Chemical
& BioWeapons Review @ 2014
In Part I:
Preface & Introduction
Preface
Why
This Article?; and Why Now?
I
was very fortunate to be born at a time of peace and in an era of
hope for the world. All of these lights have gradually dimmed and we
are entering into an era of considerably more uncertainty than ever
before in the past 70 years.
What
if Edward Snowden, for example, had been a scientist, a biogeneticist
or bioengineer and had released the gene sequencing for every
bioweapon known to mankind – and more – to Al Qaeda or, even
worse, to a hitherto as yet unknown radical group somewhere in the
world ? What if something similar has already happened but we have
not been informed or the authorities are unaware? The argument might
be that with such knowledge available to all we are all much safer -
mutually assured destruction (MAD) it was called - a byword for an
era past.
But
are we? I am working on the assumption that we would not all be safer but
maybe quite the opposite.
I
do not have any solutions to any political issues in the world. For
those things you must look to your political representatives.
What
I do have is information which might enable you to think about how,
in the event of an unexpected crisis, you can act to save what is
precious to you – your community, your civil society, your family
and friends, or just yourself. While this article is primarily geared
towards those working together in the advent of a major bioterrorist
attack it is by no means critical of anyone who would choose to save
solely himself or just that of his or her immediate family and have
their own 'contingency' plan, independent of the authorities.
Before
I was born, my mother was training as a nurse. I think if I had not
been born she would have stayed in some caring profession all of her
life.
Beyond
paying all the bills (and there were many) money was never the object
of her working life. It is with my Mom Norah (and my aunt Mary) in
mind and in memory that I have written this particular article.
I
have drawn on the literature and expertise of numerous sources, both
named and unattributable, as their input was invaluable for the
research of this article. You should therefore, in the first
instance, refer to those first-hand experts, rather than to myself.
All these specialists you will find in the Reference section
following the article. Thanks to all those mentioned who have
contributed.
Introduction
Some
Definitions20:
The
following three descriptions, Toxin, Mass Casualty Biological (toxin)
Weapon and Militarily Significant Weapon
1.
A Toxin is any toxic substance that can be produced by an animal,
plant or microbe. Some toxins can also be produced by molecular
biologic techniques (protein toxins) or by chemical synthesis
(low
molecular weight toxins).
Chemical
agents, such as soman, sarin VX, cyanide and mustard agents,
typically man-made for weaponization.
2.
A Mass Casualty Biological (toxin) Weapon (MCBW) is any toxin weapon
capable of causing death or disease on a large scale, such that
the
military or civilian infrastructure of the state or organization
being attacked is overwhelmed. (Note: The commonly accepted term for
this category of weapons is ”Weapons of Mass Destruction,”
although that term brings to mind destroyed cities, bomb craters and
great loss of life; MCBWs might cause loss of life only. I do not
anticipate that
”MCBW”
will replace the term “Weapon of Mass Destruction” in common
usage, but it is technically more descriptive of toxin weapons).
3.
A Militarily Significant (or Terrorist) Weapon is any weapon capable
of affecting directly or indirectly, physically or through
psychological impact the outcome of a military operation.
Comparison
of Chemical Agents and Toxins20
Toxins
Chemical Agents
Natural
Origin
Man-made, large Scale, industrial
production
difficult,
small-scale
Non-volatile-
many are
more
toxic
Many volatile-but also many less toxic than toxins
Non-Dermally
Active
Dermally Active
Ordorless
& Tasteless
Noticeable Odor or Taste
Part
II: What Exactly Are Biological Weapons?
What
Are Biological Weapons?
''According
to an unclassified report of the Canadian Security Intelligence
Service, Chemical and Biological Terrorism: The
Threat According to the Open Literature (en français, La Menace de
Terrorisme Biologique ou Chimique Selon Les Sources Publiées):
Biological warfare agents include both living microorganisms
(bacteria, protozoa, rickettsia, viruses, and fungi), and toxins
(chemicals) produced by microorganisms, plants, or animals. (Some
authors classify toxins as chemical rather than biological agents,
but most do not, and they were included within the 1972 Biological
Weapons Convention-as reflected in its formal title, the Convention
on the Prohibition of the Development, Production and Stockpiling of
Bacteriological (Biological) and Toxin Weapons and on Their
Destruction). Writers on the subject have produced a long list of BW
agents that terrorists could potentially use. Among those mentioned
have been: anthrax, cryptococcosis, escherichia coli, haemophilus
influenzae, brucellosis (undulant fever), coccidioidomycosis (San
Joaquin Valley or desert fever), psittacosis (parrot fever), yersina
pestis (the Black Death of the 14th Century), tularemia (rabbit
fever), malaria, cholera, typhoid, bubonic plague, cobra venom,
shellfish toxin, botulinal toxin, saxitoxin, ricin, smallpox,
shigella flexneri, s. dysenteriae (Shiga bacillus), salmonella,
staphylococcus enterotoxin B, hemorrhagic fever, Venezuelan
equine
encephalitis, histoplasma capsulatum, pneumonic plague, Rocky
Mountain spotted fever, dengue fever, Rift Valley fever, diphtheria,
melioidosis, glanders, tuberculosis, infectious hepatitis,
encephalitides, blastomycosis, nocardiosis, yellow fever, typhus,
tricothecene mycotoxin, aflatoxin, and Q fever. Some of these agents
are highly lethal; others would serve mainly in an incapacitating
role. Some authors have also speculated about the possible terrorist
use of new, genetically-engineered agents designed to defeat
conventional methods of treatment or to attack specific ethnic
groups, for example.''8
Part
III: The History of Biological Weapons Since Prehistory
History
of the Use of Biological Weapons In Terrorism Since (Possibly)
Prehistoric Times
●
Prehistoric
(?) Possibly the use of poison plants, berries, nettles, feces
infused onto spears, wooden weapons, maybe even thrown at enemies as
(infused) poisonous sharp rocks to cause abrasions and lacerations
known at that time to inflict considerable pain and maybe even death.
[P.E.}
●
6th
Century BC --
Assyrians poisoned enemy wells with rye ergot1
(Part II)
●
6th
Century BC --
Solon of Athens used the purgative herb hellebore (skunk cabbage) to
poison
the water supply during the siege of Krissa2 (Part II)
●429
BC - The Great Peloponnessian War – Theban (Spartan) forces at the
siege of Plataea attempted to burn the entire town down,
poison-asphyxiate and disfigure it's inhabitants using wood soaked in
a mixture of sulphur and pitch (as both a fuel and oxidizer-similar
to Napalm) with the hope that the wind direction and current would do
the rest. Fortunately for the Plataeans heavy rain and thunder
intervened and the town did not burn down10.
If
you want to know the final outcome of The Great Peloponnesian War
[431-404 BC] read the references.
''During
the battle of Tortona in the 12th century AD, Barbarossa used the
bodies of dead and decomposing soldiers to poison wells.
●1346
AD
During the siege of Kaffa in the 14th century AD,
plague broke out in the Tartar army during its siege of Kaffa (at
present day Feodosiys
in Crimea). The attackers hurled the
plague-infected corpses of those who died over the city
walls to cause epidemic within the enemy forces; the plague epidemic
that followed forced the defenders to surrender, and some infected
people who left Kaffa may have started the Black Death pandemic which
spread
throughout
Europe.3(Part II)
●Russian
troops may have used the same tactic against Sweden in 1710. when the
Russians besieging Swedish forces at Reval in Estonia, catapulted
bodies of people who had died from plague.
11
●
1797
-- Napoleon
attempted to infect the inhabitants of the besieged city of Mantua
with
swamp
fever during his Italian campaign.
●1915
-- ...the case, dating back to 1915, of German-American physician Dr.
Anton Dilger, who established a small biological agent production
facility at his northwest Washington, DC home. Using cultures of
Bacillus Anthracis (Anthrax) and Pseudomonas Mallei (Glanders)
supplied by the Imperial German government, Dilger produced an
estimated liter or more of liquid agent. Reportedly, the agent and a
simple inoculation device were given to a group of dock workers in
Baltimore who used them to infect a reported 3000 head of horses,
mules and cattle destined for the Allied forces in Europe. Allegedly,
several hundred military personnel were also affected.
There
is also evidence that during World War I, German agents inoculated
horses and cattle with glanders in the U.S. before the animals were
shipped to France.
●1915
(December) : The German Nobel Prize Winner Fritz Harber formulates a
plan to release Phosgene into the trenches at Ypres. Much more deadly
than his earlier conceived Chlorine 'bombs' because of it's
inflammatory effects on the respiratory tract causing death by
asphyxiation.
Soon
afterwards, all combatants were using chemical weapons in The First
World War.
The
devastating aftermath of the usage of phosgene, mustard and chlorine,
the disfigurement, blinding crippling and general blight it brought
on the lives of those surviving and their carers brought a reality
check to the politicians - and probably guaranteed their limited use
by German Nazi Forces (on the Eastern Front and in Concentration
Camps) during the Second World War.
●1921
(Morocco, North Africa):Spain uses Chemical Weapons in the Riffian
Berber Rebellion12
[Because
Morocco remains a totalitarian regime, few children even today know
their history as well as Europeans do (sic. about Morocco) and are
therefore unable to place these actions into any coherent historical
framework.]
● 1931
-- in July 1994 Prince Mikasa of Japan revealed that Japanese
military officials had attempted to poison members of the League of
Nations' Lytton Commission assigned to investigate Japan's seizure of
Manchuria in 1931, by lacing fruit with cholera germs, but that "the
investigators did not develop the disease"
● In
1937, Japan started an ambitious biological warfare program, located
40 miles south of Harbin, Manchuria, in a laboratory complex
code-named “Unit 731”. Studies directed by Japanese General Ishii
continued there until 1945, when the complex was burned. A post World
War II investigation revealed that the Japanese researched numerous
organisms and used prisoners of war as research subjects. Slightly
less than 1,000 human autopsies apparently were carried out at Unit
731, mostly on victims exposed to aerosolized anthrax. Many more
prisoners and Chinese nationals may have died in this facility - some
have estimated up to 3,000 human deaths. Following reported
overflights by Japanese planes suspected of dropping plague-infected
fleas, a plague epidemic ensued in China and Manchuria. By 1945, the
Japanese program had stockpiled 400 kilograms of anthrax to be used
in a specially designed fragmentation bomb.
●In
1943, the United States began research into the use of biological
agents
for offensive purposes. This work was started, interestingly enough,
in
response
to a perceived German biological warfare (BW) threat as opposed to a
Japanese
one. The United States conducted this research at Camp Detrick (now
Fort
Detrick), which was a small National Guard airfield prior to that
time, and
produced
agents at other sites until 1969, when President Nixon stopped all
offensive
biological and toxin weapon research and production by executive
order.
Between May 1971 and May 1972, all stockpiles of biological agents
and
munitions
from the now defunct U.S. program were destroyed in the presence of
monitors
representing the United States Department of Agriculture, the
Department
of Health, Education, and Welfare, and the states of Arkansas,
Colorado,
and Maryland. Included among the destroyed agents were Bacillus
anthracis,
botulinum toxin, Francisella tularensis, Coxiella burnetii,
Venezuelan
equine
encephalitis virus, Brucella suis, and Staphylococcal
enterotoxin B. The
United
States began a medical defensive program in 1953 that continues today
at USAMRIID1.
●1972
-- the arrest in 1972 in Chicago of members
of a US right-wing group known as the
"Order
of the Rising Sun," "dedicated to creating a new master
race," who possessed 30 to
40
kilograms of typhoid bacteria cultures for use against water supplies
in Chicago, St.
Louis,
and other Midwestern cities. According to one source, the two
instigators, charged
with
conspiracy to commit murder, were college students, one of whom, a
19-year-old, "had apparently developed the culture in a school
laboratory, where a quantity was found". Ponte identifies the
facility in question as a Chicago City College lab. According to him,
the two arrested members of this "neo-Nazi" organization,
one of whom was a "local hospital worker," had "in
their possession detailed plans for dumping the deadly germs into the
water supplies". Berkowitz et al. report that the Chicago City
College student, one Steven Pera, "had worked as a volunteer at
a Chicago hospital medical center, but was ordered off the premises
when it was learned that he had grown bacterial cultures there and
had attempted to obtain chemicals without the proper authority".
After recounting this incident, Mengel noted that "the organism
selected would have been readily destroyed by normal chlorination".
Jenkins and Rubin, agreeing with this judgment, added that "The
two had recruited six or seven members who were to be inoculated
against the disease, but two of the recruits panicked and tipped off
the police.")
●In
1972, the United States, UK, and USSR signed the Convention on the
Prohibition
of the Development, Production and Stockpiling of Bacteriological
(Biological)
and Toxin Weapons and on Their Destruction, commonly called the
Biological
Weapons Convention. Over 140 countries have since added their
ratification.
This treaty prohibits the stockpiling of biological agents for
offensive
military
purposes, and also forbids research into such offensive employment of
biological
agents. However, despite this historic agreement among nations,
biological
warfare research continued to flourish in many countries hostile to
the
United
States. Moreover, there have been several cases of suspected or
actual
use
of biological weapons. Among the most notorious of these were the
“yellow
rain”
incidents in Southeast Asia, the use of ricin as an assassination
weapon in
London
in 1978, and the accidental release of anthrax spores at Sverdlovsk
in
1979.
●Testimony
from the late 1970’s indicated that Laos and Kampuchea were
attacked
by planes and helicopters delivering aerosols of several colors.
After
being
exposed, people and animals became disoriented and ill, and a small
percentage
of those stricken died. Some of these clouds were thought to be
comprised
of trichothecene toxins (in particular, T2 mycotoxin). These attacks
are
grouped under the label “yellow rain”. There has been a great
deal of
controversy
about whether these clouds were truly biological warfare agents.
Some
have argued that the clouds were nothing more than feces produced by
swarms
of bees.
●In
1978, a Bulgarian exile named Georgi Markov was attacked in London
with
a device disguised as an umbrella. The device injected a tiny pellet
filled
with
ricin toxin into the subcutaneous tissue of his leg while he was
waiting for a
bus.
He died several days later. On autopsy, the tiny pellet was found and
determined
to contain the toxin. It was later revealed that the Bulgarian secret
service
carried out the assassination, and the technology to commit the crime
was
supplied by the former Soviet Union.
●In
April, 1979, an incident occurred in Sverdlovsk (now Yekaterinburg)
in
the
former Soviet Union which appeared to be an accidental aerosol
release of
Bacillus
anthracis spores from a Soviet Military microbiology facility:
Compound
19.
Residents living downwind from this compound developed high fever and
difficulty
breathing, and a large number died. The Soviet Ministry of Health
blamed
the deaths on the consumption of contaminated meat, and for years
controversy
raged in the press over the actual cause of the outbreak. All
evidence
available to the United States government indicated a massive release
of
aerosolized B. anthracis spores. In the summer of 1992, U.S.
intelligence
officials
were proven correct when the new Russian President, Boris Yeltsin,
acknowledged
that the Sverdlovsk incident was in fact related to military
developments
at the microbiology facility. In 1994, Meselson and colleagues
published
an in-depth analysis of the Sverdlovsk incident (Science 266:1202-
1208).
They documented that all of the cases from 1979 occurred within a
narrow
zone extending 4 kilometers downwind in a southerly direction from
Compound
19. There were 66 fatalities of the 77 patients identified.
●1982
-- the reported
arrest by Los Angeles police and FBI agents of a man "who was
preparing
to poison the city's water system with a biological poison" .
●1983
-- the arrest by
the FBI in the Northeastern US in 1983 of two brothers who had
succeeded
in manufacturing an ounce of nearly pure ricin, stored in a 35-mm
film canister (Douglass and Livingstone 1987: 31)
● 1984
-- in September 1984 the Rajneesh cult
outside of Antelope, Oregon was said to have contaminated salad bars
in local restaurants in The Dalles, Oregon, with Salmonella typhi
(typhoid), resulting in the poisoning of 750 people, in order to
"influence the outcome of a local election".
● 1984
-- the discovery in Paris, variously dated to
1980, the "mid-'80s", or 14 October
1984,
of a Red Army Faction "safe house" that included a
"primitive laboratory" (according
to
one source, a bathtub containing quantities of botulinal toxin).
Douglass and Livingstone provide the most detailed account of this
incident: "The sixth-floor apartment contained typed sheets on
bacterial pathology. Marginal notes were identified by graphologists
as being the handwriting of Silke Maier-Witt, a medical assistant by
profession, terrorist by night. Other items included medical
publications dealing with the struggle against bacterial
infection....In the bathroom, the French authorities found a bathtub
filled with flasks containing cultures of Clostridium botulinum".
This may be the same incident as that described by the US House Armed
Services Committee as having occurred in 1989 (!) involving the
discovery of a culture of clostridinium botulinum in a "home
laboratory" in Paris of a cell of the German "Bader Mainhof
gang".
● UNSCOM
has discovered that Iraq produced 19,000 litres of botulinum, 8,400
litres of
anthrax,
2,000 litres of aflatoxin and clostridium.
●Russia
- A defector from the former Soviet biological weapons program
said in an interview on 24 February that Moscow's Cold War plans for
World War III
included preparing "hundreds of tons" of anthrax bacteria
and scores of tons of smallpox and
plague viruses for deployment on inter-continental ballistic
missiles. The
defector, debriefed by the CIA in 1992 after his defection, said that
the Russian military was
still running an offensive biological weapons program in 1991, and
may still do so.
●In
1995, further information on Iraq’s offensive program was made
available
to United Nations inspectors. Iraq conducted research and
development
work on anthrax, botulinum toxins, Clostridium perfringens,
aflatoxins,
wheat cover smut, and ricin. Field trials were conducted with
Bacillus
subtilis
(a simulant for anthrax), botulinum toxin, and aflatoxin.
Biological agents
were
tested in various delivery systems, including rockets, aerial bombs,
and
spray
tanks. In December 1990, the Iraqis filled 100 R400 bombs with
botulinum
toxin,
50 with anthrax, and 16 with aflatoxin. In addition, 13 Al Hussein
(SCUD)
warheads
were filled with botulinum toxin, 10 with anthrax, and 2 with
aflatoxin.
These
weapons were deployed in January 1991 to four locations. In all, Iraq
produced
19,000 liters of concentrated botulinum toxin (nearly 10,000 liters
filled
into
munitions), 8,500 liters of concentrated anthrax (6,500 liters filled
into
munitions)
and 2,200 liters of aflatoxin (1,580 liters filled into munitions).
The
threat of biological warfare has increased in the last two decades,
with
a number of countries working on the offensive use of these agents.
●The
extensive program of the former Soviet Union is now primarily under
the control of Russia. Former Russian President Boris Yeltsin
(1931-2007) stated that he would put an end to further offensive
biological research; however, the degree to which the program was
scaled back is not known. Recent revelations from a senior BW program
manager who defected from Russia in 1992 outlined a remarkably robust
biological warfare program, which included active research into
genetic engineering, binary biologicals and chimeras, and industrial
capacity to produce agents. There is also growing concern that the
smallpox virus, now stored in only two laboratories at the CDC in
Atlanta and the Institute for Viral Precautions in Moscow, may be in
other countries around the globe9.
''Medical
defense against biological warfare or terrorism is an area of
study
unfamiliar to most military and civilian health care providers during
peacetime.
In the aftermath of Operations Desert Shield/Desert Storm, it
became
obvious that the threat of biological attacks against our soldiers
was real.
Increased
incidents and threats of domestic terrorism (e.g., New York City
World
Trade
Center bombing, Tokyo subway sarin release, Oklahoma City federal
building
bombing, Atlanta Centennial Park bombing) as well as numerous
anthrax
hoaxes around the country have brought the issue home to civilians as
well.
Other issues, including the disclosure of a sophisticated offensive
biological
warfare program in the Former Soviet Union (FSU), have reinforced
the
need for increased training and education of health care
professionals on
how
to prevent and treat biological warfare casualties.
Numerous
measures to improve preparedness for and response to
biological
warfare or terrorism are ongoing at local, state, and federal levels.
Training
efforts have increased both in the military and civilian sectors. The
Medical
Management of Chemical and Biological Casualties Course taught at
both
USAMRIID and USAMRICD trains over 560 military medical professionals
each
year on both biological and chemical medical defense. The highly
successful
3-day USAMRIID satellite course on the Medical Management of
Biological
Casualties has reached over 40,000 medical personnel over the last
three years1.''
Part
IV: First Responders - What To Do In An Emergency
What
To Do Immediately If A Suspected Bioweapon or Bio-engineered Agent is
Released?
●
Decontamination
of Exposed Personnel.
●Determination
of the type of Contamination:
●
Primary
Contamination or
●
Secondary
Contamination
●
General
Supportive Measures.
●
Isolation
Procedures (Barrier Nursing).
●
Antibiotic
Therapy. ●Antiviral Therapy.
●Antitoxin
Therapy.
●PROTECTION
OF HEALTH CARE PERSONNEL
●
Use
of Barrier Techniques.
●
Potential
Biological Hazards.
●SECTION
V - HANDLING OF CONTAMINATED REMAINS
●SECTION
VI - MASS CASUALTY MANAGEMENT
(source:
Handbook on the Medical Aspects Of NBC Defensive Operations FM 8-9:
Recommendation
for Medical First Responders, Support Staff and Medical Volunteers:
At
a time of crisis this server will be overloaded so it is best that
you identify the appropriate publicly available sections (Chapter 4,
Management) in the above reference, download, hard print and file
save now rather than in the middle of a crisis.
Don't
forget to notify the CDC and USAMRIID (!)
Part
V
You
Can Never Predict With 100% Certainty The Next Surprise Attack
''Generals
Are Always Fighting the Last War – Especially If They Have Won
It''6(Part II)
I
read a fascinating article by
Colonel (Dr.) Jim A. Davis18
where he
presents several hypothetical scenarios for an attack on the United
States.
Other
scenarios could equally be applied to any other country.
Dr
Davis very logically covers each build up step, objective and
motivational analysis. But what happens if our terrorists are not
thinking 'inside the box'?
The
fact is we do not know how, why nor when such an attack (if ever)
will take place nor what the motives will be. It's assumed that a
superpower will be the 'first strike' option for either a 'terrorist'
country or group.
To
be guaranteed success in a first world country however, a Third World
country may well be the experimental testing ground for such a group
with a particular technical strategy in mind. I mention this because
there is always the inverted assumption that the superpowers develop
their biological and nuclear capabilities in Third World settings
(such as, for example, French nuclear tests on Moruroa Atoll – some
fair distance from the Champs Elysee and the Arrondissements where
such policies are formulated.) If this is so for developed nations,
why should a terrorist group contemplating a bioterrorist attack not
likewise seek out to test an experimental device(s) in a more remote
region before launching it's main offensive in the developed world?
But would this not alert the world? If it was identified as a
bioterrorist attack, then yes. But what if it is misdiagnosed or
misinterpreted? Or indeed what if a 'milder or 'designer'' version of
the weapon is deployed – resulting in it physical symptoms and the
'outbreak' passing by unrecognized by the international community?
Some
time ago I was told or read that a major Western power, as an
exercise, had 'deployed' a 'relatively' harmless 'bioweapon' in
secret, to test what the 'real' impact would be should 'the real'
thing ever occur. The number of personnel involved were not
insignificant but were all sworn to secrecy as the objective was of
course to protect the entire population should the real deal ever
occur. [I was not part of this deployment nor do I know anyone who
was, but somewhere, at the time, I heard or read a rumor that
something had taken place.]
Even
for a 'designer' variation of the common cold, deployed as a binary
weapon, the numbers of victims could be of epidemic proportions.
Most
morbidity and mortality from BW threat agents is preventable.
Immunizations, pre-exposure chemoprophylaxes, post-exposure
chemoprophylaxes, and protective clothing are available to provide
protection.
Personnel
must have all required immunizations administered prior to entering
an AO where BW agent employment is a threat. All immunizations should
be administered in sufficient time to provide the initial protection
before troops are deployed to the AO; when administration prior to
deployment is impossible, troops must receive the immunizations as
soon as the mission permits in the AO. Some immunizations are used in
conjunction with pre-exposure chemoprophylaxes or post-exposure
chemoprophylaxes to provide protection. The supporting PHS/PVNTMED
units/staffs can assist commanders in determining which specific
immunizations and chemoprophylaxes are required for the AO. The
corps/division/wing/equivalent service/joint task force commander
will decide whether to begin, continue, or discontinue the
administration of chemoprophylaxes based on the BW threat. The
intelligence officer, chemical officer, and surgeon advise the
commander on appropriate courses of action. For those BW agents that
a specific immunization is not available, the use of protective
equipment combined with chemoprophylaxes may be employed to provide
protection19.
Part
VI – Ebola and Misinformation
Ebola
The
spreading of Ebola beyond Central Africa was not unpredicted but the
prophets of doom and gloom were brushed aside for decades in the
interests of free market trade and commerce. To be more accurate,
there were different professional viewpoints and as no coherent
proactive strategy existed (nor exists) against the outbreak of a
deadly virus it was not deemed appropriate to persuade African
governments to devote considerable resources to education, hygiene
and healthcare. Another issue is the philosophy of public service
provision – infrastructure, healthcare and education. There is a
perception in the United States that public services have a negative
(non-productive) impact on economies so must therefore be consigned
to the barest of minimum resource allocation while at the same time
encouraging the private sector to develop ranges of chargeable
services which would otherwise be the responsibility of the State.
Where the provision of public services are contrary to the market
economy then they must not be encouraged.
It
is this misperception which, in part, has led to the present Ebola
crisis and it will ultimately be that same misguided belief which
will fuel future epidemics and pandemics - especially in parts of the
world where such public services are either virtually non-existent or
such are outsourced to the private sector.
Other
than as a commercial beneficiary, the private sector has no interest
whatever in healthcare infrastructures to 'save' populations.
Already
we see in the stricken countries of West Africa that the best,
brightest, most highly educated individuals who were 'first
responders' to the crisis, that at least 50% of them are dead. The
figure is probably higher. No country or region can sustain such
losses without civil unrest. So the role of foreign military forces,
initially deployed to assist with the medical 'mercy' missions, could
very well face yet other dilemmas which they are wholly inadequately
configured to manage – as recent global conflicts have so clearly
demonstrated.
Other
than Scare Tactics, What The Mainstream Media Is Not Addressing In
Detail
What
is not being addressed in the media at large is the potential to
synthesize Ebola for terrorism. There are many easily obtainable
items which can be synthesized to be deadly and some virtually
untraceable by forensic experts if administered under the right
conditions. These are well known facts to those 'in the business'.
Fortunately
there are few in any country engaged in bioweapons research who have
such motivations but the potential for mass infection is steadily
increasing.
As
terrorists find themselves frustrated by advanced technological
security systems they will seek to respond asymmetrically – by
using base and crude elementary systems which completely bypass
sophisticated arrays created in the developed world.
Part
VII – What The Article Will Cover
What
This Article Will Address
I
want to focus on why Bioweapons are an optimal terrorist choice so
that the layperson can have some insight and appreciation into the
thinking behind the choice of such options on the battlefield – and
indeed where the term 'battlefield' may be extended to larger
conurbations in order to create maximum havoc, disruption and chaos
and bring to a swift end, with minimum loss of life, a situation
where the potential for protracted warfare resulting in the loss of
millions of souls, is very real.
The
introduction was meant to make you be 'comfortable' with the fact
that biowarfare is not a 20th nor 21st century
phenomenon.
Objectives
Of This Article
The
purpose of this article is therefore not to look at countermeasures
nor present anything but the crudest of scenarios already in the
public domain.
Neither
is this article concerned with how to develop them for first strike
capability but it does focus on how to identify them when they have
arrived and how to respond to protect the populace. So the objective
here is knowledge, protection and survival.
This
article will therefore not examine the efficacy or otherwise of
countermeasures to defeat such terrorism but make a few suggestions
as to how would-be first responders (including volunteers) can
proactively prepare for something which, hopefully, will never happen
(at least not in my lifetime.)
Don't
Die of Ignorance
The
second purpose is to inform the general public about what is out
there, being worked on, so that some may take appropriate measures to
protect themselves and their families – because no government has
the resources to protect entire populations from germ warfare and the
only contingency measures in place are containment and martial law to
(it is hoped) prevent civil unrest.
What
You Need To Know
A
further recommendation is that you access pictures on the internet
showing diseases and symptoms of infectious diseases outlined below.
The
USAMRICD1 and CDC2 are good starting points for
such an exercise.
You
should download these public access materials save and hard file them
in appropriate folders under the relevant medical categories for
pathogen symptoms.
For
medical professionals, both The USAMRICD1 and CDC2
provide distance learning courses and will welcome your contact
and input.
The
article below is by no means comprehensive but at least it's probably
more knowledge than you had before reading.
Part
VIII - Bioweapons
Bioweapons
– A Summary & Review
There
are 3 distinct types of Bioweapons:
1.Respiratory
2.Bacteria-Based
Weapons
3.Genetically
Engineered Bioweapons
Respiratory
and Dispersion
The
first thing which is to be mentioned is that any medium which carries
air over water has the capability to absorb toxic clouds ultimately
dispersing them, through air filtration (air conditioning systems)
througtals and other public buildings, decorative waterfalls and
fountains in public places, even showers can all be utilized as
effective mediums by biological weaponry agents.
Other
mediums can create 'false flags':hout a target area.
This
is how Legionnaires disease first got started. Supermarket air
coolers for fruit, vegetables, other produce, air vents in hotels,
hospitals and office buildings.
For
example terrorists can create scenarios where members of the public
unwittingly 'carry' or 'transport' lethal viruses which under certain
conditions will activate and disperse.
[This
could be, for example, in the form of a 'present' given to a child to
'carry' through any locus where there are major public gatherings.]
A
terrorist scenario, for example, would be to 'infect' all hospitals
or indeed other emergency response personnel – including police and
military - in a region – thereby incapacitating if not crippling
the ability of the critical emergency services to respond to the
forthcoming secondary (principle or primary) biological attack as
most of the response personnel are now either infected or dead.
In Third World countries the ratio of Military medical emergency
parallel services is very weak if existing at all and few ever
practice for such a scenario. I will not go into the reasons why as
the objective here is to identify weaknesses and it's not my job to
provide 'band aid' solutions for the Third World – they need to
look to their respective governments to do that. Even Third World
countries should have a 'backup' emergency plan in the event of such
a scenario. There should be a tier of paramedicals who are not within
the system but engaged (and valued) as local, district and regional
volunteer helpers and who have some basics in a range of skills which
could, potentially, 'hold the line' until large-scale assistance
arrives on the scene.
There
is no Third World country I know of which, at present, is even
contemplating having such a system as major crises, by their very
nature, result in reactive and not (preparatory) proactive management
actions – principally because of the time and costs involved.]
The
innocent person will then, after perhaps exhaustive utilization of
time, scientific and human resources, be apprehended while the real
terrorists will meanwhile have implemented their real objective or
objectives – overwhelming the ability of even the most advanced
country to respond with the specialized resources – overstretched
as they now already are. Invasive pathogens - Salmonella, Shigella,
Cholera, E Coli,are examples of infective gram negative bacteria1
which can with ease establish harmful infective human hosts.
For
health professionals, how substances traverse the
gastrointestinal tract are of fundamental importance.
If,
like me, you are not a medical professional, please ensure
that you contact the Press Office of both The USAMRICD1 and
CDC2 with any enquiries.
Other
Bioweapons
Sexually
transmitted diseases (Gonorrhoea, Syphilis and AIDS) can be grown in
cultures and incorporated into abrasion dusts (weapons which cause
scratching-like symptoms.)
Once
the host (victim) starts scratching, the abrasions are uploaded with
the disease organisms at the contact points and under the fingernails
of the targets. Once inside the tissues, the infections are dispersed
through the tissues, organs, and bloodstream.
Any
scenario where there is a massive build up of organisms in colonies
(billions for each colony) that can be seen and the accumulation of
toxins can cause very rapid infection followed by expiration (death.)
As
I mentioned in an earlier article extract (U.S. Army, Fort Sam,
Texas) animals, birds, and insects can be reservoirs (vectors) for a
wide range of disease organisms. The vectors transmit the deadly
organisms usually by biting the victim and passing the microbial into
the tissues with saliva or similar liquid medium. This is only one
means of transmission. Urination and death of the vector also have
the potential to spread the pathogenic bacteria.
Rabies,
Yellow Fever, Dengue Fever,Encephalitis, Tick Fever, Plague,
Tularaemia, Rocky Mountain Spotted Fever, Typhus, Chagas, Sleeping
Sickness, Malaria are passed to humans in the aforementioned ways14.
There
are very special characteristics for the above for use as bioweapons.
The
first is that none can survive for prolonged periods outside their
host carriers or humans. If they can create a bridge or bridges to
enter the victims target tissues, the respiratory tract will
facilitate as the transport medium for mass dispersal inside the
human body.
Direct
Contact From Burns, Wounds, Chemical Injuries or Abrasions
For
the medical professional knowledge of how the epidermis and dermis
function as active and passive absorption layers and defenders is
critical. Below the two layers lie the tissues and circulatory
systems which move all the nutrients around the human body.
The
same system is easily hijacked by infecting organisms in the context
of our discussion.
Bacteria-Based
Weapons
The
thing to be cognizant about here is that bacteria which require
oxygen to grow and replicate are called aerobic bacteria and those
which only grow in the absence of oxygen are know as anaerobic
bacteria. The mediums which can be utilized to grow bacteria and
toxins for use as Bioweapons are available to the poorest countries
in the Third World.
They
are pretty basic and are at the core of what I have often referred to
over the years as 'the poor man's nuclear bomb.'
Part
IX - Anthrax
Anthrax
Identification
of Anthrax as a Cause of Death
Before
discussing anthrax it is worth mentioning a very unique identifying
feature of the deadly infection: The blood oxygen level falls to less
than 1%. from the normal 18-21% for arterial blood and 12% - 15%
(v/v) for cleated erythrocytes.
In
all other causes of death (including death by asphyxiation) the blood
oxygen level remains above 6%.
The
locus of application of any toxin and it's density (strength)
together with the strain of anthrax will determine it's rate of
effectiveness. Applications of different strengths and strains to
different parts of the human body will dramatically affect the time
taken for the the bioweapon to affect the target.
There
are 4 routes to anthrax infection
1.Cutaneous
Infection (an abrasion to the skin)
2.Gastrointestinal
Infection (eating undercooked meat from an infected animal)
3.Inhalation
(Pulmonary) Infection (where you breathe in anthrax spores)
4Injection
Infection
Anthrax
is aerobic, facultative anaerobe, non-motile and spore forming.
It
has existed since man first started domesticating animals in the
fertile region of the Tigris-Euphrates delta. It was believed to be
one of the seven plagues of Egypt at the time of Moses and has been
described in detail by the ancient Greeks.
It
is spread exclusively from the nose, mouth, anus, faeces, tissues of
infected and dead animals and humans. It forms spores which can last
for decades and is highly resistant to heat, pH changes, and humidity
all of which account for the almost impossible task of eradicating it
from infected areas and why the import of on the hoof or cooked meat
from infected zones is strictly forbidden. For example, anthrax
spores were isolated from naturally infected soil one hundred years
after the soil was first infected. Humans are infected with anthrax
in the natural environment through dermal, respiratory and ingestion
routes of entry.
To
give two examples, anthrax has been isolated from the animal hide and
skins covering traditional wooden drums from Africa.
Anthrax
spores are highly resilient even after decades in dry ,arid climates.
The
anthrax spores of Infected animals which were slaughtered and cooked
were found to have survived the cooking process – and have also
ended up in the bone meal which were industrially packaged and fed as
meal feed to animals. Anthrax produces a toxin which requires 3
factors to be virulent.
All
32 must be present for maximum toxicity (to cause maximum
harm.)
1.Protective
Antigen (PA)
2.Lethal
Factor (LF)
3.Edema
Factor (EF)
All
3 components are serologically active, distinct, and immunogenic.
A
combination of PA and LF are required for lethal infections.
PA
and EF cause infection (Edema reaction.)
EF
and LF together, have no effect whatsoever.
The
path to infection is that PA is activated (reacts) to receptors on
the host (victim) cell surface.
These
produce changes on the cell surface which changes themselves act as
'keys' to 'unlock' the cell, thereby permitting EF and LF to enter
the cell through these 'keyholes' created by the PA-cell surface
interface. EF then reacts with a heat stable substance to produce the
toxin activated swelling (or edema) reaction. The toxin alone,
however, is not sufficient for virulence.
Only
strains of B, anthracis13, that produces both a spore
(capsule) and a toxin are considered virulent.
Why
Anthrax is So Deadly and a 'Designer' Bioweapon of Choice?
When
anthrax infects a host (victim) antibodies are produced against the
capsular antigen but these antibodies are not protective
against the toxin. The toxin gradually accumulates inside the host
until it causes death from respiratory failure and anoxia by it's
actions on the CNS (central nervous system.) On an ordinary culture
medium (or media) the anthrax grows but does not produce it's
exotoxin. The anthrax bacteria itself is not toxic either.
This
is the reason why vaccines produced with 'dead' anthrax cells were
ineffective at providing immunity. The 3 factors identified above
require live animal tissue to
produce the toxin. In nature, when the spores germinate and when they
vegetate in incubator areas, they likewise do not produce these
factors nor toxin.
Immediate
Signs of Infection
When
the organism gains access to living (human) tissue through a cut or
abrasion, they multiply with a very dramatic inflammatory response:
2-5
days after infection a small papule develops that quickly becomes a
vesicle filled with dark bluish-black fluid. Rupture of this vesicle
reveals a black eschar at the base with a prominent ring of reaction
around the eschar. This is called the malignant pustule.
If
at this stage the carbuncle is incised and drained or surgically
removed, the natural immunity system of a healthy individual will
normally 'kick-start' to prevent further spread of the infection.
This assumes an active, healthy, immune system and the statistics for
persons of different ages would identify 21-33 year-olds as the
optimal for such systems activations. 12al professionals,
knowledge of the inhalation process all the way to the lungs to the
draining hilar lymph nodes and identifying the initial signs of
haemorrhagic necrosis is critical. Knowledge of the bloodstream flow
to the spleen where the toxin multiplies in enormous numbers,
together with knowledge of how alveolar phagocytes attempt to contain
the infection by attacking and ingesting the spores (toxins) and then
naturally carry them to the mediastinal lymph nodes – where they
have not only have survived the phagocyte attack but are here
actively germinating, is critical to the understanding of the spread
of the infection throughout the organism. From here the cells now
infect the entire organism. The symptoms are typically those of a
respiratory infection with fever, malaise, myalgia, and unproductive
cough. Within several days marked respiratory distress septicaemia,
meningitis, and cyanosis become apparent.
Expiration
(Death) usually occurs within 24 hours of this worsening. Only a very
small number of spores are required to be effective by the inhalation
route.
This
is why health professionals may not, at first, be prepared to
believe or accept or even recognize what they are seeing as symptoms
of an anthrax attack.
This
is not uncommon nor is it to be criticized in hindsight but most will
quickly recognize that if numbers of individuals are displaying
similar symptoms there must be something happening and will quickly
then work out that what was a side show in their medical training has
now just become mainstream. It is for these reasons that I refer
health professional s to the best available sources of data on
these topics in the world - USAMRICD1 and The CDC2.
Part
X
I
don't Want To Be Alarmist but.....
We
Are [or Could Be] Under An [Unknown] BioWeapon Attack, What Should We
Do?
In
Third World countries, for health
professionals having access to the internet,
the first advice in such circumstances should always be to follow the
chain of command within their country's medical structure. In
addition to this however no medical or
paramedical or health worker or health assistant or High School First
Aid Volunteer should be without the email and
Skype contact details for the Center for Disease Control in Atlanta,
Georgia, The United States, and USAMRICD. This they should
retain in a book of international health emergency contacts.
The reason I suggest these is because local chains of command may
neither have the expertise, personnel nor the resources and if the
'attack' which is occurring is over a religious festive period
(during Christmas, Ramadan, Eid, Nowruz, Diwali, Wesak or Songkran as
examples) the country may not have the senior political nor medical
personnel in place to quickly respond to an emergency situation.
Therefore assistance with some vital questions and answers may not be
easily forthcoming, locally, at this time of crisis which has the
potential to escalate into a national, regional and, at the very
worst, potentially global, tragedy.
'Designer'
Genetically Modified Bioweapons: - Weapons of First World Terrorist
Choice
Genetically
engineered pathogens would likely prove to be more challenging than
any preceding anthrax attack to date. Their unique properties would
include:
1.High
transmissivity
2.Higher
Communicability
3.Higher
antibiotic resistance – since the strains can easily be
'intelligently' bio-engineered to 'mutate' on each new 'encounter'
developing a counter-vaccine would prove very challenging.
For
example, the entire DNA sequence of the smallpox genome is known and
may, already, have been genetically manipulated.
Apart
from the Center for Disease Control in Atlanta, it's counterpart in
The Russian Federation is The Russian State Research Center for
Virology and Biotechnology at Koltsovo, Novosibirsk.
You
will find when you reference the website that it is not as 'globally'
orientated as it's U.S. Counterpart as is more 'ethnocentrically'
focused on it's FSU (Former Soviet Union) 'client' states than, for
example, on the Third World, where it has little input nor impact on
daily lives.
There
have been reports that Al Qaeda have sought to financially acquire
Bioweapons.
What
you must appreciate here is that the vast majority of individuals
involved in researching such organisms are not motivated by the
desire to destroy the world but to understand the 'psychology' and
bio-mechanisms of unknown structures to prevent catastrophes
not to create them. Sadly it only takes one (or a few working
and cooperating in consort with a range of required skills) or an
intelligent 'lone wolf' - and there goes the neighborhood (!) In this
regard I am not unconvinced that there are not many intelligent 'lone
wolfs' worldwide. For this reason, I am predicting, there will be
individuals and groups who have enough knowledge to not just create
the scenarios outlined above but maybe even go further – as their
programs and objectives are unknown and not subject to 'oversight'
(!)
Part
XI – Asymmetric Warfare
Most
would-be bioterrorists are seeking to identify, cultivate, engineer
and utilize viruses with the capability for 'instant kills' -
usually on behalf of a political, economic, financial religious
(cult) or spiritual ideology. By their very
nature, this reduces the morbidity-mortality** ratio to the bare
minimum.
In
the context of this article however, the 'perfect' virus is one which
adaptively, sequentially, and non-sequentially will mutate, infect
widely (exponentially - high transmissibility), cause general panic
(fear of the unknown) kill over months or even years - and during
this time be virtually undetectable - thereby ensuring the
perpetrator(s) are difficult to identify and have long-since made
their exit from the target area before the effects (symptoms) become
apparent. The 'perpetrator' could be a State, or a 'false flag'
created by a State, group, individuals or even by the proverbial
'lone wolf'. Fortunately such a virus (known or unknown) does not (or
is unlikely to) provide for 'instant gratification' - and is of
limited use (if at all) for terrorists attempting to achieve
objectives within timeframes as determined by circumstances on the
ground. One cannot be entirely dismissive of a State-backed
group having the motivation and support to be 'encouraged' to
'pursue' a long-term strategy in this regard.
Asymmetric
BioWarfare
As
we develop more complex systems of deterrence what more ideal
scenarios for Bioterrorists is to 'get back to basics' with such
mediaeval and crude responses to completely make sophisticated
systems almost obsolete. There are a myriad of ways to significantly
degrade modern security systems specifically designed to detect a
Bio-terror attack.
Initial
Confusion – A Natural Reaction To An Unexpected Bioterror Attack
In
the event of an attack with a genetically engineered pathogen
likewise health professionals would, initially have some
confusion as to whether this was a naturally occurring event or
something more sinister. Other than in the medical textbooks or as a
sideshow to their University medical course few (if any) will ever
have seen the effect on humans of smallpox or the visible aftermath
of an anthrax attack.
The
Scenario
A
genetically engineered attack could unfold unlike no other to date.
The
time sequence between infection and outbreak could be days, weeks or
even months.
The
symptoms and progress or course of the infection, if the pathogen
mutates sequentially or non-sequentially, would cause general panic.
I
recall from my childhood reading about, I believe it was a French
colony in the West Indies, perhaps Guadeloupe, where after a volcanic
eruption the only survivors in an area were prisoners. They had
survived because they were locked in dungeon cells.
You
might find similar scenarios in the aftermath of such an attack where
individuals and groups who, perhaps by accident, were 'isolated' from
mainstream populations had initially been unaffected until contact
was resumed.
As
with the Black Death in Mediaeval Europe, individuals with particular
genetic sequences or 'gene defects' may well prove resilient to such
a bioterrorist or bioengineered attack. We cannot say with any
certainty how a bioengineered agent would 'code' with an 'abnormal'
genetic sequence.
As
with any virus, the 'key' requires and exact 'lock' to fit in order
to open the cell for exploitation.
For
the health professionals and volunteers securing
teams of non-infected individuals should be a priority.
Protective
clothing and masks must, as a priority, be upgraded to ensure it will
match the anticipated NBCR environments.
By
choosing inferior quality products, Third World (and perhaps also
Developed countries) countries will only learn, sadly, from bitter
experience, why cost-cutting in their choice of suppliers in this area,
was a bad choice.
Part
XII – The Next Generation of Bioweapons
The
Next Generation Of Bioweapons
6
major categories of future pathogens have been assessed:
●Binary
Biological Weapons
●Designer
Genes23
●Gene
Therapy As A Weapon24
●Stealth
Viruses25
●Host-swapping
Diseases26
●Designer
Diseases27
Binary
Biological Weapons
This
would consist of 2 main components or parts which, when separate,
would be innocuous but when combined would form the lethal pathogen.
Many pathogenic bacteria contain multiple plasmids (small circular
extrachromosomal DNA fragments that 'code' for virulence or other
special tasks.)
To
produce a binary biological weapon a host bacteria and a virulent
plasmid could be independently isolated and produced in the required
quantities. Just before deployment, the two or more individual
components would be 'mixed' together to produce the lethal toxin. The
transformation of the host organism back into a pathogen could
conceivably, take place after the bioweapon is 'triggered' during
whilst in transit.
Categories
2-6:
If
you are a health professional, health volunteer or first
responder please refer to the references below for each of the
other given categories above.
It
will be a very useful and worthwhile exercise for you to appreciate
the references first
hand
and for you to extrapolate potential scenarios from each. Such could
well be used for emergency drills or other emergency planning
exercises.
Part
XIII – Neither Virus Nor Bacteria
BioWarfare
Engineered Diseases Which Are Neither Virus nor Bacteria21
While
there is fierce controversy (at this historical point) about the
reference I am citing here, the core message is, without doubt,
pointing to futureworld scenarios (already arrived) - which you
ignore at your peril. I would refer you to pages 3-5 of 9 (.pdf
version-not the similar version as cited below) in particular. I will
not quote as fact from this article only refer you to it so you can
judge it's relevance or otherwise - If We Can Do It Then So Can
The Bioterrorists - it's a 'walk in the park'.
I
have a very personal reason for citing this reference which I will on
this occasion share with you:
Some
years ago, at a diplomatic reception an individual I don't know
confronted me about something I had written about a country I had not
visited (at least not recently.) He (or his superiors) were clearly
irritated (or frustrated) that an insignificant 'upstart' (myself)
should 'get it right' on an issue of major significance. Our
conversation ended amicably but quite firmly along the lines
that...well...maybe I should stick to writing about places I had
visited recently rather than shoot my mouth (or pen as it was) off
about places about which I had no first hand experience. Of course
totally ignoring that I was factually accurate and more concerned
with the fact that, in some inconvenient way, I had 'upset' the
'pecking order' of things, much to the irritation of those
fat-do-nothing-chickens who just squawk and cluck and shake their
feathers in all directions in the pen when anything wakes them up and
they have to do something.
I
assiduously try to avoid discussing anything (written article) I have
worked on with people I don't know but sometimes it's unavoidable. I
don't know the relevance nor significance of this article (reference
21) but I am motivated to include it because many of it's
references cited are of highly respected individuals who are
controversial but have significantly increased our understanding of
Biowarfare as a developing tool in the Superpowers optional arsenals.
If it is a developing tool in a State's arsenal, be assured the
significance of this is not lost to terrorists.
Part
XIV – Let Us Take An Example of State-Sponsored Bioterrorism
Chemical
and Biological Agents Available To Any Developing Third World
Country22
[and,
because of either the absence or lax security, likewise potentially
available to terrorists]
Note
that the choice of chemical and biological agents below is based on
an actual real occurrence documented by the United Nations22
I
have identified and chosen this country's Program as a template
because it's level of technological development at that time is
currently being matched by countries in the Middle East, The
Caucasuses, South East Asia and South America today.
Chemical
and Biological Agents
Aldicarb
is a pesticide. Its white crystals have a slightly sulphurous
odour.
It is toxic. The probable oral lethal dose for humans is less than 5
milligram/kilogram
(1/15th of a teaspoon for a 70-kilogram person).
It is
poisonous
by ingestion and skin contact. Death is caused by muscle
weakness,
accumulation of fluids in the lungs, respiratory and heart failure,
epileptic
fits and coma. (RRL offered aldicarb dissolved in orange juice).
Anthrax/
Bacillus anthracis is a highly infectious and virulent microorganism.
Human
infection in the natural state is usually through the skin
but
also follows after inhalation or ingestion. Inhaling B. anthracis
spores
(dormant
form) may result in pulmonary anthrax, which is often fatal.
Anthrax
of the lungs follows 2-5 days after exposure and is
characterized
by a mild initial phase of fever and malaise followed by
sudden
onset of severe acute illness with high fever. The lymph nodes in the
chest
become swollen and ulcerate, and these festering, bleeding
ulcerations
spread to other important organs in the chest. Respiratory
distress
develops, followed by cyanosis, shock, coma and death. Dr Mike
Odendaal
told the TRC and the court that he had put anthrax spores on
cigarettes
and on the gum of an envelope.
Azide
(sodium azide, hydrazoic acid) salts are used industrially in the
manufacture
of explosives and preservatives. It is a cell poison causing
death
by a mechanism similar to that of cyanide. Sodium azide crystals are
colourless
and odourless.
Azide
is poisonous by ingestion, inhalation and skin contact. According
to
Dr G. Muller, the medical expert who testified in the Basson
trial,306 an
individual
who ingested 700-800 milligrams (1/6th of a
teaspoon) died three
days
later as a result of failure to breathe. Death is caused by a fall in
body
temperature
and blood pressure, respiratory failure, epileptic fits and coma.
(RRL
offered 3 doses of 1.5 grams of this substance mixed in whisky—well
over
a fatal dose. RRL research reports relate that this poison was tested
on
dogs,
pigs and baboons.)307
Botulinum
is a nerve poison produced by the micro-organism
Clostridium
botulinum. It is the most poisonous biological toxin known,
about
1 million times more poisonous than arsenic. Ingestion in food causes
progressive
paralysis of nerves and voluntary muscles (from half an hour to
90
several
days after ingestion) resulting in respiratory failure and death.
(RRL
offered
4 beer bottles contaminated with botulinum).
Brodifacoum
is classified as a superwarfarin. It prevents the clotting of
blood
and is used in rat poison. It is an off-white powder. Poisonous by
ingestion,
it blocks the blood clotting cascade, causing bleeding for weeks
to
months. Bleeding starts 36-48 hours after ingestion. Death is caused
by
blood
loss and brain haemorrhage. According to an RRL report prepared by
James
Davies and André Immelman, this substance was tested on 8 blue-apes,
who
all bled to death, starting with their gums, over a 24-hour period.
The
researchers suggested that a larger group of primates be tested and
other
species
be included in the experiment.308 RRL offered two
peppermint chocolates
contaminated
with brodifacoum.
The
pathogenic micro-organism B. melitensis causes the disease
known
as brucellosis (Malta Fever). This infectious disease is
characterized
by
an acute fever stage and a chronic stage with relapses of fever,
weakness,
sweats
and vague aches and pains recurring over months or years. A single
dose
is listed as having been given to a security force operator in
October
1989.309
Cantharadin
is a biological poison derived from blister beetle (Spanish
fly).
The crystals are colourless and odourless. As little as 10 milligrams
of
this
toxin has been fatal. Systemic poisoning can develop after ingestion
or
by
skin contact. Physical contact causes potent skin and mucous membrane
irritation
and blistering. Oral poisonous doses cause extensive organ
damage
characterized by a burning sensation of the mouth and throat,
followed
eventually by kidney and respiratory failure, shock and coma.
(Immelman
gave 70 milligrams, enough to kill 7 people, to a policeman in
1989).310
Colchicine
is an anti-inflammatory agent used in the management of
severe
gouty arthritis. It is a pale yellow nearly odourless substance which
darkens
on exposure to light. As little as 7 milligrams can cause death.
Symptoms
and signs of poisoning, 2 to 12 hours after ingestion, include
severe
nausea and vomiting, bleeding from the gut, and shock. This
progresses
to multiple organ failure, especially heart and respiratory failure,
and
bleeding tendencies. Death, which may occur 7-36 hours after
91
ingestion,
is usually due to respiratory failure and cardiovascular collapse.
(Immelman
gave 75 milligrams of colchicine, enough to kill 10 people,
hidden
in whisky, to a policeman, in September 1989.)
Digoxin
is a well-known drug classified as a cardiac glycoside. It is
commonly
used in the management of heart failure and abnormalities in
heart
rhythm. Digoxin powder is composed of odourless, white crystals.
The
therapeutic dose is close to the lethal dose. The usual therapeutic
dose
ranges from 0.125 to 0.25 milligrams per day. Adult patients with
normal
hearts (those not on digoxin) rarely develop life-threatening
poisoning
with less than 5 milligrams in an acute ingestion. However, acute
ingestion
of 2 milligrams in patients on long-term digoxin therapy may result
in
potentially serious poisoning. Acute digoxin poisoning usually
presents
with
nausea, vomiting, diarrhoea, abdominal pain, fatigue, delirium,
hallucination
and seizures. Death is caused by severe heart rhythm
disturbances,
resulting in heart failure and cardiac arrest. Immelman gave 5
milligrams
away. (The State prosecutors allege that the intention was to use
this
to poison ANC leader Dullah Omar.311 Basson was
acquitted on the
charge
of having been involved in this incident.)
The
mamba is a dangerously venomous snake. The venom is a
neurotoxin.
Prodomal symptoms of neurotoxicity, including drowsiness,
vomiting,
hyper salivation, increased sweating, trembling, skeletal muscle
fasciculation
and circumoral sensation of pins and needles may appear
within
5-10 minutes. More specific and classical neurotoxic symptoms and
signs,
which may develop within 30-120 minutes, include: blurred speech
and
difficulty in swallowing. Progressive respiratory muscle paralysis,
leading
to respiratory failure, is the most serious neurotoxic effect,
usually
developing
within one to three hours and is usually the cause of death.
(Immelman
gave away an unspecified amount of mamba toxin.)312
Mercuric
oxycyanide is a white crystalline powder. It contains both
mercury
and cyanide. The clinical picture of acute organic mercury
poisoning
includes vomiting, a bloody diarrhoea, a profound circulatory
collapse
(shock) and kidney failure within 24 hours. (Immelman gave a man
he
knew only as “Koos”, believed to have been a policeman, 4 grams
of this
poison.)313
92
Methanol
(wood alcohol) is a poisonous alcohol. It is an inherent cell
poison.
At room temperature it is a colourless liquid with a slight alcoholic
odour.
Methanol is converted in the human liver to formaldehyde and then
to
formic acid. It is these two metabolites, rather than the methanol,
that
are
highly poisonous. If untreated, methanol poisoning can lead to visual
changes,
severe acidosis, kidney failure, coma and finally respiratory or
heart
failure and arrest. (Three doses of 30 millilitres are recorded on
the
RRL
Sales list.)
Paraoxon
is an organophosphate pesticide. It is a potent nerve poison
which
is poisonous by ingestion, by mucous membrane as well as skin
contact.
Probable oral lethal dose for humans may be as low as 1/50th
of a
teaspoon
for a 70-kilograms person. One drop in the eye may be fatal.
Death
is caused by muscle weakness, accumulation of fluids in the lungs,
respiratory
and heart failure, epileptic fits and coma. (Ten doses of 2
millilitres,
far more than what is needed to kill one adult, were made
available
by Immelman.)314
Paraquat
is a domestic and commercial herbicide. It is a potent cell
poison
causing multisystem organ failure and lung damage in fatal cases.
Colourless
to yellow salt, odourless to mild ammonia smell. An estimated
lethal
dose of the concentrated solution is 10-15 millilitres, and 1-2 grams
of
the salt. Ingestion causes chemical burning of the mouth and throat
with
ulceration.
Severe paraquat poisoning may result in severe toxicity and
death
within 24 hours as a result of lung, heart, liver and kidney damage.
Survivors
usually develop progressive fibrosis (scarring) of the lung within 5-
10
days after exposure. Patients eventually die of respiratory failure.
Paraquat
poisoning is almost always fatal. (RRL offered 75 millilitres of this
poison
in whisky, enough to kill 5 people.)
Phencyclidine
(PCP) has become a drug of abuse since the 1970s. It
is
a standardised chemical warfare agent known as agent SN. It can be
described
as a psychedelic agent. It was originally developed as a general
anaesthetic
agent and its effects are similar to those of ketamine. It is a white
crystalline
powder, readily soluble in water and alcohol, with a bitter taste.
Catatonic
posturing is produced, resembling that of schizophrenia.
Abusers
may appear to be reacting to hallucinations and exhibit hostile or
dissociative
behaviour. Severe psychological disturbance can be produced
93
by
toxic doses. (Immelman gave 5 doses of 100 milligrams to psychologist
Johnny
Koortzen in 1989.)315
Salmonella
typhimurium and S. typhi are pathogenic microorganisms
which
can cause various disease states, e.g. food poisoning and
typhoid
fever. Salmonella typhimurium patients usually present with
vomiting,
severe watery diarrhoea, colicky stomach pains, blood in the
stools.
Duration varies from 1 or 2 days to weeks or longer. (RRL offered 3
bottles
of deodorant contaminated with this pathogen.)
Salmonella
typhi is the cause of typhoid fever. The incubation period
(3-25
days) related directly to the number of organisms ingested. Typhoid
fever
is a generalized infection causing fever, headache, chills, backache
and
nose bleeds. Stomach pains dominate, heart rate slows down and
diarrhoea
occurs late. Delirium and confusion are common. Complications
include
bleeding from the bowels. Bowel perforation is the most frequent
fatal
complication.
Sodium
cyanide is a white solid which may be powder, granular, egg
shaped
or flake form. It is odourless when dry but may have the
characteristic
bitter almond odour when wet. The ability to detect this
odour
is genetically determined and 20 to 60 per cent of the population are
unable
to detect its presence.
The
fatal dose of cyanide salts is estimated at 200-300 milligrams for
an
adult (1/25th of a teaspoon). Cyanide is absorbed
by ingestion,
inhalations,
through eye and intact skin. Sodium cyanide exposure may
produce
death within minutes. Exposure to smaller amounts may produce
nausea,
vomiting, palpitations, confusion, rapid breathing and vertigo and
dizziness.
Fatal doses rapidly progress to agitation, seizures, accumulation
of
fluid in lungs, coma, respiratory arrest and death. (The Sales list
records
50
capsules having been given to “Koos” in August 1989. Three
peppermint
chocolates
contaminated with cyanide are offered by RRL.)316
Thallium
acetate is a thallium salt, used as an insecticides and
rodenticide.
Due to the toxicity of thallium salts these have been banned in
many
countries. Thallium is a cellular toxin causing cell death.
It
is colourless, odourless and tasteless and extremely toxic. The
lethal
dose
is 12 milligrams/kilogram of body weight based on animal data.
94
Thallium
salts are well absorbed after ingestion, inhalation or skin contact.
Symptoms
of acute poisoning are usually delayed for 12 to 24 hours and
may
only reach their peak effect in the second or third week after
exposure.
This
may lead to complete paralysis and death. Nerve damage may be
permanent
in survivors. (One gram of the substance is offered by RRL317—
enough
to kill a large person.)
Vibrio
cholerae is the causative organism of the disease known as
cholera.
Cholera is an acute infection involving the entire bowel. It is
characterized
by profuse watery diarrhoea, vomiting, muscular cramps,
dehydration,
kidney failure and collapse. Cholera can be a fulminant,
rapidly
lethal disease. The incubation period is 1-3 days. Children and the
elderly
are the first and most severely affected in a cholera outbreak. (32
bottles
are offered by RRL—enough to affect the health of more than one
community.)
Vitamin
D (cholecalciferol) is one of the fat-soluble vitamins and is
used
as a rodenticide. It is a white, odourless crystalline salt. Daily
ingestions
in
excess of 2000 international units in children or 1.88 milligrams in
adults
may
produce toxic symptoms within weeks or months. Most of the acute
toxic
effects of Vitamin D overdose are due to a rise in blood calcium. In
acute
overdose, patients may present with nausea, vomiting, diarrhoea,
headache,
itching, weakness, peripheral nerve damage, depression,
confusion,
heart rhythm disturbances and myocardial infraction. Four
grams
are offered by RRL.318
Other
substances investigated at RRL, not on the Sales list, but
allegedly
used by the operators in some cases include:
Ketalar
or Ketamine can be classified as a general anaesthetic. It is also
a
potent analgesic (pain reliever). It is commercially available as a
solution,
under
the trade name Ketalar. Because ketamine can be given
intramuscularly,
it is relatively easy for a layperson to administer this drug.
General
anaesthesia is induced within 4 minutes after injection. (Bothma
testified
that he gave Theron Ketalar with which to anaesthetise the three
men
at Dukuduku before injecting them with muscle relaxants.319
Theron
testified
to having used it more than once under similar circumstances.320)
Aluminium
phosphide or Phosphine is used as a fumigant/
rodenticide
(for rats and moles). Upon contact with moisture, the pellets
95
release
the poisonous gas phosphine. If ingested, phosphine is released
from
aluminium phosphide by action of the stomach fluids. Pure aluminium
phosphide
is a grey or yellowish salt. Phosphine is a colourless, flammable
gas
with a decaying fish or garlic-like odour.
It
is highly toxic. The normal lethal dose in a 70-kilogram person is
reported
to be less than 500 milligrams. All patients who died had
consumed
3 or more aluminium phosphide tablets. Inhalation of phosphine
causes
severe irritation of the airways, with cough, headache, tightness of
the
chest, coma, epileptic fits, heart failure and fluid on the lungs.
Death
can
occur within 24 hours.
BZ
(a-hydroxy-a-phenylbenzeneacetic acid, 1-azabicyclo[2.2.2]oct-3-
yl
ester, 3-quinuclidinyl benzilate). BZ is an incapacitating agent.
Approximately
30 minutes after exposure to BZ aerosol, symptoms appear
such
as disorientation with visual and auditory hallucinations. The
symptoms
peak in four to eight hours, and may take up to four days to pass.
Other
symptoms can include distended pupils, dry mouth, and increased
body
temperature. The action of BZ on the central and peripheral nervous
systems
resembles that of atropine. Like atropine, BZ binds to muscarinic
acetylcholine
receptors.321
RRL
microbiologist, Adriaan Botha told the authors that he worked
with
the additional following organisms, which were part of the RRL
culture
collection
(maintained by Odendaal and Botha):322
Escherichia
coli. This was used in the cloning of the Clostridium
perfringens
epsilon toxin gene for vaccine development purposes. Although
Botha’s
intention was to produce a vaccine as a result of this work, he was
aware
of its potential military application. If the cloned gene could be
placed
in E. coli it would have been able to produce the deadly toxin at a
far
higher rate than the Clostridium would have been able to do.323
Clostridium
perfringens. The cloning of the epsilon toxin gene for
introduction
into Escherichia coli for vaccine development purposes.324
Flavobacterium
sp and Pseudomonas sp. Both used in the
development
of a method for detoxification of organophosphorus
compounds
for both defensive and commercial purposes.325
96
Hormoconis
resinae. This organism can grow in diesel and aviation
fuel
leading to problems such as engine problems in tanks and ships as a
result
of clogged fuel lines. It is suspected that this organism had caused
several
airplane crashes. Botha was investigating this organism for both
defensive
and offensive purposes.326
Included
in the RRL culture collection were the following microorganisms:
Shigella
flexneri
Salmonella
typhimurium
Salmonella
typhi
Yersinia
enterocolitica
Escherichia
coli H157
Vibrio
parahaemolyticus
Escherichia
coli EP
Brucella
melitensis
Brucella
abortus (terminates pregnancy in cows)
Bacillus
anthracis
(The
above list of pathogens was taken from the culture collection,
these
organisms were grown and freeze-dried in 10 millilitres and 25
millilitres
quantities which contained a high concentration of the
organisms.)327
The
Report has approximately 297 pages and I suggest that health
professionals and other personnel access and read it from cover
to cover.
(access
reference 22 below from UNIDIR to read the full Report)
Where To Go From
Here?
We
are reaching ominous watersheds or crossroads - driven by excessive
greed, the blood-thirst for money and power at the expense of the
weak and helpless, almost on a roller-coaster ride which begins to
have dynamics all of it's own - and end up being unstoppable until it
simply jumps off the rails.
Casualties
(originally
omitted from the final draft)
When
you start to contemplate casualties (fatalities) in the hundreds of
millions (or billions*) human life and the philosophies of life lose
all meaning.
The
concepts of what it means to be human and humanity almost cease, at
least in their present form.
Is
such thinking completely irrational? Only if you are a
politician (and by definition a hypocrite with regard to the
rationale of conflict or 'the good fight'.)
Will
sanity prevail? If you are an optimist then you must work on
the basis that conflicts will be resolved without bloodshed and that
scenarios such as those briefly outlined here will be consigned to
the dustbin of antiquated history, a bygone age of stupidity and
adolescence.
I
fear however, the opposite is about to unravel - hence my own wish to
make available what little knowledge which might be useful in the
advent of something very dark, very ancient and very familiar to come
coming knocking with tidings of a very different future than the
confidence, the arrogance and the certainty of victory of good over
evil our religious leaders, politicians, scientists and others would
have us believe is inevitable - if we trust in their judgement and
follow the Piper.7 (Part II)
.
*6.5-deceased
0.5
varying/terminal injuries
+0.125
- others - terminal
8
million completely unaffected
+The figure of
0.125 is not included in varying + terminal because such are
dependent-living and genetically damaged beyond repair/replacement.
For those cognizant, the dilemmas and options here are painful.
Figures are
based on the world population at the year 2013 (Sources include:World
Bank8 (Part II) )
[Percent ratios
can be calculated based on increased numbers.]
**http://www.cdc.gov/mmwr/mmwr_wk.html
**http://www.diffen.com/difference/Morbidity_vs_Mortality
Patrick
Emek
November
5, 2014
©
Patrick Emek 2014
Permissions:
Full
permission is given to reproduce any part or all of this document for
educational and any non-profit purposes on condition that full
acknowledgement is given to the author and any referenced material,
if likewise utilized, is also acknowledged.
References
(Part I)
8.Biological
Warfare FAQs.
This
FAQ was compiled as an adjunct to a presentation on biological
weapons for the Ann
Arbor,
Michigan Democratic Party April 23, 1998.
For
further details email:racooncity1@inbox.com
9.Medical
Defense Against Biological Warfare: Source-Unknown
contact
racooncity1@inbox.com for further information on where to go
-
-
-
-
Respiratory
Bioweapons examples:
The
Looming Biological Warfare Storm: Misconceptions and Probable
Scenarios by
Colonel
(Dr.) Jim A Davis, 2003
19.
TREATMENT OF BIOLOGICAL WARFARE AGENT CASUALTIES:
ARMY
FM 8-284 NAVY NAVMED P-5042 AIR FORCE AFMAN (I) 44-156 MARINE CORPS
MCRP 4-11.1C,
July
17, 2000
-
The
United Nations Institute for Disarmament Research (UNIDIR):
Project
Coast:Apartheid's Chemical and Biological Warfare Programme,
Chandré Gould and Peter Folb Edited by Robert Berold,
UNIDIR/2002/12
25:Dr.
John Martin: Stealth Viruses A Public Menace - CSF Radio Program
Interview 11th.
April. 1999 - with Roger G. Mazlen, M.D. , as Host Presenter
25:
What Are Stealth Viruses? Dr John Martin ,
M.D. , Ph.D Centre
For Complex Infectious Diseases
Explore
10:17 -19,2001
26.The
following is one title I highly recommend that you read:
26:The
Gathering Biological Warfare Storm: Barry R. Schneider, Jim A.
Davis - 2004 - History extracts available for preview at:
26.The
Next generation Bioweapons by Michael J. Ainscough,Colonel, USAF
27.ISIS
Report (extract only available on-line to non-members but useful
reading for the layperson and health
professional) GM
& Bio-weapons in the post-Genomics Era:
http://www.i-sis.org.uk/gmbiopost.php
Genetic
Engineering and Bioweapons by Dr Mae-Wan Ho
[if
taken off-line please contact racooncity1@inbox.com for advice on
where to go]
References
(Part II)
references
and further recommended reading:
1.USAMRIID:Medical
Management of Biological Casualties Handbook, 2006
2.The
History of Biological Warfare (Galen Press)
2.Medical
Defense Against Biological Warfare: USAMRIID handbook for medical
professionals (first 88 pages) - contact USAMRIID
3.USAMRIID’s
MEDICAL MANAGEMENT OF BIOLOGICAL CASUALTIES HANDBOOK Fourth
Edition, February 2001
3.U.S.
Army Medical Course Sub Course MD 0152 - Diseases of Military
Importance
Preventive
Medicine Division, Army Medical Department Center and School, ATTN:
MCCS-MP, Fort Sam Houston, Texas, 78234-6100.
4.Emerging
Viruses - Aids & Ebola - Nature, Accident or Intentional
(Leonard G. Horowitz, D.M.D, M.A.,M.P.H,; Tetrahedron, Inc. 1996)
5.September
12, 2014:
5.WHO
Emergency Notification For Health Professionals Worldwide:
5.
WHO:
List
of essential medicines for Ebola Treatment
(Re-Issued
November 2014)
5.Alcohol-based
hand rub Solution, 100ml bottle; 500ml bottle Disinfectant
Ampicillin
Powder for injection, 500mg. 1g (as sodium salt)in vial
Antibacterials (in sceptic shocks management)
Artesunate
+ Amodiaquine Tablet: 25mg + 67,5mg; 50mg + 135mg; 100mg + 270mg
Antimalarial
Arthemether
+ Lumefantrine Tablet: 20mg + 120mg (dispersible or not)
Antimalarial
Arthemether
Oily injectable: 80mg/ml in 1ml ampoule Antimalarial
Artesunate
Injection,
ampoules containing 60mg anhydrous artesunic acid with a
separate
ampoule of 5% sodium bicarbonate solution Antimalarial
Ceftriaxone
Powder for injection: 1g (as sodium salt) in vial Antibacterials
(in sceptic shocks management)
Ciprofloxacin
Tablet: 250mg (as hydrochloride) Antibacterials (in sceptic shocks
management)
Diazepam
Tablet (scored): 2mg; 5mg Anxiety and confusion In cooperative
patients
Diazepam
Injection: 5mg/ml Convulsions
Diazepam
Gel or rectal solution: 5mg/ml in 0.5ml; 2ml; 4 ml tubes
Convulsions
Doxycycline
Solid oral dosage form: 100mg (as hyclate) Antibacterials
Epinephrine
(adrenaline) Injection: 1mg (as hydrochloride or hydrogen tartrate)
in 1 ml ampoule To manage shocks
Ergometrine
Injection: 200mcg (hydrogen maleate) in 1ml ampoule In case of
pregnancy
Furosemide
Injection: 10mg/ml in 2 ml ampoule and 10mg, 20mg or 40 mg tablets
In case of overload of fluids, diuretics
Furosemide
Tablet: 10mg; 20mg; 40mg In case of overload of fluids, diuretics
Gentamicin
Injection, 10mg; 40mg (as sulfate)/ml in 2ml vial Antibacterials
(in sceptic shocks management)
Glucose
Injectable solution: 50% (hypertonic) Sign of hypoglycemia
Haloperidol
Injection: 5mg in 1 ml ampoule
Confusion
and aggression in non-cooperative
patients
Hydrocortisone
Powder for inection: 100mg (as sodium succinate) in vial To manage
shocks
Insulin
injection (soluble) Injection: 40IU/ml in 10ml vial; 100IU/ml in
10ml vial Antidiabetic
Metoclopramide
Injection: 5 ml (hydrochloride)/ml in 2ml ampoule Diarrhea,
vomiting
Metoclopramide
Tablet: 10mg (hydrochloride) Diarrhea, vomiting
Metronidazole
Injection: 500mg in 100ml vial Antibacterials
Metronidazole
Tablet: 200mg to 500mg Antibacterials
Morphine
Tablet (immediate release): 10mg (morphine sulfate Analgesic
Morphine
Tablet
(slow release): 10mg-200mg (morphine hydrochloride or
morphine
sulfate) Analgesic
Omeprazole
Solid oral dosage form: 10, 20, 40 mg Dyspepsia
Ondansetron
Solid oral dosage form: eq 4mg base; eq 8mg base; eq 24mg base
Antiemetic
Ondansetron
Injection: 2mg base/ml in 2 ml ampoule (as hydrochloride)
Antiemetic
Oral
rehydratation salts Powder in sachets for dilution in 200ml, 500ml
or 1 liter Rehydratation
Oxygen
Inhalation (medicinal gas) Difficult breathing/respiratory distress
Oxytocin
Injection: 10 IU in 1ml In case of pregnancy
Paracetamol
Tablet: 100mg to 500mg Fever and analgesic
Phenobarbital
Injection: 200mg/ml (sodium) Convulsions
Phytomenadione
(Vitamin K) Injection: 10mg/ml in 5ml ampoule Bleeding
Potassium
chloride
Solution:
11,2% in 20ml ampoule (equivalent to K+ 1,5mmol/ml,
Cl:1,5mmol/ml
Correction of electrolytes disturbances
Quinine
Injection: 300mg quinine hydrochloride/ml in 2ml ampoule
Antimalarial
Salbutamol
Inhalation (aerosol): 100mcg (as sulfate) per dose Difficult
breathing/respiratory distress
Sodium
bicarbonate Injection: 8.4%, 1 Meq/ml, 20ml, ampoule
Sodium
chloride
Injectable
solution: 0.9% isotonic (equivalent to Na+ 154mmol/l, Cl-
154mmol/l)
Rehydratation
Sodium
lactate, compound
solution
Injectable solution Rehydratation
Tetracycline
Eye ointment: 1% (hydrochloride) Antiinfective
Tramadol
Injection: 50mg/ml, 2ml ampoule (hydrochloride) Analgesic
References:
"INTERIM
version 1.2 Ebola and Marburg virus disease epidemics:
preparedness, alert, control, and evaluation, WHO, August 2014
(module of PPE in Annex 32 and 33)"
http://www.who.int/csr/disease/ebola/manual_EVD/en/
Clinical
Management of Patients with Viral Harmorrhagic Fever, WHO, March
2014
http://www.who.int/csr/resources/publications/clinical-managementpatients/
en/
Interagency
Emergency Health Kit 2011, WHO, 2011
http://www.who.int/medicines/publications/emergencyhealthkit2011/en/
Bwaka
et al., Journal of Infectious Diseases 1999; 179:(Suppl 1) S1-7
WHO
Model List of Essential Medicines, 18th list (April 2013)
http://www.who.int/medicines/publications/essentialmedicines/en/
Interim
Infection Prevention and Control Guidance for Care of Patients with
Suspected or Confimed Filovirus Haemorrhagic Fever in Health-Care
Settings, with Focus on Ebola, WHO, August 2014
http://www.who.int/csr/resources/who-ipc-guidance-ebolafinal-09082014.pdf?ua=1
Clinical
Management of Patients with Viral Harmorrhagic Fever, WHO, March
2014
Ebola
and Marburg Outbreak Control Guidance Manual Version 2.0, MSF, 2007
