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| 1 |
ID:
107457
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| 2 |
ID:
107480
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| Publication |
2011.
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| Summary/Abstract |
An urban wide-area recovery and restoration effort following a large-scale biological release will require extensive resources and tax the capabilities of government authorities. Further, the number of private decontamination contractors available may not be sufficient to respond to the needs. These resource limitations could create the need for decontamination by the building owner/occupant. This article provides owners/occupants with a simple method to decontaminate a building or area following a wide-area release of Bacillus anthracis using liquid sporicidal decontamination materials, such as pH-amended bleach or activated peroxide; simple application devices; and high-efficiency particulate air-filtered vacuums. Owner/occupant decontamination would be recommended only after those charged with overseeing decontamination-the Unified Command/Incident Command-identify buildings and areas appropriate for owner/occupant decontamination based on modeling and environmental sampling and conduct health and safety training for cleanup workers.
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| 3 |
ID:
107458
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2011.
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| Summary/Abstract |
The case of Carol Anne Bond v the United States of America stemmed from a domestic dispute when Ms. Bond attempted to retaliate against her best friend by attacking her with chemical agents. What has emerged is a much greater issue-a test of standing on whether a private citizen can challenge the Tenth Amendment. Instead of being prosecuted in state court for assault, Ms. Bond was charged and tried in district court under a federal criminal statute passed as part of implementation of the Chemical Weapons Convention (CWC). Ms. Bond's argument rests on the claim that the statute exceeded the federal government's enumerated powers in criminalizing her behavior and violated the Constitution, while the government contends legislation implementing treaty obligations is well within its purview. This question remains unanswered because there is dispute among the lower courts as to whether Ms. Bond, as a citizen, even has the right to challenge an amendment guaranteeing states rights when a state is not a party to the action. The Supreme Court heard the case on February 22, 2011, and, if it decides to grant Ms. Bond standing to challenge her conviction, the case will be returned to the lower courts. Should the court decide Ms. Bond has the standing to challenge her conviction and further questions the constitutionality of the law, it would be a significant blow to implementation of the CWC in the U.S. and the effort of the federal government to ensure we are meeting our international obligations.
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| 4 |
ID:
107472
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2011.
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| Summary/Abstract |
Recovering from a biological attack is a complex process requiring the successful resolution of numerous challenges. The Interagency Biological Restoration Demonstration program is one of the first multiagency efforts to develop strategies and tools that could be effective following a wide-area release of B. anthracis spores. Nevertheless, several key policy issues and associated science and technology issues still need to be addressed. For example, more refined risk assessment and management approaches are needed to help evaluate "true" public health risk. Once the risk is understood, that information can be considered along with the types of characterization activities deemed necessary to determine whether the cost and time of decontamination are actually warranted. This commentary offers 5 recommendations associated with decision making regarding decontamination and clearance options that should accompany a comprehensive risk analysis leading to more effective risk management decisions. It summarizes some of the most important technological gaps that still need to be addressed to help decision makers in their objective of reducing health risks to an acceptable level. The risk management approach described should enable decision makers to improve credibility and gain public acceptance, especially when an adequate science and technology base is available to support the required decisions.
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| 5 |
ID:
107481
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| Publication |
2011.
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| Summary/Abstract |
Disasters often create large amounts of waste that must be managed as part of both immediate response and long-term recovery. While many federal, state, and local agencies have debris management plans, these plans often do not address chemical, biological, and radiological contamination. The Interagency Biological Restoration Demonstration's (IBRD) purpose was to holistically assess all aspects of an anthrax incident and assist in the development of a plan for long-term recovery. In the case of wide-area anthrax contamination and the follow-on response and recovery activities, a significant amount of material would require decontamination and disposal. Accordingly, IBRD facilitated the development of debris management plans to address contaminated waste through a series of interviews and workshops with local, state, and federal representatives. The outcome of these discussions was the identification of 3 primary topical areas that must be addressed: planning, unresolved research questions, and resolving regulatory issues.
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| 6 |
ID:
107478
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| Publication |
2011.
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| Summary/Abstract |
A biological attack would present an unprecedented challenge for local, state, and federal agencies, the military, the private sector, and individuals on many fronts, ranging from vaccination and treatment to prioritization of cleanup actions to waste disposal. To prepare for recovery from this type of incident, the Seattle Urban Area Security Initiative (UASI) partners collaborated with military and federal agencies to develop a regional recovery framework. The goal was to identify key information that will assist policymakers and emergency managers in shortening the timeline for recovery and minimizing the economic and public health impacts of a catastrophic anthrax attack. Based on discussions in workshops, tabletop exercises, and interviews with local, state, federal, military, and private sector entities responsible for recovery, the authors identified goals, assumptions, and concepts of operation for various areas to address critical issues the region will face as recovery progresses. Although the framework is specific to a catastrophic, wide-area biological attack using anthrax, it was designed to be flexible and scalable so it could also serve as the recovery framework for an all-hazards approach in other regions and jurisdictions. Benefits from this process include enhanced coordination and collaboration across agencies, a more thorough understanding of the anthrax threat, an opportunity to proactively consider long-term recovery, and a better understanding of the specific policy questions requiring resolution.
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| 7 |
ID:
107462
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| Publication |
2011.
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| Summary/Abstract |
An overview of available literature on the use of protective facemasks by children for protection from respiratory infectious agents reveals relatively few articles dealing specifically with the topic, despite their use during recent outbreaks (eg, severe acute respiratory syndrome, pandemic influenza). Little is known about the physiological and psychological burdens imposed by these devices and a child's ability to correctly use and tolerate them. This article focuses on the myriad issues associated with protective facemask use by children in the hope of educating public health personnel, healthcare professionals, and families on their limitations and associated risks, and in the hope of fostering much-needed research.
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| 8 |
ID:
107470
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| Publication |
2011.
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| Summary/Abstract |
Following the terrorist attacks in 2001, much time and effort has been put toward improving catastrophic incident response. But recovery-the period following initial response that focuses on the long-term viability of the affected area-has received less attention. Recognizing the importance of being able to recover an area following a catastrophic incident, the Department of Defense, through its Defense Threat Reduction Agency (DTRA), and the Department of Homeland Security, through its Science and Technology Directorate (DHS S&T), created the Interagency Biological Restoration Demonstration (IBRD) program. IBRD was a 4-year program jointly managed and funded by DTRA and DHS S&T, the goal of which was to reduce the time and resources necessary to recover a wide urban area from an intentional release of Bacillus anthracis. Specific program objectives included understanding the social, economic, and operational interdependencies that affect recovery; establishing long-term coordination between the Departments of Defense and Homeland Security; developing strategic recovery/restoration plans; identifying and demonstrating technologies that support recovery; and exercising recovery activities and technology solutions. IBRD has made important first steps toward improving national preparedness in the area biological incident recovery. Specifically, IBRD has helped enhance the efficacy and efficiency of recovering large urban areas by developing consequence management guidance; identifying key S&T capabilities and integrating them with planning and guidance documents; and establishing key relationships across the federal interagency, federal-to-regional, civilian-to-military, and public-to-private stakeholders. Upon completion of IBRD in fall 2010, both DTRA and DHS S&T planned follow-on programs.
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| 9 |
ID:
107464
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| Publication |
2011.
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| Summary/Abstract |
The Seventh Review Conference of the Biological Weapons Convention in December 2011 provides an opportunity to modernize the treaty to better address the challenges of the 21st century. The key to this modernization is to redesign the treaty's Confidence-Building Measures (CBMs), the only formal mechanism for increasing transparency and demonstrating compliance with the treaty, to address changes in the global scientific, health, and security environments since the end of the Cold War. The scope of the CBMs should be expanded beyond state-run biological warfare programs to encompass a broader array of threats to global security, such as biological terrorism, laboratory accidents, dual-use research, and disease pandemics. Modernizing the CBM mechanism to take into account these new risks would extend the transparency-enhancing benefits of CBMs to a range of new and important topics, such as biosafety, laboratory biosecurity, and dual-use research oversight; make the CBMs and the treaty itself more relevant to the concerns and priorities of more states; and build on progress made during the recent series of intersessional meetings. To accomplish this, the CBMs need to be revised to shift their focus from hardware, the dual-use capabilities relevant to the treaty, to software, the political and legal institutions that govern the development and use of these capabilities. A more modern CBM mechanism should encourage greater participation in the confidence-building process, improve international cooperation against the full spectrum of biological risks, and promote the goal of universal membership in the treaty.
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| 10 |
ID:
107476
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| Publication |
2011.
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| Summary/Abstract |
Consequence management following a release of aerosolized Bacillus anthracis spores requires a high level of technical understanding and direction. National policies and regulations address the topics of preparedness goals and organizational structure, but they do not tell responders how to perform remediation. Essential considerations include determining what must be cleaned, evaluating health risks, ascertaining the priority of cleanup, and selecting appropriate decontamination technologies to meet consensus and risk-derived clearance goals. This article highlights key features of a national-level framework that has been developed to guide a risk-based decision process and inform technical personnel of the best practices to follow during each activity leading to the restoration of functions at affected facilities or areas. The framework and associated guidance follows the scheme of 6 phases for response and recovery arrived at through interagency consensus and approval. Each phase is elaborated in a series of detailed decision flowcharts identifying key questions that must be addressed and answered from the time that first indications of a credible biological attack are received to final reoccupancy of affected areas and a return to normal daily functions.
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| 11 |
ID:
107460
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| Publication |
2011.
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| Summary/Abstract |
Native air sampling (NAS) is distinguished from dedicated air sampling (DAS) devices (eg, BioWatch) that are deployed to detect aerosol disseminations of biological threat agents. NAS uses filter samples from heating, ventilation, and air conditioning (HVAC) systems in commercial properties for environmental sampling after DAS detection of biological threat agent incidents. It represents an untapped, scientifically sound, efficient, widely distributed, and comparably inexpensive resource for postevent environmental sampling. Calculations predict that postevent NAS would be more efficient than environmental surface sampling by orders of magnitude. HVAC filter samples could be collected from pre-identified surrounding NAS facilities to corroborate the DAS alarm and delineate the path taken by the bioaerosol plume. The New York City (NYC) Native Air Sampling Pilot Project explored whether native air sampling would be acceptable to private sector stakeholders and could be implemented successfully in NYC. Building trade associations facilitated outreach to and discussions with property owners and managers, who expedited contact with building managers of candidate NAS properties that they managed or owned. Nominal NAS building requirements were determined; procedures to identify and evaluate candidate NAS facilities were developed; data collection tools and other resources were designed and used to expedite candidate NAS building selection and evaluation in Manhattan; and exemplar environmental sampling playbooks for emergency responders were completed. In this sample, modern buildings with single or few corporate tenants were the best NAS candidate facilities. The Pilot Project successfully demonstrated that in one urban setting a native air sampling strategy could be implemented with effective public-private collaboration.
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| 12 |
ID:
107466
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| Publication |
2011.
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| Summary/Abstract |
An attack with Bacillus anthracis ("anthrax") is a known threat to the United States. When weaponized, it can cause inhalation anthrax, the deadliest form of the disease. Due to the rapid course of inhalation anthrax, delays in initiation of antibiotics may decrease survival chances. Because a rapid response would require cooperation from the public, there is a need to understand the public's response to possible mass dispensing programs. To examine the public's response to a mass prophylaxis program, this study used a nationally representative poll of 1,092 adults, supplemented by a targeted focus on 3 metropolitan areas where anthrax attacks occurred in 2001: New York City (n=517), Washington, DC (n=509), and Trenton/Mercer County, NJ (n=507). The poll was built around a "worst-case scenario" in which cases of inhalation anthrax are discovered without an identified source and the entire population of a city or town is asked to receive antibiotic prophylaxis within a 48-hour period. Findings from this poll provide important signs of public willingness to comply with public health recommendations for obtaining antibiotics from a dispensing site, although they also indicate that public health officials may face several challenges to compliance, including misinformation about the contagiousness of inhalation anthrax; fears about personal safety in crowds; distrust of government agencies to provide sufficient, safe, and effective medicine; and hesitation about ingesting antibiotic pills after receiving them. In general, people living in areas where anthrax attacks occurred in 2001 had responses similar to those of the nation as a whole.
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| 13 |
ID:
107468
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| Publication |
2011.
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| Summary/Abstract |
T
he prospect of cleaning and decontaminating a U.S. city after a wide-area biological attack is a daunting challenge.
Ten years after the anthrax letter attacks of 2001, the U.S. is still striving to understand and prepare for biological
remediation. As evidenced by the Amerithrax attacks, biological clean-up efforts are inherently time-consuming and costly.
Yet, the 2001 remediation response, which involved only a handful of heavily contaminated buildings, would pale in
comparison to a wide-area anthrax attack involving thousands of contaminated properties and outdoor spaces.
Faced with this challenge, policymakers and public of?cials are working to reduce the time and cost of remediation, to
limit public health risk, and to minimize long-term economic damage from such an event.
This special feature on biological remediation highlights the recent work and ?ndings of the Interagency Biological
Restoration Demonstration program (IBRD), a 4-year program jointly managed and funded by the Department of
Homeland Security's Science and Technology Directorate (DHS S&T) and the Department of Defense's (DoD) Defense
Threat Reduction Agency (DTRA). The program is aimed at reducing the amount of time and resources needed to recover
from an intentional wide-area urban release of Bacillus anthracis.
Topics for this special feature include regional and national recovery frameworks, the role of the private sector in
decontamination, the behavior of aerosolized B. anthracis, recommended approaches to decontamination for indoor and
outdoor spaces, and disposal of anthrax-contaminated waste. This feature is not intended to be a comprehensive review of
the work done under IBRD. Instead, it highlights some of IBRD's major accomplishments and ?ndings over the past 4
years of the project. This feature represents the ?rst publication of IBRD materials on remediation planning and response
frameworks, and the ?rst time that the public will have ready, open access to the results of IBRD remediation studies.
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| 14 |
ID:
107474
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| Publication |
2011.
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| Summary/Abstract |
Decontamination and recovery of a facility or outdoor area after a wide-area biological incident involving a highly persistent agent (eg, Bacillus anthracis spores) is a complex process that requires extensive information and significant resources, which are likely to be limited, particularly if multiple facilities or areas are affected. This article proposes a systematic methodology for evaluating information to select the decontamination or alternative treatments that optimize use of resources if decontamination is required for the facility or area. The methodology covers a wide range of approaches, including volumetric and surface decontamination, monitored natural attenuation, and seal and abandon strategies. A proposed trade-off analysis can help decision makers understand the relative appropriateness, efficacy, and labor, skill, and cost requirements of the various decontamination methods for the particular facility or area needing treatment-whether alone or as part of a larger decontamination effort. Because the state of decontamination knowledge and technology continues to evolve rapidly, the methodology presented here is designed to accommodate new strategies and materials and changing information.
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| 15 |
ID:
107479
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| Publication |
2011.
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The intentional and controlled release of an aerosolized bacterium provides an opportunity to investigate the implications of a biological attack. Since 2006, Los Alamos National Laboratory has worked with several urban areas, including Fairfax County, VA, to design experiments to evaluate biodefense concepts of operations using routine spraying of Bacillus thuringiensis var. kurstaki (Btk). Btk is dispersed in large quantities as a slurry to control the gypsy moth, Lymantria dispar. Understanding whether personnel and equipment pick up residual contamination during sampling activities and transport it to other areas is critical for the formulation of appropriate response and recovery plans. While there is a growing body of literature surrounding the transmission of viral diseases via fomites, there is limited information on the transport of Bacillus species via this route. In 2008, LANL investigated whether field sampling activities conducted near sprayed areas, post-spray, resulted in measurable cross-contamination of sampling personnel, equipment, vehicles, and hotel rooms. Viable Btk was detected in all sample types, indicating transport of the agent occurred via fomites.
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