Construção e validação de instrumento para avaliação das medidas de biossegurança em bioterrorismo pelos bombeiros / Construction and validation of and assessment tool for biosafety measures in bioterrorism for firefighters / Construcción y validación de un instrumento para evaluar las medidas de bioseguridad en el bioterrorismo de los bomberos

Objetivo: Este estudo teve como objetivo desenvolver e validar um instrumento de avaliação das medidas de Biossegurança adotadas pelos bombeiros militares, para a contenção dos agentes biológicos frente a um evento de bioterrorismo. Métodos: Tratou-se de um estudo descritivo de abordagem quantitativa, de desenvolvimento metodológico e do tipo de validação de conteúdo de um instrumento de avaliação. O estudo foi dividido nas fases de desenvolvimento e validação do instrumento. Para o desenvolvimento do instrumento foram feitas revisões da literatura e para a validação do instrumento foi utilizado o método Delphi. Para o estudo foram incluídos 6 juízes que avaliaram o instrumento através da escala numérica tipo Likert. Resultados: Os juízes avaliaram que o instrumento proposto está bem estruturado, possuindo boa clareza e coesão de escrita, com aplicabilidade no campo de estudo e de grande relevância, principalmente em vista a ausência desse tipo de instrumento para a população de bombeiros militares. Para avaliar a concordância entre os juízes foi utilizado o índice de Validade de Conteúdo, que alcançou 98% de concordância e o Índice de Fidedignidade Interavaliadores, que alcançou os conceitos bom e muito bom, mostrando baixa variância das respostas dos juízes, sendo estatisticamente válido. Conclusão: O estudo descreveu o processo de construção e validação do instrumento, provando ser apropriado e confiável para ser utilizado.

Objective: This study aimed to develop and validate an instrument to assess the Biosafety measures adopted by firefighters, for the containment of biological agents in the face of a bioterrorism event. Methods: This is a descriptive study with a quantitative approach, methodological development, and the type of content validation of an assessment instrument. The study was divided into instrument development and validation phases. For the development of the instrument, literature reviews were conducted and for the instrument validation, the Delphi method was used. For the study, 6 judges were included who evaluated the instrument using the Likert-type numerical scale. Results: The judges evaluated that the proposed instrument is well structured, with good clarity and cohesion of writing, with applicability in the field of study and of great relevance, especially considering the absence of this type of instrument for the military firefighter population. To evaluate the agreement between the judges, we used the Content Validity Index which reached 98% of agreement and the Interrate agreement, which reached the concepts good and very good, showing low variance of the judges' answers, being statistically valid. Conclusion: The study described the process of construction and validation of the instrument, proving to be appropriate and reliable to be used.

Objetivo: Este estudio tenía como objetivo desarrollar y validar un instrumento para evaluar las medidas de bioseguridad adoptadas por los bomberos militares para contener los agentes biológicos durante un evento de bioterrorismo. Métodos: Se trata de un estudio descriptivo de abordaje cuantitativo, de desarrollo metodológico y del tipo de validación de contenido de un instrumento de evaluación. El estudio se dividió en las fases de desarrollo y validación del instrumento. Para la elaboración del instrumento se realizaron revisiones bibliográficas y para la validación del mismo se utilizó el método Delphi. Para el estudio se incluyeron 6 jueces que evaluaron el instrumento mediante una escala numérica tipo Likert. Resultados: Los jueces evaluaron que el instrumento propuesto está bien estructurado, poseyendo buena claridad y cohesión de redacción, con aplicabilidad en el campo de estudio y de gran relevancia, especialmente en vista de la ausencia de este tipo de instrumento para la población de bomberos militares. Se utilizó el Índice de Validez de Contenido para evaluar la concordancia entre los jueces, alcanzando un 98% de acuerdo y el Índice de Fiabilidad Inter-registrador, que alcanzó conceptos buenos y muy buenos, mostrando una baja varianza en las respuestas de los jueces, siendo estadísticamente válido. Conclusión: El estudio describió el proceso de construcción y validación del instrumento, demostrando ser apropiado y confiable para ser utilizado.

Early Detection of Bacillus anthracis From Saliva in Anticipation of a Bioterrorism Attack

Objective: To assess potential for early detection of oral infection by B. anthracis spores for preparedness of a bioterrorism attack. Material and Methods: The laboratory study used saliva with a range of initial anthrax concentrations, to compare detection by direct observation from conventional blood agar culture and by anthrax-specific PCR after a shorter culture in BHI broth. Three types of saliva were collected: stimulated saliva, unstimulated/whole saliva, and unstimulated/whole saliva with antibiotic treatment (for negative control). Using bivariate Kruskal-Wallis and Mann-Whitney tests for statistical analysis for factors that could affecting anthrax detection, significant differences between the test groups was assumed at p<0.05. Results: From unstimulated whole saliva heat shock treated at 62.50C, B. anthracis growth was detected with both methods. PCR detection from a BHI broth culture could shorten the time to diagnosis in comparison to conventional culture in blood agar. Conclusion: Saliva can provide useful samples for diagnosis of oropharyngeal anthrax. In comparison to conventional culture on blood agar, shorter-term culture in BHI broth provides potential for earlier detection and diagnosis.

Estimating the medical capacity required to administer mass prophylaxis: a hypothetical outbreak of smallpox virus infection in Korea / 한국역학회지

OBJECTIVES: The aim of this study was to estimate the medical surge capacity required for mass prophylaxis based on a hypothetical outbreak of smallpox.METHODS: We performed a simulation using the Bioterrorism and Epidemic Outbreak Response Model and varied some important parameters, such as the number of core medical personnel and the number of dispensing clinics.RESULTS: Gaps were identified in the medical surge capacity of the Korean government, especially in the number of medical personnel who could respond to the need for mass prophylaxis against smallpox.CONCLUSIONS: The Korean government will need to train 1,000 or more medical personnel for such an event, and will need to prepare many more dispensing centers than are currently available.

Injury Prevention, Disaster and Public Health Preparedness and Response / 보건행정학회지

Injury is a serious problem that not only causes death but also significantly degrades the quality of life of the people and causes loss of socioeconomic opportunities and costs. Damage occurs as a result of an accident. Among them, natural disasters and artificial disasters take lives of many people in a short time and threaten their physical and mental health. The United States has responded to the disaster by establishing relevant laws and regulations and a response system with the recognition that health is recognised soon to be as national security in the wake of the 9/11 terrorist attacks and the Katrina disaster. It is necessary to build a knowledge infrastructure to train disaster response experts in public health area and to have health competence to cope with disasters.

Governança de novas dimensões de segurança internacional: Doenças infecciosas emergentes / Governance of new dimensions of international security: Emerging infectious diseases

Esse estudo objetiva compreender de que forma se estrutura a governança de uma nova dimensão de segurança internacional: as doenças infecciosas emergentes (DIEs). Inicialmente, discute-se como o tema das doenças infecciosas ­ em geral ­ tem sido apresentado pela literatura acadêmica especializada como novos riscos à segurança internacional. A partir desse escrutínio, foi possível organizar as contribuições de diversos autores sobre o tema, propondo cinco abordagens diferentes da relação entre doenças infecciosas e segurança internacional. A partir disso, averígua-se a maneira mais adequada para compreender a governança das DIEs com a análise das teorias de governança nos campos das Relações Internacionais e da "saúde global". Nesse contexto, e com essas ferramentas, mapeiam-se os atores e dispositivos internacionais que caracterizam a governança das doenças infecciosas, e, posteriormente a das DIEs. Do ponto de vista metodológico, essa dissertação adota o modelo analítico de Young (1999) e Fidler (2002) para analisar a principal peça jurídica desse regime, o Regulamento Sanitário Internacional, examinando sua evolução entre versões de 1969 e 2005 em seus componentes substantivos, processuais e de implementação. Essa análise inova ao apresentar, de um ângulo original, o desenvolvimento da governança internacional das DIEs nas últimas décadas.

This study aims to understand how is developed the governance of a new dimension of international security: emerging infectious diseases (EIDs). At first, we discuss how the topic of infectious disease - in general - have been presented by the academic literature as new risk to international security. From this analysis, it was possible to organize the contributions of various authors on the subject by proposing five different approaches to the relationship between infectious diseases and international security. After that, this study investigates the most appropriate way to understand the governance of EIDs analyzing theories of governance in the fields of International Relations and "global health." In this sense, and adopting these tools, it was possible to map actors and international devices that are involved in the governance of infectious diseases, and later in the EID. Methodologically, this dissertation adopts the analytical model of Young (1999) and Fidler (2002) to analyze the centerpiece of this regime, the International Health Regulations, tracing its development between its 1969 and 2005 versions. This analysis innovates for it presents, from an original point of view, the development of international governance of EIDs in recent decades.

Bioterrorismo, riscos biológicos e as medidas de biossegurança aplicáveis ao Brasil / Bioterrorism, biological risks and biosafety measures applicable to Brazil

A história registra o uso de patógenos como potencializadores de recursos bélicos. Considerando os eventos bélicos da contemporaneidade, observa-se a formulação de projetos voltados para elaboração tecnológica sofisticada. Nessa categoria se incluem as armas biológicas, vinculadas aos programas de caráter coercitivo conhecidos como guerras biológicas, que pertencem à lógica da ameaça assimétrica, não definindo território e gerando repercussões econômicas, políticas e sociopsicológicas devastadoras. Esses eventos demandam a elaboração de planos que contemplem o risco, incluindo a capacitação de recursos humanos, investimentos na identificação de materiais empregados em bioterrorismo e também em equipamentos de segurança. Objetiva-se neste artigo discutir a associação entre patógenos, seu potencial de risco e eficácia para o emprego em estratégias de bioterrorismo, destacando as medidas de biossegurança necessárias. Utiliza-se a revisão integrativa para a construção de análises de contextos de risco. O levantamento bibliográfico compreendeu o período 1990/2010, nas bases de dados ISI, LILACS, SciELO e PubMed. Demonstra-se a importância do envolvimento e da capacitação dos profissionais na identificação de agentes biológicos com potencial de risco, considerando que o bioterrorismo pode resultar na sobrecarga dos sistemas de saúde. A biossegurança orienta os procedimentos que devem ser adotados para a contenção dos patógenos, visando ao controle dos riscos...

History records the use of pathogens as improvers of military resources. Considering the events of contemporary war, there is the formulation of projects aimed at sophisticated technological development. They shall include biological weapons, linked to coercive programs known as biological warfare, which belong to the logic of asymmetric threat, not defining territory and generating devastating economic, political and socio-psychological repercussions. These events require the preparation of plans that address the risk, including the training of human resources, investments in the identification of materials used in bioterrorism and also in safety equipment. This paper aims to discuss the association between pathogens, their potential risk and effectiveness for use in bioterrorism strategies, highlighting the necessary biosecurity measures. It uses an integrative review to construct contexts risk analysis. The literature included the period 1990/2010, the ISI databases, LILACS, SciELO and PubMed. It demonstrates the importance of the involvement and training of professionals in the identification of biological agents with potential risk, whereas bioterrorism may result in overload of health systems. Biosecurity guides the procedures to be adopted for the containment of pathogens, aimed at controlling risk...

Botulism as a food poisoning: what is it?

Botulism is a rare but potentially life-threatening neuroparalytic syndrome resulting from the action of a neurotoxin elaborated by the microorganism Clostridium botulinum. This disease has a lengthy history; the first investigation of botulism occurred in the 1820s with a case report on hundreds of patients with [sausage poisoning] in a southern German town. Several decades later in Belgium, the association was demonstrated between a neu-romuscular paralysis and ham infected by a spore forming bacillus that was isolated from the ham. The organism was named Bacillus botulinus after the Latin word for sausage, botulus

Normativas internacionais de proteção contra bioterrorismo e biocrimes: lacunas e vulnerabilidades no Brasil / International standards for protection against bioterrorism and biocrimes: gaps and vulnerabilities in Brazil

Saúde Global pode ser entendida como questões de saúde que transcendem fronteiras nacionais e demandam intervenções nos assuntos que determinam a saúde das populações. Atualmente, os Estados deparam-se seguidamente com problemas e crises relacionadas à área da saúde. Em relação à segurança nacional, essa preocupação se manifesta sob a forma de ameaças de proliferação de Armas Biológicas e de Bioterrorismo. A comunidade internacional tem se esforçado para propor normas que previnam tais atos. Os melhores exemplos são a Convenção para a Proibição de Armas Biológicas e suas Toxinas (CPAB), a Resolução 1540 do Conselho de Segurança das Nações Unidas (Res 1540/CSNU) e o Regulamento Sanitário Internacional (RSI). Contudo, existem várias lacunas e vulnerabilidades que podem ser exploradas nesses documentos. O escopo desse estudo é propor questionamentos a partir da Análise Documental desses tratados, ponderando a articulação entre os órgãos nacionais com a responsabilidade de prevenção, controle e resiliência contra ataques biológicos. O Brasil é signatário das principais normativas internacionais direcionadas à prevenção e controle de uso intencional de agentes biológicos e vem respondendo a contento à comunidade internacional. Ainda assim, é necessário mais que uma resposta formal a entidades supranacionais para prover, efetivamente, a devida proteção à população. O País possui capacidades técnicas estruturadas de forma isolada e fragmentada em diversos órgãos inexistindo um sistema formalmente instituído para a prevenção,resposta e controle de ataques bioterroristas...

Global Health can be understood as health issues that transcend national borders andrequire intervention in matters that determine the health of populations. Currently, States face crisis and problems related to health realm. Regarding national security, thisconcern is manifested in the form of threats of Biological Weapons proliferation and Bioterrorism. The international community has endeavored to propose regulations that prevent such acts. The best examples of it are the Convention for the Prohibition ofBiological Weapons and their Toxins (BWC), the United Nations Security Council Resolution 1540 (Res 1540/UNSC) and the International Health Regulations (IHR). However, there are several gaps and vulnerabilities that can be exploited in thesedocuments. The scope of this study is questioning these treaties using DocumentAnalysis, pondering the link between national entities responsible for prevention,control and resilience against biological attacks. Brazil is signatory of the major international instruments aimed at the prevention and control of biological agentsintentional use and has responded satisfactorily to the international community. Never theless, it takes more than a formal supranational response to provide effectivelyappropriate protection to population. The country owns technical capabilities not connected, distributed in several organs and lacks a system for the prevention, responseand control of bioterrorist attacks. Likewise, there is no national protocol established inorder to coordinate the activities of the bodies responsible for controlling the threat. Factors that determine individuals or groups to employ biological agents and toxins intheir violent attacks are not fully understood. Thus, more reckless than exacerbate therisk of intentional actions with biological agents is not being properly prepared toprevent and control such acts...

The Management of Laboratory Biological Safety in Korea

The Laboratories engaging with microorganisms have some potential risks, depending on handling of pathogens. The safety management system to extend recognition of biosafety and biosecurity needs to be established and practiced in order to prevent hazard possibility and secure safety of researchers who deal with pathogen. As the importance and regulation of global biosafety and biosecurity tended to be intensified, various laws and institutions for the security of biosafety were established when the Act on implementation of Living Modified Organisms, an implantation act of Cartagena was enforced in Korea in 2008. In particular, the system of permission report for Living Modified Organism (LMO), Highly Dangerous Pathogens (HDPs) and Biological Weapons Convention (BWC), in order to prevent intended or non-intended leakage and occurrence of biohazard derived from pathogen and infectious substance and safely use them. The bioterrorism can be controlled and autonomous management of biosafety by agencies that handle pathogens can be also secured by practicing the various laws and institutions.

Bioterrorismo e microrganismos patogenicosApresentacao / Bioterrorism and pathogenic microorganisms

O uso de microrganismos patogênicos em atos de bioterrorismo é já há algum tempo objeto de grande preocupação em vários países. O presente trabalho apresenta a possível aplicação de vírus e bactérias para fins bélicos e terroristas, bem como o diagnóstico laboratorial para a identificação desses agentes. Foram salientados, entre outros, como agentes de infecções humanas visando o bioterrorismo, os vírus da varíola (ortopoxvírus), os de febres hemorrágicas e os pertencentes aos filovírus. Entre as bactérias foram destacadas as do antrax ( Bacillus anthracis ), da peste ( Yersinia pestis ), do botulismo ( Clostridium botulinum ) e da tularemia ( Francisella tularensis ), incluindo ainda a ricina ( Ricinus communis ) como componente do grupo B de agentes.

In recent years the use of pathogenic microorganisms in acts of bioterrorism has been the subject of major concern in many countries. This paper presents a possible application of viruses and bacteria for warfare and terrorist purposes, as well as a laboratory diagnosis to identify those agents. The viruses of smallpox (orthopoxvirus), of hemorrhagic fever and those belonging to filovirus have been highlighted, inter alia, as agents of human infection with bioterrorist intent. Among the bacteria, the emphasis has been on anthrax (Bacillus anthracis), the plague (Yersinia pestis), botulism (Clostridium botulinum) and tularemia (Francisella tularensis), not to mention ricin (Ricinus communis), as one of the Group B agents.

Bioterrorismo e a facilidade de acesso à biotecnologia e seus insumos / Bioterrorism and easy access to biotechnology and its inputs

Os fundamentalismos surgiram no Ocidente a partir de questões religiosas e posteriormente difundiram-se para outras partes do mundo tomando outras conotações, principalmente políticas. As técnicas de manipulação genética difundiram-se pelas universidades, que formam mestres e doutores com os conhecimentos básicos sobre clonagem gênica, que se tornou de domínio público. Todos os insumos para clonagem gênica podem ser adquiridos por meio de catálogos via internet. Podem-se recrutar profissionais fanáticos e com a competência para a manipulação genética de organismos patogênicos, lado perverso da biotecnologia. Os conflitos étnicos, culturais e religiosos estão associados a um cenário de contrastes entre os países ricos e carentes de matéria-prima e aqueles pobres, mas detentores de insumos básicos e energia, e atingem a sua forma mais aguda nos fundamentalismos. Grupos de fanáticos têm pleno acesso a essa biotecnologia. Estariam assim as populações civis vulneráveis aos ataques do bioterrorismo com armas biológicas geneticamente modificadas?.

Fundamentalism arose in the West based in religious matters and afterward diffused to other parts of theworld with other connotations, especially political. Genetic manipulation techniques spread to universities,which has given masters and doctors the basic knowledge on gene cloning, which has become public domain.All inputs for gene cloning may be obtained through online catalogs. Fanatic professionals may be recruited,with qualification for genetic manipulation of pathogenic organisms, the negative side of biotechnology. Eth-nic, cultural and religious conflicts are linked to a series of contrasts between countries that are rich but witha lack of raw materials and the poor countries that possess basic input and energy sources, when it reachesthe highest fundamentalist form. Fanatic groups have complete access to this biotechnology. Are civilian po-pulations in vulnerable to bioterrorist attacks involving genetically modified biological weapons?

remarkable adaptability of syndromic surveillance to meet public health needs

The goal of syndromic surveillance is the earlier detection of epidemics, allowing a timelier public health response than is possible using traditional surveillance methods. Syndromic surveillance application for public health purposes has changed over time and reflects a dynamic evolution from the collection, interpretation of data with dissemination of data to those who need to act, to a more holistic approach that incorporates response as a core component of the surveillance system. Recent infectious disease threats, such as severe acute respiratory syndrome [SARS], avian influenza [H5N1] and pandemic influenza [H1N1], have all highlighted the need for countries to be rapidly aware of the spread of infectious diseases within a region and across the globe. The International Health Regulations [IHR] obligation to report public health emergencies of international concern has raised the importance of early outbreak detection and response. The emphasis in syndromic surveillance is changing from automated, early alert and detection, to situational awareness and response. Published literature on syndromic surveillance reflects the changing nature of public health threats and responses. Syndromic surveillance has demonstrated a remarkable ability to adapt to rapidly shifting public health needs. This adaptability makes it a highly relevant public health tool

Anthrax threat: a review of clinical and diagnostic measures

Anthrax is the plague of the ancient world and its existence is confirmed by the Roman poet Virgil. Also it is a threat in the modern world as it can be used in biological wars and bioterrorism. Anthrax is caused by Bacillus anthracis an unmovable, aerobic, gram-positive rod. It forms spores, which can survive for years in the environment. Three clinical forms result after exposure to anthrax spores: cutaneous, respiratory, and gastrointestinal. The cutaneous anthrax commonly prevails among humans. The respiratory form occurs most likely due to inhalation of the bacterial spores, whereas the gastrointestinal form happens after spores' ingestion. Prophylactic, early diagnosis and proper treatment will reduce mortalities of anthrax. Thus, the physicians, senior nurses and individuals at risk should be aware of the danger of this disease

Current status of vaccine development for tularemia preparedness

Tularemia is a high-risk infectious disease caused by Gram-negative bacterium Francisella tularensis. Due to its high fatality at very low colony-forming units (less than 10), F. tularensis is considered as a powerful potential bioterrorism agent. Vaccine could be the most efficient way to prevent the citizen from infection of F. tularensis when the bioterrorism happens, but officially approved vaccine with both efficacy and safety is not developed yet. Research for the development of tularemia vaccine has been focusing on the live attenuated vaccine strain (LVS) for long history, still there are no LVS confirmed for the safety which should be an essential factor for general vaccination program. Furthermore the LVS did not show protection efficacy against high-risk subspecies tularensis (type A) as high as the level against subspecies holarctica (type B) in human. Though the subunit or recombinant vaccine candidates have been considered for better safety, any results did not show better prevention efficacy than the LVS candidate against F. tularensis infection. Currently there are some more trials to develop vaccine using mutant strains or nonpathogenic F. novicida strain, but it did not reveal effective candidates overwhelming the LVS either. Difference in the protection efficacy of LVS against type A strain in human and the low level protection of many subunit or recombinant vaccine candidates lead the scientists to consider the live vaccine development using type A strain could be ultimate answer for the tularemia vaccine development.

Evaluation of the protective performance of a positive pressure bio-protective clothing against viral aerosol / 中华预防医学杂志

<p><b>OBJECTIVE</b>To evaluate the protective performance of a positive pressure bio-protective clothing against viral aerosol.</p><p><b>METHODS</b>The suspension of indicating virus phage Phi-X174 was made for viral aerosol generating in a hermetic cabin. The diameter of viral aerosol particles were measured with a aerodynamics size analyzer. By adjusting the inner humidity of the cabin, the protective efficiency of the positive pressure bio-protective clothing against viral aerosol in high and low windshield conditions was determined with Andersen six-stage air sampler sampling and plage forming unit (PFU) counting, respectively.</p><p><b>RESULTS</b>The mass median diameter of Phage Phi-X174 aerosol particles was about 0.922 µm and the background concentration is beyond 2 × 10⁴ particles/m³. The protective efficiency of the clothing against phage Phi-X174 aerosol particles was above 99.9% under different test conditions with the range of viral aerosol concentration between 0 - 23 PFU/m³. Airflow (P = 0.84), environment humidity conditions (P = 0.33) and sampling time (P = 0.07) did not affect the protective efficiency statistically.</p><p><b>CONCLUSION</b>The positive pressure bio-protective clothing provided a relatively high efficiency against phage Phi-X174 aerosol regardless of airflow rate, environment humidity and sampling time.</p>

Bioterrorism - “My Role as a Dentist”.

Bioterrorism is the intentional use of micro-organisms and toxins to produce disease and death in humans, livestock and crops, their attraction in war and for use in terrorist attacks is attributed to various unique features. Biological weapons can be disseminated by aerosol sprays, explosives or food and water contamination. They can strike suddenly without any warning and inflict considerable mortality and morbidity that can continue for a long period, such attacks may create high level of panic, environment contamination and extreme pressures on emergency health services. Accurate and substantial information given to the public by credible public health and medical experts can do much to allay their fears and encourage their cooperation and participation in constructive, organized community response efforts. The dental profession could potentially play a significant role in the emergency response to a major bioterrorism attack.

Biological warfare, bioterrorism and biodefence.

Biological warfare is the intentional use of micro-organisms and toxins to produce disease and death in humans, livestock and crops, their attraction in war, and for use in terrorist attacks is attributed to various unique features. Biological weapons (BWs) can be disseminated by aerosol sprays, explosives or food and water contamination. Bws can strike suddenly without any warning and inflict considerable mortality and morbidity that can continue for a long period, such attacks may create high level of panic, environment contamination and extreme pressures on emergency health services. Bioterrorism is the use of bws in terrorism. Current concerns regarding the use of bws result from the increasing number of countries that are engaged in the proliferation of such weapons and their acquisition by terrorist organizations. The need of the hour is to develop biodefence by full international cooperation and to educate the likely target populations about precautions and protective measures to be taken in such attacks.

Bioterrorismo: dados de uma história recente de riscos e incertezas / Bioterrorism: data of a recent history of risks and uncertainties

O bioterrorismo é hoje uma ameaça real em todo o mundo. Considerando-se que as ações de bioterrorismo utilizam agentes biológicos capazes de promover grandes epidemias e sobrecarga nos sistemas de saúde de qualquer cidade, estado ou país, o bioterrorismo passa a ser não apenas uma preocupação de governantes e militares, mas também dos profissionais da área da saúde. Este artigo discute, através de uma revisão bibliográfica, nas bases de dados LILACS, MEDLINE, SciELO e REPIDISCA, no período de 1997 a 2007, as características das publicações nacionais relacionadas ao bioterrorismo, o tipo de agentes biológicos estudados e o conhecimento já existente no país para fazer frente a um evento de bioterrorismo, a fim de subsidiar com informação os profissionais que irão atuar em ações de primeira resposta aos eventos de bioterrorismo e que são imprescindíveis para reduzir o número de vítimas.

Today, bioterrorism is a real threat in the whole world. Considering the actions of bioterrorism by using biological agents capable of promoting great epidemics and overload in the health systems of any city, state or country, the bioterrorism is not only a health professional concern, but government and military also. This article discusses a bibliographical review done in the LILACS, MEDLINE, SciELO and REPIDISCA databases, during the period of 1997 the 2007, the characteristics of related national publications to the bioterrorism, the type of biological agents studied, and the existing knowledge in the country to face a bioterrorism event, in order to feed with information the professionals who will act in first reply to the bioterrorism events and that are essential to reduce the number of victims.

[Biological warfares as a threat to drinking water supplies- a review study]

Historically during wars, urban water supply systems have been always exposed to threats and sabotage. These actions have been done in order to kill the military forces and civilians and sometimes to create political inconstancy. The intentional contaminating of water supplies can cause different diseases in humans and animals and it can also result in long term disorder in water supply services. Since the drinking water, foods and medicines are commonly being consumed, it is the easiest way to enter lethal dose of chemical and pathogenic agents into water supplies. A lot of people can be exposed to disease and death quickly by adding pathogenic and biotoxin agents in different places of water system, from the source of water absorption installations to water distribution system and wells of water. Unfortunately, in normal state, water supply systems are vulnerable and it is so difficult to detect the contamination easily. This issue is very important in nation security against possible bioterrorism attacks, and because of this, knowing these agent's hazards and responding actions is vital. This work is a review study in which potential biological threats, biological agents, vulnerable points of water supplies and water sources, possible ways of their contaminating, diagnosis and detection of agents and methods of effective disinfecting water, preventive and responding measures are studied. Planed programs for prevention of sabotage in drinking water, food supplies and other consumption products such as drugs should be based on 1-prevention, 2-detection and 3- response. Preparation plays the main role in all of these cases. Consider to necessity of water distribution authorities' knowledge about water bioterrorism hazards, prevention methods and response are vital for authorities of water supply particularly in military centers in aspects of security, politic, public and health. This study assesses different aspects of water bioterrorism in water sources and water supplies. In addition, potential threats of biological agents in water systems and current challenges for its detection, prevention ways and mitigation of vulnerability have been studied in this article

The public health implications of melioidosis

Melioidosis, which is caused by the bacterium Burkholderia pseudomallei, is a potentially fatal tropical infection, little known outside its main endemic zone of Southeast Asia and northern Australia. Though it has received more attention in recent years on account of its claimed suitability as a biological weapon agent, the principal threat from melioidosis is a result of naturally occurring events. Occasional case clusters, sporadic cases outside the known endemic zone and infections in unusual demographic groups highlight a changing epidemiology. As melioidosis is the result of an environmental encounter and not person-to-person transmission, subtle changes in its epidemiology indicate a role environmental factors, such as man-made disturbances of soil and surface water. These have implications for travel, occupational and tropical medicine and in particular for risk assessment and prevention. Practical problems with definitive laboratory diagnosis, antibiotic treatment and the current lack of a vaccine underline the need for prevention through exposure avoidance and other environmental health measures. It is likely that the increasing population burden of the tropical zone and extraction of resources from the humid tropics will increase the prevalence of melioidosis. Climate change-driven extreme weather events will both increase the prevalence of infection and gradually extend its main endemic zone.