Intimidates governments or societies • Goal is to achieve political, religious or ideological objectives

Arthur H. Garrison

Prevention of Terrorism
• Primary prevention:
– Education!!! – Understand the differences in cultures, religions, beliefs and human behaviors – Think of the peace, freedom and equality of all human beings, not just “my group of people” – Eliminate the root of terrorism

Prevention of Terrorism
• Secondary prevention:
– Establish surveillance and monitoring system on terrorism attack – Improve protective system for citizens

Prevention of Terrorism
• Tertiary prevention
– Early detection of the sources – Prevent the extension of impairments – Rescue the survivors – Console the rest of the population

Proportion of death from terrorism in total death in the United States
Average death per year 1990’s From terrorism 8 From all causes 2534203 Proportion (%) 0.0003

2001

2893

2404624

0.12

Risk of Dying
Smoking 10 cigarettes a day All natural causes age 40 Road accident Playing soccer Homicide Terrorism attack in 2001 Hit by lightning Terrorism attack in 1990’s One in 200 One in 850 One in 8,000 One in 25,000 One in 100,000 One in 100,000 One in 10,000,000 One in 50,000,000

Penguin Books, 1987

Death Rate of Various Causes in 2000 USA and that from Terrorism
Heart disease* Cancer * Cerebrovascular diseases* Accidents * Diabetes* Suicide* Homicide* Terrorism in 2001 Terrorism in 1990’s One in 400 One in 500 One in 2,000 One in 3,000 One in 4,000 One in 10,000 One in 20,000 One in 100,000 One in 50,000,000

Why did terrorism draw considerable attention in 2001?
• The risk of dying from terrorism was extremely low in 1990’s, and was still relatively low compared with some diseases in 2001 • But the death rate increased by 500 times in 2001 due to Sept. 11 • Overall the death rate of terrorism has not been high • Despite the low risk, shock, surprise and fear engulfed the United States and world

Conclusion
• Terrorism is unlawful act • Terrorism has a long history of being used to achieve political, religious and ideological objectives • Terrorism can be conducted through firearms, explosive devices and biological, chemical, nuclear materials • Even through the events of 2001, the risk of dying from terrorism has remained much lower than that from motor vehicles, smoking, and alcoholic beverage.