Transcript Slide 1

Emergency Response to Terrorism:
Operations
A Safe Response for
Public Safety Personnel
The International Association of Fire Fighters
General President
Harold A. Schaitberger
General Secretary-Treasurer
Vincent J. Bollon
UNIT 5: Biological Agents
Introduction
• Group Activity
BIOLOGICAL AGENTS
Objectives
• By the end of this unit, you will:
• Recognize the threat characteristics of biological
agents
• Determine possible types of harm posed to First
Responders at biological WMD incidents
• Describe the use of First Responder PPE and its
limitations at biological WMD incidents
• Identify First Responder protective actions at
incidents involving biological hazards
Background
• May seem unlikely
• Availability greater
• 20+ Countries with Active CW Programs
• 12+ Countries with Active BW Programs
• 30+ Countries with Nuclear Capabilities
• At home - FBI
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37 cases - 1996
74 cases - 1997
181 cases - 1998
2001 + - ???
The Worst Source of Contagion
…Your Fingers
Did you know that 80 % of all infectious
illnesses, from the common cold, to
flesh eating bacteria, to lethal viruses
(i.e. EBOLA), are transmitted by touch?
The Secret Life of Germs
Grand Central Station Hidden Camera
• 60% of people observed did not wash their
hands after using the restroom
• 90% of those who did wash their hands did
not wash them effectively
New York Observer Swipe Study
• Tested random headsets and found:
• E Coli; Fecal germ
• Tested a bar glass at an exclusive hotel
and found:
• Group D Strep; Fecal germ
• Tested public telephone on Madison
Avenue and found:
– Hemolytic Strep A; Flesh eating bacteria
Bathroom
• Potential Sources
• Toothbrush
• Soap Bars
• Hand Towels
Flushing a toilet spreads
contamination……
everywhere in YOUR bathroom
Stomach Viruses
• 80% of all are foodborne
• Found often on cruise ships
• Doctors call them stomach viruses
• ie; E Coli, Shigella Coli
• Transmitted via Fecal-Oral route
What’s In a Sneeze?
• Aerosolized dispersion
• Particles may travel up to 20’
• Coughs can also spread bacteria
Identify Responder Issues SM 5-5
• Determine the following:
• Team 1: Threat Characteristics
• Team 2: Types of Harm
• Team 3: PPE Considerations
• Team 4: First Responder Protective Actions
Team 1
• Threat Characteristics
•
Exposure/Contamination
•
Secondary devices
•
Other hazardous materials
Team 2
• Types of Harm
• Illness
• Death
Team 3
• Personal Protective Equipment
• Self Contained Breathing Apparatus (SCBA)
• Body Substance Isolation (BSI)
Team 4
• First Responder Protective Actions
•
Establish Command
•
Isolate/Assess
•
Prepare for Decon
WMD
Biological
Pathogen
Toxin (poison)
WMD
Biological
Pathogen
Bacteria or Viruses
Living organisms
Can be contagious
Symptoms are often delayed
Examples
Bacillus anthracis
Ebola virus
Hepatitis B
HIV
WMD
Biological
Toxin (poison)
Non-living
Not contagious
Symptoms may develop in
minutes to hours
Examples
Botulinum
Ricin
SEB (staphylococcal enterotoxon B)
Biological
Pathogen
Toxin (poison)
Bacteria or Viruses
Non-living
Living organisms
Not contagious
Can be contagious
Symptoms may develop in
minutes to hours
Symptoms are often
delayed
Examples
Examples
Bacillus anthracis
Ebola virus
Hepatitis B
HIV
Botulinum
Ricin
SEB (staphylococcalenterotoxon B)
Threat Characteristics
• Pathogens
• Are living organisms
• Multiply once released into
the environment or host
(carriers)
• Symptoms are often delayed
from days to weeks
• Bloodborne and airborne
Threat Characteristics
• Toxins
• Are not living organisms
• Do not multiply once released
into the environment or host
• Not transmitted by carriers
• Symptoms may happen within minutes to hours
Threat Characteristics
Pathogens
Toxins
(bacteria, viruses)
examples: Bacillus anthracis
bacteria (Anthrax)*, Ebola virus,
Hepatitis B virus, HIV,
Mycobacterium tuberculosis
examples: Botulinum, Ricin
(derived from castor beans),
Saxitoxin, SEB (Staphylococcal
Enterotoxin B
Living organisms; can multiply
after dispersion
Non-living; cannot multiply after
dispersion
Can be contagious; can cause
epidemics/mass casualties
Not contagious; do not cause
epidemics
Symptoms often delayed several
days to weeks
Symptoms may develop within
minutes to hours
Workbook Task SM 5-7
List three ways First Responders can contract
diseases in the course of their work.
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Inhalation of pathogens spread through coughs or
sneezes of sick patients
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Ingestion of pathogens spread through food and water
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Injection/needle sticks with infected blood/body fluids
Threat Characteristics
• Dissemination
• Needs to contact as many as possible
• Aerosols most effective
• Others?
Dissemination
Discussion - Recognizing a Problem
In the 1980s, members of a cult in Oregon
contaminated several salad bars with salmonella
bacteria in an effort to affect the outcome of a local
election. As a result, 751 people became ill; 45 were
hospitalized.
• Unusually high number of sick patients
• Numerous patients with similar symptoms
• Unusual number of patients within the same neighborhood/s
• First Responders may have asked and discovered that
patients recently ate at the same restaurants
What is the Threat? SM 5-7
Naturally Occurring Diseases
AIDS
Hepatitis B, C
Influenza
Tuberculosis
WMD-Related Diseases
Anthrax
Hemorrhagic fevers
Pneumonic plague
Ricin*
Smallpox
Threat Characteristic
(How does it spread?)
Bloodborne/Body Fluid
Bloodborne/Body Fluid
Airborne
Airborne
Threat Characteristic
(How does it spread?)
Not usually transmitted
Bloodborne/Airborne
Airborne
Not usually transmitted
Airborne
*Ricin is the name of a toxin, not a disease. Toxins injure by poisoning rather
than causing disease, so their effects are typically known by the name of the
toxin rather than the name of a disease.
Toxins are not transmitted by carriers; they typically enter the victim’s system
through direct ingestion of the toxin, though injection of the agent may also
cause poisoning.
Threat Characteristics
Key Point
• Importance of BSI
• Use Protective
Clothing
• Use Respiratory
Protection
Types of Harm SM 5-15
• Fill in the blanks
on page 5-15
Naturally Occurring Diseases
AIDS
Body System/s
Affected
Immune
Hepatitis B, C
Liver
Influenza
Initial Signs and Symptoms
Symptoms are often delayed for years;
eventually may be noticed as skin lesions and
respiratory infections occur
Lack of appetite, mild abdominal
pain, nausea and vomiting,
jaundice; many patients
experience no symptoms
Respiratory
Fever, headache, body aches, cough,
malaise
Tuberculosis
Systemic, beginning with
respiratory
WMD-Related Diseases
Anthrax
Hemorrhagic fevers
Pneumonic plague
Body System/s
Affected
Respiratory
Blood, Liver, Kidneys
Most patients show no signs or
symptoms
Initial Signs and Symptoms
Initial symptoms include fever,
malaise, mild cough, chest pain
Initial symptoms resemble the flu—
sudden onset of fever, headache,
malaise
Respiratory
Early symptoms resemble the flu
Ricin
Smallpox
Page 5-15
Respiratory
Systemic, beginning with
skin
Weakness, fever, cough,
pulmonary edema, pulmonary
distress
Early symptoms resemble the flu,
then small blisters develop on the
face, hands, and forearms and,
eventually, the trunk
PPE
• Review Routes of
Entry
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Absorption
Inhalation
Injection
Ingestion
• Types of PPE
• Fire
• EMS
PPE
• How to enhance PPE Effectiveness
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Open building windows
Open ambulance windows
Increase air flow in the area of the patient
Put a mask on the patient
Avoid blood and body fluids
Limit crew exposure
• Review Workbook Activity – SM 5-19
PPE
• First Responder Protective Actions
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Establish Command
Isolate hazard/assess situation
Evaluate rescue
Decon
Call for technical assistance
• Does the ERG help?
ERG 2004
ERG 2004
25 meters (75 feet) in all directions
First Responder Actions
Question to Consider SM 5-21
• How do you protect yourself if encountering a
patient who has been exposed to a biological
release?
• Wear appropriate PPE (SCBA, barrier materials)
• Utilize Back-up team
• Victims must be viable
• Victims can be quickly removed
Decontamination
• Removing contaminated clothing may
remove up to 80% of contamination
• Use of hypochlorite is controversial
• Use on equipment
• Technical Assistance
Team Activity: Identify Responder Issues
SM 5-25
• Determine the following:
• Team 1: Threat Characteristics
• Team 2: Types of Harm
• Team 3: PPE Considerations
• Team 4: First Responder Protective
Actions
Team Activity SM 5-25
Your department has been called to assist law
enforcement personnel at a self-storage facility.
They have gathered information that leads them to
believe that evidence, including biological materials,
may be stored inside the self-storage unit.
Three days following your response to this situation,
your department conducts a post-incident analysis.
The stored product was tested and has been
identified as Ricin.
Team 1
• Threat Characteristics
•
Exposure/Contamination
•
Secondary devices
•
Other hazardous materials
Team 2
• Types of Harm
• Illness
• Death
Team 3
Personal Protective Equipment
• Self Contained Breathing Apparatus (SCBA)
• Body Substance Isolation (BSI)
Team 4
• First Responder Protective Actions
•
Establish Command
•
Isolate/Assess
•
Prepare for Decontamination
Case Study
• Answers are basically the same
• Good, basic protective actions --- used
all the time --- protect against hoaxes
and real incidents