Decontamination During Human Biological Incidents

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Decontamination During Human Biological Incidents

• Presented by
• The Ohio Department of Health
• Disaster Preparedness Response Program

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Our Decontamination Focus

• Nuclear devices/material
• Biological weapons
• Chemical weapons

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Potential List of Biological Agents

• Anthrax (bacteria)
• Plague (bacteria)
• Smallpox (virus)
• Ebola/Other Viral Hemorrhagic Fevers (virus)
• Ricin (toxin)
• Botulinum (toxin)

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About Biologicals

• Biological incidents involve bacteria, viruses
  and toxins
• Detection monitors are currently unavailable
• Most likely dispersed as aerosols with simple
  technologies
• Yard sprayers
• A plane or boat upwind
• Might be delivered by oral ingestion

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About Biologicals

• Routes of entry
• Deliberate incident is usually through inhalation
  ingestion
• Infectious versus communicable
• Usually have an incubation period

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Decon/Infection Control

• Decon The process of removing or neutralizing
  an external hazard from a person, the property or
  the environment.
• Disinfection Selective elimination of
  undesirable microorganisms to prevent their
  transmission (or removal of infectious organisms
  below necessary level to cause infection).
• Sterilization Complete killing of all organisms.

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Decontamination after Biological Release

• Material
• often unnecessary
• less relevant than for chemical attack
• 5.0 bleach more than adequate
• 0.1 bleach kills anthrax spores

• People
• decon rarely needed
• less relevant than for chemical attack
• soap and water

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Key Points

• Biological decon is different from chemical decon
• People can be injured by inappropriate decon
• Physical harm
• Psychological harm

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Decontamination Checklist

• What are we decontaminating?
• Which decon are we using - biological or
  chemical?
• Is decontamination possible?
• Who needs decontamination?
• What level of protection is needed for those in
  area?
• for the responders?

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Decon

• Removes but does not necessarily neutralize an
  agent
• Decon cannot kill or render an infectious disease
  harmless in a human

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Bio Decon

• 1. Immediately wash exposed skin with soap and
  water
• 2. Remove clothes and bag for evidence
• 3. Soap and water shower
• Steps 2 and 3 can be done at home

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Why Showering is Enough

• Agent does not re-aerosolize
• Agent must be device driven for effectiveness
• Intact skin is THE best protection
• Agent already captured in lungs, gastrointestinal
  tract, or open wounds

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The Use of Chemicals in Bio Decon

• Disinfectants (chemicals) can make agent harmless
  with time and contact (e.g. bleach or
  hypochlorite solution)
• Not recommended for decon of people
• Surfaces and equipment - YES
• People - NO

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Ohio Guidelines

• Weapons of
• Mass Destruction
• Bioterrorism
• Protocol

PROCEDURES FOR LOCAL, STATE AND FEDERAL PERSONNEL
AND AGENCIES
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Bioterrorism

• There are a number of things which make this type
  of incident different from others
• Non-traditional responders involved
• The incident is a crime scene

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Local Dispatch 911 Centers

• Initial dispatch call should include
• EMA
• Fire/EMS
• Law enforcement
• Hospitals
• Secondary notification should include
• FBI
• Local health department

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Agencies Involved

• State Federal
• CDC
• EMA
• FBI
• OSP
• State Dept Of Health
• USPHS

• Locally
• EMA
• EMS
• Fire
• Health Dept
• Hospital
• Law Enforcement
• Poison Control

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Detection of Covert Biological Attacks

• Medical community response
• Epidemiology and public health response
• Calls to 9-1-1 EMS response

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Covert Incident Will be Hard to Recognize

• Symptoms resemble other sicknesses
• May not surface for 3 or 4 days
• Physicians may not be familiar
  with symptoms
• Mortality will be expected
• Lab analysis must be expedited in any case

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Questions?

• Review Points
• Biological and chemical decontamination
  procedures are different
• WATER ONLY, please
• People can be injured by inappropriate decon
• The Ohio Guidelines provide procedures for
  dealing with biological incidents