Evaluation of sponge wipe surface sampling for collection of potential surrogates for non-spore-forming bioterrorism agents.

AIM: Evaluate the efficacy of sponge wipe sampling at recovering potential bacterial surrogates for Category A and B non-spore-forming bacterial bioterrorism agents from hard, nonporous surfaces. METHODS: A literature survey identified seven nonpathogenic bacteria as potential surrogates for selected Category A and B non-spore-forming bacterial agents. Small (2 × 4 cm) and large (35.6 × 35.6 cm) coupons made from either stainless steel, plastic, or glass, were inoculated and utilized to assess persistence and surface sampling efficiency, respectively. Three commercially available premoistened sponge wipes (3M™, Sani-Stick®, and Solar-Cult®) were evaluated. RESULTS: Mean recoveries from persistence testing indicated that three microorganisms (Yersinia ruckeri, Escherichia coli, and Serratia marcescens) demonstrated sufficient persistence across all tested material types. Sampling of large inoculated (≥107 CFU per sample) coupons resulted in mean recoveries ranging from 6.6 to 3.4 Log10 CFU per sample. Mean recoveries for the Solar-Cult®, 3M™ sponge wipes, and Sani-Sticks® across all test organisms and all material types were ≥5.7, ≥3.7, and ≥3.4 Log10 CFU per sample, respectively. Mean recoveries for glass, stainless steel, and ABS plastic across all test organisms and all sponge types were ≥3.8, ≥3.7, and ≥3.4 Log10 CFU per sample, respectively. CONCLUSIONS: Recovery results suggest that sponge wipe sampling can effectively be used to recover non-spore-forming bacterial cells from hard, nonporous surfaces such as stainless steel, ABS plastic, and glass.

COVID-19: the trends of conspiracy theories vs facts.

Coronavirus disease (COVID-19) caused by SARS-CoV-2-a new single-stranded RNA virus with respiratory system proclivity and epithelial cell- is a novel infectious disease that originated in Wuhan, China in December, 2019 and has spread to many countries with the total number of confirmed cases put at 20,259,579 cases as of 12th August, 2020. It is transmitted from human-to-human via droplets. When an infected person coughs or sneezes, these droplets find their way into the mouth or nostrils of another person that is within a close range. Alternatively it can be contracted by touching infected hard surfaces and using the same hands to touch the mouth, nose and eye(s). COVID-19 has been declared a global pandemic by the World Health Organization (WHO) on 11th March, 2020. There is currently no therapeutic substance accepted as a panacea for the prophylaxis of this infectious disease. As a result of this back drop, many nations have instituted fourteen (14) days quarantine for suspected cases, social distancing and border closure in an attempt to curb the spread of COVID-19. There has been several conspirary theories that emanated since the disease was declared a pandemic. This paper provides useful information to serve as reference to those who seek proper understanding of COVID-19 and its deleterious effects in the body, by distiguishing between the factsand the conspiracy theoriesof coronavirus disease.

Willingness of New England dental professionals to provide assistance during a bioterrorism event.

A bioterrorism attack could overwhelm medical personnel and facilities, suggesting a need for aid from nonmedical personnel. The American Dental Association suggests that dental professionals should assist in such cases, utilizing their strong scientific and technical skills. This study describes New England dental professionals' willingness, potential roles, motivators, and barriers to providing this aid. This cross-sectional study used a self-administered survey to collect data addressing the knowledge and opinions of dental professionals concerning acting as responders. The survey was distributed to 370 attendees of the 2005 Yankee Dental Conference, in Boston, Massachusetts. Most dental professionals expressed willingness to help during an attack (N = 340, 92%), reporting that dental professionals, in general, should perform a mean number of 6 roles. Three-quarters of dentists and dental students were personally willing, with proper training, to give immunizations, and 54% would perform triage. Knowledge was weak, but most dental professionals were interested in obtaining further education (83%). Since dental professionals are willing to assist during a bioterrorism attack and are motivated to obtain disaster response training, government officials and local directors and managers of disaster/emergency response agencies should consider incorporating dental professionals into their disaster management plans.

Bioterrorism update--information for the dentist.

The United States was awakened to the perils of bioterrorism in October 2001 with the news that letters laced with anthrax had been mailed to the media and select politicians. At that time, it became evident that a widescale attack using a bioweapon of mass destruction could rapidly overwhelm the health care system. Dentists could make a tremendous contribution to the response of such an attack by gaining an understanding of the bioweapons that could be used, as well as the symptoms of their diseases and therapies for treatment. This article gives a general overview of the biological agents that terrorists are most likely to use and provides the dentist with information about how to contribute to an effective response in the event of such an attack.

Regulations for vaccines against emerging infections and agrobioterrorism in the United States of America.

The Virus-Serum-Toxin Act of 1913, as amended in 1985, provides the legal basis for the regulation of veterinary vaccines and related biological products in the United States of America (USA). The regulatory authority for the issuance of licences and permits that allow the shipment or importation of pure, safe, potent, and effective veterinary biological products lies with the Center for Veterinary Biologics (CVB), an agency of the United States Department of Agriculture (USDA). Under the standard licensing or permitting process, a manufacturer must develop and completely characterise and evaluate a product prior to licensure, and the CVB must review and evaluate the submitted information, audit and inspect the manufacturing facilities and methods of production and testing, and confirm key product test results through independent testing of product. This complete and comprehensive evaluation may not be possible in emergency situations, so processes and mechanisms are in place that allow for the more rapid availability of veterinary vaccines. Next generation vaccine development against foreign animal diseases such as foot and mouth disease is actively in progress in the USA and the authorities must ensure that there is an adequate supply of these vaccines in the National Veterinary Stockpile.

Bioterrorism: processing contaminated evidence, the effects of formaldehyde gas on the recovery of latent fingermarks.

In the present age of heightened emphasis on counter terrorism, law enforcement and forensic science are constantly evolving and adapting to the motivations and capabilities of terrorist groups and individuals. The use of biological agents on a population, such as anthrax spores, presents unique challenges to the forensic investigator, and the processing of contaminated evidence. In this research, a number of porous and non-porous items were contaminated with viable [corrected] spores and marked with latent fingermarks. The test samples were then subjected to a standard formulation of formaldehyde gas. Latent fingermarks were then recovered post decontamination using a range of methods. Standard fumigation, while effective at destroying viable spores, contributed to the degradation of amino acids leading to loss of ridge detail. A new protocol for formaldehyde gas decontamination was developed which allows for the destruction of viable spores and the successful recovery of latent marks, all within a rapid response time of less than 1 h.

Pharmaceuticals and the strategic national stockpile program.

This article discusses current stockpile practices after exploring a history of the use of biologic agents as weapons, the preventive measures that the federal government has used in the past, and the establishment of a Strategic National Stockpile Program in 2003. The article also describes the additional medical supplies from the managed inventory and the federal medical stations. The issues (financial burden, personnel, and materiel selection) for local asset development are also discussed. Critical is the cost to local communities of the development and maintenance of a therapeutic agent stockpile and the need for personnel to staff clinics and medical stations. Finally, the important role of the dental profession for dispensing medication and providing mass immunization in the event of a disaster is described.

A history of biological disasters of animal origin in North America.

This paper examines past occurrences in North America relevant to the possibility of biological disasters with animal origins. With respect to naturally occurring animal disease outbreaks, North America, while not as adversely affected by epizootics as other regions, has had its fair share of such outbreaks of both 'traditional' and emerging animal diseases. The traditional category includes such diseases as anthrax, classical swine fever, bluetongue, brucellosis, foot and mouth disease, and the family of equine encephalomyelitis viruses. The emerging diseases include relatively more recent culprits such as postweaning multisystemic wasting syndrome, poultry enteritis mortality syndrome, and newly discovered examples of the transmissible spongiform encephalopathies. Additionally, several serious diseases of human beings that involve animal vectors or reservoirs occur naturally in North America or have emerged in recent decades; these include plague, hantavirus, monkeypox, West Nile virus and avian-derived influenza. At the same time, there have been very few intentional attacks on livestock using biological agents and no recorded cases in North America of animals intentionally being used to transmit disease to humans. According to the historical record, therefore, naturally occurring emerging zoonoses probably constitute the greatest threat in terms of biological disasters with animal origins. However, some of the general trends in terrorist activity, such as the intensification of activities by animal rights extremists against facilities undertaking animal research, mean that the possibility of intentional animal-related biological disasters should not be discounted.

Dentists' preparedness for responding to bioterrorism: A survey of Hawaii dentists.

BACKGROUND: The authors conducted a survey of dentists in Hawaii to assess their knowledge of, perceived readiness for and willingness to respond to bioterrorist (BT) events. METHODS: Using a cross-sectional study design to access a random sample (n = 240) of all licensed dentists residing in the state of Hawaii (N = 1,016), the authors mailed study participants an anonymous survey up to three times during June and July 2004. Knowledge-based questions were taken from accredited Internet-based free continuing medical education offerings. RESULTS: Of 234 deliverable surveys, 133 were returned (response rate of 56.8 percent). Only 2.3 percent of respondents reported having received prior BT preparedness training. A total of 14.5 percent felt able to identify and recognize a BT event, and 9.2 percent indicated they were able to respond effectively to a BT attack. A total of 73.8 percent expressed willingness to provide assistance to the state in the event of a BT attack. Dentists scored a mean of 62 percent correct (5.6 of nine questions) on the objective knowledge-based questions. CONCLUSIONS: A low prevalence of prior training coupled with a high degree of willingness to provide assistance indicates the need for additional BT preparedness training. This should be provided as continuing education offerings to practicing dentists and incorporated into the dental school curriculum. CLINICAL IMPLICATIONS: Dentists have the basic knowledge and experience to perform a number of key roles in a BT event; however, additional training must be provided to develop BT preparedness competencies.

Introducing a senior course on catastrophe preparedness into the dental school curriculum.

This article describes an integrated fourth-year course in catastrophe preparedness for students at the New York University College of Dentistry (NYUCD). The curriculum is built around the competencies proposed in "Predoctoral Dental School Curriculum for Catastrophe Preparedness," published in the August 2004 Journal of Dental Education. We highlight our experience developing the program and offer suggestions to other dental schools considering adding bioterrorism studies to their curriculum.

Proposed educational objectives for hospital-based dentists during catastrophic events and disaster response.

The purpose of this project was to define education and training requirements for hospital-based dentists to efficiently and meaningfully participate in a hospital disaster response. Eight dental faculty with hospital-based training and/or military command and CBRNE (chemical, biological, radiological, nuclear, and explosive) expertise were recruited as an expert panel. A consensus set of recommended educational objectives for hospital-based dentists was established using the following process: 1) identify assumptions supported by all expert panelists, 2) determine current advanced dental educational training requirements, and 3) conduct additional training and literature review by various panelists and discussions with other content and systems experts. Using this three-step process, educational objectives that the development group believed necessary for hospital-based dentists to be effective in treatment or management roles in times of a catastrophic event were established. These educational objectives are categorized into five thematic areas: 1) disaster systems, 2) triage/medical assessment, 3) blast and burn injuries, 4) chemical agents, and 5) biological agents. Creation of training programs to help dentists acquire these educational objectives would benefit hospital-based dental training programs and strengthen hospital surge manpower needs. The proposed educational objectives are designed to stimulate discussion and debate among dental, medical, and public health professionals about the roles of dentists in meeting hospital surge manpower needs.

Preparing health professions students for terrorism, disaster, and public health emergencies: core competencies.

The recent increased threat of terrorism, coupled with the ever-present dangers posed by natural disasters and public health emergencies, clearly support the need to incorporate bioterrorism preparedness and emergency response material into the curricula of every health professions school in the nation. A main barrier to health care preparedness in this country is a lack of coordination across the spectrum of public health and health care communities and disciplines. Ensuring a unified and coordinated approach to preparedness requires that benchmarks and standards be consistent across health care disciplines and public health, with the most basic level being education of health professions students. Educational competencies establish the foundation that enables graduates to meet occupational competencies. However, educational needs for students differ from the needs of practitioners. In addition, there must be a clear connection between departments of public health and all other health care entities to ensure proper preparedness. The authors describe both a process and a list of core competencies for teaching emergency preparedness to students in the health care professions, developed in 2003 and 2004 by a team of experts from the four health professions schools of Columbia University in New York City. These competencies are directly applicable to medical, dental, nursing, and public health students. They can also easily be adapted to other health care disciplines, so long as differences in levels of proficiency and the need for clinical competency are taken into consideration.

Educating health professionals to respond to bioterrorism.

In September 2003, a consortium of bioterrorism and health education experts from the University of Louisville, the University of Kentucky, the Kentucky Department for Public Health, and the Louisville Metro Health Department received funding from the Health Resources and Services Administration (HRSA) to develop a broadly based bioterrorism education program for health professionals in the Commonwealth of Kentucky and the surrounding region. This grant will fund a series of presentations tailored to the needs of professionals in medicine, dentistry, public health, nursing, behavioral medicine, allied health, pharmacy, veterinary medicine, and agriculture, providing coordinated training both on site and through distance learning technology. This article outlines the major grant-funded activities envisioned for the grant years 2003 through 2005, focusing on the use of standardized patients and computerized biosimulators, the transdisciplinary partnerships of the universities involved, and the essential collaboration provided by the state and local health departments.

Rational monoclonal antibody development to emerging pathogens, biothreat agents and agents of foreign animal disease: The antigen scale.

Many factors influence the choice of methods used to develop antibody to infectious agents. In this paper, we review the current status of the main technologies used to produce monoclonal antibodies (mAbs) from the B cells of antigen-sensitized animals. While companies are adopting advanced high-throughput methods, the major technologies used by veterinary and medical research laboratories are classical hybridoma fusion and recombinant library selection techniques. These methods have inherent advantages and limitations but have many common aspects when using immunized rodents. Laboratories with expertise in both methods of antibody development have a distinct advantage in their ability to advance mAb technology. New and re-emerging infectious threats in today's world emphasize the need for quality immunoreagents and the need to maintain expertise in mAb development. We provide examples of some common applications for mAb reagents used to identify pathogens such as the SARS-coronavirus (SARS-CoV), Bacillus anthracis, and foot-and-mouth disease (FMD) virus. We also outline a framework for investigators to make rational decisions concerning which method to use to develop mAbs based upon characteristics of the pathogen under study and the intended downstream application. Lastly, we provide parameters for the immunisation of mice and a classification system which describes the expected outcome for mAb development strategies when using classes of immunogens to generate mAbs with desired activities.

Forensic dentistry in a terrorist world.

While body identification by dental means has not changed substantially since 9/11, or even since the bombing of the Murrah Federal Building in Oklahoma City in 1995, the conditions and potential risks of a bioterrorism action to the dental personnel is new. The purpose of this article is to review general forensic dentistry disaster responses and to address the impact a bioterrorism action might have on primary, secondary and tertiary dental responders. It will also examine the triage role that dental offices might play in the event of such a disaster.

Evaluation of tools for environmental sampling of Bacillus anthracis spores.

This study describes the validation of sampling techniques used to detect biological warfare agents used in terror attacks. For this purpose, we tested the efficiencies of different sampling media and extraction solutions for the recovery of bacterial pathogens. We first used Bacillus cereus ATCC 4342 spores as a surrogate for highly pathogenic B. anthracis to compare recovery efficiencies of spores from four different surfaces. We used three different types of sampling swabs and four different solutions to extract spores from the swabs. The most effective sampling method employed rayon swabs moistened with water. The efficencies of the four extraction solutions did not differ significantly, although yields were highest using phosphate-buffered saline containing Tween 80 (PBS-T). Using rayon swabs and sterile water, we recovered B. cereus ATCC 4342 and B. anthracis spores with equivalent efficiencies. These findings indicate that because of its reduced pathogenicity and relative ease in handling (Biosafety Level 1), use of B. cereus ATCC 4342 will facilitate further optimization of techniques to detect B. anthracis.

Agroterrorism: the risks to the United States food supply and national security.

Agroterrorism is a collective term that describes an intentional criminal attack against crops or mankind using viral, bacterial, fungal, or insect-borne agents. Agroterrorism also includes attacks against animals using infectious pathogens such as Burkholderia mallei (glanders), Bacillus anthracis (anthrax), viral avian influenza, foot and mouth disease, and several equine encephalitis viruses. Agents that could be used against crops include the causative agents of wheat blast, rice blast, rice brown spot disease, and wheat stem rust. The primary goal of terrorists using agroterrorism is to spread fear and cause massive economic loss. Subsequent goals include causing disease and death to humans and animals. The use of bioterrorism agents is a much more practical approach than using explosives, for example, to achieve those results since many of these biological agents are commonly found naturally in the environment and are difficult to detect with modern technology. The effective use of biological warfare dates back centuries and can still can be employed by terrorist groups, lone wolves, and political and religious groups to cause death and mayhem on a grand scale.

Retrospective dosimetry after criticality accidents using low-frequency EPR: a study of whole human teeth irradiated in a mixed neutron and gamma-radiation field.

In the context of accidental or intentional radiation exposures (nuclear terrorism), it is essential to separate rapidly those individuals with substantial exposures from those with exposures that do not constitute an immediate threat to health. Low-frequency electron paramagnetic resonance (EPR) spectroscopy provides the potential advantage of making accurate and sensitive measurements of absorbed radiation dose in teeth without removing the teeth from the potential victims. Up to now, most studies focused on the dose-response curves obtained for gamma radiation. In radiation accidents, however, the contribution of neutrons to the total radiation dose should not be neglected. To determine how neutrons contribute to the apparent dose estimated by EPR dosimetry, extracted whole human teeth were irradiated at the SILENE reactor in a mixed neutron and gamma-radiation field simulating criticality accidents. The teeth were irradiated in free air as well as in a paraffin head phantom. Lead screens were also used to eliminate to a large extent the contribution of the gamma radiation to the dose received by the teeth. The EPR signals, obtained with a low-frequency (1.2 GHz) spectrometer, were compared to dosimetry measurements at the same location. The contribution of neutrons to the EPR dosimetric signal was negligible in the range of 0 to 10 Gy and was rather small (neutron/gamma-ray sensitivity in the range 0-0.2) at higher doses. This indicates that the method essentially provides information on the dose received from the gamma-ray component of the radiation.

Determination of serum IgG antibodies to Bacillus anthracis protective antigen in environmental sampling workers using a fluorescent covalent microsphere immunoassay.

AIMS: To evaluate potential exposure to Bacillis anthracis (Ba) spores in sampling/decontamination workers in the aftermath of an anthrax terror attack. METHODS: Fifty six serum samples were obtained from workers involved in environmental sampling for Ba spores at the American Media, Inc. (AMI) building in Boca Raton, FL after the anthrax attack there in October 2001. Nineteen sera were drawn from individuals both pre-entry and several weeks after entrance into the building. Nine sera each were drawn from unique individuals at the pre-entry and follow up blood draws. Thirteen donor control sera were also evaluated. Individuals were surveyed for Ba exposure by measurement of serum Ba anti-protective antigen (PA) specific IgG antibodies using a newly developed fluorescent covalent microsphere immunoassay (FCMIA). RESULTS: Four sera gave positive anti-PA IgG results (defined as anti-PA IgG concentrations > or = the mean microg/ml anti-PA IgG from donor control sera (n = 13 plus 2 SD which were also inhibited > or = 85% when the serum was pre-adsorbed with PA). The positive sera were the pre-entry and follow up samples of two workers who had received their last dose of anthrax vaccine in 2000. CONCLUSION: It appears that the sampling/decontamination workers of the present study either had insufficient exposure to Ba spores to cause the production of anti-PA IgG antibodies or they were exposed to anthrax spores without producing antibody. The FCMIA appears to be a fast, sensitive, accurate, and precise method for the measurement of anti-PA IgG antibodies.

Dentistry's response to bioterrorism: a report of a consensus workshop.

BACKGROUND AND OVERVIEW: The possibility of a significant bioterrorist attack on the civilian population of the United States has become a focus of local, state and national attention since the fall of 2001. An appropriate role for dentistry in the response to a massive bioterrorist attack has not yet been established, even though dentistry's role in other disasters has been developed and proven to be effective. To develop a consensus on a potential role for dentistry in dealing with bioterrorism, experts in bioterrorism issues and representatives of key organizations that could play a role in dentistry's response met at the American Dental Association's Workshop on the Role of Dentistry in Bioterrorism in June. CONCLUSIONS: In the event of a bioterrorist attack, dentists may be called on to fulfill several functions: education, risk communication, diagnosis, surveillance and notification, treatment, distribution of medications, decontamination, sample collection and forensic dentistry. Local dental societies should develop a plan for the dental response to potential bioterrorist attacks that can be integrated into each community's mass disaster response plan. Educational programs for dentists should be developed to prepare them for providing services they may be recruited to perform in an emergency. PRACTICE IMPLICATIONS: Dentistry has assets in personnel and facilities that can be of great value in responding to a major bioterrorist attack on the United States.