Biological weapons recognizing, understanding and responding to the threat 2nd edition (2016)

BIOLOGICAL WEAPONS WILEY SERIES IN HOMELAND AND DEFENSE SECURITY Series Editor TED LEWIS Professor, Naval Postgraduate School Foundations of Homeland Security: Law and Policy / Marin J Alperen, Esq Comparative Homeland Security: Global Lessons / Nadav Morag Biological Weapons: Recognizing, Understanding, and Responding to the Threat / Kristy Young Johnson, Paul Matthew Nolan BIOLOGICAL WEAPONS Recognizing, Understanding, and Responding to the Threat KRISTY YOUNG JOHNSON, Ph.D PAUL MATTHEW NOLAN, Ph.D The Citadel Charleston, South Carolina Copyright © 2016 by John Wiley & Sons, Inc All rights reserved Published by John Wiley & Sons, Inc., Hoboken, New Jersey Published simultaneously in Canada No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, scanning, or otherwise, except as permitted under Section 107 or 108 of the 1976 United States Copyright Act, without either the 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Hoboken, N.J : Wiley, 2016 | Series: Wiley series on homeland defense and security | Includes bibliographical references and index Identifiers: LCCN 2015051189| ISBN 9781118830598 (hardback) | ISBN 9781119085317 (epub) Subjects: LCSH: Biological weapons–Health aspects | Bioterrorism–Health aspects | Biological warfare–Health aspects | BISAC: POLITICAL SCIENCE / Political Freedom & Security / Terrorism Classification: LCC RA647 J65 2016 | DDC 363.325/3–dc23 LC record available at http://lccn.loc.gov/2015051189 Typeset in 10/12pt TimesLTStd by SPi Global, Chennai, India Printed in the United States of America 10 We dedicate this book to first responders everywhere May they never face any of the agents discussed herein ABBREVIATED TABLE OF CONTENTS INTRODUCTION UNIT I AGENTS, IMMUNITY, AND AGENCIES Bacteria, Toxins, and Viruses The Human Immune System 27 Defense Agencies 37 UNIT I REVIEW 51 UNIT II 53 BACTERIA Anthrax 55 Plague 75 Tularemia 91 Cholera UNIT II REVIEW 103 117 viii ABBREVIATED TABLE OF CONTENTS UNIT III TOXINS 119 Ricin 121 Botulinum Toxin 135 10 Staphylococcal Enterotoxin B 151 UNIT III REVIEW 161 UNIT IV VIRUSES 163 11 Ebola 165 12 Smallpox 179 13 Hantavirus 199 14 Viral Encephalitis 211 15 Nipah Virus 221 16 Lassa Fever 231 17 Marburg Virus 243 UNIT IV REVIEW 255 18 259 Looking Ahead: Policies, Procedures, and Prevention GLOSSARY 321 Botulism—temporary muscle paralysis caused by botulinum toxin Botulus—Latin word for “sausage” Brackish water—water with salinity higher than that of freshwater but lower than that of saltwater; often occurs where freshwater and saltwater mix Bradford Rules—safety regulations developed to prevent workplace exposure to anthrax endospores Bronchopneumonia—acute inflammation of the lungs Bruce Ivins—scientist allegedly responsible for anthrax attacks of 2001; died before being charged Bubo—swollen lymph nodes associated with plague; extremely painful Bubonic plague—bacterial infection resulting from a flea bite; cause of the Black Death in the Middle Ages Bunyaviridae—family of viruses that includes hantavirus Caffa—city attacked by Tatar army in 14th century; corpses of plague victims launched into the city by Tatars Capillaries—tiny blood vessels that connect arteries to veins Castor bean plant—common name of Ricinus communis Castor oil—product of Ricinus communis; many commercial uses Category A weapons—biological or toxin agents that are easily disseminated or can spread from person to person and have high mortality rates Category B weapons—biological or toxin agents that are moderately easy to disseminate and cause moderate morbidity and low mortality rates Category C weapons—new or emerging biological or toxin agents that are reasonably available, easy to produce and disseminate, and have potentially high morbidity and mortality rates Cefazolin—antibiotic useful in the treatment of a variety of bacterial infections Cell membrane—biological membrane that separates contents of a cell from the environment; also called the plasma membrane Cell wall—tough, flexible, polysaccharide layer outside the cell membrane of bacterial cells Chickenpox—viral infection that is highly contagious; causes itchy blisters on skin Chloramphenicol—antibiotic useful in the treatment of a variety of bacterial infections Cholera—infection with Vibrio cholerae bacteria Cholera gravis—severe form of cholera involving extensive dehydration Chromosomes—threadlike structures in cell nuclei; composed of DNA coiled around histones Cidofovir—injectable antiviral medication Cilia—hair-like structures found on some eukaryotic cells; may be motile Ciprofloxacin—antibiotic useful in the treatment of a variety of bacterial infections; given to anyone exposed to anthrax; also called cipro Classical smallpox—most common presentation of smallpox 322 GLOSSARY Clostridium botulinum—anaerobic bacteria that produces botulinum toxin Coccobacilli—oval-shaped bacteria Coccus—sphere-shaped bacteria Communicability—the ability to spread from person to person Conjunctiva—membrane covering the surface of the eyeball and the inside of the eyelids Convalescence—recovery from an injury or disease Convention on the Prohibition of the Development, Production, and Stockpiling of Bacteriological (Biological) and Toxin Weapons and on Their Destruction—see Biological and Toxin Weapons Convention Cowpox—virus with structure similar to smallpox; used for smallpox vaccination Cutaneous anthrax—sores that develop from the entry of Bacillus anthracis into broken skin Cytoplasm—viscous fluid inside the cell membrane of all cells Dan Roberts—Georgia man convicted of plotting to use ricin against federal officials Date palm—tree common in Bangladesh; sap is routinely consumed by humans but can be contaminated with Nipah virus Deoxyribonucleic acid—nucleic acid molecule composed of nucleotides; contains heritable genetic information Diagnostic stains—chemicals used for viewing specific cell types or structures Diaphragm—the muscle that contracts to inflate the lungs DIC—see disseminated intravascular coagulation Disseminated intravascular coagulation—condition of widespread, erroneous initiation of blood clotting; can result in uncontrollable bleeding Diuresis—increased urine production DNA—see deoxyribonucleic acid Doxycycline—antibiotic useful in the treatment of a variety of bacterial infections Eastern Equine Encephalitis Virus—disease spread by mosquitoes in the eastern United States; commonly affects humans and horses; moderate mortality in humans Ebola—group of hemorrhagic viruses first identified near the Ebola River Ebola Bundibugyo—strain of Ebola first identified in Bundibugyo District of Uganda Ebola Reston—strain of Ebola first identified in Reston, Virginia; asymptomatic in humans Ebola Sudan—strain of Ebola first identified in Sudan; high mortality Ebola Taï Forest—strain of Ebola first identified in the Ivory Coast region of Africa; formally known as Ebola Ivory Coast Ebola Zaire—strain of Ebola first identified in Zaire; first strain of Ebola ever identified; very high mortality Ecchymosis—large bruise Edema—fluid accumulation in bodily tissues GLOSSARY 323 Edema factor—one of three proteins that make up toxin produced by Bacillus anthracis Edward Francis—scientist who discovered the cause of tularemia Edward Jenner—scientist who developed use of cowpox for vaccination against smallpox EEEV—see Eastern Equine Encephalitis Virus Electron microscope—apparatus that uses electrons to form images of specimens; capable of very high magnification and resolution Encephalitis—inflammation of brain tissue Endemic—commonly found in a given area Endospores—structures formed by some bacteria in response to unfavorable environmental conditions; virtually indestructible by natural means Endotoxin—toxic molecule bound to outer membrane of some bacteria Enterotoxin—bacterial toxin that attacks cells of the intestines Enzymes—proteins that speed up chemical reactions in cells Eosinophil—leukocyte involved in allergic reactions and parasitic infections Erythrocytes—red blood cells responsible for transporting oxygen to body cells Eschar—black scab that forms in sores of cutaneous anthrax Eukaryotic—cells with membrane-bound organelles Everett Dutschke—Mississippi man convicted in 2014 of sending letters containing anthrax to President Barack Obama and other government officials Exocytosis—process of transporting material out of a cell; vesicle containing material fuses to cell membrane, releasing contents to extracellular environment Exsanguination—fatal blood loss Fallen Angel—unidentified person responsible for sending ricin to postal facility in South Carolina in 2003 Fever—elevated body temperature FIBWA—see Field Identification of Biological Warfare Agents Field Identification of Biological Warfare Agents—courses offered through USAMRIID for training personnel to detect and identify biological warfare agents in the field Fillipo Pacini—first person to isolate Vibrio cholerae as the cause of cholera; not initially acknowledged Filoviridae—family of filament-shaped RNA viruses; includes Ebola and Marburg Flat-type smallpox—rare presentation of smallpox in which macules not become raised; very high mortality Fomite—inanimate object or substance that can transmit an infectious agent from person to person Foodborne botulism—botulism caused by ingesting botulinum toxin Francisella tularensis—bacteria responsible for causing tularemia or “rabbit fever” Frederick Thomas—Georgia man convicted of plotting to use ricin against federal officials 324 GLOSSARY Fulminant—severe; sudden onset Gastrointestinal anthrax—symptoms of anthrax resulting from ingesting raw or undercooked meat contaminated with Bacillus anthracis General Jeffrey Amherst—British officer who allegedly used smallpox against Native Americans during the French and Indian War Gene—segment of chromosomes that contains hereditary information for the production of protein or RNA Genetic mutations—heritable errors in DNA nucleotide sequences Genetic sequence—linear order of nucleotides in DNA Geneva Protocol—agreement not to use biological or chemical weapons; signed in 1925 at League of Nations conference in Geneva, Switzerland Gentamicin—antibiotic useful in the treatment of a variety of bacterial infections Georgi Markov—Bulgarian dissident assassinated with ricin in London in 1978 Gram negative—bacteria with a thin peptidoglycan layer; stain pink with the Gram stain Gram positive—bacteria with a thick peptidoglycan layer; stain purple with the Gram stain Gram stain—procedure for initial identification of bacterial species Gruinard Island—land mass off the coast of Scotland used by British military for testing anthrax; quarantined for 48 years Hantaan—Old-world hantavirus strain that caused Korean Hemorrhagic Fever Hantavirus—RNA virus carried by rodents; some strains are pathogenic in humans Hantavirus Cardiopulmonary Syndrome—disease caused by infection with a New-world hantavirus strain; moderate mortality rates Hantavirus Pulmonary Syndrome—disease also known as Hantavirus Cardiopulmonary Syndrome HCPS—see Hantavirus Cardiopulmonary Syndrome Hemorrhagic Fever with Renal Syndrome—disease caused by infection with an Old-world hantavirus strain; low mortality rates Hemorrhagic-type smallpox—rare presentation of smallpox that involves profuse internal bleeding; very high mortality HFRS—see Hemorrhagic Fever with Renal Syndrome Histamine—chemical released by basophils as part of the inflammatory response Host range—spectrum of species that can be infected by a pathogen HPS—see Hantavirus Pulmonary Syndrome Hyperinfectious—state of being more capable than usual of causing infection Hypertension—high blood pressure Hypotension—low blood pressure Immunoglobulins—antibodies; proteins produced by B-lymphocytes to combat infections Inhalational botulism—botulism caused by inhaling botulinum toxin GLOSSARY 325 Institute of Virus Preparations—one of two locations where the smallpox virus is legally stored; located in Moscow Intercostal muscles—muscles of the rib cage; necessary for breathing Intestinal botulism—botulism caused by ingesting live Clostridium botulinum bacteria Ischemia—lack of blood flow to body cells or tissues JBAIDS—see Joint Biological Agent Identification and Diagnostic System John H Bell—doctor who proposed Bradford Rules to prevent occupational exposure to anthrax John Snow—doctor who pinpointed a water pump as the source of a cholera outbreak in London in 1854 Joint Biological Agent Identification and Diagnostic System—portable instrument for rapid identification of biological agents; used by the Department of Defense Joseph Mountin—founder of the Centers for Disease Control and Prevention Justinian Plague—plague pandemic that affected the Eastern Roman Empire in the 6th century Justinus Kerner—German medical officer who characterized botulism from eating improperly cured sausage Korean Hemorrhagic Fever—HFRS caused by Hantaan virus Lassa fever—hemorrhagic disease caused by Lassa virus League of Nations—international organization founded in 1920 and headquartered in Geneva, Switzerland Lethal factor—one of three proteins that make up toxin produced by Bacillus anthracis Leukocytes—white blood cells that function as part of the immune system Light microscope—instrument that uses light to view a specimen; capable of moderate magnification and resolution Lipid—naturally occurring hydrocarbon molecule; common types of lipids include fats, oils, waxes, sterols, hormones, and phospholipids Liver—organ responsible mainly for filtering blood coming from the digestive tract, manufacturing proteins involved in blood clotting, detoxifying chemicals, metabolizing drugs, and manufacturing bile Lung—spongy organ filled with alveoli for gas exchange Lymph nodes—clusters of lymphatic tissue located throughout the human body Macrophage—monocyte that has migrated into tissue; engulfs microbes and cell debris Macules—flat lesions on the skin seen in smallpox Marburg virus—virus carried by African fruit bats; produces severe hemorrhagic disease in humans and nonhuman primates MCBC—see Medical Management of Chemical and Biological Casualties Medical Management of Chemical and Biological Casualties—training course offered by USAMRIID and the US Army Medical Research Institute for Chemical Defense 326 GLOSSARY Microgram—one-millionth (10−6 ) of a gram; μg Modified-type smallpox—mild smallpox presentation that often occurs in vaccinated individuals; no mortality Monkeypox—virus similar to smallpox but causing milder symptoms in humans Monocyte—circulating leukocyte that helps T lymphocyte recognize pathogens Morbidity—causing sickness Mortality—causing death Multimammate rat—rodent common in western Africa; carrier of Lassa virus Myalgia—muscle pain Myasthenia gravis—autoimmune disease causing weakness of skeletal muscles Nanogram—one-billionth (10−9 ) of a gram; ng National Institutes of Health—United States Department of Health and Human Services biomedical research facility in Bethesda, Maryland Natural Killer cell—type of leukocyte that aids T lymphocytes in destroying cancer cells and virus-infected cells Necropsy—postmortem examination of an animal Necrosis—the death of body cells or tissues; results from injury or lack of blood flow Neuron—nerve cell Neurotoxin—toxin that targets neurons Neurotransmitter—signaling chemical released from neurons Neutrophils—leukocyte that targets bacteria and fungi; the main component of pus New-World hantavirus—strain of hantavirus found in North, Central, or South America; causes Hantavirus Cardiopulmonary Syndrome Nicholas Helman—Pennsylvania teenager who sent a card laced with ricin to a rival in 2014 NIH—see National Institutes of Health Nipah virus—virus carried by fruit bats; causes severe disease in pigs and humans Nucleotide—subunit of the DNA polymer Nucleus—membrane-bound organelle that contains genetic material in eukaryotic cells Oladevi—the goddess of cholera Old-World hantavirus—strain of hantavirus found in Europe, Asia, and Africa; causes Hemorrhagic Fever with Renal Syndrome Olfactory nerve—sensory nerve that carries information about smells to the brain Oliguria—reduced urine production Ordinary type smallpox—most common symptoms associated with Variola major infection Organelle—intracellular structure with specific function Orthopoxvirus—category of viruses that includes cowpox and smallpox Pandemic—widespread infectious disease, usually on multiple continents or worldwide GLOSSARY 327 Papule—small raised area of skin; not fluid-filled Pathogen—infectious agent that causes disease in a host Peptidoglycan—layer of sugars and amino acids outside the cell membrane of bacteria Pestis—Latin word for pestilence or plague Pharaoh Ramses V—Egyptian king who likely died from smallpox in the 12th century B.C Plague—infection with Yersinia pestis bacteria Plasma cell—differentiated B lymphocyte that can manufacture antibodies Plasmid—circular DNA molecule found in bacteria; can be transferred to other bacterial cells Pneumonic plague—respiratory infection with Yersinia pestis; high mortality Polysaccharide—molecule composed of many sugar molecules linked together Polyuria—greatly increased urine production Prokaryotic—single-celled organisms without membrane-bound organelles Protective antigen—one of three proteins that make up toxin produced by Bacillus anthracis Pulmonary anthrax—respiratory infection with Bacillus anthracis; high mortality Pulmonary edema—fluid accumulation in the lungs Ragpicker’s disease—anthrax; common in tannery workers Ray Adams—Georgia man convicted of plotting to use ricin against federal officials Red blood cells—see erythrocytes Reservoir host—species that is commonly infected by a pathogen but is not harmed Retrovirus—a type of virus that contains RNA instead of DNA Ribavirin—medication that inhibits some viruses Ribonucleic acid—nucleic acid used in the production of proteins from genes Ribosome—cell organelle involved in protein assembly Rice-water feces—watery feces typical of cholera infection Ricin—potent toxin produced by the castor bean plant Ricin subunit A—one of two protein chains that make up the ricin toxin Ricin subunit B—one of two protein chains that make up the ricin toxin Ricinus communis—plant that produces ricin Ring vaccination—strategy of vaccinating everyone who may have had contact with an infected individual in an attempt to halt the spread of an infectious agent RNA—see ribonucleic acid Robert Koch—scientist who isolated Vibrio cholerae as the cause of cholera decades after Fillipo Pacini’s report; widely acknowledged for discovering V cholerae Roger Wicker—republican senator from Mississippi who received a letter laced with ricin in 2013 Sadie Holland—Mississippi judge who received a letter laced with ricin in 2013 Saliva—watery fluid secreted into the mouth to aid in swallowing and digesting food 328 GLOSSARY Samuel Crump—Georgia man convicted of plotting to use ricin against federal officials Sarin—man-made chemical weapon that acts as a potent nerve agent Scanning electron microscope—powerful microscope that forms an image by scanning the surface of an object with a focused beam of electrons SEB—see Staphylococcal enterotoxin B SEB conjunctivitis—inflammation of the conjunctiva associated with exposure to Staphylococcal enterotoxin B SEB food poisoning—gastrointestinal distress associated with Staphylococcal enterotoxin B ingestion SEB respiratory syndrome—inflammation of the respiratory tract associated with inhalation of Staphylococcal enterotoxin B SEM—see scanning electron microscope Sepsis—dangerous condition of the body fighting a widespread infection that spreads through the bloodstream Septicemic plague—infection with Yersinia pestis circulating throughout the body; high mortality Seroprevalence—frequency of people in a given population with antibodies to a specific agent in their serum Sin Nombre virus—strain of hantavirus that causes HCPS; found in the Four Corners region of the United States Smallpox—infection caused by Variola major virus Smallpox Eradication Program—effort by the WHO to remove smallpox from the human population Species—group of similar organisms Spirillum—Gram-negative, spiral-shaped bacteria Spleen—lymphatic organ with primary function of filtering blood Sputum—mucus coughed up from the lower respiratory tract Staphylococcal enterotoxin B—toxin produced by Staphylococcus aureus; causes food poisoning and Toxic Shock Syndrome Staphylococcus aureus—Gram-positive bacteria commonly found on skin Steven J Hatfill—scientist intensely investigated for involvement in anthrax attacks of 2001; no charges filed against him Strabismus—crossed eyes Strain—a genetic variant of virus or bacteria Streptomycin—antibiotic useful in treating a wide variety of bacterial infections Stroke—lack of blood flow to the brain Superantigen—molecule that causes an intense response from the immune system Sverdlovsk—Russian city that experienced an outbreak of anthrax in 1979 Symbiotic—relationship between two species that benefits both species T lymphocyte—leukocyte produced in the bone marrow that matures in the thymus before circulating in the bloodstream GLOSSARY 329 Tatar Muslims—soldiers who used corpses of plague victims as weapons against the city of Caffa in the 14th century TEM—see transmission electron microscope Tetanus—infection caused by Clostridium bacteria; causes rigid muscle paralysis Tetracycline—antibiotic useful in treating a wide variety of bacterial infections Thymus—lymphoid organ where T-lymphocytes mature Tom Ridge—first Director of the Department of Homeland Security Toxic Shock Syndrome—potentially fatal disease caused by a bacterial toxin; often caused by Staphylococcus enterotoxin B Toxin—poison produced in nature Trachea—the windpipe; connects the nose and mouth to the lungs Transmission electron microscope—powerful microscope that forms an image by transmitting a focused beam of electrons through an ultra-thin slice of an object Tremor—involuntary, rhythmic back and forth motion or twitching Tulare County—county in California after which tularemia is named Tularemia—infection with Francisella tularensis bacteria; also known as “rabbit fever” Tularemia sepsis—serious condition resulting from Francisella tularensis bacteria circulating in the bloodstream Unit 731—Japan’s biological weapons research facility during WWII United States Army Medical Research Institute of Infectious Diseases—the US Army’s biodefense program; researches vaccines and treatments for biological agents USAMRIID—see United States Army Medical Research Institute of Infectious Diseases Vacca—Latin term for “cow” Vaccine—medical procedure for exposing a person to a weakened or killed biological agent or a portion of the agent to allow the immune system to build a defense against the agent without danger of disease Variola major—virus that causes fulminant smallpox Variola minor—virus that causes only very mild smallpox symptoms Variola sine eruption—presentation of smallpox with fever but no rash; usually occurs in vaccinated individuals Variolation—process of inhaling powdered scabs from smallpox victims to prevent future infection with Variola major Varius—Latin term for “spotted” Vasopressor—medication that raises low blood pressure to normal levels Vector—an organism capable of transmitting a pathogen between other organisms, often from reservoir to host Vector Institute—biodefense agency located in Russia; one of two locations allowed to harbor variola major; also known as the State Research Center of Virology and Biotechnology 330 GLOSSARY VEEV—see Venezuelan Equine Encephalitis Virus Venezuelan Equine Encephalitis Virus—disease spread by mosquitoes in Central and South America; commonly affects humans and horses; low mortality in humans Vesicle—membrane-bound sac inside a cell Vibrio—comma-shaped bacteria Vibrio cholerae—bacillus bacteria that causes cholera Virions—new virus particles produced by infected cells Virus—biological agent consisting of genetic material encased in protein Vozrozhdeniye Island—land mass in the Aral Sea; site of Soviet testing of weaponized smallpox Weaponized—quality of a biological weapon that makes it easy to disseminate WEEV—see Western Equine Encephalitis Virus Western Equine Encephalitis Virus—disease spread by mosquitoes in the western United States; commonly affects humans and horses; low mortality in humans White blood cells—see leukocytes WHO—see World Health Organization Woolsorter’s disease—anthrax; common in workers who processed wool World Health Organization—international agency that monitors health conditions and biological threats throughout the world Wound botulism—botulism caused by live Clostridium botulinum bacteria or the botulinum toxin contacting broken skin Yekaterinburg—the fourth-largest city in Russia; named Sverdlovsk from 1924 to 1991 Yersinia pestis—bacteria that causes plague INDEX Note: page numbers followed by f indicate figures 1925 Geneva Protocol, 47, Appendix III aerobe, 11 African fruit bat, 245 Alexander Fleming, 13, 14f Alexandre Yersin, 76–77, 78f , 84 alphavirus, 212 alveoli, 28, 63, 81 Amerithrax, 66, Appendix VI Ames strain, 57f , 66 anaerobe, 11 Andes virus (ANDV), 202, 207 anthrax, 13, 14, 38, 40, 43, 56–71, Appendix VI antibiotic resistance, 14 antibiotics, 13, 15, 63 antibody, 28, 32 antigen, 28 antitoxin, 16, 142, 144–145 antivirals, 20 Arenaviridae, 232 arthralgia, 33 attenuated, 21 Aum Shinrikyo, 66, 146 autoimmune, 32 axon, 138 azithromycin, 109 B lymphocyte, 32 bacillus, 8, 10 Bacillus anthracis, 14, 38, 40, 56–71 bacteriophage, 17 BAIT see Biological Agent Identification and Counterterrorism Training (BAIT) basophil, 32, 34 biofilm, 105 Biological Agent Identification and Counterterrorism Training (BAIT), 44 Biological and Toxin Weapons Convention, 37, 237 biopreparat, 48 black death, 76, 79, 84 black tar heroin, 141 blepharospasm, 138 blood-brain barrier, 222 Botox™, 138, 140 botulinum toxin, 135–147 botulism, 16, 17, 38, 40, 43, 135–147 botulus, 145 Bradford Rules, 58 bronchopneumonia, 81 Bruce Ivins, 68, 71f , Appendix VI bubo, 79–80 Biological Weapons: Recognizing, Understanding, and Responding to the Threat, First Edition Kristy Young Johnson and Paul Matthew Nolan © 2016 John Wiley & Sons, Inc Published 2016 by John Wiley & Sons, Inc Companion Website: http://www.wiley.com/go/Johnson/BiologicalWeapons 332 bubonic plague, 79–87 Bunyaviridae, 200 Caffa, 83 castor bean plant, 122 castor oil, 122, 125 category A, 38, 40 category B, 38, 40 category C, 39, 40 centers for disease control (CDC), 37, 39, 41, 77, 93, 104, 122, 137, 152, 167, 180, 200, 212, 222, 226, 232, 234, 236, 245 chickenpox, 183–184 chloramphenicol, 82, 97 cholera, 14, 30, 40, 103–113 cholera gravis, 108 chromosome, 8, 21, 22 cidofovir, 188 ciprofloxacin, 64–65, 97, 109 classical smallpox, 183–186 Clostridium botulinum, 17, 38, 40, 135–147, 137f coccobacillus, 8, 76, 92 coccus, 8, 10 communicability, 19 conjunctiva, 155 convalescence, 203 Convention on the Prohibition of the Development, Production, and Stockpiling of Bacteriological (Biological) and Toxin Weapons and on Their Destruction, 47, Appendix V cowpox, 189, 190 cutaneous anthrax, 60–62, 64–65 Dan Roberts, 129 date palm, 222 deoxyribonucleic acid, Department of Homeland Security (DHS), 37, 45, 46 disseminated intravascular coagulation, 97 diuresis, 203 DNA, 17, 22 doxycycline, 64–65, 97 Eastern Equine Encephalitis Virus (EEEV), 21, 40, 212–213f , 212–217 Ebola, 12, 17, 18, 21, 38, 40, 43, 44, 165–175, 166f , 244, 251 Ebola Bundibugyo, 167, 174 Ebola Reston, 18, 45, 167, 172–173, 259 Ebola Sudan, 167, 171 Ebola Taï Forest, 167, 173–174 Ebola Zaire, 17, 167, 171–172, 174, 259 ecchymosis, 247 edema, 60 INDEX edema factor, 60 Edward Francis, 93 Edward Jenner, 188–189f EEEV see Eastern Equine Encephalitis Virus (EEEV) encephalitis, 212 endospore, 12, 13, 56–71 endotoxin, 77 enterotoxin, 152 eosinophil, 32–33 eschar, 61–62f Everett Dutschke, 130 Fallen Angel, 129 Feodosia, 83 Field Identification of Biological Warfare Agents (FIBWA), 44 Fillipo Pacini, 104 Filoviridae, 166, 244 flat-type smallpox, 183, 185, 186 fomite, 11 foodborne botulism, 139–140 Fort Detrick, 65 four corners, 205f Fracisella tularensis, 14, 38, 40, 92–100 Frederick Thomas, 129 gastrointestinal anthrax, 60–64 genetic sequence, 21 Geneva protocol see 1925 Geneva protocol gentamicin, 82, 97 Georgi Markov, 121–123f , 128 graft-vs.-host disease, 32 gram negative, 8, 10, 11 gram positive, 8, 10, 11 gram stain, Gruinard Island, 58–59f Hantaan, 205 Hantavirus, 21, 40, 43, 199–207, 201f Hantavirus Cardiopulmonary Syndrome (HCPS), 201, 203, 205–207 Hantavirus Pulmonary Syndrome (HPS), 201, 204 HCPS see Hantavirus Cardiopulmonary Syndrome (HCPS) Hemorrhagic Fever with Renal Syndrome (HFRS), 201–203 hemorrhagic-type smallpox, 183, 185, 186 Hendra virus, 222 HFRS see Hemorrhagic Fever with Renal Syndrome (HFRS) histamine, 32 HPS see Hantavirus Pulmonary Syndrome (HPS) hyperinfectious, 106 333 INDEX hypertension, 203 hypotension, 203 immunoglobulins, 32 inhalational botulism, 139, 141–142 institute of virus preparations, 190 intercostal muscles, 142, 144f intestinal botulism, 139–140 James Phipps, 189 JBAIDS see Joint Biological Agent Identification and Diagnostic System (JBAIDS) Jeffrey Amherst, 192 John H Bell, 58 John Snow, 111–112 Joint Biological Agent Identification and Diagnostic System (JBAIDS), 43 Joseph Mountin, 38–39f Justinian Plague, 82–83 Justinus Kerner, 145–146f Korean Hemorrhagic Fever, 205 Lassa fever, 21, 38, 40, 231–239, 232f League of Nations, 47 lethal factor, 60 lymph nodes, 29, 32 lymph nodules, 29 macrophage, 32 macules, 183 Marburg virus, 21, 38, 40, 243–252, 245f Medical Management of Chemical and Biological Casualties (MCBC), 43 modified-type smallpox, 183, 185–186 multimammate rat, 233f myalgia, 33 National Institutes of Health (NIH), 193 natural killer, 32 necropsy, 216 necrosis, 16 neurotoxin, 17, 38, 138 neurotransmitter, 138–139 neutrophils, 30 New-World hantavirus, 201 Nicholas Helman, 130 NIH see National Institutes of Health (NIH) Nipah virus, 21, 40, 221–227, 223f Oladevi, 104 Old-World hantavirus, 200–202 olfactory bulb, 214–215f , 222 oliguria, 203 ordinary type smallpox, 184 orthopoxvirus, 181 pandemic, 77, 82–87 papule, 183–184 Paramyxoviridae, 222 peptidoglycan, 8, 10 phage, 17, 19 plague, 8, 11, 14, 38, 40, 43, 75–87 plasma cell, 32 plasmid, 8, 9f pneumonic plague, 79, 81–82 polyuria, 204 protective antigen, 60 pulmonary anthrax, 60, 63–65 pulmonary edema, 203 Python Cave, 243–244 Ragpicker’s disease, 58 Ramses V, 18, 20f , 188 Ray Adams, 129 reservoir host, 11 Reston, 172–173f retrovirus, 17 ribavirin, 205, 235 ribonucleic acid, 17 rice-water feces, 108 ricin, 17, 40, 43, 121–130 ricin subunit A, 124 ricin subunit B, 124 Ricinus communis, 17, 40, 122, 124f ring vaccination, 41, 189 RNA, 17 Robert Koch, 104, 106f Roger Wicker, 130 Sadie Holland, 130 Samuel Crump, 129 SEB see Staphylococcal enterotoxin B (SEB) SEB conjunctivitis, 155 SEB food poisoning, 153 SEB respiratory syndrome, 155 septicemic plague, 79–82 seroprevalence, 202 Sin Nombre virus (SNV), 206 smallpox, 18–21, 38, 40, 179–194 smallpox eradication program, 41 SNV see Sin Nombre virus (SNV) spirillum, 8, 10 spleen, 32 Staphylococcal enterotoxin B (SEB), 17, 40, 43, 151–157 Staphylococcus aureus, 152–154f , 153f 334 State Research Center of Virology and Biotechnology, 41 Steven J Hatfill, 67–68, Appendix VI strabismus, 188 streptomycin, 82, 92, 97 superantigen, 152 Sverdlovsk, 65 symbiotic, T lymphocyte, 32 tetracycline, 109 thymus, 32 Tom Ridge, 45f toxic shock syndrome, 152 tremor, 235 Tulare County, 93–94f tularemia, 14, 38, 40, 92–100 tularemia sepsis, 97 unit, 65, 87, 97, 145, 731 United States Army Medical Research Institute of Infectious Diseases (USAMRIID), 37, 42, 43, 67, 259 INDEX Variola major, 21, 38, 40, 180, 181f Variola minor, 180 Variola sine eruption, 183, 186–187 variolation, 188–189 varius, 180 Vector Institute, 41 Venezuelan Equine Encephalitis Virus (VEEV), 21, 40, 212–217 vibrio, 8, 10 Vibrio cholerae, 14, 40, 103–113, 105f viral encephalitis, 21, 40, 211–217 virion, 18 Vozrozhdeniye Island, 193 Western Equine Encephalitis Virus (WEEV), 21, 40, 212–213, 215–217 Wool-sorter’s disease, 58 World Health Organization (WHO), 37, 40, 41f wound botulism, 139, 141 Yambuku Mission Hospital, 171 Yekaterinburg, 65, 66f Yersinia pestis, 14, 38, 40, 75–87 WILEY END USER LICENSE AGREEMENT Go to www.wiley.com/go/eula to access Wiley’s ebook EULA ... Homeland Security: Global Lessons / Nadav Morag Biological Weapons: Recognizing, Understanding, and Responding to the Threat / Kristy Young Johnson, Paul Matthew Nolan BIOLOGICAL WEAPONS Recognizing,. .. battlefield but in a laboratory, and their outcome could very well mean the extinction of the human race THE THREAT Biological weapons are a very real threat to the societies around the world Some agents... suspected agents of biological terrorism Biological Weapons: Recognizing, Understanding, and Responding to the Threat, First Edition Kristy Young Johnson and Paul Matthew Nolan © 2016 John Wiley & Sons,