Spread by
Sahana V
4/20/2015 1
Several bacterial, viral agents and toxins-
pose public health risk- bioterrorist attack1
14th century- siege of ukraine2
Fort Pitt, Ohio river valley3
Anthrax- 1979, Soviet Union
Anthrax, botulinum and aflatoxin- 1995,
Iraq
1. Bioterriorism: from threat to reality.Atlas RM Annu Rev Microbiol. 2002; 56():167-85.
2. Biological warfare. A historical perspective.Christopher GW, Cieslak TJ, Pavlin JA, Eitzen EM Jr.
JAMA. 1997 Aug 6; 278(5):412-7.
3. Wheelis M. Biological warfare before 1914. In: Moon JE van Courtland., editor. Biological and
toxin weapons: Research, development, and use from the middle ages to 1945. Vol. 1.
Stockholm, Sweden: Stockholm International Peace Research Institute; 1991. pp. 8–34.
4/20/2015
2
4. Why should we be concerned about biological warfare?. Richard Danzig et al,. JAMA, Vol
278,No,5,pp. 431-432
Factors
Easy
delivery
Low
visibility,
high
potency
Recipes –
available
on
internet
Extremely
Low-
technology
methods
concealment,
transportatio
n
,disseminatio
n easy
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3
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4
5. J Pharm Bioallied Sci. 2010 Jul-Sep; 2(3): 179–188.
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6
Types of
pathogen
Antipersonnel
Anti-animal
Anti-material
Anti-plant
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Pathogen
Contagious
Lethal
Mass killing
Non-lethal
Economic
Disruption
Non-
contagious
Lethal
Area Denial
Non-lethal
Incapacitation
4/20/2015
Disease Pathogen Abused
Anthrax Bacillus antracis (B) First World War
Second World War
Soviet Union, 1979
Japan, 1995
USA, 2001
Botulism Clostridium botulinum (T) –
Plague Yersinia pestis (B) Fourteenth-century
Europe
Second World War
Smallpox Variola major (V) Eighteenth-century N.
America
Tularemia Francisella tularensis (B) Second World War
6. The history of biological warfare. EMBO Rep. 2003 June; 4(Suppl 1): S47–S52
4/20/2015
8
Agent
Infective
Dose
(Aerosol)
Incubation
Period
Diagnostic
Assay
Chemotherap
y
Anthrax
8,000-50,000
spores
1-5 d Ag- ELISA
Ciproflaxin
Doxycycline
Penicillin
Plaque
100-500
organisms
2-3 d Ag-ELISA
Chlorampheni
col
Q-fever
1-10
organisms
10-40 d ELISA Tetracycline
Small pox
Assumed low
10-100 org
7-17 d
ELISA,PCR,
Virus isolation
Cidofovir
7. Clinical Recognition and management of patients exposed to biological warfare agents. JAMA,
Vol,278,No5.1997.pp.399-411 4/20/2015
9
• A release of 50 kg agent in an area with population 5
million
• Anthrax
 250,000 cases -100,000 deaths
 Plague
 150,000 cases -36,000 deaths
 Tularemia
 250,000 cases -19,000 deaths
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 Gram-positive,
 Endospore-forming,
rod-shaped
 width of 1–1.2µm and
a length of 3–5µm
 Only obligate species
on Bacillus
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12
6. The history of biological warfare. EMBO Rep. 2003 June; 4(Suppl 1): S47–S52
 Cell binding protein-
Protective Antigen(PA)
 Enzymes
• Edema Factor (EF)
• Lethal Factor (LF)
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14
• 95% of all cases globally
• Incubation: 3-5 days (up to 12 days)
• Spores enter skin through open wound or abrasion
Large skin ulcer created
• Fever and malaise  5% - 20% mortality
• Untreated – septicemia and death.
Cutaneous
• Severe gastroenteritis
• Incubation: 2-5 days after consumption of
undercooked, contaminated meat
• Case fatality rate: 25-75%
Gastrointestinal
• Incubation: 1-7 days
• Phase 1: Nonspecific - Mild fever, malaise
• Phase 2: Severe respiratory distress Cyanosis,
death in 24-36 hours
• Case fatality: 75-90% (untreated)
Inhalational
4/20/2015
15
Worst-case scenario
(Office of Technology
Assessment)
• 50 kg of spores
 Urban area of 5 million
 250,000 cases of
anthrax
 100,000 deaths
• 100 kg of spores
 Upwind of Wash D.C.
 130,000 to 3 million
deaths
4/20/2015
16
Vaccine – available but effectiveness
unproven in humans (only monkeys)
• 5-35% experience systemic side effects
• No long-term side effects proven
• Six shots plus annual booster required
Penicillin
• Has been the drug of choice
• Some strains resistant to penicillin
Ciprofloxacin
• Chosen as treatment of choice in 2001
• No strains known to be resistant
4/20/2015
Clostridium
botulinum-
Anaerobic bacteria
Neurotoxins – A to
G
Incubation: 24 to 36
hrs
0.001 pg/kg of body
weight
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17
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18
 Vaccine :
• Every case of Foodborne botulism is treated as a
public health emergency. If antitoxin is needed, it can
be quickly delivered to a physician anywhere in the
country.
• Skin should be tested for hypersensitivity before
equine antitoxin is given.
 Mortality :
• Botulism can result in death due to respiratory failure.
• In the last 50 years, patients who die from botulism
have dropped from 50% to 8%.
4/20/2015
19
Extreme neuro-specificity: BoNTs are
being exploited in the treatment of a
myriad of neuromuscular disorders and for
the removal of facial wrinkles (BOTOX).
4/20/2015
20
4/20/2015
21
4/20/2015
22
Techniques
Binary
Biological
Weapons
Designer
Genes
Gene
Therapy
8. Genetically Engineered Bioweapons: A New Breed of Weapons for Modern Warfare. Mackenzie
Foley .Applied Sciences, Winter 2013 / March 10, 2013 4/20/2015
23
 The unfortunate fact
remain that humans
are often the most
sensitive or the only
detectors of the
biological attack.9
9. Department of the Army, Navy and the Air Force NATO Handbook on the medical aspects of NBC
Defensive operations,1996.
4/20/2015
24
 Not only human sample
 Powdery material, air/water samples
 Sample preparation- hours to days
 Sample collection, handling, transportation
and preparation- vital
 Conventional culture procedures- some virus
or bacteria
• Minimum: 3-7 to 15 days
• Skilled manpower
• No real time
4/20/2015
25
Detection in
the field with
limited or no
instruments
Accurate
Rapid
4/20/2015
26
• Natural prevalence of the disease
• Becton Dickinson (USA) , Vitek (BioMe’rieux)
and Microlog (USA)
• Pure culture and trained manpower 
Biochemical test
based assays
• Luciferin- luciferase interaction
• Quality control- bacterial contamination
• ATP contamination from non-microbial source

• Non-specific 
• First line defence 
Bioluminescence
based detection
4/20/2015
27
10. Immunoassay of infectious agents.Andreotti PE, Ludwig GV, Peruski AH, Tuite JJ, Morse SS, Peruski LF
Jr Biotechniques. 2003 Oct; 35(4):850-9.
11. A review of molecular recognition technologies for detection of biological threat agents.Iqbal SS, Mayo
MW, Bruno JG, Bronk BV, Batt CA, Chambers JP Biosens Bioelectron. 2000; 15(11-12):549-78.
• ELISA based
• Quality of antigen or antibody11
• Different substrate label i.e, fluroscent,
chemiluminescent and different platforms
like ELISA plate, Visual dot and lateral
flow format
• Only one agent at a time 
Antigen-
Antibody10
• Q-PCR assays-probes for all the agents
• Software: Monitors the progress and presence
detected online on a monitor
• Data transferred over long distance
• Variation with nucleic acids, availability of
starting material
• Inhibitory substances, specificity and
sensitivity of primers, probes and enzymes
used 
Nucleic
acid
based
4/20/2015
28
DRDE, Gwalior-
• Toxicology and biochemical pharmacology
• nanotechnology-based sensors
• unmanned robot-operated aerial and ground
vehicles fitted with NBC detection sensors
HSADL, Bhopal-
• animal diseases such as avian influenza, Nipah
virus infection, rabbit haemorrhagic fever, and
swine flu.
4/20/2015
29
4/20/2015
30

Biological Warfare Agents

  • 1.
  • 2.
    Several bacterial, viralagents and toxins- pose public health risk- bioterrorist attack1 14th century- siege of ukraine2 Fort Pitt, Ohio river valley3 Anthrax- 1979, Soviet Union Anthrax, botulinum and aflatoxin- 1995, Iraq 1. Bioterriorism: from threat to reality.Atlas RM Annu Rev Microbiol. 2002; 56():167-85. 2. Biological warfare. A historical perspective.Christopher GW, Cieslak TJ, Pavlin JA, Eitzen EM Jr. JAMA. 1997 Aug 6; 278(5):412-7. 3. Wheelis M. Biological warfare before 1914. In: Moon JE van Courtland., editor. Biological and toxin weapons: Research, development, and use from the middle ages to 1945. Vol. 1. Stockholm, Sweden: Stockholm International Peace Research Institute; 1991. pp. 8–34. 4/20/2015 2
  • 3.
    4. Why shouldwe be concerned about biological warfare?. Richard Danzig et al,. JAMA, Vol 278,No,5,pp. 431-432 Factors Easy delivery Low visibility, high potency Recipes – available on internet Extremely Low- technology methods concealment, transportatio n ,disseminatio n easy 4/20/2015 3
  • 4.
    4/20/2015 4 5. J PharmBioallied Sci. 2010 Jul-Sep; 2(3): 179–188.
  • 5.
  • 6.
  • 7.
  • 8.
    Disease Pathogen Abused AnthraxBacillus antracis (B) First World War Second World War Soviet Union, 1979 Japan, 1995 USA, 2001 Botulism Clostridium botulinum (T) – Plague Yersinia pestis (B) Fourteenth-century Europe Second World War Smallpox Variola major (V) Eighteenth-century N. America Tularemia Francisella tularensis (B) Second World War 6. The history of biological warfare. EMBO Rep. 2003 June; 4(Suppl 1): S47–S52 4/20/2015 8
  • 9.
    Agent Infective Dose (Aerosol) Incubation Period Diagnostic Assay Chemotherap y Anthrax 8,000-50,000 spores 1-5 d Ag-ELISA Ciproflaxin Doxycycline Penicillin Plaque 100-500 organisms 2-3 d Ag-ELISA Chlorampheni col Q-fever 1-10 organisms 10-40 d ELISA Tetracycline Small pox Assumed low 10-100 org 7-17 d ELISA,PCR, Virus isolation Cidofovir 7. Clinical Recognition and management of patients exposed to biological warfare agents. JAMA, Vol,278,No5.1997.pp.399-411 4/20/2015 9
  • 10.
    • A releaseof 50 kg agent in an area with population 5 million • Anthrax  250,000 cases -100,000 deaths  Plague  150,000 cases -36,000 deaths  Tularemia  250,000 cases -19,000 deaths 4/20/2015 10
  • 11.
  • 12.
     Gram-positive,  Endospore-forming, rod-shaped width of 1–1.2µm and a length of 3–5µm  Only obligate species on Bacillus 4/20/2015 12 6. The history of biological warfare. EMBO Rep. 2003 June; 4(Suppl 1): S47–S52
  • 13.
     Cell bindingprotein- Protective Antigen(PA)  Enzymes • Edema Factor (EF) • Lethal Factor (LF) 4/20/2015 13
  • 14.
    14 • 95% ofall cases globally • Incubation: 3-5 days (up to 12 days) • Spores enter skin through open wound or abrasion Large skin ulcer created • Fever and malaise  5% - 20% mortality • Untreated – septicemia and death. Cutaneous • Severe gastroenteritis • Incubation: 2-5 days after consumption of undercooked, contaminated meat • Case fatality rate: 25-75% Gastrointestinal • Incubation: 1-7 days • Phase 1: Nonspecific - Mild fever, malaise • Phase 2: Severe respiratory distress Cyanosis, death in 24-36 hours • Case fatality: 75-90% (untreated) Inhalational 4/20/2015
  • 15.
    15 Worst-case scenario (Office ofTechnology Assessment) • 50 kg of spores  Urban area of 5 million  250,000 cases of anthrax  100,000 deaths • 100 kg of spores  Upwind of Wash D.C.  130,000 to 3 million deaths 4/20/2015
  • 16.
    16 Vaccine – availablebut effectiveness unproven in humans (only monkeys) • 5-35% experience systemic side effects • No long-term side effects proven • Six shots plus annual booster required Penicillin • Has been the drug of choice • Some strains resistant to penicillin Ciprofloxacin • Chosen as treatment of choice in 2001 • No strains known to be resistant 4/20/2015
  • 17.
    Clostridium botulinum- Anaerobic bacteria Neurotoxins –A to G Incubation: 24 to 36 hrs 0.001 pg/kg of body weight 4/20/2015 17
  • 18.
  • 19.
     Vaccine : •Every case of Foodborne botulism is treated as a public health emergency. If antitoxin is needed, it can be quickly delivered to a physician anywhere in the country. • Skin should be tested for hypersensitivity before equine antitoxin is given.  Mortality : • Botulism can result in death due to respiratory failure. • In the last 50 years, patients who die from botulism have dropped from 50% to 8%. 4/20/2015 19
  • 20.
    Extreme neuro-specificity: BoNTsare being exploited in the treatment of a myriad of neuromuscular disorders and for the removal of facial wrinkles (BOTOX). 4/20/2015 20
  • 21.
  • 22.
  • 23.
    Techniques Binary Biological Weapons Designer Genes Gene Therapy 8. Genetically EngineeredBioweapons: A New Breed of Weapons for Modern Warfare. Mackenzie Foley .Applied Sciences, Winter 2013 / March 10, 2013 4/20/2015 23
  • 24.
     The unfortunatefact remain that humans are often the most sensitive or the only detectors of the biological attack.9 9. Department of the Army, Navy and the Air Force NATO Handbook on the medical aspects of NBC Defensive operations,1996. 4/20/2015 24
  • 25.
     Not onlyhuman sample  Powdery material, air/water samples  Sample preparation- hours to days  Sample collection, handling, transportation and preparation- vital  Conventional culture procedures- some virus or bacteria • Minimum: 3-7 to 15 days • Skilled manpower • No real time 4/20/2015 25
  • 26.
    Detection in the fieldwith limited or no instruments Accurate Rapid 4/20/2015 26
  • 27.
    • Natural prevalenceof the disease • Becton Dickinson (USA) , Vitek (BioMe’rieux) and Microlog (USA) • Pure culture and trained manpower  Biochemical test based assays • Luciferin- luciferase interaction • Quality control- bacterial contamination • ATP contamination from non-microbial source  • Non-specific  • First line defence  Bioluminescence based detection 4/20/2015 27
  • 28.
    10. Immunoassay ofinfectious agents.Andreotti PE, Ludwig GV, Peruski AH, Tuite JJ, Morse SS, Peruski LF Jr Biotechniques. 2003 Oct; 35(4):850-9. 11. A review of molecular recognition technologies for detection of biological threat agents.Iqbal SS, Mayo MW, Bruno JG, Bronk BV, Batt CA, Chambers JP Biosens Bioelectron. 2000; 15(11-12):549-78. • ELISA based • Quality of antigen or antibody11 • Different substrate label i.e, fluroscent, chemiluminescent and different platforms like ELISA plate, Visual dot and lateral flow format • Only one agent at a time  Antigen- Antibody10 • Q-PCR assays-probes for all the agents • Software: Monitors the progress and presence detected online on a monitor • Data transferred over long distance • Variation with nucleic acids, availability of starting material • Inhibitory substances, specificity and sensitivity of primers, probes and enzymes used  Nucleic acid based 4/20/2015 28
  • 29.
    DRDE, Gwalior- • Toxicologyand biochemical pharmacology • nanotechnology-based sensors • unmanned robot-operated aerial and ground vehicles fitted with NBC detection sensors HSADL, Bhopal- • animal diseases such as avian influenza, Nipah virus infection, rabbit haemorrhagic fever, and swine flu. 4/20/2015 29
  • 30.