Terror and Medicine Medical Aspects of Biological, Chemical and Nuclear Terrorism
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J. Shemer, Y. Shoenfeld (Eds.)
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Terror and Medicine Medical Aspects of Biological, Chemical and Nuclear Terrorism
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Pabst Science Publishers
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9783899670189
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1
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CHF 27.10
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Allgemeines
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English
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563
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Wasserzeichen/DRM
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PC/MAC/eReader/Tablet
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PDF
Das Buch"Terror an Medicine" wurde wegen der großen Nachfrage nach weiteren konkreten Informationen herausgegeben, die u.a. durch einen Artikel entstanden war, der im Juli 2002 im IMAJ (The Israel Medical Association Journal) erschienen ist. Der Artikel war auf Basis der umfangreichen medizinischen Erfahrungen entstanden, die in Israel im Zusammenhang mit terroristischen Anschlägen und der Bedrohung durch selbige gemacht wurden. Jüngere Ereingnisse auf der ganzen Welt - wie z.B. in den USA, Groß Britanien, Australien, Kneia, Bali, Indonesien und dem Nahe Osten - haben auf die weltweit um sich greifende Bedrohung des Terrors aufmerksam werden lassen. Dieses Nachschlagewerk versammelt Beiträge der herausragendsten israelischen Spezialisten auf den Gebiet der Medizin im Umgang mit biologischer, chemischer und atomarer Kriegsführung. Das Buch soll anhand der israelischen Erkenntnisse Praktiker und auch Institutionen dabei unterstützen, sich mit dem Thema vertraut zu machen. Es werden sowohl vorbeugende und vorbereitende Maßnahmen und Strategien in bezug auf terroristische Anschläge dargestellt, als auch die Maßnahmen zur Betreuung und Behandlung der Opfer danach. Das Buch soll hauptsächlich von praktischem Nutzen sein und es bietet Wissen und Erfahrungen, die in keinem anderen aktuellen Werk zu finden sind.
The Epidemiologic Pyramid of Bioterrorism (M. Huerta1, A. Leventhal)
(p. 70-71)
Key words
: bioterrorism, epidemiologic pyramid, anthrax, smallpox
Bioterrorism preparedness appears squarely on today's global agenda. World attention in general, and specifically that of health professionals, is now directed towards"mythological diseases" such as anthrax, plague and smallpox, which have been out of the mainstream spotlight for some decades. The scope of coverage by the mass media and the high levels of public anxiety that accompanied the 2001 anthrax crisis in the United States, and the current smallpox vaccination campaigns in the U.S. and Israel, reflect prevailing concerns over the potential global dissemination of these diseases. The sudden world panic about ancient diseases historically well known to practitioners of public health is perplexing. Modern public health is, in essence, rooted in the prevention of diseases such as smallpox and plague, and much of what we now know about epidemic intervention and disease prevention, including environmental measures, quarantine and vaccination, we learned over history through our experience in dealing with these very diseases. As early as the 12th century, ships arriving in the Republic of Venice from the plague-infected Levant were required to sit at anchor for 40 days before landing, in an effort to protect coastal cities from plague epidemics (the Latin root quadraginta, meaning"40," is the source of the modern term"quarantine") [1,2]. By the 17th century, port towns in the American colonies had enacted laws forbidding people with smallpox to enter port [3]. In the late 1800s federal legislation was passed in the United States which established the Division of Quarantine, the agency with oversight of quarantine activities that would merge with today's Centers for Disease Control and Prevention (CDC) some 100 years later [4].
If these diseases are historically well known to the public health sector, and if experience in preventing their spread has been amassed over time, why are we so surprised by the sudden reality of their existence?
The classic epidemiologic paradigm
When contemplating an infectious disease system, epidemiologists classically refer to the epidemiologic triangle [Figure 1]. According to this model, disease is the product of a unique interaction between the human host, the infectious agent, the environment in which the host's exposure to the agent takes place, and the vector that brokers this exposure [5]. Changes in any one of the apices of this triangle can affect the characteristics of the disease system as a whole. Such disease-altering modifications can be either naturally occurring or man-made. During the 20th century, for example, pandemics of influenza occurred in 1918, 1957 and 1968 [6,7]. These pandemics were associated with major antigenic changes in the influenza virus itself, which harbored a combination of animal and human viral genes [7,8]. This represents a naturally occurring change in the"agent" apex of the epidemiologic triangle. Contrary to this mechanism, some changes to the balance of the epidemiologic triangle may be induced by man. For example, forced isolation of infectious persons during an epidemic of a communicable disease alters the forces of the epidemiologic triangle by artificially severing the connection between agent and host. When we consider the diseases currently thought to be the most likely to be encountered in the context of a bioterror attack - namely anthrax, smallpox and plague (anthrax, of course, is no longer a threat but a fact) - it becomes apparent that changes have occurred over time in all three apices of the epidemiologic triangle, leaving today's population at an unprecedentedly high level of risk for disease. The alteration of checks and balances within the epidemiologic triangle has the potential to drive each disease system towards a new equilibrium, one with which we are not familiar and have not experienced in the past.
Contents
5
Preface
11
Introduction
13
Diabolical, Haunting Terror - Here and Now
15
Terror and Medicine -The Challenge
17
Epidemiology of Terror
18
Non-conventional warfare - unique epidemiology and medical management
19
Biological MDW management
20
Chemical MDW management
20
Radiation MDW
21
Conclusion
21
References
22
From Geneva to Afghanistan: The Ethical Implications of Terror and its Effect on the Physician
24
Ethics in a World of Terror
25
The role of the physician
26
Terror and civil liberties
28
The Model State Emergency Health Powers Act
29
The Revised Model Act
30
Terror and the allocation of resources
30
And what the future ...
31
References
31
National Preparedness for a Biological Mass Casualty Event: Between the Devil and the Deep Blue Sea
32
Policies and Doctrines of Non-Conventional Warfare
35
Non-Conventional Terrorism: Historical Aspects
37
Chemical Agents
37
Biological Agents
39
Conclusions
41
References
41
The Medical Management of Terrorist Attacks
43
Pre-event medical preparedness for the terrorist attack
43
Planning
44
Resources
45
Instruction and drills
45
Eventmanagement
45
Pre-hospital phase
46
At the hospital: immediate preparation phase
48
Treatment process
48
Post-event procedures
49
Conclusion
49
References
50
Hospital Management of a Bioterror Event
51
Pre-bioterror event preparations
52
Hospital management for bioterror event
53
Conclusio
