2. Decontamination During Human Biological Incidents Presented by The Ohio Department of Health Disaster Preparedness & Response Program

3. Our Decontamination Focus l N uclear devices/material l B iological weapons l C hemical weapons

4. Potential List of Biological Agents l Anthrax (bacteria) l Plague (bacteria) l Smallpox (virus) l Ebola/Other Viral Hemorrhagic Fevers (virus) l Ricin (toxin) l Botulinum (toxin)

5. About Biologicals bacteria, viruses and toxins Biological incidents involve bacteria, viruses and toxins l Detection monitors are currently unavailable l Most likely dispersed as aerosols with simple technologies: l Yard sprayers l A plane or boat upwind l Might be delivered by oral ingestion

6. About Biologicals l Routes of entry l Deliberate incident is usually through inhalation & ingestion l Infectious versus communicable l Usually have an incubation period

7. Decon/Infection Control Decon : The process of removing or neutralizing an external hazard from a person, the property or the environment. Disinfection : Selective elimination of undesirable microorganisms to prevent their transmission (or removal of infectious organisms below necessary level to cause infection). Sterilization : Complete killing of all organisms.

8. Decontamination after Biological Release Material l often unnecessary l less relevant than for chemical attack l 5.0% bleach more than adequate l 0.1% bleach kills anthrax spores l People l decon rarely needed l less relevant than for chemical attack l soap and water

9. Key Points Key Points l Biological decon is different from chemical decon l People can be injured by inappropriate decon: l Physical harm l Psychological harm

10. Decontamination Checklist What are we decontaminating? Which decon are we using - biological or chemical? l Is decontamination possible? Who needs decontamination? What level of protection is needed for those in area? l for the responders?

11. Decon l Removes but does not necessarily neutralize an agent l Decon cannot kill or render an infectious disease harmless in a human

12. Bio Decon 1. Immediately wash exposed skin with soap and water 2. Remove clothes and bag for evidence 3. Soap and water shower Steps 2 and 3 can be done at home

13. Why Showering is Enough l Agent does not re-aerosolize l Agent must be “device driven” for effectiveness Intact skin is THE best protection l Agent already captured in lungs, gastrointestinal tract, or open wounds

14. The Use of Chemicals in Bio Decon l Disinfectants (chemicals) can make agent harmless with time and contact (e.g. bleach or hypochlorite solution) l Not recommended for decon of people l Surfaces and equipment - YES l People - NO

15. Ohio Guidelines Weapons of Weapons of Mass Destruction Mass Destruction Bioterrorism Bioterrorism Protocol Protocol PROCEDURES FOR LOCAL, STATE AND FEDERAL PERSONNEL AND AGENCIES

16. Bioterrorism l There are a number of things which make this type of incident different from others l Non-traditional responders involved l The incident is a crime scene

17. Local Dispatch & 911 Centers Initial dispatch call should include: l EMA l Fire/EMS l Law enforcement l Hospitals Secondary notification should include: l FBI l Local health department

18. Agencies Involved Locally l EMA l EMS l Fire l Health Dept l Hospital l Law Enforcement l Poison Control State & Federal l CDC l EMA l FBI l OSP l State Dept Of Health l USPHS

19. l Medical community response l Epidemiology and public health response l Calls to 9-1-1 & EMS response Detection of Covert Biological Attacks

20. Covert Incident Will be Hard to Recognize l Symptoms resemble other sicknesses l May not surface for 3 or 4 days l Physicians may not be familiar with symptoms l Mortality will be expected l Lab analysis must be expedited in any case

21. Questions? l Review Points: l Biological and chemical decontamination procedures are different l WATER ONLY, please l People can be injured by inappropriate decon l The Ohio Guidelines provide procedures for dealing with biological incidents