1. Bioterrorism: The Threat Continues Byron Austin Jacob Norton Joseph Rooney The ripples of our background represent the spread of the disease throughout the metropolitan area

2. Bioterrorism Revisited The use during British/American Indian conflict Considered for use in World War II Worldwide vaccination program initiated by WHO Last U.S. vaccination in late 1970’s U.S. military continued vaccination until the late 1980’s Russia and United States of America hold stores of smallpox virus –Political conflict More vaccinations ordered for probable situation

3. The Infamous Smallpox Virus The variola major virus responsible for a 30% death rate Incubation period: 12-14 days Death may occur in 2 weeks or less Recovery may occur in 3 weeks or more Airborne transmission via coughing and sneezing of latently infected Treatment only compensates for common, secondary bacterial infection It could take up to 2 weeks before authorities would realize the attack

4. Vaccinations VIG (Vaccinia Immune-Globulin) –Must be administered in 3 days or more after exposure Vaccinia virus (cowpox) –Must be administered in 4 days or less after exposure Duration of immunity: 5-30 years Immunity by contact with disease (latent/infected) Dryvax (ineffective: past its shelf life) Other vaccines (i.e. VIG and vaccinia) are rumored past their effective life span If a vaccine was to be made now, it would cost approximately $8.58 per dose to manufacture OraVax

5. Prevention and Control Transmission rate removed by vaccination and quarantine Time issue due to incubation period vs. inactivation of virus All persons should be vaccinated and then monitored for fever for 17 days following exposure Air control i.e. air pressure, temperature, humidity and UV index Decontamination: high temperature (88-90 F) and high humidity (80%); chemicals e.g. bleach, hypoclorite, and quaternary ammonia

6. What if biowarfare were to break out in Manhattan? Population: 1,537,000 people Population density: 65,050 per square mile Birth rate:.00003890410959 Death rate:.00002383561644 Immigration rate: 52.14 people per day

7. The Basic Model

8. The Graphs

9. Modifications Universal –Immigration –Oscillation Quarantine Vaccination Tourism

10. Oscillation and Immigration Equations I1 I2

11. Oscillation and Immigration Latent and Infected

12. Quarantine Equation :=eq3    t ()Inft   q) ( ) Ltb()Inft  () t  ( ) t  (1-q)L(t) –b Inf(t)-  Inf(t) –  Inf(t)  S(t)L(t) – b L(t)-  (1-q)L(t) – qL(t) + I2

13. Quarantine

14. Quarantine continued…

15. Quarantine Long–term Quarantine, Latent, Infected

16. Vaccination AS(t)- bS(t) –  S(t)L(t) +I1 –vaccine vacexp t S(t)  Inf(t) - bR(t) + vaccine vacexp t S(t)

17. Vaccinations

18. Vaccinations Real

19. Vaccination Long-term

20. Tourism Equations

21. Tourism Equations Continued

22. Tourism Susceptible Recovered Quarantine Infected Latent

23. Tourism/Behavior Continued Recovered Latent Infected

24. Tourism/Behavior Continued

25. ZL(t) and Spread of Disease on a Larger Scale ZL(t) is… The spread of the disease to different parts of the world Next Step is to find the Tourism and Commuter Statistics for Manhattan during different times of the year Then use these portions of ZL(t) in different areas ZL(t) is the link to the global distribution of the disease ZL(t) will lead to more ZL(t)’s until  S local (ZL local +L local ) is approximately zero Intervention Conclusion

26. Conclusion: Intervention VaccinationQuarantine

27. To be continued… New alternatives to smallpox for biowarfare: –Anthrax (Inhalation, Cutaneous, Gastrointestinal) –Ebola (Zaire, Sudan) –Hybrid (combination of more than one pathogen)

28. Anthrax Gram-positive, aerobic Spore- forming bacterium Bacillus anthracis (3 main different forms) Cutaneous: 95% of cases. Easily treated with antibiotics if diagnosed in time. Responsible for a 20% death rate. Inhalation: Rare form. Not easily treated. Extremely fatal (99% death rate). Kills quickly (1-2 days). Gastrointestinal: Rare form. Often fatal (25-60% death rate) Latency period: 1 to 6 days Easily and widely distributed if used as a weapon Spores can remain dormant but viable for decades Not transmittable from person- to-person Mandatory vaccination of all military personnel Vaccine is 93% effective; Antibiotics kill bacteria but do not remove toxins from bloodstream

29. EBOLA

30. Ebola Sudan 450000 deaths

31. Ebola Zaire 8000000 deaths

32. References CDC Johns Hopkins Tim Clarke and Joe Geddes Dr. Fleischman, Dr. Norton, Dr. Short, and everyone else who helped us Soon we’ll thank one more person...

33. Overall Conclusions We are susceptible… ANY QUESTIONS?