Pathogens and Their Weaponization. Geoffrey Zubay. Columbia University Press . Agents of Bioterrorism. Google Preview. Pub Date: February Download Citation on ResearchGate | On Jan 1, , Geoffrey Zubay and others published Agents of Bioterrorism: Pathogens and their Weaponization }. [Book Review: Agents of Bioterrorism: Pathogens and Their Weaponization.] Article in The Quarterly Review of Biology 81(3) · September with 5.

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Because of their unique biological characteristics, such as environmental stability, small size, aerosol transmission, persistence in infected hosts, low infectious dose, and high associated wexponization and mortality, Rickettsia prowazekii and Coxiella burnetii have been weaponized.

These biological attributes would make the pathogenic rickettsiae desirable bioterrorism agents. However, production of highly purified, virulent, weapon-quality rickettsiae is a daunting task that requires expertise and elaborate, state-of-the art laboratory procedures to retain rickettsial survival and virulence. Another drawback to developing rickettsial pathogens as biological weapons is their lack of direct transmission from host to host and the availability of very effective therapeutic countermeasures against these obligate intracellular bacteria.

Epidemics of louseborne typhus, plague, influenza, and dysentery weaponizaion been important in the shaping of human destiny and have caused more deaths than all the wars throughout history [ 123—4 ]. The ease with which these epidemics can spread within crowded human populations has made their causative agents attractive to nations, for use as battlefield weapons, or to terrorists, for use as weapons of mass destruction or civil disruption [ 123—4 ].

Several biological agents, including Rickettsia prowazekii and Coxiella burnetii —the causative agents of louseborne typhus and Q fever, respectively—have been weaponized and field-tested, with variable effectiveness, by the former Soviet Union, Japan, and the United States [ 23 ].

The impact of the use of such a biological weapon would be beyond imagination, because scores of innocent and unsuspecting people would be affected. In the present article, the pros and cons of weaponizing rickettsial pathogens and the potential of these pathogens in the hands of bioterrorists are discussed, taking into consideration the biological attributes of this group of gram-negative, obligate intracellular bacteria. Rickettsioses are a good example of diseases whose importance is not adequately appreciated, except by patients.

Even today, many cases of weaponizatino diseases sgents never be diagnosed. Rickettsial diseases are widely distributed throughout the world as zoonotic cycles in foci of endemicity, with sporadic and often seasonal outbreaks developing [ 56 ]. However, from time to time, these infections have reemerged in epidemic form in human populations e.

In contrast to the explosive nature weapoinzation outbreaks of louseborne typhus, sporadic but limited outbreaks of louseborne typhus and other rickettsial diseases have been reported bioterroriam the world.

In the United States, drastic increases in the number of cases of murine typhus in the s, Rocky Mountain spotted fever RMSF in pathofens late s, and human ehrlichioses in the s attest to the potential emergence of these infections in at-risk populations [ 16 ].

In recent years, increased awareness and proper treatment and care have had a great impact on reducing case-fatality rates associated with rickettsial diseases. The severity of rickettsial disease has been associated with pathogen virulence and host-related factors e. Despite bioterrlrism variability in their clinical presentation, pathogenic rickettsiae cause debilitating disease, and any one of the highly virulent rickettsial species listed in table 1 could be used as a potential biological weapon.


During later stages of infection, patients appear to be delirious and exhibit neurologic symptoms, including stupor.

Bioterrorism: pathogens as weapons.

Thrombosis of the tbeir vessels in the extremities may produce gangrene and necrosis. The human body louse, Pediculus humanus corporisis the principal vector for R. Although the head louse P.

The body louse will abandon a patient with a fever and seek another host. This one attribute is a major factor in the transmission of typhus and is responsible for the flaring of an epidemic in a susceptible population.

However, there is another face of typhus, a recrudescent typhus i. Patients with this disease could serve as a long-term source of R. Recrudescent typhus may have been the thei for the dissemination of R. Because of their bloterrorism biological characteristics environmental stability, small size, aerosol transmission, persistence in infected hosts, low infectious dose, high morbidity, and substantial mortalityR.

According to the World Health Organization’s estimate, if 50 kg of aerosolized R. Although the attributes of rickettsial pathogens that increase their potential for use as a biological weapon parallel those of other highly publicized, weaponized pathogens, realistically several compounding factors would make it very difficult to produce large quantities of highly purified weapon-quality rickettsiae.

As obligate intracellular bacteria, rickettsiae require eukaryotic host cells for propagation, and the isolation and purification of rickettsiae without host cell contaminants would require highly skilled personnel and elaborate laboratory procedures.

The virulent strains of both C. Considering that the median infective dose of R. Furthermore, mass production of rickettsial pathogens and the procedures required for their aerosolization are highly hazardous.

Another drawback to developing rickettsial pathogens as a biological weapon is their lack of direct transmission from host to host. Rickettsiae are maintained in nature in their arthropod vectors, via transovarial and transstadial transmission, and human infection occurs accidentally through either a bite from the infected arthropod or contact with Rickettsia -laden feces.

Thus, the use of these agents for mass transmission requires a massive number of either infected arthropod vectors or kilograms of aerosolized rickettsiae. Because several rickettsial pathogens are on the Centers for Disease Control and Prevention’s list of select agents, their acquisition from established repositories and their transportation are restricted.

In addition, acquisition of rickettsial pathogens from reservoir hosts would be a daunting task requiring time-consuming protocols to obtain pure and virulent isolates. Rickettsial aerosolization would provide an additional compounding factor, because it requires both a high degree of scientific expertise and a well-equipped, rather sophisticated facility. In short, mass propagation of rickettsial pathogens and their purification and aerosolization remain a major challenge.

Comparison of selected rickettsial pathogens with examples of bacteria used in biological warfare.

Intentional release of R. To slow down the epidemic, the most significant challenge is to identify the source of infection intentional vs. Because the disease is still endemic in highlands and cold areas of Africa, Asia, and Central and South America, as well as in parts of Eastern Europe, bioterrorixm the source of infection would be difficult.

In the United States, where sylvatic znd is endemic in the eastern states, it would be difficult to determine the source of infection immediately after the onset of disease. Humans serve as a host to R. In addition, humans serve as a mobile component of the louseborne typhus cycle, the behavior of which influences the pattern of typhus transmission.


Pathogenic Rickettsiae as Bioterrorism Agents | Clinical Infectious Diseases | Oxford Academic

The conditions that allow for the coexistence of body lice and a susceptible population could be the starting point for a bioterrorism-initiated infection, because the release of the rickettsiae would set off a subsequent chain reaction. A similar situation could also exist for other rickettsial pathogens that are endemic in an affected area. Knowledge of the transmission cycle would play an important role in identifying the initial source of an epidemic.

The sudden occurrence of a few human cases in areas of nonendemicity could set off the alarm. Preventive measures are complicated because of the lack of effective and safe rickettsial vaccines [ 11 ]. Surveillance of naturally or intentionally released pathogens is a first step in preventing the epidemics via rapid identification of causative agents and assessing the degree of their virulence.

Initiating the proper treatment and curtailing outbreaks is the most crucial step, because prompt initiation of antibiotic treatment would prevent people from becoming ill and from dying. Prophylactic measures are badly needed, because population growth and increased land use bring arthropods and their associated pathogens into human habitations. In addition, analysis of rickettsial genomics and proteomics will enhance our clinical and field diagnostic capabilities, thus reducing misdiagnosis and false-negative results in routine surveillance studies.

The present article is dedicated to the memory of Dr. Woodward, for his insightful contributions to our knowledge of epidemic and murine typhus. Oxford University Press is a department of the University of Oxford. It furthers the University’s objective of excellence in research, scholarship, and education by publishing worldwide. Sign In or Create an Account.

Close mobile search navigation Article navigation. The Challenge Of Rickettsial Pathogens. Biological Attributes Of Pathlgens Pathogens. Abstract Because of their unique biological characteristics, such as environmental stability, small size, aerosol transmission, persistence in infected hosts, low infectious dose, and high associated morbidity and mortality, Rickettsia prowazekii and Coxiella burnetii have been weaponized.

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Epidemiologic characteristics of selected highly pathogenic rickettsiae. The past and present threat of rickettsial diseases to military medicine and international public health. Add comment Close comment form modal. I agree to the terms and conditions. You must accept the terms and conditions. You hteir entered an invalid code.

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Bioterrorism: pathogens as weapons.

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