Presentazione sul tema: "Bioterrorismo: gli agenti"— Transcript della presentazione:
1Bioterrorismo: gli agenti Prof. Pasquale Urbano7 aprile 2011
2Categoria A: Massima priorità Facili a disseminare e a propagarsiMolto letaliCapaci di sconvolgere la societàRichiedono una preparazione specifica per essere fronteggiatiThe CDC classifies bioterrorist agents into 3 categories: A, B and C based on the combined factors of availability of the agent, potential for morbidity and mortality, and ease of dissemination.Category A agents are believed to have the greatest potential for use as a biological weapon.Category A agents meet the following criteria:Easily disseminated or transmitted: refers to agents that can either be aerosolized or spread through secondary contact.High mortality: results in casualties well above what would occur from endemic levels of the disease with the likelihood of creating an outbreak.Social disruption: would result from the public’s reaction to news of a bioterrorist attack and the possible lack of adequate resources by local response teams.Special Preparation: by the health care community is required to prepare for a bioterrorist attack of this level because category A agent response may require stockpiling of antibiotics, isolation rooms, extensive tracking and monitoring systems.Although virtually any micro-organism has the potential to be used as a biological weapon, most would be difficult to weaponize and disseminate effectively.Article References:Lillibridge SR, Bell AJ, Roman RS. Centers for Disease Control and Prevention bioterrorism preparedness and response. Am J Infect Control 1999;27:463-4.Centers for Disease Control and Prevention, MMWR 2000;49(RR-4) or
3Agenti di Categoria A Carbonchio Botulismo Peste Vaiolo Tularemia Febbri emorragiche virali
4Agenti di Categoria B Abbastanza facili da disseminare Provocano morbosità moderata e bassa letalitàRichiedono misure specifiche per migliorare le possibilità diagnostiche e il sistema di sorveglianza e controllo
5Agenti di Categoria B Coxiella burneti (Febbre Q) Brucella species (brucellosi) Burkholderia mallei (morva) e B. pseudomallei [melioidosi]Enterotossina B stafilococcicaRicino tossina da Ricinus communisTossina epsilon di Clostridium perfringensMelioidosis is a bioterrorism category B disease, and _B. pseudomallei_ isa soil/water organism found primarily in Southeast Asia and northernAustralia. Severe pneumonia with sepsis syndrome is the most common causeof death with this infection and usually occurs in the compromised host,particularly the diabetic. No information is given regarding co-morbiditiesthat may have existed in the boy.
6Agenti di Categoria C Facilmente disponibili Facili a produrre e a disseminarePotenziali cause di alte morbosità e mortalità, con forte impatto sui sistemi sanitari
7Agenti di Categoria C Nipah virus Hantavirus [v. nota – Germania] Virus da zecca delle febbri emorragiche o delle encefalitiVirus della Febbre giallaM.tbc multi-resistente [E. Tortoli]Date: Fri, 26 Feb :18: (EST)From: ProMED-mailSubject: PRO/AH/EDR> Hantavirus update Europe: Germany (BW)HANTAVIRUS UPDATE EUROPE: GERMANY (BADEN-WUERTTEMBERG)************************************************************A ProMED-mail post<http://www.promedmail.org>ProMED-mail is a program of theInternational Society for Infectious Diseases <http://www.isid.org>Date: Wed 24 Feb 2010Source: RP Online (RPO), Deutscher Depeschendienst (DDP) report [in German, machine trans., edited] <http://www.rp-online.de/panorama/deutschland/Hantaviren-Epidemie-in-Baden-Wuerttemberg_aid_ html>A dangerous hantavirus is spreading in Baden-Wurttemberg. Since thebeginning of the year , 85 cases have been reported in theadministrative district of Stuttgart, the regional council announced onWednesday [24 Feb 2010].The number is unusually high for the season and exceeded the previousrecord year of 2007 with 41 cases in the same period, it said. This leavesan expectation of high infection levels in the coming months. The [numberof] cases have been piling up since December .According to [health] information, hantavirus disease [in this part ofEurope] manifests itself usually in the form of a common cold with suddenonset and high fever. In addition, [infected individuals] have head andbody aches and abdominal pain. The illness lasts about 3 weeks and morethan half of those affected are hospitalized. Some patients develop kidneyfailure. A vaccine does not exist.Hantaviruses are [maintained in] wild rodents that spread the virusprimarily through faeces and urine. Humans usually become infected byinhaling dust [with excreta having the] pathogen. [The red-backed vole,_Myodes] glareolus_, whose principal food is beechnuts, is the main reservoir.Regions with a high prevalence are Swabian Alb and Schoenbuch, which arethe most affected. The current incidence is probably due to a particularlyhigh population of red-backed voles.- --communicated by:HealthMap Alerts via ProMED-mail[The virus involved in these cases is most likely Puumala hantavirus. Adetailed account of the 2007 Puumala virus outbreak in Germany can be foundin ProMED-mail archive noImages of the bank vole reservoir of Puumala virus in Germany (_Myodesglareolus_), can be accessed at<http://commons.wikimedia.org/wiki/Category:Myodes_glareolus>.A map of Germany showing the location of Baden-Wurttemberg state can beaccessed at <http://www.lib.utexas.edu/maps/europe/germany.jpg>. AHealthMap/ProMED-mail interactive map of Germany can be accessed at<http://healthmap.org/r/018s>. - Mod.TY][see also:2007- ---Puumala virus infections - GermanyCategory C agents are third highest priority agents that include emerging pathogens that could be engineered for mass dissemination in the future because ofAvailability;Ease of production and dissemination; andPotential for high morbidity and mortality and major health impact.It is important to remember that just because these biological agents have been identified by the CDC as the priority agents, whether A, B, or C, a terrorist using a biological agent is not bound to use one of these. Physicians and all primary health care providers need to be alert to all unusual syndromes.For more information on these agents, visit:
8Panoramica sugli Agenti: Manifestazioni cliniche e trattamento This first discussion will focus on Category A agents.In order to better understand and identify the biological agents, it may be easier to understand the diseases by the syndromes they produce.
9Carbonchio da inalazione Peste polmonare Tularemia polmonare/tifoide Sindromi PolmonariCarbonchio da inalazionePeste polmonareTularemia polmonare/tifoideCategory A agents that produce pneumonic syndromes are:Inhalational anthraxPneumonic plaguePneumonic/typhoidal tularemiaMelioidosis is a bioterrorism category B disease, and _B. pseudomallei_ isa soil/water organism found primarily in Southeast Asia and northernAustralia. Severe pneumonia with sepsis syndrome is the most common causeof death with this infection and usually occurs in the compromised host,particularly the diabetic. No information is given regarding co-morbiditiesthat may have existed in the boy.
10Botulismo Avvelenamento da ricinotossina Sindromi tossicheBotulismoAvvelenamento da ricinotossinaContinua
11Sindromi eruttive e febbrili VaioloFebbri emorragiche viraliCollegamenti: consensus Linee guida