Bioterrorism Agents/Diseases

Student name: Ayesha Andleeb

VUID: BC180200563

Presented to: Dr. Sarfaraz Iqbal

Belong to course cell biology (bio201)

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Bioterrorism can be categorizing into 3 major categories as:

1-Category A

2-Category B

3-Category C

Category A:

Consist of 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.
Agents:

 Anthrax (Bacillus anthracis)

Anthrax is a serious infectious disease caused by gram-positive, rod-shaped bacteria

known as Bacillus anthracis. Although it is rare, people can get sick with anthrax if they
come in contact with infected animals or contaminated animal products.

Symptoms:

The symptoms of anthrax depend on the type of infection and can take anywhere from 1
day to more than 2 months to appear.  All types of anthrax have the potential, if
untreated, to spread throughout the body and cause severe illness and even death.

 Botulism (Clostridium botulinum toxin)

Botulism is a rare but serious illness caused by a toxin that attacks the body’s nerves.

Symptoms : botulism usually start with weakness of the muscles that control the eyes,
face, mouth, and throat. This weakness may spread to the neck, arms, torso, and legs.
Botulism also can weaken the muscles involved in breathing, which can lead to difficulty
breathing and even death.

 Plague (Yersinia pestis)

Plague is a disease that affects humans and other mammals. It is caused by

the bacterium, Yersinia pestis. Humans usually get plague after being bitten by
a rodent flea that is carrying the plague bacterium or by handling an animal
infected with plague. Plague is infamous for killing millions of people in
Europe during the middle Ages. Today, modern antibiotics are effective in
treating plague. Without prompt treatment, the disease can cause serious
illness or death. Presently, human plague infections continue to occur in the
western United States, but significantly more cases occur in parts of Africa and
Asia.

 Smallpox (variola major)
 Thousands of years ago, variola virus (smallpox virus) emerged and began
causing illness and deaths in human populations, with smallpox outbreaks
occurring from time to time. Thanks to the success of vaccination, the last natural
outbreak of smallpox in the United States occurred in 1949. In 1980, the World
Health Assembly declared smallpox eradicated (eliminated), and no cases of
naturally occurring smallpox have happened since. 

Smallpox research in the United States continues and focuses on the

development of vaccines, drugs, and diagnostic tests to protect people against
smallpox in the event that it is used as an agent of bioterrorism.

 Tularemia (Francisella tularensis)

Tularemia is a disease of animals and humans caused by the bacterium Francisella

tularensis. Rabbits, hares, and rodents are especially susceptible and often die in large
numbers during outbreaks. Humans can become infected through several routes,
including:

 Tick and deer fly bites

 Skin contact with infected animals
 Ingestion of contaminated water
 Inhalation of contaminated aerosols or agricultural dusts

Laboratory exposure

In addition, humans could be exposed as a result of bioterrorism.

Symptoms vary depending on the route of infection. Although tularemia can be life-

threatening, most infections can be treated successfully with antibiotics.

Steps to prevent tularemia include:

 Use of insect repellent

 Wearing gloves when handling sick or dead animals
 Avoiding mowing over dead animals
In the United States, naturally occurring infections have been reported from all states
except Hawaii

 Viral hemorrhagic fevers,

Viral hemorrhagic fevers (VHFs) refer to a group of illnesses that are caused by
several distinct families of viruses. In general, the term “viral hemorrhagic fever” is
used to describe a severe multisystem syndrome (multisystem in that multiple organ
systems in the body are affected). Characteristically, the overall vascular system is
damaged, and the body’s ability to regulate itself is impaired. These symptoms are
often accompanied by hemorrhage (bleeding); however, the bleeding is itself rarely
life-threatening. While some types of hemorrhagic fever viruses can cause relatively
mild illnesses, many of these viruses cause severe, life-threatening disease.

It’s also including:

o Filoviruses (Ebola, Marburg)

Filoviruses belong to a virus family called Filoviridae and can cause severe

hemorrhagic fever in humans and nonhuman primates. So far, three genera of
this virus family have been identified: Cuevavirus, Marburgvirus and Ebolavirus.
Six species of Ebolavirus have been identified: Ebola virus (species Zaire
ebolavirus), Sudan virus (species Sudan ebolavirus), Taï Forest virus
(species Taï Forest ebolavirus, formerly Côte d’Ivoire ebolavirus), Bundibugyo
virus (species Bundibugyo ebolavirus), Reston virus (species Reston ebolavirus),
and Bombali virus (species Bombali ebolavirus). Of these, only four (Ebola,
Sudan, Taï Forest, and Bundibugyo viruses) are known to cause disease in
people. Reston virus is known to cause disease in nonhuman primates and pigs,
but not in people. Bombali virus was recently identified in bats, and it is unknown
at this time if it causes disease in either animals or people.

o Arena viruses (Lassa, Machupo)

 The Arenaviridae are a family of viruses whose members are generally
associated with rodent-transmitted diseases in humans. Each virus usually is
associated with a particular rodent host species in which it is maintained.
Arenavirus infections are relatively common in humans in some areas of the
world and can cause severe illnesses.

The virus particles are spherical and have an average diameter of 110-130
nanometers. All are enveloped in a lipid (fat) membrane. Viewed in cross-section,
they show grainy particles that are ribosome acquired from their host cells. It is
this characteristic that gave them their name, derived from the Latin “arena”,
which means “sandy”. Their genome, or genetic material, is composed of RNA
only, and while their replication strategy is not completely understood, we know
that new viral particles, called virions, are created by budding from the surface of
their hosts’ cells.

Category B:

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.

Agents:

 Brucellosis (Brucella species)

Brucellosis is an infectious disease caused by bacteria.

People can get the disease when they are in contact with infected animals or
animal products contaminated with the bacteria. Animals that are most commonly
infected include sheep, cattle, goats, pigs, and dogs, among others.

Symptoms:
  fever
 sweats
 malaise
 anorexia
 headache
 pain in muscles, joint, and/or back
 fatigue

Some signs and symptoms may persist for longer periods of time. Others may
never go away or reoccur.

 Epsilon toxin of Clostridium perfringens

Clostridium perfringens is one of the most common types of food borne

illness in the United States. CDC estimates it causes nearly 1 million cases
of food borne illness each year

 Food safety threats (Salmonella species, Escherichia coli O157:H7, Shigella)

CDC estimates that each year 48 million people get sick from a food borne
illness 128,000 are hospitalized and 3000 die.

Symptoms:

Common symptoms of food borne diseases are nausea, vomiting, stomach cramps, and
diarrhea. However, symptoms may differ among the different types of foodborne
diseases. Symptoms can sometimes be severe and some foodborne illnesses can even
be life-threatening. Although anyone can get a food borne illness, some people are
more likely  to develop one. Those groups include:

 Pregnant women
 Young children
  Older adults
 People with immune systems weakened from medical conditions, such as
diabetes, liver disease, kidney disease, organ transplants, HIV/AIDS, or from
receiving chemotherapy or radiation treatment.

Most people with a food borne illness get better without medical treatment, but people
with severe symptoms should see their doctors.

 Glanders (Burkholderia mallei)

Glanders is an infectious disease that is caused by the bacterium Burkholderia

mallei. While people can get the disease, glanders is primarily a disease affecting
horses. It also affects donkeys and mules and can be naturally contracted by
other mammals such as goats, dogs, and cats.

Symptoms:

Symptoms of glanders commonly include:

 Fever with chills and sweating

 Muscle aches
 Chest pain
 Muscle tightness
 Headache
 Nasal discharge
 Light sensitivity (sometimes with excessive tearing of the eyes)

The particular symptoms experienced, however, will vary depending on the type
of infection.

 Melioidosis (Burkholderia pseudomallei)

Melioidosis, also called Whitmore's disease, is an infectious disease that can

infect humans or animals. The disease is caused by the bacterium Burkholderia
pseudomallei.
 It is predominately a disease of tropical climates, especially in Southeast Asia
and northern Australia where it is widespread. The bacteria causing melioidosis
are found in contaminated water and soil. It is spread to humans and animals
through direct contact with the contaminated source.

Symptoms:

There are several types of melioidosis infection, each with their own set of symptoms.

However, it is important to note that melioidosis has a wide range of signs and
symptoms that can be mistaken for other diseases such as tuberculosis or more
common forms of pneumonia.

Localized Infection:

 Localized pain or swelling

 Fever
 Ulceration
 Abscess

Pulmonary Infection:

 Cough
 Chest pain
 High fever
 Headache
 Anorexia

Bloodstream Infection:

 Fever
 Headache
 Respiratory distress
 Abdominal discomfort
 Joint pain
 Disorientation
Disseminated Infection:

 Fever
 Weight loss
 Stomach or chest pain
 Muscle or joint pain
 Headache
 Seizures

Psittacosis (Chlamydia psittaci)

Chlamydia psittaci is a type of bacteria that often infects birds. Less commonly, these
bacteria can infect people and cause a disease called psittacosis. Psittacosis causes a
wide range of symptoms, including fever, headache, and a dry cough. This illness can
also cause pneumonia (a lung infection) that may require treatment or care in a hospital.
Rarely, psittacosis can be deadly.

 Q fever (Coxiella burnetii)

Q fever is a disease caused by the bacteria Coxiella burnetii. This bacteria

naturally infects some animals, such as goats, sheep, and cattle. C.
burnetii bacteria are found in the birth products (i.e. placenta, amniotic fluid),
urine, feces, and milk of infected animals. People can get infected by breathing in
dust that has been contaminated by infected animal feces, urine, milk, and birth
products. Some people never get sick; however, those who do usually develop
flu-like symptoms including fever, chills, fatigue, and muscle pain.

Symptoms:

About 5 out of 10 people infected with Coxiella burnetii will get sick. Illness typically
develops 2-3 weeks after being exposed to the bacteria. Signs and symptoms of Q
fever may include:

 Fever
 Chills or sweats
 Fatigue (tiredness)
 Headache
 Muscle aches
 Nausea, vomiting, or diarrhea
 Chest pain
 Stomach pain
 Weight loss
 Non-productive cough

Symptoms can be mild or severe.  People who develop severe disease may experience
infection of the lungs (pneumonia) or liver (hepatitis).

Women who are infected during pregnancy may be at risk for miscarriage, stillbirth, pre-
term delivery, or low infant birth weight.

 Ricin toxin from Ricans communes (castor beans)

 The major symptoms of ricin poisoning depend on the route of exposure and the
dose received, though many organs may be affected in severe cases.
 Initial symptoms of ricin poisoning by inhalation may occur as early as 4- 8 hours
and as late as 24 hours after exposure. Following ingestion of ricin, initial
symptoms typically occur in less than 10 hours.
 Inhalation: Within a few hours of inhaling significant amounts of ricin, the likely
symptoms would be respiratory distress (difficulty breathing), fever, cough,
nausea, and tightness in the chest. Heavy sweating may follow as well as fluid
building up in the lungs (pulmonary edema). This would make breathing even
more difficult, and the skin might turn blue. Excess fluid in the lungs would be
diagnosed by x-ray or by listening to the chest with a stethoscope. Finally, low
blood pressure and respiratory failure may occur, leading to death. In cases of
known exposure to ricin, people having respiratory symptoms should seek
medical care.
 Ingestion: If someone swallows a significant amount of ricin, he or she would
likely develop vomiting and diarrhea that may become bloody. Severe
dehydration may be the result, followed by low blood pressure. Other signs or
 symptoms may include seizures, and blood in the urine. Within several days, the
person’s liver, spleen, and kidneys might stop working, and the person could die.
 Skin and eye exposure: Ricin is unlikely to be absorbed through normal skin.
Contact with ricin powders or products may cause redness and pain of the skin
and the eyes. However, if you touch ricin that is on your skin and then eat food
with your hands or put your hands in your mouth, you may ingest some.
 Death from ricin poisoning could take place within 36 to 72 hours of exposure,
depending on the route of exposure (inhalation, ingestion, or injection) and the
dose received.

 Staphylococcal enterotoxin B

Staph food poisoning is a gastrointestinal illness caused by eating foods

contaminated with toxins produced by the bacterium Staphylococcus
aureus (Staph) bacteria.

About 25% of people and animals have Staph on their skin and in their nose. It
usually does not cause illness in healthy people, but Staph has the ability to
make toxins that can cause food poisoning.

Symptoms:

 Staph food poisoning is characterized by a sudden start of nausea,

vomiting, and stomach cramps. Most people also have diarrhea.
 Symptoms usually develop within 30 minutes to 8 hours after eating or
drinking an item containing Staph toxin, and last no longer than 1 day.
Severe illness is rare.
 The illness cannot be passed from one person to another.

 Typhus fever (Rickets prowazekii)

Typhus fevers are a group of diseases caused by bacteria that are spread to
humans by fleas, lice, and chiggers. Typhus fevers include scrub typhus, murine
typhus, and epidemic typhus. Chiggers spread scrub typhus, fleas spread murine
typhus, and body lice spread epidemic typhus.
 Symptoms:

The most common symptoms are fever, headaches, and sometimes rash.

 Viral encephalitis (alpha viruses, such as eastern equine encephalitis,

Venezuelan equine encephalitis, and western equine encephalitis])

Eastern equine encephalitis virus (EEEV) is transmitted to humans by the bite

of an infected mosquito. Eastern equine encephalitis (EEE) is a rare illness in
humans, and only a few cases are reported in the United States each year. Most
cases occur in the Atlantic and Gulf Coast states (see map). Most persons
infected with EEEV have no apparent illness. Severe cases of EEE (involving
encephalitis, an inflammation of the brain) begin with the sudden onset of
headache, high fever, chills, and vomiting. The illness may then progress into
disorientation, seizures, or coma. EEE is one of the most severe mosquito-
transmitted diseases in the United States with approximately 33% mortality and
significant brain damage in most survivors. There is no specific treatment for
EEE; care is based on symptoms. You can reduce your risk of being infected
with EEEV by using insect repellent, wearing protective clothing, and staying
indoors while mosquitoes are most active. If you think you or a family member
may have EEE, it is important to consult your healthcare provider for proper
diagnosis.

 Water safety threats (Vibrio cholera, Cryptosporidium partum)

Cryptosporidium is a microscopic parasite that causes the diarrheal disease

cryptosporidiosis. Both the parasite and the disease are commonly known as
"Crypto."

There are many species of Cryptosporidium that infect animals, some of which

also infect humans. The parasite is protected by an outer shell that allows it to
survive outside the body for long periods of time and makes it very tolerant to
chlorine disinfection.

While this parasite can be spread in several different ways, water (drinking water
and recreational water) is the most common way to spread the
 parasite. Cryptosporidium is a leading cause of waterborne disease among
humans in the United States.

Symptoms:

Symptoms of cryptosporidiosis generally begin 2 to 10 days (average 7 days)

after becoming infected with the parasite. The most common symptom of
cryptosporidiosis is watery diarrhea. Symptoms include:

 Watery diarrhea
 Stomach cramps or pain
 Dehydration
 Nausea
 Vomiting
 Fever
 Weight loss

Category C:

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.

Agents:

 Emerging infectious diseases such as Nipah virus and hantavirus

 Nipah virus:

Infection with Nipah virus is associated with encephalitis (inflammation of the

brain). After exposure and an incubation period of 5 to 14 days,illness presents
with 3-14 days of fever and headache, followed by drowsiness, disorientation and
mental confusion. These signs and symptoms can progress to coma within 24-48
hours. Some patients have a respiratory illness during the early part of their
 infections, and half of the patients showing severe neurological signs showed
also pulmonary signs.

During the Nipah virus disease outbreak in 1998-99, 265 patients were infected
with the virus. About 40% of those patients who entered hospitals with serious
nervous disease died from the illness.

Long-term sequelae following Nipah virus infection have been noted, including
persistent convulsions and personality changes.

Latent infections with subsequent reactivation of Nipah virus and death have also
been reported months and even years after exposure

 Hantavirus:

Infection with hantavirus can progress to Hantavirus Pulmonary Syndrome (HPS),

which can be fatal. People become infected through contact with hantavirus-infected
rodents or their urine and droppings. The Sin Nombre hantavirus, first recognized in
1993, is one of several New World hantaviruses circulating in the US. Old World
hantaviruses, including Seoul virus, are found across the world and can
cause Hemorrhagic Fever with Renal Syndrome (HFRS). Rodent control in and
around the home remains the primary strategy for preventing hantavirus infection.
All cases of Hantavirus infection are reported to the CDC.

Hantavirus Pulmonary Syndrome (HPS) is a severe, sometimes fatal, respiratory

disease in humans caused by infection with hantaviruses.

Anyone who comes into contact with rodents that carry hantaviruses is at risk of HPS.
Rodent infestation in and around the home remains the primary risk for hantavirus
exposure. Even healthy individuals are at risk for HPS infection if exposed to the virus.

Early Symptoms

Early symptoms include fatigue, fever and muscle aches, especially in the large muscle
groups— thighs, hips, back, and sometimes shoulders. These symptoms are universal.

There may also be headaches, dizziness, chills, and abdominal problems, such as
nausea, vomiting, diarrhea, and abdominal pain. About half of all HPS patients
experience these symptoms.
Late Symptoms

Four to 10 days after the initial phase of illness, the late symptoms of HPS appear.
These include coughing and shortness of breath, with the sensation of, as one
survivor put it, a “…tight band around my chest and a pillow over my face” as the
lungs fill with fluid.