Counter Terrorism and WMD Emergency Response --

by Gavin Spencer, Safety & Security Office, Taitech, Inc.

 

Types of attacks:

Six basic types of terror 1. Conventional terrorism (car bombs, bombing government buildings, hostage taking) 2. Chemical (Nerve agents, Mustard agents, peroxide formers) 3. Biological (bacterial- i.e. Anthrax and viral- i.e. Smallpox) 4. Toxins (Botulinum, Ricin, Staphyolococcal Enterotoxin B) 5. Nuclear (any radiological device) 6. Non-conventional terrorism (all the things we didn’t think of--like flying a commercial airliner into a building)

Conventional Terror:

As the name suggests this is what we are “use to” seeing. Typically involves explosives used in crowded areas and/or around targets of political interest like U.S. government facilities at home and abroad. Some examples are the Khobar towers in Saudi Arabia in June 1996, Oklahoma City bombing in April 1995, as well as most plane hijackings. This type is most often used to make a political statement-not usually intended to cause mass casualties or mass terror. Easier to spot because conventional weapons/means are used- i.e. guns and bombs. We should all be looking for signs of conventional terrorism all the time (not just due to recent concerns).

Conventional Terror Prevention: Prevention Tips:

Know bomb reporting procedures (review your bomb threat card). Look out for boxes or containers that are unfamiliar and/or out of place-like in hall ways. Never accept a delivery that is leaking or “abnormal” looking. Never accept a delivery that is not expected. Contact shipper prior to accepting. Immediately report any firearms found.

Chemical Terror:Acute types of chemical terror:

Mustard agents-mustard gas Nerve agents-Sarin-- Mustard gas produces blisters and damage to the skin, eyes, respiratory, and gastrointestinal tracts. Secondary infection in survivors is a legitimate concern. Large doses can be life-threatening if untreated. Long term effects include eye, skin, lung and fertility carcinogenesis and mutagenesis.

Chem. Terror-Mustard Agents Treatment:

Antidotes-there is none. Fast decontamination is the key to survival. Must be completed in 2 minutes to prevent tissue damage, 5 minutes to prevent death. This is further complicated by the fact that symptoms may have a delayed onset. Decontamination: For skin-Use 0.5% hypochlorite solution or alkali, baking soda solution even soap and water will help. For eyes-use salt water (don’t use bleach!) For lungs isolate contaminated individual (don’t expose other people while trying to help) and seek medical treatment. Warn emergency responder of contamination concerns. SCBA or supplied air respirators should be worn by responders.

 

Chem. Terror-Mustard Agents Aftermath --

Mustard gas has a low volatility so it is an environmental persistent. May persist for several years unless hydrolyzed (i.e. bleach the soil). Persistence makes it a great groundwater contaminate also. Keep this in mind in a rescue/rebuilding effort.

Chemical Terror-Nerve Agents:

Some known and commonly stockpiled nerve agents are: SARIN TABUN VX SOMAN Basically nerve agents affect the central and peripheral nervous systems. Key symptoms are eye pain, blurred vision, mental confusion, headaches, muscle twitching.

Chemical Terror-Nerve Agents Treatment:

The drug Atropine is effective against most nerve agents at ameliorating muscarinic effects but has little effect on nicotinic effects such as twitching. Oximes are used to treat nicotinic effect, but must be used with Atropine. Pyridostigmine bromide protects against SOMAN when given as a preventative, but won’t help after the fact and is ineffective against SARIN, TABUN and VX.

Practical Guidelines for CivilianDefense Against Chemical Warfare Agents:

Shelter- Stay indoors. Shut all windows and doors. Move toward inner spaces, closets etc. If possible prepare ahead of time food and drinking water supply in sealed plastic containers. Protection- Avoid contact with chemical agent. Cover skin with plastic bags. If a bio-warfare mask is not available use regular towels soaked with baking soda and water breathe through wet areas. Decontaminate- remove chemical from skin using clean gauze (do not rub the skin). Use Fuller’s earth powder or baking soda. Leave on skin for a minute then remove with gauze or cotton. Alternately use soap and water. Post Attack- When area declared clear, remove all protective clothing (with rubber gloves) put material into plastic containers and seal them. When leaving house or shelter move opposite to wind direction.

Tokyo SARIN subway attack:

After SARIN attack on the Tokyo subway in 1995 only 10% of the closest victims arrived by ambulance (having been decon’d and triaged). 600 people who had not been decon’d or triaged arrived at area hospitals and made a bad situation worse when they contaminated ER personnel and started a secondary spread. Because poor dispersal methods were used only 12 people died-but 5,000 were injured.

Other types of chemical terror:

Flammable material Poison gases like CO and Chlorine Cyanide

Biological Terror:

Two basic types of biological agents and common example of each: Bacterial--Anthrax, Tularemia and Plague Viral--Smallpox, Marburg/Ebola hemorrhagic fevers and VEE Main difference is mode of infection.

Anthrax:

Infectious Agent-Bacillus anthracis, a gram-positive, encapsulating, spore-forming nonmotile rod bacteria. Symptoms- (3 types) Cutaneous- lesions characterized by a black color with intense edema. Fatality rate 5-20% *Inhalation- Resemble URI. Identifiable by x-ray evidence of mediastinal widening. Death occurs within 3-5 days. Gastrointestinal- Very rare in humans caused uncooked contaminated meat. Reservoir- On exposure to air, the vegetative forms sporulate. Spores are very resistant to adverse environmental conditions and may remain viable for many years. Human to human transmission is very rare. Contaminated soil can remain infective for decades. Immunization-Use cell-free vaccine (available in USA from Michigan Dept. of Public Health, Division of Bio Products, 3500 N. Logan, Box 30035, Lansing MI 48909) Use oral Doxycycline or Ciprofloxacin (Cipro (R)) Treatment-Penicillin, tetracyclines, erythromycin are all effective.

How might I be exposed to a Anthrax?

In the mail? It is possible-remember that the spores of Anthrax could remain viable in the soil for decades and can be spread to humans through breathing. What can I do to prevent an exposure? Well since it can be spread anywhere dirt can be spread the only defense is good old fashion human security. Lock doors, secure everything! As far as opening letters-only open it if you are expecting it and nothing looks out of ordinary.

Smallpox:

Last naturally acquired case was in October 1977. WHO validated eradication in 1980. All known virus held under tight security in two places: CDC in Atlanta, Georgia. Centre for Virology and Biotechnology, Koltsovo, Novosibirsk Region, Russian Federation The reason these stockpiles exist and were not destroyed is because of the threat of a biological attack from a terrorist group. Vaccine- vaccina virus For vaccine contact CDC at phone # 404-639-3670 Transmitted by human-to-human contact! It is really only considered a Bio-terror threat and not a natural disease threat. The WHO warns that any case should be treated as a public health threat. In a sense that is our best defense against smallpox-the fact that any positive diagnosis of the disease can only be the result of intentional bio-terror.

Tularemia:

Called Rabbit fever or Deer-fly fever because of transmission mode. Normal transmission similar to Anthrax (animal hides-bacteria). Not transmitted from person to person. Treated with conventional antibiotics. Oropharyngeal type has a case fatality rate of 30-60% if untreated. Lesions (buboes) and severe pneumonia are primary symptoms and may be confused with Plague.

Plague:

Infectious Agent-Yersinia pestis bacillus bacteria (non-spore-forming) Symptoms are flu-like with extreme lymph-node pain and swelling in the groin and lower abdomen. Secondary pneumonic plague may be transferred person to person through respiratory droplets. This can lead to “localized outbreaks or devastating epidemics” Normal transmission is from fleas (bacteria is transferred to host when flea bites) on wild rodents. Antibiotic therapy has shown a favorable clinical response. Persons having symptoms of pneumonic plague must be immediately isolated. Bubonic Plague is not transmitted person to person. Only through a vector (flea). Untreated case fatality rate is 50-60% There have been no human-to-human transmissions in the USA since 1925. Secondary has occurred in about 20% of bubonic cases in recent years. From 1984-1993 in US annual average of 12 plague cases (mostly in west) Precautions against airborne spread in any plague case is essential.

Marburg/Ebola Viral diseases:

The Movie Outbreak was “based” on this disease. Commonly referred to as a hemorrhagic fever due to symptoms of severe hemorrhaging. Only know human-to-human transmission mode is blood/body fluid contact like HIV (not airborne). Case fatality rate for Ebola has hovered around 70-90% in human infections in Africa. Most recent outbreak was in Kitwit Zaire in 1995 If bioengineered to spread airborne could be catastrophic. This has been a self defeating disease--It kills its victims too quickly to spread. Isolation of patients is mandatory and all items contaminated with body fluid should be soaked in bleach. Treatment-Ribavirin (Virazole(R)) Protect food sources in an epidemic.

Biological Terror:

Keys to minimizing biological terror impact: Quick identification of BW agent attack. Correct human and animal diagnosis of BW agents Augment existing base medical patient treatment capacity. Formulate a workable plan for antibiotic disbursement to all personnel in the attack. Effective patient isolation.

Toxins:

Basically somewhere between a biological and a chemical attack. Toxins are harmful substances produced by living organisms (plant, animal, microbe). Key features are: Not man-made Non-volatile (no vapor hazard) Not dermally active Extremely toxic Examples are: Botulism and Ricin.

Toxins-Botulism:

Is a neurotoxin Key symptoms are blurred vision throat tightness and flaccid paralysis. Cause of death is respiratory failure. Onset is 12-36 hours. Treatment- Early administration of trivalent licensed anti-toxin or hepatavalent antitoxin may prevent or decrease progression to respiratory failure and hasten recovery. Vaccine-Pentavalent toxoid vaccine (types A-E). Isolation and Decontamination- Not an aerosol hazard (no human-to-human transmission like some chemical agents). Toxin is very environmentally sensitive-sunlight (1-3 hours), heat (100 C for a few minutes) and chlorine will all destroy the toxin. Botulism is produced by the bacteria Clostridium Botulinum and is the reason you are never supposed to eat dented or bulging cans of food. Toxins produced in Anaerobic incubation. Botulinum toxin is the most toxic substance known to man with an LD50 of 0.001 micrograms! Aerosol attack is the most probable but a food or water supply attack is also possible. If confused for nerve agent poisoning treatment may be deadly (no atropine for botulism!) The Antitoxin is very effective if given before the onset of symptoms, but may be useless after symptom progression has ceased.

 

Toxins-Ricin:

Ricin is a cytotoxin derived from the beans of the castor plant. Key symptoms-Chest tightness, fever, joint pain, airway necrosis and pulmonary edema. Death occurs from respiratory distress at 36-72 hours. Treatment-is supportive and general treatment for pulmonary edema. Vaccine-None, but immunization works well in animals. Prevention-respiratory protection is the best prevention. Isolation and Decontamination-Ricin is non-volatile so human-to-human transmission is not a threat. Bleach will inactivate ricin toxin.

 

Nuclear/Radiological?

Is there a nuclear/radiological threat? Yes. You don’t need “weapons grade” uranium or plutonium isotopes for an effective nuclear attack-(but it would increase effectiveness). Terrorist use would fall under one of two categories: Improvised Nuclear Device Radiological Dispersion Device. The obvious difficulty in responding to a nuclear or radiological attack is the radiation itself. Chernobyl-the fire fighters who first rushed in to put out the fire were all exposed to lethal doses of radiation and added to the casualty rate rather than reducing it. Additionally it may not be readily known after an explosion that any nuclear or radiological material was involved.

 

Non-Conventional Terror:

Is a commercial airliner a weapon of mass destruction? Who would have said yes before September 11th?

The Threat:

The U.S.--under Nixon destroyed all of our biological/chemical weapons-it was assumed that our nuclear arsenal was a sufficient deterent. Russia (former USSR)--produced biological weapons such as Anthrax by the ton. The state and security of this material today is largely unknown. IRAQ--is the largest state threat of biological and chemical terrorism. When Weapons Inspections were stopped in 1995 the U.N. confirmed that IRAQ had deployed 10,000 liters of Botulism against enemies on more than 100 warheads. IRAQ admitted to the U.N. in 1995 that it had weaponized Anthrax. IRAQ has chemical agents also. Terrorist Groups--???

In the event of an attack...

Adapted from the DDN: 1. Be alert to any changes in your health status. May be difficult during flu-season (many biological weapons will mimic flu-like symptoms). 2. Remain calm following any incident. Observe and try to offer help if feasible. 3. Tune into your radio or TV for accurate information. Rumors may be spreading you need to act on facts. 4. Follow the directions of public health and safety officials. 5. React quickly, but sensibly. 6. Try not to tie up the phone system. Use a cell phone if you have one instead of normal phone lines.

References:

Crisis Management Handbook-Biological Weapons Decontamination & Training, Naval Criminal Investigative Services. 1990. Treatment of Chemical Agent Casualties and Conventional Military Chemical Injuries-Joint Army, Navy Air Force 1990. Control of Communicable Diseases Manual, American Public Health Association, 16th Edition, 1995. Combating Terrorism bulletin, Department of Defense Security Institute, 1996. Medical Management of Biological Casualties Handbook, 4th edition, 2001, USAMRIID. Guide for All-Hazard Emergency Operations Planning, Federal Emergency Management Agency (FEMA), April 2001.

May the FORCE be with You

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Last modified: February 20, 2002