GIS in a context of Bioterrorism

1
GIS in a context of Bioterrorism

• Maria Styblinska
• University of Silesia
• Institute of Informatics

2
Deaths in Angola
3
Deadly Powder
4
Bioterrorism and Biowarfare
Bioterrorism (BT) and biowarfare (BW) are the
intentional or the alleged use of infectious
biological agents as viruses, bacteria, fungi,
toxins or germs to cause illness and produce
death or disease in humans, animals or plants.
5
Bioterrorism or Biowarfare

• Micro organisms or their toxins
• Intentionally produce sickness or death
• Target people, plants, animals

6
Anthrax Bacillus anthracisLymth tissue
7
Biological Diseases/Agents Listing

• Category A
• Anthrax (Bacillus anthracis)
• Botulism (Clostridium botulinum toxin)
• Plague (Yersinia pestis)
• Smallpox (variola major)
• Tularemia (Francisella tularensis)
• Viral hemorrhagic fevers (filoviruses e.g.
  Ebola, Marburg
• and arenaviruses e.g. Lassa, Machupo)

8

• Category B
• Brucellosis (Brucella species)
• Epsilon toxin of Clostridium perfringens
• Food safety threats (Salmonella species,
  Escherichia coli, Shigella)
• Glanders (Burkholderia mallei)
• Melioidosis (Burkholderia pseudomallei)
• Psittacosis (Chlamydia psittaci)
• Q fever (Coxiella burnetii)
• Ricin toxin from Ricinus communis (castor beans)
  
• Staphylococcal enterotoxin B
• Typhus fever (Rickettsia prowazekii)
• Viral encephalitis (alphaviruses Venezuelan
  equine
• encephalitis, eastern equine encephalitis,
  western equine
• encephalitis)
• Water safety threats (Vibrio cholerae,
  Cryptosporidium parvum)

9
Category C Emerging infectious disease
threats such as Nipah virus and hantavirus
10
Category Descriptions Category A
Diseases/Agents High-priority agents include
organisms that pose a risk to national security
because they can be easily disseminated or
transmitted from person to person result in
high mortality rates and have the potential for
major public health impact might cause public
panic and social disruption and require special
action for public health preparedness.
11
Category B Diseases/Agents Second highest
priority agents include those that are moderately
easy to disseminate result in moderate
morbidity rates and low mortality rates and
require specific enhancements of CDC's diagnostic
capacity and enhanced disease surveillance.
Category C Diseases/Agents Third highest
priority agents include emerging pathogens that
could be engineered for mass dissemination in
the future because of availability ease of
production and dissemination and potential for
high morbidity and mortality rates and major
health impact.
12
The threat of terrorists using biological
warfare agents has received increased attention
in recent years. The most distinguishing
feature separating BW terrorism from conventional
terrorism is the extraordinarily larger number of
casualties that could follow a major terrorist
attack involving biological agents.
13
Rather, the most likely BW terrorist tactic will
be to release BW agents anthrax spores, botulinum
toxin, ricin, smallpox or other deadly agents
into the air as a biological aerosol, a stable
cloud of suspended microscopic droplets of
bacterial or virus particles. Since BW agents
are invisible, odorless, and tasteless, no one
would know that a terrorist attack is under way.
14
The aerosol release of BW agents could be
accomplished in several ways, including using
low-flying airplanes, crop dusters, or trucks
equipped with spray tanks and releasing the BW
agent upwind of populated areas leaving
aerosol canisters filled with the BW agent and
timing devices in subways, airports,
air-conditioning/heating systems in buildings, or
other crowded places or directly contaminating
bulk food supplies in restaurants, supermarkets,
or other places with a BW agents.
15
(No Transcript)
16

• Bioterrorist attacks can be, at least in theory,
  executed at several levels
• The strategic level, which can cover large
  populations or geographic areas. This may also be
  directed against crops and livestock resulting in
  famine or economic disruption.
• The tactical level, which is a more directed
  attack. These are usually limited by the
  incubation times. They are most effective against
  a fixed position, e.g.is the intentional
  contamination of a salad bar at a restaurant in
  The Dallas, Oregon82
• The terrorist approach, which doesn't have to
  make anybody ill. This may be easy to deliver and
  difficult to detect, e.g. in Washington D.C. the
  downtown area was grid locked because somebody
  sent a petrie dish labeled "anthrax," into rush
  hour traffic.

17
Clues to a biological attack.

• Large unexplained epidemic with similarly acute
  patients with an unusual epidemic curve.
• More severe case of disease than usual with
  higher mortality, refractory to treatment and
  usually with respiratory manifestations.
• Multiple diseases in the same patient.
• Unusual geographic, seasonal, or patient
  distribution.
• Suspicious transmission pattern.
• Unusual genetic or molecular patterns.
• Multiple simultaneous epidemics.
• Unusual clinical presentation.
• Unexplained animal deaths.
• Direct evidence of biowarfare munitions.

18
Comparative Cost /km2

• Smart bombs 80,000
• Explosive 10,000
• Nuclear 4,000
• Chemical 300
• Biologic 5
• (Stanford,personal comm,1988)

19
DEATHS

• 1 KT H-BOMB
• .6M - 2M
• 100 Kg ATX
• 1M - 3M
• (IDSA, 2001)

20
MASS EFFECT

• "Subnational attacks using genetically engineered
  organisms are inevitable"
• "Biologic agents now join nuclear agents"
• (Stansfield Turner, CIA, 2001)

21
History Corpses Catapults

• 600 BC Assyrians -- Ergot
• 300 BC Greeks -- Wells
• 1346 Tartars -- Plague
• 1500 Pissaro -- Smallpox
• 1710 Russia/Sweden -- Plague

22
History Specific Disease Application

• 1763 Amherst -- Bouquet
• 1915 Germany
• Cholera -- Italy
• Plague -- Russia
• Glanders, Anthrax -- Rumania, Syria
• 1925 Geneva Convention

23
History Modern Era

• 1937 Japan -- Many
• 1943 US -- Bacteria, virus
• 1945 Japan -- Generators
• 1969 US -- Stops efforts
• 1970 Russia -- Bio-preparat

24
Biologic Arms Race
25
(No Transcript)
26
How GIS can be used for phases of Bioterrorism
planning and response
27
The benefits of infectious disease surveillance
are as follows

• To detect trend in disease occurrence
• Detect epidemics
• Provide estimates of morbidity and mortality
• Stimulate epidemiologic research
• Identify risk factor for disease
• Assess the effectiveness of disease controls
• Improve clinical practice
• Improve resource allocation

28
GIS has been used for many after event
analyses Objective is to create dynamic real
time information systems that allow greater
access to the data for decision making and
problem characterization
29

• GIS and Events
• Characteristics of an event
• starts locally, spreads by water, air, vector, or
  contact
• Event is a spatial problem geographic space
  (2-3D) and social space
• GIS has tools for geographic and (to limited
  degree) social space
• visualization, summary, management of attribute
  and spatial data
• hydrological and network modeling
• population models/simulation
• weather models/simulation

30
Data Management, Visualization,
Analysis/Modeling, Scenario ManagementPreparednes
s Detection/Surveillance, Response, Communication
Using GIS to turn Data into Information
31
What is required for GIS?

• Mandate and management support
• Spatially enabled data sets
• topographic and environmental data provide the
  spatial context
• demographic data provide the social context
• health data provide the health context
• Trained staff
• Software to visualize, manage, and analyze the
  data sets
• Hardware to store,

32
GIS issue

• Security/Privacy of health data
• legislation and privacy laws
• GIS architectures
• stand-alone vs. networked
• Analysis
• mapping units
• statistics
• error
• Metadata

33
Hypothetical application of GIS
34
A disease surveillance report at the onset and
peak of a bioterrorism event plots cases, street
networks, community facilities, administrative
boundaries.
35
(No Transcript)
36
(No Transcript)
37
Predominance of cases in low population density
areas
38
Examples of GIS applicationsCDC BT Scenario -
Traffic management
39
Early Warning Outbreak Recognition System
Department of Defense, USA
40
GIS System ESSENCE - Electronic Surveillance
System for Early Notification of Community-based
Epidemics, Washington, D.C.
41
International Biological Warfare Agreements

• The Geneva Protocol of 1925
• 1972 the Biological Weapons Convention

42
Thinking About the Unthinkable
"No return address"

• Kahn H.Thinking About the Unthinkable.London,
  England Weidenfeld Nicolson 1962.

43
REFERENCES

1. 1.        Biological Terrorism Introduction,
   Center for the Study of Bioterrorism and Emerging
   Infections, Saint Loius University School of
   Public Health
2. 2. Carter A, Deutch J, Zellcow P. Catastrophic
   terrorism., Foreign Affair., 1998 7780-95
3. 3.  Public Health Emergency Preparedness and
   Response Centers for Disease Control and
   Prevention US Department of Health and Human
   Services http//www.bt.cdc.gov/Agent/Agentlist.as
   p
4. 4. Working Group on Civilian Biodefense, USA
5. 5. Bioterrorism Alert and Response University
   of Washington, School of Public Health and
   Community Medicine http//www.hscer.washington.ed
   u/em_inf/bio/bio2.html
6. 6. Meselson M, Guillemin J, Hugh-Jones M,
   Langmuir A, Popova I, Shelokov A, et al. The
   Sverdlovsk anthrax outbreak of 1979. Science
   19942661202-8
7. 7. Investigation of bioterrorism related
   anthrax Connecticut, 2001. MMWR Morb Mortal Wkly
   Raport, 2001501077-1079.
8. 8. Simnott J. Bioterrorism, Lecture and
   Presentation, University of South Florida College
   of Medicine http//www.medinfo.ufl.edu
9. 9.  Stanford, personal comments, 1988
10. 10. Fiedler R, Hughes T, Garcia M,GIS Mapping
    and Use of Spatial Data in a BioTerrorism
    Scenario, cientific Technologies Corporation
11. 11. Styblinska M..Internet GIS Application in
    Health Care and Medical Information, GIS Polonia
    2001, p. 268-276, Zagreb 2001.
12. 12. Bioterrorism GIS Can Help Fight the New
    Threat website GeaoWorld geoplace.com The
    Authorative Resources for Spatial Information
    http//www.geoplace.com/gw/2002/0207/0207bio2

44
13.     Northwest Center for Public Health
Practice at the University of Washington School
of Public Health and Community Medicine
http//healthlinks.washington.edu/nwcphp/niphp/gis
.html 14.     Mitchell JT, Everly GS.Critical
Incident Stress Debriefing An Operations Manual
for the Prevention of Traumatic Stress Among
Emergency Services and Disaster Workers 2nd ed
rev. Ellicott City, Md Chevron Publishing Corp
1995, 1996. 15.     Popovich M., Fiedler R.,
Fiedler S. Massee J Bioterrorism GIS Can Help
Fight the New Threat website GeaoWorld
geoplace.com The Authorative Resources for
Spatial Information http//www.geoplace.com/gw/200
2/0207/0207bio2 16.     US Congress, Office of
Technology Assessment. Proliferation of Weapons
of Mass Destruction Assessing the Risks.
Washington, DC Office of Technology Assessment
August 1993. Document OTA ISC 559 17. Kahn H.
Thinking About the Unthinkable. Weidenfeld
Nicolson, London, England 1962 1962