Bioterrorism Agents

Question 1

Bioterrorism Agents and 3 categories

Answer 1

Any agent intended to produce death and disease in humans
May be modified versions of normally occurring pathogens

Cat A: Most serioius
Cat B: Pretty dangerous
Cat C : Least dangerous

Question 2

Category A (tend to cause haemohaggic fever)

Answer 2

Bacillus Antrax: gram +, spore exotoxin, poly D, edema and lethal factor entry, Hemorrhage mediastinitis, cutaneous black eschar, GI anthrax
Clostridium Botulinum: Anaer gram +, exotoxin, heat labile, spores, prevent Ach release by cleaving SNARE, flaccid paralysis, Antitoxin
Yersinia Pestis: gram -, Oxi neg, no H2S production, Bubonic plague, exotoxin, coagulase,
Franciscella Tuleransis: Ana gram - coccobacillus, Ulceroglandular tularemia (conjuctivis, headache, pharyngitis), typhoid tuleremia (Nausea, vomiting), Pulmonary tularemia (flu-like illness)

Question 3

Category A Agents: Unheard

Answer 3

Many Many Viruses Exist Lethally
Marbug Virus
Machupo Virus
Variola Major (Smallpox)
Ebola Virus
Lassa Virus

Question 4

Marburg Virus

Answer 4

Filovirus
Linear non segmented ssRNA virus
Uses a Niemann Pick Cholesterol transporter mediates cell entry
Spread via Contact with bodily fluids
Spread from primate contact
Egyptian fruit bat
5-10 incubation
Haemorrhagic fever, pancreatitis, maco rash, flu-like

Question 5

Machupo

Answer 5

Arena Virus
Black Typhus or Bolivian Haemorrhagic fever
Large vesper Mouse
Spread from bodily fluids
Petechiae and massive oral bleeds

Question 6

Variola Major (Smallpox)

Answer 6

Brick shaped dsDNA
Thick enveloped
Golgi Membranes w/polypeptides & modified Hemmagluttnin
7-9 day incubation
Sores in mouth or oral cavity (Guarneir inclusion bodies)
Eruption into pharyngeal rash
Full body rash: pustules—> scar

Question 7

Ebola

Answer 7

Enveloped, linear, non segmented neg sense
SsRNA
Filovirus
Targets endothelial
Contact with bats pigs primates
Haemorrhagic fever

Question 8

Lassa Virus

Answer 8

Enveloped ssRNA bisegment ambissense RNA viruses
Glycoproteins bind to alpha dystroglycan
Zinc Binding protein regulated virus transcription
Hemorrhagic fever
Deafness (lassoing up the ear)

Question 9

Category B Agents

Answer 9

Brucellosis
Clostridium perfringes
Salmonella Shigella O157:H7
Vibrio Cypto
Viral encephalitidies

BRB
Burkholderia Mallei
Ricinus communis
Burkholderia Pseudomallei

Question 10

Burkholderia Mallei (Glanders)

Answer 10

Type IV secretion( has its own injection system)
Lyses entry vacuole—> multinucleated giant cells
Horses
Causes Glanders Pulmonary glanders Abscess formation Nasal discharge
Supportive treatment
Nasal discharge coming from your upper track

Question 11

Burkholderia Pseudomallei (Whitmores Disease)

Answer 11

Gram - bipolar, aerobic safety pin appearance, rod shape, motile
Strong flagella
Contact with dust, soil and droplets
Immunocompromised patients
Acute pneumonia
Chronic TB
Risk DM
IV Ceftazidime or Meropenem

Question 12

Ricinus Communis

Answer 12

Toxin in castor bean (mash) (castor oil plant)
Prevents protein translation
Pulmonary edema & heart failure
Food poison —> hypovolemic shock
Supportive

Question 13

Category C

Answer 13

TB, SARS,YELLOW FEVER, INFLUENZA,HANTA VIRUS
NIPAH CHIKUNGUNYA “NOW C”

Question 14

Nipah Virus

Answer 14

RNA paramyxovirus
Followed ebola
Fruit bats
Raw date Palm sap
Encephalitis —> psychosis & seizure
Supportive

Question 15

Chikungunya

Answer 15

RNA Togavirus
+sense single stranded
Aedes Mosquito
Fibroblast and endothelial
Fever and arthralgia
Supportive no vaccine
Chicken joints

Question 16

Emerging Infectious Disease
Accidentally emerging
Most Common Emerging Infectious diseases (EID)

Answer 16

Infectious disease whose incidence is increasing
Occurs changes in emerging pathogen - expanding geog, change in virulence, change in host range
Human derived eg Polio vaccine
Zoonoses (bats rodents birds and swine) and Vector Borne

Question 17

Infectious Agents most likely to Emerge and Stages involved in adapting to human hosts —> Pandemic

Answer 17

RNA Viruses - high mutation rate
Bacteria that can acquire genes via horizontal gene transfer
Pathogens with broad host range

Animal to animal changes in environment alter transmission between animal host - overlap habitats,migration,
Animal to human (limited but freq spillover to human overtime); live animal markets, mass prod of livestock crow ani reserves
Human to human (global spread)

Question 18

SARS & MERS

Answer 18

Stage 1: Virus in bats spill over to civets
Stage 2: Virus transmitted from civets to humans
Stage 3: Virus is person to person

Stage 1: Virus in bats spill over to camels
Stage 2: Infection from camels
Stage 3 not developed yet

Question 19

Categories of Emerging Infectious Diseases (EID) and Adaptation to new host

Answer 19

Pathogen infects a novel host
Pathogen develops novel traits within same host (Antibiotic resistant)
Pathogen extends its range into a new geographic area

Binds new receptor to new host
Uses a homolog of existing receptor in the new host
Viral can bind target cells but cannot infect the novel host as a whole

Question 20

Viral Receptors and Evolve novel traits within the same host

Answer 20

SAR-COV 1 and SARS-COV 2 bind ACE2 as receptor except bats don’t use ACE 2
MERS - Homologue of receptor used by bat corona virus (DPP2 also known as CD26)

Pathogenicity islands or virulence cassettes
Antibiotic resistance genes often encoded on plasmids
Frequent antimicrobial use will select for resistant organisms
MRSA

Question 21

Ecoli Outbreak and Pathogen emerging to new site

Answer 21

Foodborne outbreak
Shiga Toxin producing E coli (STEC): dysentery (diarrhea with blood & mucus)
EHEC (enteroaggregative Ecoli): Attached via aggregative adherence fimbriae, watery diarrhea
Antibiotic resistance (Addt virulence factor) Resistant plasmid (CTX-M15)

New population eg West Nile virus

Some pathogens in a new environment may just be newly detected

Question 22

Factors Influencing Emergence

Answer 22

Economic development & Agricultural practices
International travel & Commerce
Climate & weather

Question 23

Influence of Economic development on EID and Animal food production in EID

Answer 23

Deforestation: Increase contact between animal reservoirs and human eg Nipah spread from bats to pigs crowded pens
Urbanization (poverty stricken cities: Crowding increase person to person
Moving to Suburbs: Exposure to tick vectors

Crowded pens
Increased infection of livestock
Antibiotic use in animal feed
Shipping of livestock provides risk of dissemination of pathogens
Live Animal markets
International trade or travel
Migrating birds

Question 24

Factors Influencing Emergence of New geographical area

Answer 24

Global warming
Natural disasters
Environmental conditions favoring expansion of animal reservoirs-Hanta virus
expansion of mosquito or tick vector range

Question 25

Limiting Emergence of Pathogens and How did CoV2 become COV19 pandemic

Answer 25

Surveillance/detection - reporting globally
Prevent exposure
Reduce Spread
Reduce#s of susceptible individuals

Broad host of CoV
Variability of RNA viruses

Question 26

Why Didn’t MPOX become widespread pandemic

Answer 26

2 Known Clades
Transmission - direct (& prolonged)
Preexisting Vaccine

Covid is more variable than Mpox, can generate immune escape variants
Covid is more transmittable than pox
There is no pre existing vaccines to manage SARS