1. History of Biological Warfare - Globally
1925 Geneva Protocol
1972 Biological Weapons
Convention
signed by 103 nations
1975 Geneva Conventions
Ratified

2. PROTOCOL FOR THE PROHIBITION OF THE USE IN WAR OF ASPHYXIATING, POISONOUS OR OTHER GASES, AND OF BACTERIOLOGICAL METHODS OF WARFARE
Opened for signature: 17 June 1925, entered into force: 8 February 1928
Geneva Protocol
The undersigned Plenipotentiaries, in the name of their respective governments:
Whereas the use in war of asphyxiating, poisonous or other gases, and of all analogous liquids, materials or devices, has been justly condemned by the general opinion of the civilised world; and
Whereas the prohibition of such use has been declared in Treaties to which the majority of Powers of the world are Parties; and
To the end that this prohibition shall be universally accepted as a part of International Law, binding alike the conscience and the practice of nations;
Declare:
That the High Contracting Parties, so far as they are not already Parties to Treaties prohibiting such use, accept this prohibition, agree to extend this prohibition to the use of bacteriological methods of warfare and agree to be bound as between themselves according to the terms of this declaration.
The High Contracting Parties will exert every effort to induce other States to accede to the present Protocol. Such accession will be notified to the Government of the French Republic, and by the latter to all signatories and acceding Powers, and will take effect on the date of the notification by the Government of the French Republic.
The present Protocol, of which the English and French texts are both authentic, shall be ratified as soon as possible. It shall bear to-day's date.
The ratifications of the present Protocol shall be addressed to the Government of the French Republic, which will at once notify the deposit of such ratification to each of the signatory and acceding Powers.
The instruments of ratification of and accession to the present Protocol will remain deposited in the archives of the Government of the French Republic.
The present Protocol will come into force for each signatory Power as from the date of deposit of its ratification, and, from that moment, each Power will be bound as regards other Powers which have already deposited their ratifications.
In witness whereof the Plenipotentiaries have signed the present Protocol.
Done at Geneva in a single copy, the seventeenth day of June, One Thousand Nine Hundred and Twenty-Five.

3. ПРОТОКОЛ О ЗАПРЕЩЕНИИ ПРИМЕНЕНИЯ НА ВОЙНЕ УДУШАЮЩИХ, ЯДОВИТЫХ ИЛИ ДРУГИХ ПОДОБНЫХ ГАЗОВ И БАКТЕРИОЛОГИЧЕСКИХ СРЕДСТВ
Женева, 17 июня 1925 года
Нижеподписавшиеся уполномоченные от имени своих соответственных Правительств:
считая, что применение на войне удушающих, ядовитых или других подобных газов, равно как и всяких аналогичных жидкостей, веществ и процессов, справедливо было осуждено общественным мнением цивилизованного мира;
считая, что запрещение этого применения было сформулировано в договорах, участниками коих является большинство держав мира;
в целях повсеместного признания вошедшим в международное право сего запрещения, равно обязательного для совести и практики народов;
заявляют:
что Высокие Договаривающиеся Стороны, поскольку они не состоят уже участниками договоров, запрещающих это применение, признают это запрещение, соглашаются распространить это запрещение на бактериологические средства ведения войны и договариваются считать себя связанными по отношению друг к другу условиями этой Декларации.
Высокие Договаривающиеся Стороны приложат все свои усилия к побуждению других государств присоединиться к настоящему Протоколу. Об этом присоединении будет уведомлено Правительство Французской Республики, а последним — все подписавшие и присоединившиеся державы. Он войдет в действие со дня уведомления, сделанного Правительством Французской Республики.
Настоящий Протокол, французский и английский тексты которого будут считаться аутентичными, будет ратифицирован в возможно кратчайший срок. Он будет носить дату сего дня.
Ратификация настоящего Протокола будет препровождена Правительству Французской Республики, которое уведомит каждую подписавшуюся или присоединившуюся державу о принятии таковой на хранение.
Ратификационные грамоты или документы о присоединении будут храниться в архивах Правительства Французской Республики.
Настоящий Протокол войдет в силу для каждой подписавшей державы со дня поступления ратификации, и с этого момента таковая держава будет связана в отношении других держав, уже произведших сдачу своих ратификаций.
В удостоверение чего уполномоченные подписали настоящий Протокол.
Учинен в Женеве в одном экземпляре семнадцатого июня тысяча девятьсот двадцать пятого года.

4. Biological Weapons Convention
Convention on the Prohibition of the Development, Production and Stockpiling of
Bacteriological (Biological) and Toxin Weapons and on Their Destruction
Signed at Washington, London, and Moscow April 10, 1972
Convention on the Prohibition of the Development, Production and Stockpiling of
Bacteriological (Biological) and Toxin Weapons and on Their Destruction
Biological and chemical weapons have generally been associated with each other
in the public mind, and the extensive use of poison gas in World War I
(resulting in over a million casualties and over 100,000 deaths) led to the
Geneva Protocol of 1925 prohibiting the use of both poison gas and
bacteriological methods in warfare. At the Disarmament Conference,
unsuccessful attempts were made to work out an agreement that would prohibit the
production and stockpiling of biological and chemical weapons. During World War
II, new and more toxic nerve gases were developed, and research and development
was begun on biological weapons. Neither side used such weapons. President
Roosevelt, in a statement warning the Axis powers against the use of chemical
weapons, declared:
Use of such weapons has been outlawed by the general opinion of civilized
mankind. This country has not used them, and I hope we never will be compelled
to use them. I state categorically that we shall under no circumstances resort
to the use of such weapons unless they are first used by our enemies.
In the postwar negotiations on general disarmament, biological and chemical
weapons were usually considered together with nuclear and conventional weapons.
Both the United States and Soviet Union, in the 1962 sessions of the
Eighteen-Nation Disarmament Committee (ENDC), offered plans for general and
complete disarmament that included provisions for eliminating chemical and
biological weapons.
An issue that long hindered progress was whether chemical and biological weapons
should continue to be linked. A British draft convention submitted to the ENDC
on July 10, 1969, concentrated on the elimination of biological weapons only. A
draft convention proposed in the General Assembly by the Soviet Union and its
allies on September 19 dealt with both chemical and biological weapons. The
Soviet representative argued that they had been treated together in the Geneva
Protocol and in the General Assembly resolutions and report, and should continue
to be dealt with in the same instrument. A separate biological weapons
convention, he warned, might serve to intensify the chemical arms race.
The United States supported the British position and stressed the difference
between the two kinds of weapons. Unlike biological weapons, chemical weapons
had actually been used in modern warfare. Many states maintained chemical
weapons in their arsenals to deter the use of this type of weapon against them,
and to provide a retaliatory capability if deterrence failed. Many of these
nations, the United States pointed out, would be reluctant to give up this
capability without reliable assurance that other nations were not developing,
producing, and stockpiling chemical weapons.
While the United States did not consider prohibition of one of these classes of
weapons less urgent or important than the other, it held that biological weapons
presented less intractable problems, and an agreement on banning them should not
be delayed until agreement on a reliable prohibition of chemical weapons could
be reached.
Shortly after President Nixon took office, he ordered a review of U.S. policy
and programs regarding biological and chemical warfare. On November 25, 1969,
the President declared that the United States unilaterally renounced first use
of lethal or incapacitating chemical agents and weapons and unconditionally
renounced all methods of biological warfare. Henceforth the U.S. biological
program would be confined to research on strictly defined measures of defense,
such as immunization. The Department of Defense was ordered to draw up a plan
for the disposal of existing stocks of biological agents and weapons. On
February 14, 1970, the White House announced extension of the ban to cover
toxins (substances falling between biologicals and chemicals in that they act
like chemicals but are ordinarily produced by biological or microbic processes).
The U.S. action was widely welcomed internationally, and the example was
followed by others. Canada, Sweden, and the United Kingdom stated that they had
no biological weapons and did not intend to produce any. It was generally
recognized, however, that unilateral actions could not take the place of a
binding international commitment. A number of nations, including the Soviet
Union and its allies, continued to favor a comprehensive agreement covering both
chemical and biological weapons.
Discussion throughout 1970 in the General Assembly and the Conference of the
Committee on Disarmament (CCD) -- as the ENDC was named after its enlargement to
26 members in August produced no agreement. A breakthrough came on March
30, 1971, however, when the Soviet Union and its allies changed their position
and introduced a revised draft convention limited to biological weapons and
toxins. It then became possible for the co-chairmen of the CCD -- the U.S. and
Soviet representatives -- to work out an agreed draft, as they had done with the
Non-Proliferation and the Seabed Treaties. On August 5, the United States and
the Soviet Union submitted separate but identical texts.
On December 16, the General Assembly approved a resolution, adopted by a vote of
110 to 0, commending the convention and expressing hope for the widest possible
adherence.
The French representative abstained, explaining that the convention, though a
step forward, might weaken the Geneva Protocol ban on the use of chemical
weapons, and he did not consider that adequate international controls were
provided. He announced, however, that France would enact domestic legislation
prohibiting biological weapons, and this was done in June of the next year.
The Peoples Republic of China did not participate in the negotiations on the
convention and did not sign it. At the 1972 General Assembly its representative
attacked the convention as a "sham," and criticized it for not prohibiting
chemical weapons.
The convention was opened for signature at Washington, London, and Moscow on
April 10, President Nixon submitted it to the Senate on August 10, calling
it "the first international agreement since World War II to provide for the
actual elimination of an entire class of weapons from the arsenals of nations."
The Senate Foreign Relations Committee delayed action on the convention,
however, holding it for consideration after resolution of the herbicide and
riot-control issues involved in the Geneva Protocol (see section on the Geneva
Protocol).
In the latter part of 1974 the Ford Administration undertook a new initiative to
obtain Senate consent to ratification of both the Geneva Protocol and the
Biological Weapons Convention, and ACDA Director Fred Ikle testified with
respect to both instruments before the Senate Foreign Relations Committee on
December 10. Soon thereafter the Committee voted unanimously to send the two
measures to the Senate floor, and on December 16 the Senate voted its approval,
also unanimously.
President Ford signed instruments of ratification for the two measures on
January 22, 1975.
Under the terms of the convention, the parties undertake not to develop,
produce, stockpile, or acquire biological agents or toxins "of types and in
quantities that have no justification for prophylactic, protective, and other
peaceful purposes," as well as weapons and means of delivery. All such material
is to be destroyed within nine months of the conventions entry into force. In
January 1976, all heads of Federal departments and agencies certified to the
President that as of December 26, 1975, their respective departments and
agencies were in full compliance with the convention.
The parties are to consult and cooperate in solving any problems that arise.
Complaints of a breach of obligations may be lodged with the Security Council,
and parties undertake to cooperate with any investigation the Council initiates.
If the Security Council finds that a state has been endangered by a violation,
the parties are to provide any assistance requested.
Nothing in the convention is to be interpreted as lessening the obligations
imposed by the Geneva Protocol, and the parties undertake to pursue negotiations
for a ban on chemical weapons.
In addition, articles provide for exchange of information on peaceful uses,
amendment and review, and accession and withdrawal. The convention is of
unlimited duration.
At the second Review Conference in September 1986, the parties agreed to
implement data exchange measures to enhance confidence and to promote
cooperation in areas of permitted biological activities. In accordance with the
Final Declaration of that Review Conference, an ad hoc meeting of scientific and
technical experts was held March 31 - April 15, 1987, to develop procedures for
implementing annual data exchanges.
At the third Review Conference in September 1991 it was agreed to reaffirm and
extend confidence building measures agreed at the second Review Conference and
to create an Ad Hoc Group of Governmental Experts open to all parties to
identify, examine, and evaluate from a scientific and technical standpoint
potential verification measures with respect to the prohibitions of the
convention. The Ad Hoc Group met four times in 1992 and 1993, completing its
work and submitting a consensus report circulated to all States Parties. As
provided in the mandate, a majority of States Parties called for a Special
Conference to discuss the final report and consider further actions. The Special
Conference, held in September 1994, agreed to establish an Ad Hoc Group, open to
all States Parties, to consider appropriate measures, and draft proposals to
strengthen the Convention in a legally binding instrument. The Ad Hoc Group
convened two substantive sessions in 1995, with additional meetings scheduled
for The Ad Hoc Group will prepare a report, to be considered at the Fourth
Review Conference of the BWC in the Fall of 1996.

5. Joint Statement by President George W
Joint Statement by President George W. Bush and President Vladimir on Cooperation Against Bioterrorism
November 13, 2001
At Shanghai, we resolved to enhance cooperation in combating new terrorist threats, including those involving weapons of mass destruction.
We agree that, as a key element of our cooperation to counter the threat of terrorist use of biological materials, officials and experts of the United States and Russia will work together on means for countering the threat of bioterrorism, now faced by all nations, and on related health measures, including preventive ones, treatment and possible consequence management.
We will continue to work to enhance the security of materials, facilities, expertise, and technologies that can be exploited by bioterrorists. We also confirm our strong commitment to the 1972 Convention on the Prohibition of the Development, Production and Stockpiling of Bacteriological (Biological) and Toxin Weapons and on Their Destruction.
We have directed all of our officials and experts working on these critical matters to expand their cooperation and to consult on strengthening related international efforts.

6. What role can Russia play in Combating Infectious Diseases And Bioterrorism Threats
The threat of biological weapons and their use in bioterrorism have increased. At the same time there are huge improvements in the knowledge of infectious diseases. How do we contain the threat of biological warfare (BW) and bioterrorism and continue to make progress in eliminating and treating infectious diseases?
S.V. Netesov, L.S. Sandakhchiev, VECTOR, Novosibirsk

7. In the past 20 years, more than 30 previously unknown infectious agents have been identified.
They causing such diseases as AIDS, hemorrhagic fevers, antibiotic resistant bacterial strains, hepatitis C, etc., A significant part of these infectious diseases result from the ability of microorganisms to mutate and adapt to humans and their medical treatment environment of medical prophylaxes and treatments. These properties, combined with increasing human mobility and migration and the increasing number of people with suppressed immunity, and several other factors, make the emergence of new diseases and variants more likely.

8. Biological Warfare Nonproliferation and Threat Reduction
The issues of nonproliferation and threat reduction of biological weapons based on infectious agents are different from other weapons of mass destruction (WMD).
We believe that the major nonproliferation and threat reduction efforts should focus on already working with emerging pathogens research centers, which might present a source of expertise for potential bioterrorists.

9. Russia’s Role in Infectious Disease Research and International Cooperation
Russia has great potential in the area of infectious disease research, as well as in development and manufacture of therapeutic and prophylactic preparations at facilities of the Russian Ministry of Public Health, those of BIOPREPARAT and of local public health establishments. Two large State Research Centers of the Russian Ministry of Public Health — for Applied Microbiology (Obolensk, European region) and Virology and Biotechnology VECTOR (Koltsovo, eastern region) — were involved in biological defense programs of the former Soviet Union before 1990.
Consequently they have years of experience in bacterial and viral pathogen research. With their technical and staff capabilities they could play a significant role within a global network for infectious diseases control. VECTOR fully follows the Russian guidelines and forwards annual reports to the Committee on the Biological and Chemical Weapons Conventions compliance at the office of the Russian president. These reports are the documents that are envisaged by the Review Conference of the 1972 BW Convention for subsequent submission to the UN.
Through the Russian Ministry of Science and Technologies, the Russian Ministry of Public Health and RAO "BIOPREPARAT", both the Obolensk and Koltsovo Centers are actively involved in broad international collaborations. These collaborations are under such organizations as International Science and Technology Center (ISTC, EC+USA+Japan), US National Academy of Sciences (NAS), Association for the Promotion of Cooperation with Scientists from New Independent States of the FSU (INTAS, EC), Civilian Research and Development Foundation (CRDF, USA), Initiatives for Proliferation Prevention (IPP-DOE, USA), National Aeronautics and Space Administration (NASA, USA), Defense Advanced Research Projects Agency (DARPA, USA). These international collaborations are aimed at nonproliferation and threat reduction by strengthening the confidence building measures and transparency, but do not involve dual use technologies.
In 1997 an expert group of the US National Academy of Sciences (NAS) under the leadership of Prof. Joshua Lederberg and Dr. John Steinbruner, with the involvement of Russian experts, developed a concept for international collaboration in dangerous pathogen research [9]. This concept uses confidence building measures and transparency extensively. In particular, each project would have freedom of access at the place of performance and all results are to be provided to all counterparts. Collaborative work between Russian and US scientists would be carried out in laboratories of these countries under a separate agreement. This freedom of access is also defined in programs such as CRDF, NASA, DARPA and IPP (DOE).

10. The State Research Center of Virology and Biotechnology VECTOR, operated by the Russian Ministry of Public Health, is a large research and production complex, whose primary activities are focused on basic and applied research in the theoretical virology, molecular biology, virology, immunology, aerobiology, epidemiology, and biotechnology. VECTOR also develops and manufactures preventive, therapeutical and diagnostic preparations.
VECTOR

11. VECTOR is one of two scientific and experimental facilities in Russia mainly focusing on virus infection research. The State Research Center for Applied Microbiology, Russian Ministry of Public Health (Obolensk, Moscow Oblast), is a similar scientific and experimental center, involved in bacterial infections research. VECTOR and Obolensk are the only institutions in both Russia and the rest of the CIS countries in which studies of highly dangerous pathogens can be done at an up-to-date level.

12. VECTOR
VECTOR’s research and production facilities amount to more than 250,000 m2 on over 8,000 hectares (19,768 acres). The research and experimental facilities at VECTOR are equipped for up-to-date scientific work with highly pathogenic human and animal viruses, under conditions of complete biosafety. Several buildings meet special biosafety requirements for high containment facilities (BSL 2, 3, and 4): an air-tight external perimeter, negative pressure in the working zone, complete sterilization (liquid, and solid) or reliable filtration (air) of all types of discharge.

13. VECTOR
The research and technical staff of the Center are highly qualified personnel, specializing in the field of genetic engineering, molecular biology, virology, theoretical virology, immunology, epidemiology, and ecology. The staff has extensive experience in highly dangerous viruses research and in production of diagnostic and prophylactic preparations for public health and veterinary needs.

14. VECTOR
The Collection of Cultures of Microorganisms in VECTOR contains over 10,000 deposit entries: various viral strains, including the national collection of variola virus strains and strains of BSL-4 viral pathogens; recombinant viral strains; strains of microorganisms, including producer strains. The Collection received international recognition in 1995 when it was affiliated with the European Culture Collection Organization (ECCO).

15. VECTOR
VECTOR also houses one of the two WHO Collaborating Centers for orthopoxvirus diagnosis and repository for variola virus strains and their DNA. The other WHO Collaborating Center for smallpox and other poxvirus infections is at the CDC in Atlanta, USA. As a WHO Collaborating Center, VECTOR preserves and studies the Russian collection of variola virus isolates. The research collaboration between these two Centers is promising in terms of basic science and confidence building.

16. VECTOR
VECTOR’s Breeding and Holding Facility for laboratory animals, which includes one of only two monkey breeding facilities operating in Russia, is used for testing therapeutic and diagnostic preparations. Facilities for the performance of preclinical and clinical trials of new medicinal preparations are available at VECTOR.

17. VECTOR
Possible research at the proposed International Center could focus on arboviruses, including tick-borne encephalitis virus that is endemic in Russia; HFRS virus, Omsk hemorrhagic fever virus – both endemic in Siberia; filoviruses: Marburg and Ebola; orthopoxviruses: smallpox virus, monkeypox, and cowpox viruses; viruses causing hepatitis A, B, C; paramyxoviruses, rabdoviruses, influenza viruses, etc. This list of viruses could be extended by bacteria and parasites, such as tuberculosis, which is increasing sharply now in Russia, and opisthorchiasis – human parasitic disease affecting the liver. The latter is endemic in Siberia, too.
Data from this centers or from network created will also be very beneficial for outside the world, as it is not clear as to where to obtain accurate data on health and research in Russia. All participants of the network will be in constant contact with each other through out newsletters and personal contacts. Program will help for rational spending of limited resources for disaster mitigation in FSU countries as well may be a backbone for any other health projects and, for example, cooperation in the field of prevention of bioterrorism.

18. Now, In Russia the State Federal Center of Hygiene and Epidemiology is responsible for infectious diseases control.

19. The aims of the Federal Center of Hygiene and Epidemiology
Sanitary and Epidemiological measures in case of situation with the outbreaks of infectious diseases or during disasters;
Statistical monitoring for control of infectious diseases at the federal level, reporting;
участие в реализации государственной политики в области обеспечения санитарно-эпидемиологического благополучия населения и первичной профилактики заболеваний;
информационное, научно-методическое и нормативное обеспечение по вопросам санитарно-эпидемиологического благополучия населения, государственного санитарно-эпидемиологического надзора и деятельности Службы;
развитие и совершенствование лабораторного дела, аккредитация, стандартизация и метрология в системе учреждений Службы, кадровая и материально-техническая политика развития Службы;
обеспечение и проведение санитарно-эпидемиологических мероприятий    в системе работы Службы при чрезвычайных ситуациях;
ведение Федеральной базы данных социально-гигиенического мониторинга;
участие в разработке и реализации Федеральных целевых программ по вопросам обеспечения санитарно-эпидемиологического благополучия и первичной профилактики заболеваний населения;  
проведение санитарно-эпидемиологической экспертизы, расследования, обследования, исследования, испытания, токсикологические, гигиенические и иные виды оценок;
статистическое наблюдение в области обеспечения санитарно-эпидемиологического благополучия населения на федеральном уровне, государственный учет инфекционных заболеваний, профессиональных заболеваний, массовых неинфекционных заболеваний (отравлений) в связи с вредным воздействием факторов среды обитания в целях формирования государственных информационных ресурсов;
организация и участие в проведении научно-исследовательских и иных работ, направленных на совершенствование системы госсанэпиднадзора и совершенствования деятельности службы;
проведение исследования исторического наследия организации и деятельности Службы.  

20. The structure of the Federal Center of Hygiene and Epidemiology
Disaster department
Epidemiological department
Laboratory services
USSR priorities in medicine were always infectious diseases.

21. Now, the Russia also ready for infectious disease outbreaks, not to long-long period of the epidemic of non-infectious diseases.
Russia is divided into 89 equal “federal subjects”. Administrative reforms carried out in 2000 grouped the 89 subjects into 7 federal districts. Novosibirsk is the capital of Siberian Federal district.

22. The period until 1991 Life expectancy (both sexes)
At the end of the nineteenth century, life expectancy in Russia was about 32 years, compared to 47 years in France and the United States. By 1938 the gap had increased.

23. The period until 1991 Life expectancy in 1965
During the next 15 years, however, Russia made huge steps forward and succeeded in closing much of the gap. However this progress was not maintained in later years.

24. The health care principles upon which the Soviet health care system was to be based (Nikolai Semashko):
government responsibility for health
universal access to free services
a preventive approach to “social diseases”
quality professional care
a close relation between science and medical practice
continuity of care between health promotion, treatment and rehabilitation.
Based on these principles, the state developed a unified health system which provided free medical services for everyone. Enormous emphasis was placed upon epidemic control and prevention of infectious diseases.

25. Next steps following the establishment of the “Semashko” model in 1918
The health care system was under the centralized control of the state, which financed services by general government revenues as part of national social and economic development plans.
All health care personnel became employees of the centralized state, which paid salaries and provided supplies to all medical institutions.
The main policy orientation throughout this period was to increase numbers of hospital beds and medical personnel.
By 1941, when Russia entered the Second World War, the health care system was well developed and had succeeded in bringing reliable health care services to the entire population.

26. Next steps following the establishment of the “Semashko” model in 1918 (cont.)
Russia made massive strides in arresting the spread of infectious diseases.
Drastic epidemic control measures were implemented, particularly in the cases of tuberculosis, typhoid fever, typhus, malaria and cholera.
These involved community prevention approaches, routine check-ups, improvements in urban sanitation and hygiene, quarantines, etc.
Mortality rates from infectious diseases falling from 87 for in 1960 to 12 in Yet, these successes were not reflected in improvements in the overall health status of the population.

27. Health crisis
The diverging paths of Russia and other industrialized nations with respect to health status from the 1960s onward has been attributed to the failure of the Russian health care system to successfully respond to the epidemiological transition.
Russian health care system was unable to fight with noncommunicable diseases using current prevention strategy.
Old Russian system of prevention, with its primarily medical orientation, did not evolve into one of population-based health promotion.

28. The leading causes of death in the Russia Federation
Cardiovascular diseases with rates that are the highest in the European Region.
External causes of injury and poisoning
Cancer
There is now considerable evidence that many of the excess deaths especially among younger men are because of heavy alcohol consumption.

29. CVD Injury Cancer Average for 1999-2001
The male mortality rate in category of external causes of injury and poisoning is 4.4 times greater than that of women.
Now, infectious diseases responsible for only 1,76% of all mortality.
Cancer
Average for

30. WHY was prophylaxis with Ciprofloxacin extended to 60 days?
More on Sverdlovsk 
The accident took place near Sverdlovsk. Outbreak of anthrax killed at least 68 people.
Humberto Guerra
Source: New York Department of Health
BECAUSE in Sverdlovsk cases appeared more than 40 days after exposure, and because of data from animal experiments
Source: New York Department of Health

31. A mysterious outbreak of anthrax killed at least 68 people, including Karsayev, 22 years ago in the Russian industrial center of Sverdlovsk, today known as Yekaterinburg. At the time, neither the victims nor their families suspected they had been hit by a biological weapon. (AP Photo/Alexei Vladykin)
Lidia Tretyakova looks at the tombstone of her father, Lazar Karsayev, at a cemetery in Yekaterinburg, Russia, Thursday, Oct. 18, A mysterious outbreak of anthrax killed at least 68 people, including Karsayev, 22 years ago in the Russian industrial center of Sverdlovsk, today known as Yekaterinburg. At the time, neither the victims nor their families suspected they had been hit by a biological weapon. (AP Photo/Alexei Vladykin)

32. Laboratory workers at the Sverdlovsk regional epedemiological service put on the special suits they wear when working with anthrax and other dangerous bacteria in Yekaterinburg, Russia, Wednesday, Oct. 17, 2001

33. Supercourse has plans for future collaborations and actions in the field of antiterrorism with the creation of networks.
Establish a 5 member expert task force to establish epidemiology data needs: It is not clear as to what is the optimal epidemiologic data that would be needed for disaster mitigation. We will establish a 5 member task force headed by Dr. Noji to identify disaster data needs. It is essential to evaluate data quality, and consistency across countries.
Examples of types of data that likely would prove to be important include: We will focus on existing data systems. We will scientifically vet these to maximize their validity and accuracy. The types of data are presented below.

34. Terrorism Is an unlawful act of violence
Intimidates governments or societies
Goal is to achieve political, religious or ideological objectives
Arthur H. Garrison

35. Prevention of Terrorism
Primary prevention:
Education!!!
Understand the differences in cultures, religions, beliefs and human behaviors
Think of the peace, freedom and equality of all human beings, not just “my group of people”
Eliminate the root of terrorism
Just because of its uncertainty, it is hard to collect unbiased data on terrorism and it is hard to propose specific prevention measures. Here we present the general approaches of prevention from the epidemiological and public health point of view.

36. Prevention of Terrorism
Secondary prevention:
Establish surveillance and monitoring system on terrorism attack
Improve protective system for citizens

37. Prevention of Terrorism
Tertiary prevention
Early detection of the sources
Prevent the extension of impairments
Rescue the survivors
Console the rest of the population

38. Proportion of death from terrorism in total death in the United States
0.12
2893
2001
0.0003 8
1990’s
Proportion (%)
From all causes
From terrorism
Average death per year

39. Risk of Dying One in 50,000,000 Terrorism attack in 1990’s
Hit by lightning
One in 100,000
Terrorism attack in 2001
Homicide
One in 25,000
Playing soccer
One in 8,000
Road accident
One in 850
All natural causes age 40
One in 200
Smoking 10 cigarettes a day
Penguin Books, 1987

40. Death Rate of Various Causes in 2000 USA and that from Terrorism
One in 50,000,000
Terrorism in 1990’s
One in 100,000
Terrorism in 2001
One in 20,000
Homicide*
One in 10,000
Suicide*
One in 4,000
Diabetes*
One in 3,000
Accidents *
One in 2,000
Cerebrovascular diseases*
One in 500
Cancer *
One in 400
Heart disease*

41. Why did terrorism draw considerable attention in 2001?
The risk of dying from terrorism was extremely low in 1990’s, and was still relatively low compared with some diseases in 2001
But the death rate increased by 500 times in 2001 due to Sept. 11
Overall the death rate of terrorism has not been high
Despite the low risk, shock, surprise and fear engulfed the United States and world
The risk of dying from terrorism was even lower than that from hitting by lightening. Assume how surprised you will be, if someone tell you that your chance of hitting by lightening will be as high as that of homicide.

42. Conclusion Terrorism is unlawful act
Terrorism has a long history of being used to achieve political, religious and ideological objectives
Terrorism can be conducted through firearms, explosive devices and biological, chemical, nuclear materials
Even through the events of 2001, the risk of dying from terrorism has remained much lower than that from motor vehicles, smoking, and alcoholic beverage.
Sources: Information on how to help children understand the terrorist attacks:
Suggestions for Adults: Talking and Thinking with Children About the Terrorist Attacks
Suggestions for Educators: Meeting the Needs of Students
A Letter to Elementary School Students from First Lady Laura Bush
A Letter to Middle and High School Students from First Lady Laura Bush
President Bush Participates in Launch of Friendship Through Education Consortium
School Officials Urged to Prevent Harassment of Muslim and Arab-American Students
Where you can find additional information and resources:
American Academy of Child and Adolescent Psychiatry
American Counseling Association
American Psychological Association Online: Help with Trauma
Emergency Services and Disaster Relief Branch, Center for Mental Health
Helping Children and Adolescents Cope with Violence and Disasters
Helping Children Cope with Disaster, National Parent Information Network
High Schools for Heroes
National Association of School Psychologists
National Center for Post-Traumatic Stress Disorder
Post-Traumatic Stress Disorder (PTSD), Trauma, Disasters, and Violence
Talking with Children When Disaster Strikes
Ten Tips to Help Your Kids Deal with Violence, Parenting Press
Terrorism and Children, Purdue University Extension
University of Oklahoma, Department of Pediatrics
U.S. Government Information and Resources in Response to September 11th Events