Construção e validação de instrumento para avaliação das medidas de biossegurança em bioterrorismo pelos bombeiros / Construction and validation of and assessment tool for biosafety measures in bioterrorism for firefighters / Construcción y validación de un instrumento para evaluar las medidas de bioseguridad en el bioterrorismo de los bomberos

Objetivo: Este estudo teve como objetivo desenvolver e validar um instrumento de avaliação das medidas de Biossegurança adotadas pelos bombeiros militares, para a contenção dos agentes biológicos frente a um evento de bioterrorismo. Métodos: Tratou-se de um estudo descritivo de abordagem quantitativa, de desenvolvimento metodológico e do tipo de validação de conteúdo de um instrumento de avaliação. O estudo foi dividido nas fases de desenvolvimento e validação do instrumento. Para o desenvolvimento do instrumento foram feitas revisões da literatura e para a validação do instrumento foi utilizado o método Delphi. Para o estudo foram incluídos 6 juízes que avaliaram o instrumento através da escala numérica tipo Likert. Resultados: Os juízes avaliaram que o instrumento proposto está bem estruturado, possuindo boa clareza e coesão de escrita, com aplicabilidade no campo de estudo e de grande relevância, principalmente em vista a ausência desse tipo de instrumento para a população de bombeiros militares. Para avaliar a concordância entre os juízes foi utilizado o índice de Validade de Conteúdo, que alcançou 98% de concordância e o Índice de Fidedignidade Interavaliadores, que alcançou os conceitos bom e muito bom, mostrando baixa variância das respostas dos juízes, sendo estatisticamente válido. Conclusão: O estudo descreveu o processo de construção e validação do instrumento, provando ser apropriado e confiável para ser utilizado.

Objective: This study aimed to develop and validate an instrument to assess the Biosafety measures adopted by firefighters, for the containment of biological agents in the face of a bioterrorism event. Methods: This is a descriptive study with a quantitative approach, methodological development, and the type of content validation of an assessment instrument. The study was divided into instrument development and validation phases. For the development of the instrument, literature reviews were conducted and for the instrument validation, the Delphi method was used. For the study, 6 judges were included who evaluated the instrument using the Likert-type numerical scale. Results: The judges evaluated that the proposed instrument is well structured, with good clarity and cohesion of writing, with applicability in the field of study and of great relevance, especially considering the absence of this type of instrument for the military firefighter population. To evaluate the agreement between the judges, we used the Content Validity Index which reached 98% of agreement and the Interrate agreement, which reached the concepts good and very good, showing low variance of the judges' answers, being statistically valid. Conclusion: The study described the process of construction and validation of the instrument, proving to be appropriate and reliable to be used.

Objetivo: Este estudio tenía como objetivo desarrollar y validar un instrumento para evaluar las medidas de bioseguridad adoptadas por los bomberos militares para contener los agentes biológicos durante un evento de bioterrorismo. Métodos: Se trata de un estudio descriptivo de abordaje cuantitativo, de desarrollo metodológico y del tipo de validación de contenido de un instrumento de evaluación. El estudio se dividió en las fases de desarrollo y validación del instrumento. Para la elaboración del instrumento se realizaron revisiones bibliográficas y para la validación del mismo se utilizó el método Delphi. Para el estudio se incluyeron 6 jueces que evaluaron el instrumento mediante una escala numérica tipo Likert. Resultados: Los jueces evaluaron que el instrumento propuesto está bien estructurado, poseyendo buena claridad y cohesión de redacción, con aplicabilidad en el campo de estudio y de gran relevancia, especialmente en vista de la ausencia de este tipo de instrumento para la población de bomberos militares. Se utilizó el Índice de Validez de Contenido para evaluar la concordancia entre los jueces, alcanzando un 98% de acuerdo y el Índice de Fiabilidad Inter-registrador, que alcanzó conceptos buenos y muy buenos, mostrando una baja varianza en las respuestas de los jueces, siendo estadísticamente válido. Conclusión: El estudio describió el proceso de construcción y validación del instrumento, demostrando ser apropiado y confiable para ser utilizado.

Bioterrorismo, riscos biológicos e as medidas de biossegurança aplicáveis ao Brasil / Bioterrorism, biological risks and biosafety measures applicable to Brazil

A história registra o uso de patógenos como potencializadores de recursos bélicos. Considerando os eventos bélicos da contemporaneidade, observa-se a formulação de projetos voltados para elaboração tecnológica sofisticada. Nessa categoria se incluem as armas biológicas, vinculadas aos programas de caráter coercitivo conhecidos como guerras biológicas, que pertencem à lógica da ameaça assimétrica, não definindo território e gerando repercussões econômicas, políticas e sociopsicológicas devastadoras. Esses eventos demandam a elaboração de planos que contemplem o risco, incluindo a capacitação de recursos humanos, investimentos na identificação de materiais empregados em bioterrorismo e também em equipamentos de segurança. Objetiva-se neste artigo discutir a associação entre patógenos, seu potencial de risco e eficácia para o emprego em estratégias de bioterrorismo, destacando as medidas de biossegurança necessárias. Utiliza-se a revisão integrativa para a construção de análises de contextos de risco. O levantamento bibliográfico compreendeu o período 1990/2010, nas bases de dados ISI, LILACS, SciELO e PubMed. Demonstra-se a importância do envolvimento e da capacitação dos profissionais na identificação de agentes biológicos com potencial de risco, considerando que o bioterrorismo pode resultar na sobrecarga dos sistemas de saúde. A biossegurança orienta os procedimentos que devem ser adotados para a contenção dos patógenos, visando ao controle dos riscos...

History records the use of pathogens as improvers of military resources. Considering the events of contemporary war, there is the formulation of projects aimed at sophisticated technological development. They shall include biological weapons, linked to coercive programs known as biological warfare, which belong to the logic of asymmetric threat, not defining territory and generating devastating economic, political and socio-psychological repercussions. These events require the preparation of plans that address the risk, including the training of human resources, investments in the identification of materials used in bioterrorism and also in safety equipment. This paper aims to discuss the association between pathogens, their potential risk and effectiveness for use in bioterrorism strategies, highlighting the necessary biosecurity measures. It uses an integrative review to construct contexts risk analysis. The literature included the period 1990/2010, the ISI databases, LILACS, SciELO and PubMed. It demonstrates the importance of the involvement and training of professionals in the identification of biological agents with potential risk, whereas bioterrorism may result in overload of health systems. Biosecurity guides the procedures to be adopted for the containment of pathogens, aimed at controlling risk...

Guatemala's ministry of health rapid response team manuals.

The function of public health rapid response teams (RRTs) is to quickly identify, investigate, and control an outbreak before it can spread. The Central America Regional Office in Guatemala provided assistance to the Guatemalan Ministry of Health and Social Assistance (MSPAS) to develop RRT manuals at the district and regional levels. The manuals are divided into 4 sections: background, activity lists, standard operating procedures, and annexes. The manuals outline Guatemala's RRT members' responsibilities and will be tested in the near future through tabletop exercises. The development of the manuals is a concrete and significant step toward the attainment of Guatemala's IHR goals and should be integrated into a larger emergency management system to promote "a world safe and secure from global health threats posed by infectious diseases."

Experimental adaptation of an influenza H5HA strain confers respiratory droplet transmission to reassortant H5H/H1N1 virus strain in ferrets.

An evaluation of the role - if any - of censorship in scientific papers, based on the publishing of the article that shows it is possible to modify the genetics of the H5N1 aviary influenza virus, enhancing its transmission among mammals, which was followed by much ado and ethical discussion.

What have we learned from the novel influenza A (H1N1) pandemic in 2009 for strengthening pandemic influenza preparedness?

We need to apply lessons learned from previous influenza pandemics to continuously update preparedness and response plans. It has become evident that strengthening networks of international referral laboratories coupled with scaling-up efforts to expand epidemiological surveillance networks is critical for responding and mitigating the impact of influenza pandemics. The current swine-related influenza A (H1N1) pandemic has also shown that international collaboration remains a critical component to effectively respond to influenza pandemics in the current globalized world.

Análise da construção da competência do Brasil em direção ao laboratório de contenção máxima: realidades e perspectivas / Analysis of the construction of the power of Brazil toward the maximum containment laboratory: realities and prospects

Este estudo apresenta uma análise sobre a necessidade de instalação de umlaboratório de contenção máxima (NB-4) no Brasil, a fim de atender as necessidades de pesquisa e diagnóstico de agentes patogênicos, de relevância epidemiológica e risco de disseminação ou causador de doença emergente que se torne epidemiologicamente importante ou cujo mecanismo de transmissão seja desconhecido.Discute, através de uma revisão bibliográfica, a emergência e reemergência de doenças infecciosas mostrando situações críticas enfrentadas no âmbito mundial.Destaca a susceptibilidade do Brasil, considerando a sua complexidade, representada especialmente, pela sua biodiversidade e pelos problemas sócio-econômicos, que afetam diretamente a saúde pública. Sublinha a questão dos investimentos no setor da saúde, voltados à vigilância, ao fortalecimento de bases epidemiológicas, laboratorial e clínica, centradas em medidas de prevenção e de controle nas áreas de vigilância, onde se inclui a perspectiva da Biossegurança. Aborda aspectos do monitoramento de risco, enfatizando as intercessões entre a Biossegurança e a Biosseguridade, como campos integrados e voltados para controlar aspossibilidades de risco relacionado com as questões de saúde pública , tais como o bioterrorismo, considerando a importância da construção de políticas institucionais voltadas para atender as demandas dos laboratórios e das situações de risco de saúde pública, em especial, através de eventos de grande impacto provocados pela circulaçãode agentes biológicos de alta letalidade.Em termos metodológicos, utiliza os dados do Centro de InformaçõesEstratégicas em Vigilância em Saúde, da Secretaria de Vigilância em Saúde, doMinistério da Saúde para construção do estudo de caso. =Conclui, a partir da análise da relevância epidemiológica dos eventos notificados e sua relação com o potencial de risco manifesto ou latente, a pertinência de investimentos em Biossegurança em termos da construção de uma infra-estrutura laboratorial e a conseqüente capacitação de profissionais, indicando a importância do debate sobre a localização desta unidade, a partir do contexto epidemiológico traduzido pelo sistema de notificação.

Use of atomic force microscopy as a diagnostic tool to identify orthopoxvirus.

Atomic force microscopy (AFM) is a versatile technique that permits the imaging of surfaces and generates topographical images from a variety of materials. Due to the fact that AFM requires minimum sample manipulation, it is a valuable tool for studying biological materials such as cells, DNA, bacteria and viruses. The aim of the present study was to standardize the AFM technique as a diagnostic tool for detection of naturally occurring orthopoxviruses. The samples analyzed were collected during natural outbreaks of Vaccinia virus (VACV) in dairy cattle in Brazil. These viruses are zoonotic infections; and therefore safe manipulation of all samples is required. The AFM technique would provide a more secure way to diagnose infection. By using the "in air" AFM technique after purification and inactivation process, relatively crude preparations of viruses were visualized rapidly. Details for efficient sample preparation and AFM imaging are described. The AFM technique provides a rapid and biosecure tool for the diagnosis of emerging orthopoxviruses and has potential as a tool for screening bioterrorism samples.

[Biological research and security institutes]. / Institutos de investigación y seguridad biológica.

The threat of using biological material for ago-bioterrorist ends has risen in recent years, which means that research and diagnostic laboratories, biological agent banks and other institutions authorised to carry out scientific activities have had to implement biosafety and biosecurity measures to counter the threat, while carrying out activities to help prevent and monitor the accidental or intentional introduction of exotic animal diseases. This article briefly sets outthe basic components of biosafety and biosecurity, as well as recommendations on organisational strategies to consider in laboratories that support agro-bioterrorist surveillance and prevention programs.

Venezuelan equine encephalitis virus complex-specific monoclonal antibody provides broad protection, in murine models, against airborne challenge with viruses from serogroups I, II and III.

The alphavirus Venezuelan equine encephalitis virus (VEEV) is highly infectious by the airborne route. It is a hazard to laboratory workers, has been developed as a biological weapon and is a potential bioterrorist agent. A suitable vaccine appears in an advanced stage of development but there remains a need for antiviral drugs, effective in prophylaxis of disease prior to or a short time after exposure to airborne virus. Using a murine model to study monoclonal antibody (MAB) a VEEV complex-specific, glycoprotein E2-binding MAB was identified, able to protect against disease induced by exposure to aerosolised VEEV from serogroups I, II and IIIA (mouse-virulent strains). There was no synergy in protection between anti-E1 and anti-E2 MAB. Assays of MAB virus neutralising activity in a homologous (mouse fibroblast) cell line suggested that neutralisation played a significant role in protection in addition to the previously reported mechanism of Fc receptor-binding [Mathews et al., 1985. J. Virol. 55, 594-600]. Development of an analogous human MAB with identical VEEV epitope specificity may be informed and monitored by reference to these properties.

Agentes del bioterrorismo: preparándose para lo impensable / Bioterrorism agents: getting ready for the unthinkable

The September 11, 2001 terrorist attacks in the USA demonstrated our vulnerability to terrorist raids. Furthermore, in the same year inhalational anthrax cases in humans caused by the international release of Bacillus anthracis spores via the USA postal system inflicted a lot of panic and terror over the civilian population. The succeeding terrorist events scattered in several other countries are continous reminders of our failness and of the risk that terrorists attempts in the future may be implemented by means of deliberate evil release of biological agents. These events may be perpetrated by either the release of an infectious agent or any of its products in order to spread death or sickness in humans, animals, or plants with the obnoxius purpose of scaring governments and societies for the profit of particular ideological causes. In the current article, we present a review of the main bioterrorism agents, as well as a historical and clinical aspects and their significance for public health preparedness and response.

Los eventos terroristas del 11 de septiembre del 2001 en Estados Unidos de América (EUA) cambiaron para siempre nuestra percepción de la vulnerabilidad a los ataques terroristas. Aunado a esto, los primeros casos de ántrax en humanos ocasionados por la liberación intencional de esporas de Bacillus anthracis a través del sistema postal de EUA infligieron pánico y terror en la población general. Los subsecuentes eventos de terrorismo ocurridos en diversos países son recordatorios continuos de nuestra fragilidad y del riesgo que futuros ataques terroristas pudieran organizarse a través de liberación intencional de agentes biológicos. El bioterrorismo consiste en el uso intencional o amenaza de utilizar agentes biológicos; ya sea el propio agente infeccioso o sus productos para causar la muerte o enfermedad en humanos, animales o plantas con el objetivo de intimidar a gobiernos y sociedades en beneficio de causas ideológicas particulares. En el presente artículo se hace una revisión de los principales agentes del bioterrorismo, aspectos históricos, clínicos y terapéuticos, así como su prevención e importancia para la salud pública mundial.

[Bioterrorism agents: getting ready for the unthinkable]. / Agentes del bioterrorismo: preparándose para lo impensable.

The September 11, 2001 terrorist attacks in the U.S.A. demonstrated our vulnerability to terrorist raids. Furthermore, in the same year inhalational anthrax cases in humans caused by the intentional [corrected] release of Bacillus anthracis spores via the U.S.A. postal system inflicted a lot of panic and terror over the civilian population. The succeeding terrorist events scattered in several other countries are continuous reminders of our frailness [corrected] and of the risk that terrorists attempts in the future may be implemented by means of deliberate evil release of biological agents. These events may be perpetrated by either the release of an infectious agent or any of its products in order to spread death or sickness in humans, animals, or plants with the obnoxius purpose of scaring governments and societies for the profit of particular ideological causes. In the current article, we present a review of the main bioterrorism agents, as well as a historical and clinical aspects and their significance for public health preparedness and response.

[Bio-terrorism, bio-defense, bioethics]. / Bioterrorismo, biodefensa, bioética.

The terrorist attacks launched on September 11, 2001, ignited fear of further aggression with biological weapons, leading to a discourse and allocation of resources for both defensive and dissuasive/ offensive use in order to counteract such threats. Many such measures involved the investigation and production of biological agents, and the public health field has been called upon to participate in these strategic efforts. Participation by health programs is in moral contradiction with military tactics and should be limited to protecting the health of the purportedly threatened population, in itself a difficult task due to the numerous imponderable factors. The additional resources being made available to public health are largely conditioned on their strategic military application, leaving traditional public health care in its chronic state of insufficient funding and non-egalitarian allocation.

[Bioterrorism: notes for an agenda in case of the unexpected]. / Bioterrorismo: apuntes para una agenda de lo inesperado.

UNLABELLED: The vulnerability of human populations to chemical, biological, radiological, and nuclear terrorism has been widely discussed but insufficiently studied. Current public health policies are not guided by solid and relevant information to design cost-effective programs for preventing or controlling this kind of incidents in the future. Governmental budgets are insufficient to respond to bioterrorist attacks. To face these threats, developing countries like Mexico should frame strategies and devise specific preventive actions that consider the transmission dynamics of potential infectious agents likely to be used in a bioterrorist attack. PROPOSALS: The international reaction to a biological attack must be supported by international agreements that ban the use of biological agents for warfare and/or defense purposes, as well as on academic and technological exchange for the prevention of bioterrorist attacks. At the national level, the recommendations in the event of a biological attack are: a) establishing a legal defense strategy against bioterrorism; b) implementing education programs as a key strategy for defense against bioterrorism; c) devising a national program of interinstitutional anti-bioterrorist coordination that includes medical emergency assistance and collection of medical forensic evidence; d) including a biological weapon registry in epidemiological surveillance systems; e) implementing a laboratory for biological material analysis related to terrorist incidents; f) devising public health information campaigns, g) assuring the supply of diagnostic testing, special protection, and emergency treatment materials; h) decentralizing alert systems for the timely detection of bioterrorist attacks; i) responding to bioterrorist actions addressed against animals and plants, and j) organizing Ethics Committees in case of urgent events derived from a biological attack. CONCLUSIONS: The proper response to sudden and unexpected events of emergent or unusual infectious diseases involved in a bioterrorist attack requires an adequate public health infrastructure. Modern technology allows the timely identification of multiple infectious agents by nucleic acid analyses and should be widely available in reference laboratories. All these measures require sufficient funding to respond to this potential threat. Resource allocation to respond to bioterrorist attacks must be consonant with their potential public health consequences.