Block 3

a microorganism, or toxin derived from a microorganism, which causes disease in man, plants, or animals or which causes the deterioration of material.

the intentional use of viruses, bacteria, other microorganisms, or toxins derived from living organisms to cause death or disease in humans, animals, or plants.

a microorganism able to cause disease.

microorganisms that are present in human blood and can cause disease in humans.

1) human body fluids

2) Any unfixed tissue or organ from a human

3) HIV containing cell or tissue cultures, organ cultures, and HIV or HBV containing culture medium or other solutions.

microorganism able to overcome the defense barriers and live inside the host; tissue damage may or may not result.

conditions where the host's tissues are damaged or their function is altered by the microorganisms.

(1) Pathogen

(2) Reservoir

(3) Escape from reservoir

(4) Transmission through Environment

(5) Portal of entry

(6) Susceptible Host

(1) Inhalation

(2) Absorption via dermal (skin) contact

(3) Ingestion

(4) Injection

oldest and most abundant life forms (unicellular and simple) on earth and are found almost everywhere.

Causes diseases usually by invading host tissues or by producing poisons (toxins).

nonliving infectious agents. They are intracellular parasites that are totally dependent on a living host and require living host cells in order to replicate.

harmful substances produced by living organisms (includes ricin)

(1) Fungi

(2) Parasites

(3) Prions

when a susceptible host comes in contact with a pathogen source either directly or indirectly.

microorganisms are transferred from one infected person to another person without a contaminated intermediate object or person.

includes Droplet spread

occurs when organisms are spread to a susceptible host via a contaminated intermediate object or person.

occurs when an infectious agent is transmitted to a host by a vector such as a mosquito, flea, or tick.

when infectious agents, carried by dust or droplet nuclei suspended in the air, are inhaled into the respiratory system.

CFR 1910.1030

Requires employers to develop an exposure control plan and identify job classifications, tasks, and procedures where there are occupational exposures.

Exposure plan also addresses hepatitis B, post-exposure procedures, staff training, related waste handling , engineering/work practice controls and PPE. The plan is required to be reviewed annually

- Infection Control Committee

- Engineering Controls and PPE

- Regulated Waste

Guidelines created by CDC to avert a resurgence of TB and to eliminate the threat to health care workers in various settings:

- inpatient settings

- outpatient settings

- nontraditional facility-based settings

environmental - administrative - respiratory protection

(1) Infection Control Committee

(2) TB Screening Program

(3) Respiratory Protection

(4) Engineering Controls

Highest Risk, Can be easily spread or transmitted, result in high death rates, cause public panic / social disruption, and reqiure special action for public health preparedness.

- Variola Major (smallpox)- Bacillus anthracis (anthrax)- Yersinia pestis (plague)- Clostridium botulinum toxin (botulism)- Francisella tularensis (tularaemia- Filoviruses- Ebola hemorrhagic fever- Marbug hemorrhagic fever- Arenaviruses

Second highest priority - moderately easy to spread- result in moderate illness rates and low death rates.- require specific enhancements of CDC's laboratory capacity and enhance disease monitoring.

- Coxiella burnetti (Q fever)- Brucella species (brucellosis)- Burkholderia mallei (glanders)- Alphaviruses - Venezuelan encephalomyelitis- Eastern and Western equine encephalomyelitis- Ricin toxin from Ricinus communis (castor beans)- Epsilon toxin of Clostridium perfringens- Staphylococcus enterotoxin B

Third highest priority agents include emerging pathogens that could be engineered for mass spread in the future.

- easily available- easily produced and spread- have potential for high morbidity and mortality rates and major health impact.

- Nipah virus- Hantaviruses- Tickborne hemorrhagic fever viruses- Tickborne encephalitis viruses- Yellow fever- Multidrug-resistant tuberculosis

- Intelligence Sources - Existing Documentation - Other service organizations and support agencies - Assessments of local hazardous facilities - Observations and interviews

- Intelligence Officer - Medical Intelligence Officer (PH) - National Center for Medical Intelligence (NCMI)

- Site specific data in DOEHRS - Water Vulnerability Assessments - After Action Reports (AARs) can identify issues with a location and lessons learned during past deployments - Prior Inspection Reports - Medical Treatment Facility IC Plan, TBIC Plan, and BBP Exposure Control Plan

- US Army Medical Research Institute for Infectious Diseases (USAMRIID) - US Army Public Health Command (USAPHC) - Centers for Disease Control and Prevention (CDC)

- Review Toxic Industrial Chemical (TIC)/ Toxic Industrial Material (TIM) Assessments - Local Government Agencies

- Visual Clues - Potential Hazardous facilities - Speaking to personnel

- Type of mission - Length of operation/ deployment- Living conditions - Working conditions- Geographical location and conditions- Threat characteristics - Exposure parameters - Personal protective equipment or individual protective equipment - Medical treatment resources

- Determine how the health affects personnel. - Consider how the health threat will affect the mission and operational requirements. - Clarify what are the psychological consequences on the unit? - Ask are there occupational or exposure standards that apply? - Consider the potential for exposure variability. - Identify plausible outcome or potential consequences.

- Ruggedized Advanced Pathogen Identification Device (RAPID)- Joint Biological Agent Identification and Diagnostic System (JBAIDS)- Portal Shield - Joint Biological Standoff Detection System (JBSDS) - Dry Filter Unit

- Chem/Bio Sampling Kit (QuickSilver) (for sample collection)- HAZMAT ID- Biological Sampling Kit including the Hand Held Assay (HHA) - XMX/2L-MIL Bio-aerosol Sampler

- limited detection- provides simple and quick ID of specific biological agents- single-use test

- used for collection of aerosols.- intended to be stationary for collecting aerosols in the air.- sample is collected in a vial and analyzed with HHAs, ELISA test kits or sent to lab for analysis.

- should be placed in the normal breathing zone range which is 5-6 feet. - capable of collecting aerosolized samples of 1-10 microns in size required to be able to be adsorbed in the lungs- collected in an impinger containing 5 mL of liquid (deionized water and pbs liquid).

- portable, impact resistant instrument.- designed for use in military field hospital, first responders and other rough environments.- detects 5 biological agent

- rapid and specific identification of biological threat agents.- detects 14 biological agents.- specimen and samples analyzed include blood, sputum, etc

- variable number of biological sensors networked with a central Command Post Computer (CPC)- detection of biological warfare agent triggers warning from CPC.

- early warning biological detection (BD) system.

- provides real time detection of biological conditions and early warning of biological attacks/incidents.- used in conjunction with point detectors.

- uses infrared light to analyze chemical bonds in compounds.- results from power-up to analyze take only a few minutes- indicates presence of pathogen bur nor specific pathogen identity.

features: aerosol collection system suitable for use in buildings or limited areas. Results take only a few minutes. Can not analyze, but indicates presence of pathogen.

- contains all tools, all required components needed for chemical/biological sampling.- lightweight- can be tailored to specific user requirements.

use on: - visible powders (or suspensions)- suspicious liquids- sampling a suspect area where visible contamination is present- Filed screening of suspect improvised explosive devices and munitions- Identification of aerosolized biological agents

- Inlet Stock- Manual Trigger- Timer- Liquid Impingement Module Access Door- 110V AC Power Input- Main Power Switch- Remote Trigger Cable Receptacle

Method of isolating, removing, and preventing biological hazard transmission.

- sharp disposal containers- laser scalpels - mechanical pipettes - splatter guards- negative pressure ventilation systems- ventilated biological cabinets- centrifuge tubes with caps

provide a physical barrier which keeps some of the contamination away from the people inside.

a dedicated hardened or unhardened shelter equipped with an air filtration unit providing over pressure. Protect those inside a building, room, shelter or tent against contamination through the combination of:

- impermeable structure materials- air filtration equipment- air locks- overpressurization

Located in a medical treatment facility, used to keep potentially infected patients away from the rest of the patients who may be waiting for treatment for other issues.

- Hand Hygiene- Sanitation- Food and Water Sanitation- Immunoprophylaxis- Chemoprophylaxis - Standard Precautions - Proper Labeling - Marked Contamination- Isolation, Quarantine and restriction of movement. - Safe Work Practices- Decontamination

prevention of disease by the administration of vaccines or hyperimmune sera before a person is exposed.

Only means of providing continuous protection against BW threats prior to, as well as during hostile actions.

the administration of medicines to treat a person. Generally, medication administered after exposure.

- Proper handling of used needles and other sharps including proper disposal and not recapping needles.- Following procedures for collecting and transporting potentially infectious fluids and tissue.- Limiting access to work areas where biological hazards are in use.- Performing procedures carefully to minimize the creation of splashes or aerosols.- Prohibited mouth pipetting- Not eating, drinking, smoking, handling of contact lenses, application of cosmetics, or storing food for human use in the work area.

prevents biological agent from reaching worker's airways, skin, mucous membranes, and clothing.

"selection is based upon anticipated level of exposure risk associated with different response situations."

- gloves- lab coats- gowns- shoe covers- goggles- glasses with side shields- masks- respiratory protection

- Carbon Dioxide - Carbon Monoxide - Relative Humidity - Temperature- Bio-Aerosols - Dusts/Fibers - Volatile Organic Compounds - Tobacco Smoke - Other

- HVAC system- Poor Office Layout- Combustion - Volatile Organic Compound (VOC) containing products- Wet/Damp Materials - Tobacco

- Building Walkthrough- Worker Interview- Measure Comfort Parameters- Investigate Odor/Smell Complaints- Investigate Mold/Bacteria Contamination- Air Sampling- Reporting Recommendations- Follow-up Visits