Bibliographies Pandemics ADM002177, Summer 2009

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ADA496737
The Pandemic Pendulum: A Critical Analysis of Federal and State Preparedness for a Pandemic Event
Descriptive Note: Master's thesis
Personal Author(s): Foley, John R
Report Date: Mar 2009
Media Count: 89   Page(s)
Descriptors: (U) *CASE STUDIES, *INFLUENZA VIRUS, *PUBLIC HEALTH, *PLANNING, POPULATION, STATE GOVERNMENT, DEFICIENCIES, SECONDARY, PREPARATION, UNITED STATES GOVERNMENT, UNITED STATES
Identifiers: (U) *PANDEMIC THREATS, PANDEMIC EVENTS
Distribution Statement: Approved for public release; distribution is unlimited.
Abstract: (U) This paper explores pandemic planning efforts across federal and state jurisdictions and how the absence of collaboration could have major consequences upon the population of the United States. How adequate are state and federal pandemic plans, and what must be done nationally to address common shortfalls? The methodology used a hybrid approach by combining a secondary analysis of available data with a modified case study approach. Analyzing the individual state plans and HHS' Pandemic Influenza Plan revealed common deficiencies, and disclosed distinct functional areas where stringent collaboration across multiple jurisdictions and functional areas would mitigate the deficiencies and provide a blueprint for potential development into an all-hazards national catastrophe plan. This resultant comprehensive plan would provide a solid template for all stakeholders to use in further development of their individual plans, and additionally provide a mechanism to propagate proactive planning efforts among international disaster preparedness partners.

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ADA494293
The Military Response to Pandemic: The New Global Threat
Descriptive Note: Strategy Research project
Personal Author(s): Tornabene, Pietro
Report Date: 28 Jan 2009
Media Count: 33   Page(s)
Descriptors: (U) *MILITARY PERSONNEL, *PLAGUES, *INFECTIOUS DISEASES, ARMY TRAINING, SARS, HUMAN IMMUNODEFICIENCY VIRUSES, INFLUENZA, EBOLA VIRUS, THREATS, SOCIETIES, GLOBAL, ECOSYSTEMS
Identifiers: (U) MICROBES, MENACE, PREPAREDNESS, AVIAN FLU
Distribution Statement: Approved for public release; distribution is unlimited.
Abstract: (U) The more we develop, the more people gather in enormous urban conglomerates, the more we become intertwined in a complex society characterized by large availability of means of transportation, and the more the disruptive effects of a global plague stemming from an unknown infection will be. It is necessary to address this new type of menace in order to know the enemy we face, and once known, find feasible, acceptable, and suitable course of actions to defeat it or, at least, minimize the undesirable effects to our complex society. To fight this kind of war is not only the duty of a few researchers or doctors. The Army, as the ultimate bulwark between order and chaos when a threat becomes disruptive for the entire society, has a big role to play in order to assure order, deliver goods and medicines, control the stream of infected people, and maintain open vital communication`s routes. The threat of pandemic does not find place in the The Spectrum of Conflict, and requires new tasks to be accomplished by the Armed Forces. This paper has been developed to address this kind of problem.

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ADA493591
Getting Beyond Getting Ready for Pandemic Influenza
Report Date: Jan 2009
Media Count: 44   Page(s)
Descriptors: (U) *PREPARATION, *INFLUENZA, *EPIDEMICS, *UNITED STATES GOVERNMENT, DETECTION, LEADERSHIP, EARLY WARNING SYSTEMS, PLANNING, REQUIREMENTS, HOMELAND SECURITY, NATIONAL SECURITY, UNITED STATES, DRUGS
Identifiers: (U) *PANDEMIC INFLUENZA, *READINESS, PREPAREDNESS, DEPARTMENT OF HOMELAND SECURITY, MEDICAL REQUIREMENTS, NATIONAL STRATEGY, FEDERAL GOVERNMENT
Distribution Statement: Approved for public release; distribution is unlimited.
Abstract: (U) Pandemic influenza is not a new phenomenon. Historically, there have been other influenza pandemics, enough so that we now believe the planet is well overdue. We watch avian influenza move across the world, worry about how more than 60% of those people that contract the disease die from it, and realize that further mutations in currently circulating strains could cause them to easily infect human beings. Work is clearly underway to prepare for such a biological event. However, despite the fact that we are overdue for an influenza pandemic and that we fear the consequences of such a disease spreading unchecked - we are not prepared as a Nation to fully withstand the impact of such a devastating widespread biological event. Recognizing the devastating impact an influenza pandemic would have on our Homeland and National Security, and the need to be ready to handle the pandemic when it occurs, Chairman Thompson and Subcommittee Chairman Langevin directed the Majority Staff to: * Conduct oversight regarding the pandemic influenza preparedness activities of DHS and other members of the Executive Branch; * Gather information through hearings, briefings, and meetings to determine the status of National efforts to prepare for pandemic influenza; * Identify weaknesses in our National preparedness for pandemic influenza; and * Determine what specific actions could strengthen such efforts and help the Nation achieve readiness for pandemic influenza.

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ADA494388
Global Survey of Research and Capabilities in Genetically Engineered Organisms That Could be Used in Biological Warfare or Bioterrorism
Descriptive Note: Final rept. May 2007-Jul 2008
Personal Author(s): Sagripanti, Jose-Luis, Griffiths, Christine, Ramsbotham, Jr, Alan J
Report Date: Dec 2008
Media Count: 63   Page(s)
Descriptors: (U) *BIOLOGICAL WARFARE, *GENETIC ENGINEERING, *BIOTERRORISM, DEOXYRIBONUCLEIC ACIDS, PATHOGENIC MICROORGANISMS, INFECTIOUS DISEASES, BIOSYNTHESIS, BACTERIA, THREATS, NATIONAL SECURITY
Identifiers: (U) *GENETICALLY ENGINEERED ORGANISMS, BIOLOGICAL THREAT, BIODEFENSE, NOVEL ORGANISMS, INTERNATIONAL SECURITY
Distribution Statement: Approved for public release; distribution is unlimited.
Abstract: (U) This report summarizes the scientific principles underlying genetic modification of microorganisms. It assesses the global availability and cost of technology (know-how, keystone equipment, and synthesized biological materials) needed to acquire and produce potentially lethal biological agents in quantity. The analysis includes technology to engineer novel organisms previously unknown in nature, to synthesize organisms de novo, or to modify naturally pre-existing organisms. The document considers the growing proliferation of legitimate activities, and how such activities may enable nations or non-traditional actors to produce genetically engineered infectious agents for uses that could impact national United States or international security.

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ADA493650
Public Health Planning for Vulnerable Populations and Pandemic Influenza
Descriptive Note: Master's thesis
Personal Author(s): Cameron, Wendy K
Report Date: Dec 2008
Media Count: 79   Page(s)
Descriptors: (U) *PUBLIC HEALTH, *INFLUENZA VIRUS, *VACCINES, PLANNING PROGRAMMING BUDGETING, THESES, EMERGENCIES
Identifiers: (U) *VULNERABLE POPULATIONS
Distribution Statement: Approved for public release; distribution is unlimited.
Abstract: (U) This thesis addresses planning for vulnerable populations, those segments of each community that are normally independent but that may require special assistance during a health emergency such as an influenza pandemic. Analysis of plans from sixty of Georgia's 159 counties provides insight into the extent to which vulnerable populations are defined and identified; relevant agencies are engaged in planning; and opportunities are identified for improvement. Recommended strategies will enable local jurisdictions to more effectively plan for vulnerable populations. Some strategies have now been implemented and others are in progress.

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ADA493923
Regional Mass Fatality Management in Pandemic Surge
Descriptive Note: Master's thesis
Personal Author(s): Stanley, Sharon A
Report Date: Dec 2008
Media Count: 210   Page(s)
Descriptors: (U) *EPIDEMICS, *PUBLIC HEALTH, *DEATH, *RESPONSE, *INTERAGENCY COORDINATION, CATASTROPHIC CONDITIONS, SURGES, INFLUENZA, STATE GOVERNMENT, LOCAL GOVERNMENT, CASUALTIES, BARRIERS, PLANNING, THESES, COMMUNITIES, PREPARATION
Identifiers: (U) *MASS FATALITY MANAGEMENT, MASS FATALITY RESPONSE AND RECOVERY, PANDEMIC INFLUENZA, *PANDEMICS, PUBLIC ENGAGEMENT, PUBLIC HEALTH PREPAREDNESS, PUBLIC HEALTH SURGE, REGIONAL CAPACITY, REGIONAL RESPONSE, GAPS
Distribution Statement: Approved for public release; distribution is unlimited.
Abstract: (U) National and state planning documents designate public health as the lead for mass fatality management (MFM). MFM planning, however, demands multiagency participation and full public-business-government leverage. This thesis explores pathways to reach operational regional MFM capability in Ohio, but also has implications for MFM planning across the nation. Survey research was conducted with three key MFM stakeholder groups: county coroners, emergency management directors, and health commissioners. The survey addressed realistic and actionable MFM planning by: 1) identifying state guidance gaps; 2) identifying local/regional operational gaps; 3) assessing regional resource capabilities; 4) categorizing proposed solutions to address identified gaps; and 5) listing legal, financial, and organizational barriers to the solutions. Findings show that the key stakeholder communities are confused, with a willingness to build MFM capacity that is accompanied by worries about who should lead and how to coordinate efforts. Research recommendations include a three-sector collaboration (government-business-citizens) operating at the regional level and public engagement. Another recommendation calls for alignment of state guidance and regional operations with The Joint Task Force Civil Support Working Group MFM areas: command and control; body identification; medico-legal investigation; morgue operations; funeral services; final disposition; and family assistance and behavioral health services.

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ADA488731
A 21st Century National Public Health System
Descriptive Note: Master's thesis
Personal Author(s): Jones, Mary J
Report Date: Sep 2008
Media Count: 145   Page(s)
Descriptors: (U) *NATIONAL SECURITY, *PUBLIC HEALTH, *INFECTIOUS DISEASES, THREATS, CANADA, EPIDEMICS, CASE STUDIES, RESPONSE, MISSIONS, PUBLIC OPINION, ORGANIZATIONS, UNITED STATES GOVERNMENT, POLITICAL SCIENCE, THESES
Identifiers: (U) *SARS(SEVERE ACUTE RESPIRATORY SYNDROME)
Distribution Statement: Approved for public release; distribution is unlimited.
Abstract: (U) The attention that SARS created in 2003 has influenced public and political perceptions about the risks associated with infectious diseases and the role the public health system should play in national security. This comparative case study was conducted to examine the Canadian public health's system response to SARS in order to formulate recommendations for the U.S. public health system. This analysis demonstrated that the governmental organizational structure of the U.S. public health system does not support its current mission or its new responsibilities for public health security. A national public health system is needed to support dual missions: the traditional mission of tailoring public health programs specific to the social and demographic needs of the citizens; and the new mission of public health security. In order to transform the current U.S. public health system into a national public health system two critical components must be addressed at the federal, state, and local level: 1) organizational capacity and 2) service delivery. Recommendations are provided regarding the way forward at the federal level and work needing to be done at the state and local level towards building a national system capable of meeting the public health threats of the 21st century.

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ADA487526
Charge Density Quantification and Antimicrobial Efficacy
Descriptive Note: Final rept. Apr 2007-May 2008
Personal Author(s): Zander, Nicole, Leadore, Julia, Orlicki, Joshua A
Report Date: Aug 2008
Media Count: 20   Page(s)
Descriptors: (U) *CHARGE DENSITY, *BACTERIAL TOXINS, *INFECTIOUS DISEASES, *ANTIMICROBIAL AGENTS, *FUNGICIDES, AMMONIUM COMPOUNDS, QUATERNARY COMPOUNDS, CHEMICAL WARFARE AGENTS, BIOLOGICAL WARFARE AGENTS, OPERATIONAL READINESS, DECONTAMINATION, WARFARE, MILITARY FORCES(UNITED STATES)
Identifiers: (U) QUATERNARY AMMONIUM SALT, UV-VIS(ULTRAVIOLET-VISIBLE)
Distribution Statement: Approved for public release; distribution is unlimited.
Abstract: (U) Emerging threats to soldiers on the battlefield include traditional dangers such as conventional weapons and chemical or biological warfare agents. A less obvious threat is represented by the growing numbers of serious bacterial and fungal infections. Reducing overall warfighter susceptibility to opportunistic infections would improve force readiness in all operational environments. The capability of a material to autonomous decontaminate in situ with an active additive is therefore highly desirable and may increase the warfighter's safety and reduce the logistical burdens associated with decontamination operations. However, to maintain the critical performance characteristics of the coating or fabric, a minimal amount of active material is preferred, reducing the overall impact on bulk physical properties.

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ADA485701
HIV/AIDS: A Nontraditional Security Threat for AFRICOM
Descriptive Note: Monograph
Personal Author(s): Letcher, Kenneth W
Report Date: 22 May 2008
Media Count: 68   Page(s)
Descriptors: (U) *MILITARY FORCES(FOREIGN), *EPIDEMICS, *SUBSAHARAN AFRICA, *HUMAN IMMUNODEFICIENCY VIRUSES, *NATIONAL SECURITY, *OPERATIONAL EFFECTIVENESS, *THREATS, ABSENTEEISM, PEACEKEEPING, EPIDEMIOLOGY, WORKLOAD, GOVERNMENT(FOREIGN), STRATEGY, UNITED STATES GOVERNMENT, POLICIES, MILITARY FORCES(UNITED STATES), COMBAT EFFECTIVENESS
Identifiers: (U) *HIV/AIDS, *AFRICOM(US AFRICA COMMAND), HIV INFECTIONS, AIDS(ACQUIRED IMMUNODEFICIENCY SYNDROME), *SECURITY THREATS, MILITARY EFFECTIVENESS, REGIONAL SECURITY, AFRICAN UNION, SADC(SOUTHERN AFRICAN DEVELOPMENT COMMUNITY)
Distribution Statement: Approved for public release; distribution is unlimited.
Abstract: (U) The purpose of this study is to analyze the effectiveness of the militaries of southern Africa given the nature of the HIV/AIDS epidemic and the complexities through which U.S. Africa Command must navigate. The study will draw on research of the HIV/AIDS epidemic and its effect on the effectiveness of the militaries of southern Africa, leaning heavily on the research of Stefan Elbe and a small cadre of associated scholars that focused their academic attention on this specific issue. Prior to the discussion of the effect the epidemic has had on these militaries, the study discusses military effectiveness, utilizing the model of effectiveness prescribed by Allan Millett, Williamson Murray, and Kenneth Watman in their article "The Effectiveness of Military Organizations." The monograph then analyzes HIV/AIDS as a security issue, focusing on the scholarship of Stefan Elbe and Barry Buzan in this matter. Next it focuses on the regional implications of the epidemic and its effect on the militaries of southern Africa before moving on to the epidemic's international ramifications. The final analysis is a discussion of U.S. national interests in southern Africa and the ramifications of the effects of HIV/AIDS on U.S. national security policy. The study shows that current U.S. national security policy does not adequately address the security interests of the United States with regard to southern Africa. Specifically, the United States has failed to adequately address the impact of the HIV/AIDS epidemic on the effectiveness of the militaries of southern Africa, and the epidemic's ramifications for its own national security interests.

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ADA484794
Insurrection Act Restored: States Likely to Maintain Authority over National Guard in Domestic Emergencies
Descriptive Note: Monograph
Personal Author(s): Beckler, Mark M
Report Date: 22 May 2008
Media Count: 78   Page(s)
Descriptors: (U) *MILITARY FORCES(UNITED STATES), *MILITARY RESERVES, *LAW ENFORCEMENT, *LEGISLATION, *PRESIDENT(UNITED STATES), *EMERGENCIES, *MILITARY ASSISTANCE, DOMESTIC TERRORISM, HOMELAND SECURITY, EPIDEMICS, HISTORY, FIRST RESPONDERS, LOCAL GOVERNMENT, STATE GOVERNMENT, UNITED STATES GOVERNMENT, RESPONSE
Identifiers: (U) *INSURRECTION ACT, *STAFFORD ACT, POSSE COMITATUS ACT, ARMY NATIONAL GUARD, FEDERALISM, MSCA(MILITARY SUPPORT TO CIVIL AUTHORITIES), HURRICANE KATRINA, *ENFORCEMENT OF THE LAWS TO RESTORE PUBLIC ORDER STATUTE, TIERED RESPONSE, DISASTER RELIEF ACT, ROBERT T STAFFORD DISASTER RELIEF AND EMERGENCY ASSISTANCE ACT, NATIONAL RESPONSE FRAMEWORK, LAWLESSNESS
Distribution Statement: Approved for public release; distribution is unlimited.
Abstract: (U) Before 2006, the President had multiple legal bases available to authorize his use of federal military forces in a variety of law enforcement and natural disaster circumstances. Nevertheless, Congress amended the Insurrection Act in 2006 to create the Enforcement of the Laws to Restore Public Order. This statute stirred controversy as it arguably represented an unwarranted expansion of Presidential power. Additionally, while the statute attempted to address the kind of lawlessness seen in New Orleans immediately following Hurricane Katrina in 2005, the provision arguably offered no improvement over the Insurrection Act in instances of lawlessness or the Stafford Act in instances of disaster. Without ever having been invoked, and in the face of strong opposition, the Enforcement of the Laws to Restore Public Order was repealed on January 28, 2008 and the previous Insurrection Act was restored. This monograph reviews the Enforcement of the Laws to Restore Public Order statute and concludes that it was prudent to repeal this legislation. Moreover, author recommends that future laws and policies to improve disaster response across the whole-of-government and the private sector should be consistent with the principles in the 2008 National Response Framework, which advocates tiered response rather than a primarily federal response in most instances. The rare instances of catastrophic disaster that might require the President to shortcut tiered response and assume federal control at the outset of the situation should be clearly defined in law.

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ADA487787
Three Papers in International Health Policy: Modeling the Links between Economics and Epidemiology
Descriptive Note: Doctoral thesis
Personal Author(s): Dutta, Arindam
Report Date: Apr 2008
Media Count: 188   Page(s)
Descriptors: (U) *COMPUTERIZED SIMULATION, *POLICIES, *HEALTH, *ACQUIRED IMMUNE DEFICIENCY SYNDROME, *INDIA, *INFLUENZA, *EPIDEMIOLOGY, *DEVELOPING NATIONS, INTERNATIONAL, MORTALITY RATE, HEALTH SURVEYS, URBAN AREAS, GEOGRAPHIC DISTRIBUTION, MORBIDITY, INFECTIOUS DISEASE TRANSMISSION, THERAPY, EPIDEMICS, ESTIMATES, CONTAINMENT(GENERAL), THESES, ECONOMICS, COST EFFECTIVENESS, RISK, ALLOCATIONS
Identifiers: (U) *INTERNATIONAL HEALTH POLICY, *EPIDEMIOLOGICAL MODELS, *HEALTH RESOURCE ALLOCATIONS, PANDEMIC INFLUENZA, CONTAINMENT FAILURE, ANTIRETROVIRAL POLICIES, ANTIRETROVIRAL THERAPIES, NNRTI(NON-NUCLEOSIDE REVERSE TRANSCRIPTASE INHIBITORS THERAPY), PROTEASE INHIBITOR THERAPY, TREATMENT OUTCOMES, CO-TRIMOXAZOLE PROPHYLAXIS, POLICY ANALYSIS
Distribution Statement: Approved for public release; distribution is unlimited.
Abstract: (U) Paper I establishes the benefits of linking epidemiological modeling with international health resource allocation decisions, reviewing the recent modeling literature on pandemic influenza control. The review indicates that outbreaks in resource poor settings are controllable with moderate resource intensity and complexity of effort for viral strains of moderate infectiousness. However, very high resource allocations for preparedness in industrialized nations -- at low geographic risk for the pandemic -- are predicated on containment failure in countries at higher risk of outbreaks. Without assuming the infectiousness of a future flu virus, a redistribution of resources to the developing countries at primary risk reduces overall systemic risk of containment failure. The payoffs in terms of reduced global mortality and morbidity are higher with increased infectiousness. The two other papers are associated with implementing the experimental desktop models for the context of India. Paper II first constructs a scenario based a nonepidemiological model of pandemic influenza introduction to, and subsequent spread within, India under various assumptions. The model uses published data on attack rates in Asia during previous pandemics as well as seasonal influenza. The model exploits geographical risk variations across provinces of India as well as the provinces' demographics, transport networks, and rural urban settings. Paper III reestimates the estimates of people living with HIV/AIDS (PLWHA) in India by combining the available prevalence data from the latest sero-surveillance data as well as the National Family Health Survey (NFHS-3) of 2005-2006. The paper continues to comprehensively analyze antiretroviral (ARV) policy in India, beginning with the estimation of total costs of utilization under public and private market rates for first line ART. A cohort simulation is conducted using a desktop model of disease progress in the population without access to ARVs.

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ADA479677
Fire Fighters' Ability and Willingness to Participate in a Pandemic
Descriptive Note: Master's thesis
Personal Author(s): Delaney, Jr, John
Report Date: Mar 2008
Media Count: 117   Page(s)
Descriptors: (U) *LEADERSHIP, *FIRE FIGHTING, *INFECTIOUS DISEASES, *ANTIVIRAL AGENTS, RISK, SKILLS, CORE STORAGE, VACCINES, THESES, ESTIMATES, SURVEYS, PROTECTIVE EQUIPMENT
Identifiers: (U) FIRE FIGHTER, PARAMEDIC, EMERGENCY MEDICAL TECHNICIAN, PANDEMIC, PARTICIPATION, BIRD-FLU, H5N1, PREPAREDNESS, ABILITY, WILLINGNESS, WORKER S COMPENSATION, PERSONAL PROTECTIVE EQUIPMENT, SARS, ANTIVIRALS, VACCINES
Distribution Statement: Approved for public release; distribution is unlimited.
Abstract: (U) Current estimates predict that 30-40 percent of the population will be infected with the flu virus during a pandemic. Fire departments should anticipate a higher attack rate for their personnel because of increased exposure risk. Additionally, many variables will negatively influence fire fighter participation rates over and above these attack rates. This thesis analyzes fire fighters ability and willingness to participate in a pandemic through a comprehensive survey of fire fighters within the twelve National Capital Region fire departments. Issues that may influence fire fighters ability and willingness to work include childcare, concern of family, adequate personal protective equipment, worker's compensation coverage, and availability of vaccines and antivirals. Collectively, these variables determine a workforce participation percentage (WPP) the share of fire fighters who will be able and willing to participate in a response during a pandemic. Results indicate that between 30-70 percent of the fire fighters will not be able or willing to work during a pandemic. Although a fire fighter s participation is situationally dependent, fire departments should take urgent steps to address five core areas. These are included in a set of recommendations. Ultimately, the priority recommendation is for fire officials and regional public policymakers to rise to the challenge of the complexity of these issues. Leadership in the face of this recognized pandemic threat, however, remains an elusive solution.

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ADA482558
Tulane/Xavier Vaccine Development/Engineering Project
Descriptive Note: Annual rept.
Personal Author(s): Clements, John D, Freytag, Lucy, John, Vijay, Mandal, Tarun
Report Date: Feb 2008
Media Count: 8   Page(s)
Descriptors: (U) *VACCINES, BIOLOGICAL WARFARE AGENTS, ANTIGENS, INFECTIOUS DISEASES, IMMUNITY
Distribution Statement: Approved for public release; distribution is unlimited.
Abstract: (U) The Tulane/Xavier Biodefense Vaccine Development/Engineering project will develop new vaccines against biological threat agents to aid the war-fighter. Through the innovative use of nanotechnology, researchers and engineers from the Tulane University Schools of Medicine and Science & Engineering and the Xavier College of Pharmacy will fabricate nanoparticulate systems that are effective for transdermal and mucosal delivery of life-saving vaccines. One aim of this project will be to compare different nanocarriers (i.e., nanohydrogels, star copolymers, and spray-dried PLGA nanoparticles) for the ability to incorporate biological threat-relevant vaccine antigens and deliver those antigens through the stratum corneum to immune-responsive cells in the epidermis. The specialized assembly of each type of nanocarrier gives each unique properties and different interactions within the lipid channels of the stratum corneum. The use of nanocarriers for vaccine delivery is a platform technology, applicable to delivery of a variety of existing and potential vaccines.

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ADA487294
National Infrastructure Advisory Council: Chemical, Biological, and Radiological Events and the Critical Infrastructure Workforce. Final Report and Recommendations
Descriptive Note: Final rept.
Personal Author(s): Denlinger, Rebecca F, Marsh, Martha H, Rhode, Bruce A, Gallegos, Gilbert G, Nicholson, James B, Nye, Erle A, Thompson, John W
Report Date: 08 Jan 2008
Media Count: 89   Page(s)
Descriptors: (U) *RECOVERY, *INFRASTRUCTURE, *ATTACK, *TERRORISM, BIOLOGICAL AGENTS, TRAINING, RESPONSE, PLANNING, THREAT EVALUATION, CHEMICAL AGENTS, CASUALTIES, RADIOLOGICAL WARFARE AGENTS, FIRST RESPONDERS, CIVIL DEFENSE, DISASTERS, INTERAGENCY COORDINATION, SCENARIOS, METHODOLOGY
Identifiers: (U) CBR(CHEMICAL BIOLOGICAL RADIOLOGICAL), MASS CASUALTIES, RESPONSE, RECOMMENDATIONS, CRITICAL INFRASTRUCTURE, NIMS(NATIONAL INCIDENT MANAGEMENT SYSTEM), TIME CRITICAL, PSYCHOLOGICAL EFFECTS, PANDEMICS, DISSEMINATION, CRITICAL EMPLOYEES
Distribution Statement: Approved for public release; distribution is unlimited.
Abstract: (U) The National Infrastructure Advisory Council (NIAC) convened a Working Group to study the impact of chemical, biological, and radiological (CBR) events on the critical infrastructure worker, and to make recommendations. NIAC designed this report to identify attributes of different chemical, biological, or radiological event scenarios, identify key elements necessary to sustain critical infrastructure operations, and to make recommendations that will improve our ability to contain the impact, recover from its consequences, and restore the nation's critical infrastructure to a pre-event state. The NIAC formed an approach to the CBR study that focused on six key questions. These questions were: 1) Do organizations have programs focused on CBR event planning, preparedness, response or training? 2) Is there a market or other financial incentive to invest in CBR planning, preparedness, response or training capabilities? 3) Is there a sufficient communications infrastructure in place to support CBR event response and recovery? 4) What tools and technologies are available, or should be made available in the future, to support CBR event planning, preparedness, response or training programs? 5) Is there sufficient coordination between Federal, state, local, and private sector entities in support of CBR planning, preparedness, response, or training programs? and 6) What can the Federal government do to encourage or enhance planning, preparedness, response, and training capabilities across the public and private sectors? This Report addresses the rationale behind these questions. The Executive Summary highlights key themes found throughout the document, and identifies a number of findings and recommendations that are common across CBR events. Included in subsequent sections are appendices that identify specific findings and recommendations unique to chemical, biological, or radiological events.

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ADA476111
Avian Flu Pandemic: Potential Impact of Trade Disruptions
Descriptive Note: Congressional rept.
Personal Author(s): Langton, Danielle
Report Date: 03 Jan 2008
Media Count: 7   Page(s)
Descriptors: (U) *IMPACT, *INTERNATIONAL TRADE, *INFLUENZA, SCENARIOS, INFLUENZA VIRUS, IMPORTS, POULTRY, MEDICAL SUPPLIES, CHINA, FOOD, UNITED STATES
Identifiers: (U) *AVIAN FLU, *PANDEMICS, GLOBAL TRADE, GROSS DOMESTIC PRODUCT, TRADE RESTRICTIONS, OUTBREAKS, AVIAN INFLUENZA
Distribution Statement: Approved for public release; distribution is unlimited.
Abstract: (U) Concerns about potential disruptions in U.S. trade flows due to a global health or security crisis are not new. The possibility of an avian flu pandemic with consequences for global trade is a concern that has received attention recently, although some experts believe there is little cause for alarm. Experts disagree on the likelihood of an avian flu pandemic developing at all. This report considers possible trade disruptions, including possible impacts on trade between the United States and countries and regions that have reported avian influenza infections. These trade disruptions could include countries banning imported goods from infected regions at the onset of a pandemic, de facto bans due to protective health measures, or supply-side constraints caused by health crises in exporting countries.

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ADA487542
Spring 2008 Industry Study: Biotechnology Industry
Descriptive Note: Final rept.
Personal Author(s): Anttonen, John, Darnauer, Trish, Douglas, Tim, Ferrari, John, Zimdahl, Jennifer, Hall, Ian M, King, William, Klotzsche, Carl
Miller, Doug, Packard, Doug, Renegar, Mike, Rimback, Ed, Rogers, Gordon, Schnedar, Chris, Sekulovski, Zoran
Report Date: Jan 2008
Media Count: 41   Page(s)
Descriptors: (U) *TECHNOLOGY FORECASTING, *TECHNOLOGY ASSESSMENT, *BIOTECHNOLOGY, BIOMASS CONVERSION, AGRICULTURE, GENETICS, STEM CELLS, VACCINES, POLICIES, PATENTS, ETHANOLS, LIFE SPAN(BIOLOGY), MEDICINE, GREENHOUSE EFFECT
Identifiers: (U) BIOFUELS, GENETICALLY MODIFIED ORGANISMS, WORLD TRADE ORGANIZATION, PERSONALIZED MEDICINE, GENETIC PROFILES, HEALTH CARE, PANDEMICS
Distribution Statement: Approved for public release; distribution is unlimited.
Abstract: (U) Defined broadly as the manipulation of genetic material in living organisms or the derivatives thereof, biotechnology represents a veritable gold mine of possibilities for improving the human condition. Society tends to focus on the glamorous; the success of the Human Genome Project and its modern miracle of unraveling the composition of human deoxyribonucleic acid (DNA). However, biotechnology is much more than genetics. It twines the developments in understanding the building blocks of life with their characteristics and uses in organic systems. In short, biotechnology is a multifaceted science that supports all manner of micro and macro interactions within the life sciences. This paper addresses three specific industries within the rubric of biotechnology - bio-fuels, agriculture, and medicine and offers broad policy recommendations designed to foster discussion and debate among senior leadership in order to leverage the applications of biotechnology for the good of the nation. In addition, the paper provides the reader with three essays that provide greater depth and breadth on significant current biotechnology issues. Continued development and implementation of governmental policies and funding that aggressively promote continued scientific discovery and breakthroughs in this diverse industry offer unprecedented opportunities to increase mankind's quality of life by reducing dependence on fossil fuels, significantly reducing greenhouse gas emissions, increasing production and distribution of food, improving resistance to disease, and developing personalized medicine. The question is not if this will occur, but when and how to ensure that it takes place in an ethical, reasonable manner that benefits America and the rest of the world.

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ADA480067
Vaccine to Confer to Nonhuman Primates Complete Protection Against Multistrain Ebola and Marburg Virus Infections
Descriptive Note: Journal article
Personal Author(s): Swenson, Dana L, Wang, Danher, Luo, Min, Warfield, Kelly L, Woraratanadharm, Jan, Holman, David H, Dong, John Y, Pratt, William D
Report Date: Jan 2008
Media Count: 9   Page(s)
Descriptors: (U) *INFECTIOUS DISEASES, *HEMORRHAGIC FEVERS, *ADENOVIRUSES, *EBOLA VIRUS, *VACCINES, REPRINTS, THREATS, VIRUS DISEASES, BODY FLUIDS, ANTIGENS, LETHAL DOSAGE, LABORATORY ANIMALS, PATHOGENIC MICROORGANISMS, IMMUNIZATION, MORTALITY RATE, VIRUSES, HUMANS, BIOLOGICAL WARFARE, PRIMATES
Identifiers: (U) *FILOVIRUSES, *SUDAN EBOLA VIRUS, *NONHUMAN PRIMATES, *MARBURG VIRUS, EFFICACY, MULTI-VALENT
Distribution Statement: Approved for public release; distribution is unlimited.
Abstract: (U) Filoviruses (Ebola and Marburg viruses) are among the deadliest viruses known to mankind with mortality rates nearing 90%. These pathogens are highly infectious through contact with infected body fluids and can be easily aerosolized. Additionally, there are currently no licensed vaccines available to prevent filovirus outbreaks. Their high mortality rates, infectious capabilities when aerosolized, and the lack of licensed vaccines available to prevent such infectious make Ebola and Marburg viruses serious bioterrorism threats, placing them both on the Category A list of bioterrorism agents. Here we describe a pan-filovirus vaccine based on a complex adenovirus (CAdVax) technology that expresses multiple antigens from five different filoviruses de novo. Vaccination of non-human primates demonstrated 100% protection against infection by two species of Ebola virus and three Marburg virus subtypes, each administered at 1000 times the lethal dose. This study indicates the feasibility of vaccination against all current filoviruses threats in the event of natural hemorrhagic fever outbreak or biological attack.

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ADA475951
Cold-Chain Logistics: A Study of the Department of the Defense OCONUS Pre-Pandemic Influenza Vaccine Distribution Network
Descriptive Note: MBA Professional Report
Personal Author(s): Jones, Daniel, Tecmire, Christopher
Report Date: Dec 2007
Media Count: 75   Page(s)
Descriptors: (U) *DISTRIBUTION, *LOGISTICS, *INFLUENZA VIRUS, *VACCINES, MILITARY PERSONNEL, TRANSPORTATION, EPIDEMICS, STANDARDIZATION, DECISION AIDS, PLANNING, INFORMATION EXCHANGE, NETWORKS
Identifiers: (U) NATIONAL STRATEGY FOR PANDEMIC INFLUENZA, AVIAN FLU, *COLD-CHAIN LOGISTICS, DISTRIBUTION STRATEGY, H5N1, JOINT LOGISTICS, *PANDEMIC INFLUENZA, MEDICAL LOGISTICS
Distribution Statement: Approved for public release; distribution is unlimited.
Abstract: (U) The purpose of this MBA project is to suggest a standardized distribution process for the DoD of the Pandemic Influenza vaccine, filling an existing void in the National Strategy for Pandemic Influenza. Also, this project is intended to foster the communication and planning process for vaccine distribution between all stakeholders, including the DLA, COCOMs, and regional commanders. Currently, no DoD pre-pandemic vaccine distribution plan exists. This project identifies the essential infrastructure assets needed to develop a cold-chain distribution network for vaccine in a military application. Furthermore, the key communication and transportation elements needed for successful execution of this network are identified, including a discussion on information and vaccine flow through the distribution network. These ideas are organized into a model to provide an easily usable decision-making tool for cold-chain network design. Finally, an example using the model is provided, with PACOM as the example area of operation.

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ADA481366
The National Bio- and Agro-Defense Facility: Issues for Congress
Descriptive Note: Congressional rept.
Personal Author(s): Shea, Dana A, Monke, Jim, Gottron, Frank
Report Date: 15 Nov 2007
Media Count: 21   Page(s)
Descriptors: (U) *ECONOMICS, *BIOLOGICAL CONTAMINATION, *AGRICULTURE, *ZOONOTIC DISEASES, *INFECTIOUS DISEASES, *INFRASTRUCTURE, *HOMELAND SECURITY, CONGRESS, COASTAL REGIONS, HUMANS, CONSTRUCTION, TERRORISM, SCIENTIFIC RESEARCH, ANIMAL DISEASES, PATHOGENIC MICROORGANISMS, COUNTERMEASURES, FOOD, MEDICAL RESEARCH, RESEARCH MANAGEMENT, RESEARCH FACILITIES, STATE OF THE ART, RISK, FOREIGN
Distribution Statement: Approved for public release; distribution is unlimited.
Abstract: (U) The agricultural and food infrastructure of the United States is potentially susceptible to terrorist attack using biological pathogens. In addition to the impacts of such an attack on the economy, some animal diseases could potentially be transmitted to humans. (These diseases are known as zoonotic diseases.) Scientific and medical research on plant and animal diseases may lead to the discovery and development of new diagnostics and countermeasures, reducing the risk and impact of a successful terrorist attack. To safeguard the United States against animal disease, Congress has appropriated funds to the U.S. Department of Agriculture (USDA) to engage in research at the Plum Island Animal Disease Center (PIADC), off the coast of New York, on animal diseases not native to the United States. When creating the Department of Homeland Security (DHS) in 2003, Congress transferred the PIADC facility from USDA to DHS, though USDA continues its own research programs at the facility. However, the DHS, in cooperation with USDA, has established a foreign animal disease research program at PIADC. The DHS has identified PIADC as outdated and too limited to continue as the primary research facility. Homeland Security Presidential Directive 9 tasks the Secretaries of Agriculture and Homeland Security to develop a plan to provide safe, secure, and state-of-the-art agriculture biocontainment laboratories for research and development of diagnostic capabilities and medical countermeasures for foreign animal and zoonotic diseases. To partially meet these obligations, DHS has requested appropriations to construct a new facility, the National Bio- and Agro-Defense Facility (NBAF). This facility would house high-containment laboratories able to handle the pathogens currently under investigation at PIADC, as well as other pathogens of interest. The DHS plans to select the site in 2008 and open NBAF in 2014.

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ADA472657
Pandemic Influenza: An Analysis of State Preparedness and Response Plans
Descriptive Note: Congressional rept.
Personal Author(s): Lister, Sarah A, Stockdale, Holly
Report Date: 24 Sep 2007
Media Count: 32   Page(s)
Descriptors: (U) *CRISIS MANAGEMENT, *MEDICAL SERVICES, *PUBLIC HEALTH, *MEDICAL SUPPLIES, *VACCINES, *INFLUENZA, CONGRESS, EMERGENCIES, CORES, THREATS, DISEASES, HISTORY, DRUGS, HOMELAND SECURITY, GRANTS, HURRICANES, DISTRICT OF COLUMBIA, FEDERAL BUDGETS, TERRORISM, SURGES, ANTIVIRAL AGENTS, EARTHQUAKES, SUPPLIES, CHAINS, CAPACITY(QUANTITY), LEADERSHIP, DETECTION, UNITED STATES GOVERNMENT
Distribution Statement: Approved for public release; distribution is unlimited.
Abstract: (U) States are the seat of most authority for public health emergency response. Much of the actual work of response falls to local officials. However, the federal government can impose requirements upon states as a condition of federal funding. Since 2002, Congress has provided funding to all U.S. states, territories, and the District of Columbia, to enhance federal, state and local preparedness for public health threats in general, and an influenza ( flu ) pandemic in particular. States were required to develop pandemic plans as a condition of this funding. This report, which will not be updated, describes an approach to the analysis of state pandemic plans, and presents the findings of that analysis. State plans that were available in July 2006 were analyzed in eight topical areas: (1) leadership and coordination; (2) surveillance and laboratory activities; (3) vaccine management; (4) antiviral drug management; (5) other disease control activities; (6) communications; (7) health care services; and (8) other essential services. A history of federal funding and requirements for state pandemic planning is provided in an Appendix. This analysis is not intended to grade or rank individual state pandemic plans or capabilities. Rather, its findings indicate that a number of challenges remain in assuring pandemic preparedness, and suggest areas that may merit added emphasis in future planning efforts. Generally, the plans analyzed here reflect their authorship by public health officials. They emphasize core public health functions such as disease detection and control. Other planning challenges, such as assuring surge capacity in the health care sector, the continuity of essential services, or the integrity of critical supply chains, may fall outside the authority of public health officials, and may require stronger engagement by emergency management officials and others in planning.

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ADA477127
Understanding Public Responses to Domestic Threats
Descriptive Note: Contract rept.
Personal Author(s): Bruine de Bruin, Wandi,Florig, H K, Fischhoff, Baruch, Downs, Julie S, Stone, Eric
Report Date: Sep 2007
Media Count: 102   Page(s)
Descriptors: (U) *NUCLEAR EXPLOSIONS, *CIVILIAN POPULATION, *INFLUENZA, *EMOTIONS, *EPIDEMICS, *REACTION(PSYCHOLOGY), *FALLOUT, SCENARIOS, UNITED STATES, RISK, DECISION MAKING, THREATS, DEATH, PERCEPTION(PSYCHOLOGY), DOMESTIC TERRORISM, ABSENTEEISM, MORBIDITY, RADIATION EFFECTS, CANCER, EVACUATION, BOMBS, EXPOSURE(PHYSIOLOGY), COGNITION, CANADA, NUCLEAR RADIATION, SURVEYS, FEAR
Identifiers: (U) *PUBLIC RESPONSES, DIRTY BOMBS, PANDEMIC INFLUENZA, AVIAN FLU, BIRD FLU, RDD(RADIOLOGICAL DISPERSION DEVICES), CANCER RISK, RISK MODELS, DOMESTIC THREATS, MITIGATION STRATEGIES, MORBIDITY RISK, MORTALITY RISK, CANADIANS, AMERICANS, COMPLIANCE, EMOTIONAL RESPONSE, RELOCATION DECISIONS, ANGER, EMOTIONAL VARIABLES, COGNITIVE VARIABLES
Distribution Statement: Approved for public release; distribution is unlimited.
Abstract: (U) The overall goal of this report is to improve understanding of public responses to domestic threats. Project 1 focuses on pandemic influenza and dirty bomb threats, aiming to understand the role of emotions in anticipated behavioral responses. Project 2 examines a situation in which people are evacuated from a community to avoid exposure to radioactive fallout from an upwind nuclear explosion. This project aims to understand the factors that affect people's decisions about how long to wait until returning to their homes, given the gradual decline in radiation levels resulting from radioactive decay. First, the authors present an overview of each problem using models that summarize scientific knowledge. The models use logic of influence diagrams with nodes that reflect relevant variables affecting risk, and mitigating it, and links showing how they are connected. The models differ from traditional risk models because they include emotional and behavioral components that affect how a risk event unfolds. The Project 1 models focus on the interplay between emotional and behavioral responses to domestic threats, particularly fear and anger. The model for Project 2 focuses on the health, social, and economic factors that may affect people's decision to return to a community with residual radiation levels that elevate cancer risk. Second, they report on surveys of Canadian and U.S. participants based on these models. For Project 1, they found that, independent of anger and trait emotions, fear was related to seeing more risk of morbidity and mortality, and predicting less resilience, more compliance with mitigation strategies, and higher likelihood of being absent from work in the case of pandemic influenza. For Project 2, they found that people's decision to return were affected by the cancer risk of radioactive fallout as well as the availability of free housing in the evacuation zone.

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ADA473718
Compliance with Community Mitigation and Interventions in Pandemic Influenza: A Community Policing Strategy
Descriptive Note: Master's thesis
Personal Author(s): Alben, Sr , Timothy P
Report Date: Sep 2007
Media Count: 99   Page(s)
Descriptors: (U) *COMMUNITIES, *INTERVENTION, *EPIDEMICS, *INFLUENZA, THESES, QUARANTINE, LAW ENFORCEMENT, PUBLIC HEALTH
Identifiers: (U) *PANDEMIC INFLUENZA, *COMMUNITY MITIGATION, COMMUNITY POLICING
Distribution Statement: Approved for public release; distribution is unlimited.
Abstract: (U) A number of response plans and strategies have been published concerning preparation for an oncoming Pandemic Influenza. The majority of federal guidance and state planning with respect to pandemic preparation focuses excessively on the availability and distribution of effective vaccine and antiviral remedies; pharmaceutical solutions. Effective vaccines, presently unavailable, will not be in production and available for application for at least eight months after the onset of an identified pandemic. Community mitigations and interventions such as school closures, event cancellations, limited travel, quarantine and work at home plans are traditional responses to slowing the spread of a virus. In order to effectively implement these time tested strategies, voluntary community compliance with interventions becomes exceedingly important. The recent global experience with SARS and current mathematical modeling of virus spread characteristics support community mitigation efforts. The community policing model, having evolved over the last twenty years, provides a pre-existing framework to engage the public in grass roots pandemic education, awareness, planning and problem solving partnerships. The Incident Command System provides a structure for collaborative, multi-agency approach to successfully implementing a community awareness and compliance initiative. Community mitigations will save lives.

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ADA474947
Contract Support and Facilitation of Epidemic Outbreak Surveillance (EOS) Program Final Operating Capability (FOC)
Descriptive Note: Annual summary rept. 30 Sep 2005-31 Jul 2007
Personal Author(s): McCarty, Brian, Lott, Lisa
Report Date: Aug 2007
Media Count: 233   Page(s)
Descriptors: (U) *DIAGNOSIS(MEDICINE), *PUBLIC HEALTH, *ADENOVIRUSES, INFORMATION SYSTEMS, REAL TIME, PREVENTION, MEDICAL LABORATORIES, EPIDEMICS, INFRASTRUCTURE, CHAIN REACTIONS, PATHOGENIC MICROORGANISMS, OUTPATIENT CLINICS, PATIENTS, CLINICAL MEDICINE
Identifiers: (U) *FINAL OPERATING CAPABILITY, *EPIDEMIC OUTBREAK SURVEILLANCE, EOS(EPIDEMIC OUTBREAK SURVEILLANCE), ACTD(ADVANCED CONCEPT TECHNOLOGY DEMONSTRATION), PMD(PORTABLE MOLECULAR DIAGNOSTIC), FOC(FINAL OPERATING CAPABILITY), RT-PCR(REAL TIME POLYMERASE CHAIN REACTION), MAGNABIOSCIENCES, LIMS(LABORATORY INFORMATION MANAGEMENT SYSTEM)
Distribution Statement: Approved for public release; distribution is unlimited.
Abstract: (U) After meeting the Advanced Concept Technology Development (ACTD) original developmental milestone objectives the portable molecular diagnostic (pMD) platform contract with Applied Biosystems (ABI) was terminated when the contractor was unwilling to seek FDA approval. ABI testing up to contract termination is included in this report. The EOS ACTD program initiated a technology review process and pre-validation testing to determine if other technology platforms could be developed in time to meet EOS ACTD objectives. This process has been summarized in a series of notebooks and is included in this report for each potential vendor and technology including a composite Technology Recommendations report. Quarterly scientific meetings were held and the results and conclusions of the meeting presentations are discussed from the final Scientific Advisory Board (SAB) meeting held in Atlanta on July 31 2007. Additionally the Real Time Polymerase Chain Reaction (RT-PCR) testing performed at the Advanced Diagnostic Laboratory during the Lackland AFB Adenovirus type B14 outbreak including public health prevention and control testing strategies concludes the final report.

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ADA471695
North American Plan for Avian and Pandemic Influenza
Descriptive Note: Plan summary
Report Date: Aug 2007
Media Count: 54   Page(s)
Descriptors: (U) *UNITED STATES GOVERNMENT, *CRISIS MANAGEMENT, *MANAGEMENT PLANNING AND CONTROL, *COOPERATION, *CANADA, *INFLUENZA, *EPIDEMICS, *MEXICO, EMERGENCIES, INFORMATION EXCHANGE, CONTAINMENT(GENERAL), PUBLIC HEALTH, AIR TRANSPORTATION, VACCINES, INFLUENZA VIRUS, EPIDEMIOLOGY, SURVEILLANCE, BIRDS, PROTECTION, PREPARATION, ECONOMICS, GOVERNMENT(FOREIGN), THREATS, HUMANS
Identifiers: (U) *AVIAN INFLUENZA, *PANDEMIC INFLUENZA, BIRD FLU, BORDER SECURITY, BORDER CONTROL, CRITICAL INFRASTRUCTURE PROTECTION, POULTRY SURVEILLANCE, WILD BIRD SURVEILLANCE, AIR TRAVEL, MARITIME TRAVEL, LABORATORY PRACTICES, NOTIFICATION, NORTH AMERICAN PLAN, HUMAN INFLUENZA
Distribution Statement: Approved for public release; distribution is unlimited.
Abstract: (U) Canada, Mexico and the United States face a growing threat posed by the spread of avian influenza and the potential emergence of a human influenza pandemic. The highly pathogenic (HPAI) H5N1 avian influenza virus, which re-emerged in Asia in late 2003, has already spread to Europe, the Middle East, and Africa. Although the virus has not yet reached North America, Canada, Mexico, and the United States must be prepared for the day when it or some other highly contagious virus does. At the March 2006 Security and Prosperity Partnership of North America (SPP) summit in Cancun, the leaders of Canada, Mexico, and the United States committed to developing a comprehensive, coordinated and science-based North American approach to prepare for and manage avian and pandemic influenza. The North American Plan for Avian and Pandemic influenza outlines how Canada, Mexico, and the United States intend to work together to combat an outbreak of avian influenza or an influenza pandemic in North America. The Plan complements national emergency management plans and builds upon the core principles of the International Partnership on Avian and Pandemic Influenza, the standards and guidelines of the World Organization for Animal Health (OIE), the World Health Organization (WHO) -- including the revised International Health Regulations, as well as the rules and provisions of the World Trade Organization (WTO) and the North American Free Trade Agreement. This Plan outlines a collaborative North American approach that recognizes controlling the spread of avian influenza or a novel strain of human influenza, with minimal economic disruption, is in the best interest of all three countries. Coordination among Canada, Mexico, and the United States will be critical in the event of an avian influenza outbreak or pandemic. The Plan, therefore, describes the organizational emergency management frameworks in each of the three countries and how they intend to coordinate their activities.

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ADA487261
Rapid Detection of Bacterial Antibiotic Resistance: Preliminary Evaluation of PCR Assays Targeting Tetracycline Resistance Genes
Descriptive Note: Technical rept.
Personal Author(s): Dorsch, Matthias R
Report Date: Aug 2007
Media Count: 27   Page(s)
Descriptors: (U) *GENES, *TETRACYCLINES, *ANTIBIOTICS, *INFECTIOUS DISEASES, RESISTANCE(BIOLOGY), CHAIN REACTIONS, GRAM NEGATIVE BACTERIA, BIOLOGICAL WARFARE AGENTS, AUSTRALIA, PUBLIC HEALTH
Identifiers: (U) FOREIGN REPORTS
Distribution Statement: Approved for public release; distribution is unlimited.
Abstract: (U) The rapid spreading of bacterial antibiotic resistance and the lack of methods that would allow fast and accurate determination of the resistance profile of an infectious agent have become a major concern for public health. In the context of biological warfare or a bioterrorist attack, resistance against commonly used antibiotics would severely compromise the capabilities of the responsible agencies to protect large numbers of exposed individuals against a potentially lethal infection. In this study the possibility of developing polymerase chain reaction (PCR) assays for rapid detection of tetracycline resistance genes was evaluated. PCR assays were designed for seven resistance genes that frequently occur in Gram-positive and Gram-negative species and tested on eight tetracycline resistant clinical isolates. Positive results were obtained from seven of the eight species tested.

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ADA470342
Influenza Pandemic: DOD Combatant Commands' Preparedness Efforts Could Benefit from More Clearly Defined Roles, Resources, and Risk Mitigation
Personal Author(s): D'Agostino, Davi M, Pross, Mark A, Ditto, Susan
Gore, Nicole, Hirschfeld, Simon, Johnson, Aaron, Murrish, Hilary
Report Date: Jun 2007
Media Count: 61   Page(s)
Descriptors: (U) *OPERATIONAL READINESS, *INFLUENZA, TEST AND EVALUATION, DEPARTMENT OF DEFENSE, LESSONS LEARNED, RESPONSE, AWARENESS, PLANNING, RISK, MANAGEMENT, TRAINING
Identifiers: (U) *MILITARY PREPAREDNESS, PANDEMICS
Distribution Statement: Approved for public release; distribution is unlimited.
Abstract: (U) COCOMs have taken numerous management and operational actions to prepare for an influenza pandemic, and the COCOMs' efforts are evolving. Each of DOD's nine COCOMs has established or intends to establish a working group to prepare for an influenza pandemic. Additionally, eight of he nine COCOMs have developed or are developing a pandemic influenza plan. Half of the COCOMs have conducted exercises to test their pandemic influenza plans and several are taking steps to address lessons learned. Five of the nine COCOMs have started to use various media, training programs, and outreach events to inform their personnel about pandemic influenza. Each of the geographic COCOMs has worked or plans to work with nations in its area of responsibility to raise awareness about and assess capabilities or responding to avian and pandemic influenza.

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ADA488398
Medical Surveillance System & Medical Effect Modeling Thrust Areas
Descriptive Note: Briefing charts
Personal Author(s): Fitzgerald, Angel A, Chotani, Rashid A
Report Date: Jun 2007
Media Count: 27   Page(s)
Descriptors: (U) *CASUALTIES, *SURVEILLANCE, *BIOLOGICAL WARFARE AGENTS, *INFECTIOUS DISEASES, *PREDICTIONS, EARLY WARNING SYSTEMS, EXPOSURE(PHYSIOLOGY), EPIDEMIOLOGY, ESTIMATES, MODELS, HAZARDS, SYMPOSIA, SIMULATION, MEDICINE
Identifiers: (U) *MEDICAL SURVEILLANCE, *MEDICAL EFFECTS MODELING
Distribution Statement: Approved for public release; distribution is unlimited.
Abstract: (U) The DTRA Chemical Biological Defense Program's Joint Science and Technology Office (JSTO) Information Systems Capability Area has initiated two new thrust areas entitled Medical Surveillance Systems and Medical Effects Models. The mission of the Medical Surveillance System thrust area is to minimize warfighter casualties resulting from exposure to infectious diseases, specifically those considered biological warfare threat agents. The main objective is to combine modeling/simulation, medical surveillance, early warning detection and real-time epidemiology by not only embarking on novel technologies but also by evaluating, validating, supporting and assisting in integration of existing initiatives. The Medical Effects Model thrust area seeks to develop the tools and modules to provide casualty estimation and prediction of human performance in hazard environments for JOEF. The benefit to the warfighter is to provide increased awareness of medical impacts on warfighters to decision makers to allow for informed planning.

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ADA483838
The National Disaster Medical System's Reliance on Civilian-Based Medical Response Teams in a Pandemic is Unsound
Personal Author(s): Delaney, Jr, John B
Report Date: Jun 2007
Media Count: 10   Page(s)
Descriptors: (U) *MEDICAL SERVICES, *PUBLIC HEALTH, *DISASTERS, ORGANIZATIONS, ECONOMICS, HUMANS, HEALTH, HOSPITALS, MILITARY PLANNING, IMMUNITY, INFLUENZA VIRUS, UNITED STATES GOVERNMENT, LOCAL GOVERNMENT, REPRINTS, MILITARY STRATEGY
Identifiers: (U) NDMS(NATIONAL DISASTER MEDICAL SYSTEM'S)
Distribution Statement: Approved for public release; distribution is unlimited.
Abstract: (U) The world is threatened with a pandemic. Such an event, considered by many to be the greatest public health risk the world faces, has the potential to kill up to forty or fifty million people, sicken hundreds of millions, and significantly impact the global economy. Countries and health organizations throughout the world are monitoring the threat and developing strategic plans and systems to prepare for what many consider an inevitable and possibly imminent event. The United States has made it a national priority to develop strategic plans to coordinate preparedness and response efforts at the federal, state, and local levels. A relatively small but critical aspect of these plans calls for the utilization of the National Disaster Medical System's (NDMS) civilian-based medical teams, to assist state and local governments in the event of a pandemic. Generally, past deployments of these federal assets have had positive results; however, the reliance on these civilian-based medical teams for response in a pandemic is problematic. The medical professionals who primarily comprise the team may be more reluctant to participate in a pandemic due to the increased health risks to themselves and their families. Moreover, the hospitals and medical systems that employ these civilian responders may be unwilling or unable to allow their participation in the federal response system. The federal government should reconsider its reliance on this civilian-based resource in the event of a pandemic, and focus instead on enhancing existing state and local public health and medical capabilities and resources.

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ADA478212
1918 Flu Pandemic: Implications for Homeland Security in the New Millennium
Descriptive Note: Program research project
Personal Author(s): Kirkland, Stephen M
Report Date: 09 May 2007
Media Count: 31   Page(s)
Descriptors: (U) *PLANNING, *INFLUENZA, *HOMELAND SECURITY, *EPIDEMICS, EMERGENCIES, MEDICAL SERVICES, INFLUENZA VIRUS, VACCINES, PUBLIC HEALTH, ANTIVIRAL AGENTS, STRATEGY
Identifiers: (U) *PANDEMICS, *FLU PANDEMIC(1918), AVIAN INFLUENZA, BIRD FLU, H5N1, NATIONAL STRATEGY FOR PANDEMIC INFLUENZA
Distribution Statement: Approved for public release; distribution is unlimited.
Abstract: (U) The National Strategy for Pandemic Influenza notes that pandemic flu could overwhelm the heath and medical capabilities of the United States, cause hundreds of thousands of deaths, millions of hospitalizations, and cost hundreds of billions of dollars. The consensus within scientific circles is that the nation will likely face one or more pandemics in this century, although there is disagreement as to the probable timing of such an event. Studying the 1918 pandemic will assist modern day planners in mitigating the effects of pandemic flu and the contingency planning will have widespread applicability to other events, both natural and manmade, that may significantly impact the nation's health and security. This paper reviews the 1918 pandemic, explores concerns about the avian influenza virus H5N1, and considers current planning for pandemic flu. Weaknesses in the current schema are examined and recommendations are offered to facilitate both enhanced pandemic planning efforts and Homeland Security.

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ADA492868
Asia and the Science and Politics of Pandemics. 3rd Revision
Descriptive Note: Conference rept.
Personal Author(s): Bickford, Thomas, DuMont, Malia
Report Date: Apr 2007
Media Count: 37   Page(s)
Descriptors: (U) *EPIDEMICS, *ASIA, DISEASES, RESPONSE, PLANNING, HEALTH CARE FACILITIES, PREVENTION, HEALTH CARE MANAGEMENT, CRISIS MANAGEMENT, SYMPOSIA, MEDICAL SERVICES
Identifiers: (U) *PANDEMICS, WORKING PAPER, PE0605154N
Distribution Statement: Approved for public release; distribution is unlimited.
Abstract: (U) On February 3, 2006, The CNA Corporation's Project Asia held a one-day conference entitled Asia and the Science and Politics of Pandemics. This conference brought together a broad group of policy-makers, health care professionals, and academics to discuss the political and scientific issues of prevention and planning for a possible pandemic in Asia. The goal of the conference was to focus on Asia as a potential epicenter of emerging diseases, discuss the response capacities of various Asian health systems, and explore health crises as political issues for regional governments in Asia.

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ADA467339
Building Collaborative Capacity for Biosecurity at the Georgia Seaports
Descriptive Note: Master's thesis
Personal Author(s): Neu, Annette L
Report Date: Mar 2007
Media Count: 89   Page(s)
Descriptors: (U) *STRATEGY, *SECURITY, *TERRORISM, *RADIOLOGY, *PUBLIC HEALTH, *COMMUNICABLE DISEASES, *RISK MANAGEMENT, POLICIES, INVESTMENTS, DISEASES, MORTALITY RATE, GEORGIA, NATURAL DISASTERS, QUARANTINE, MORBIDITY, PORTS(FACILITIES), ATTENTION, SURVEILLANCE, INFECTIOUS DISEASES, MANMADE, ATTACK, SOCIAL COMMUNICATION, DETECTION
Identifiers: (U) *BIOSECURITY, *BIOTERRORISM ATTACK, *COLLABORATIVE CAPACITY, SOCIAL NETWORK, SYNDROMIC SEAPORTS, COMMUNICABLE DISEASE
Distribution Statement: Approved for public release; distribution is unlimited.
Abstract: (U) When public health interventions are incorporated into a comprehensive seaport security strategy, they can effectively prevent and reduce morbidity and mortality, resulting from natural or man-made disasters. The challenge is to build collaborative capacities through new and renewed seaport surveillance activities among government agencies and private companies to strengthen the role of public health to detect, intercept, and mitigate the potential effects of the intentional or unintentional introduction of diseases. Currently, effective collaborative processes between public health agencies and other local, state and federal partners in seaport security are weak and primarily the result of informal activities. Although seaport security receives considerable policy attention in other areas of risk management, such as radiological detection, public health investments are relatively neglected. Effective, sustainable approaches to building interagency collaboration could prove to be an indispensable homeland security initiative to prepare for a bioterrorism attack or other infectious disease incidents.

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ADA468008
Testing the Effectiveness of the North Shore - LIJ Health System's Bioterrorism Response Program to Identified Surveillance Data
Descriptive Note: Final rept.
Personal Author(s): Rowe, Thomas W
Report Date: Mar 2007
Media Count: 34   Page(s)
Descriptors: (U) *INFECTIOUS DISEASES, *SURVEILLANCE, *BIOTERRORISM, *BIOMEDICAL INFORMATION SYSTEMS, COMPUTER PROGRAMS, EPIDEMICS, MEDICAL COMPUTER APPLICATIONS, MONITORING, RESPONSE
Identifiers: (U) *DISEASE OUTBREAKS, *ELECTRONIC SYNDROMIC SURVEILLANCE SYSTEM, BIOTERRORISM SURVEILLANCE, TIMELY NOTIFICATIONS
Distribution Statement: Approved for public release; distribution is unlimited.
Abstract: (U) The research was of the project was to measure the importance of timely notifications of potential infectious disease outbreaks, provided by electronic syndromic surveillance system, compared to the manual case-review system.

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ADA470950
Molecular Pathogenesis of Rickettsioses and Development of Novel Anti-Rickettsial Treatment by Combinatorial Peptide-Based Libraries
Descriptive Note: Final rept. 1 Feb 2002-31 Jan 2007
Personal Author(s): Walker, David H, Olano, Juan P
Report Date: 01 Feb 2007
Media Count: 101   Page(s)
Descriptors: (U) *PEPTIDES, *PATHOGENESIS, *DISEASE VECTORS, *TYPHUS RICKETTSIAE, *RETROVIRUSES, *RICKETTSIAL DISEASES, *CYTOKINES, *RICKETTSIA PROWAZEKII, *ARTHROPOD BORNE DISEASES, PERMEABILITY, IN VITRO ANALYSIS, MICROSCOPY, HETEROGENEITY, RICKETTSIA, ENDOTHELIUM, RESISTANCE(BIOLOGY), COLONIES(BIOLOGY), TRANSDUCERS, CELLS(BIOLOGY), CARDIOVASCULAR SYSTEM, MOLECULAR PROPERTIES
Identifiers: (U) RICKETTSIA RICKETTSII, RICKETTSIA CONORII, ADAPTEINS, MICROVASCULAR PERMEABILITY, EPIDEMIC TYPHUS, ROCKY MOUNTAIN SPOTTED FEVER, O. TSUTSUGAMUSHI
Distribution Statement: Approved for public release; distribution is unlimited.
Abstract: (U) The purpose of this study is to utilize adaptein libraries coded within pantropic retroviral vectors that confer protection against rickettsiae and to study the molecular pathogenesis of rickettsioses. The following specific aims were proposed: 1) To establish heterogeneous cell populations, with each cell expressing a unique member of a complex combinatorial peptide-based (e.g., adaptein) library and challenge with R. prowazekii, R. rickettsii, and O. tsutsugamushi; 2) To determine the role of NF-kB, cytokines, ROS and NO in intracellular killing of rickettsia-infected monolayers containing adapteins and 3) To characterize signal transduction pathways modulating the cytoskeletal events responsible for the increased vascular permeability. Work on specific aim 1 was partially successful. Resistant colonies of 20-25 cells were obtained after rickettsial challenges. However, expansion of such colonies was not possible. Great progress was made on specifics aims 2 and 3. The role of rickettsiae, cytokines (IFN-gamma, TNF-alpha, and IL-1beta), ROS and NO in endothelial permeability was very well characterized in vitro. Changes in occludin, p120 and beta-catenin have also been documented by confocal microscopy and are related to increased endothelial permeability. mRNA microarray experiments revealed differences between infected and non-infected endothelial monolayers and between R. conorii and R. rickettsii-infected endothelial monolayers.

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ADA470468
Mitigation of Threats to the Continuation of Marine Recruit Training Posed by a Category 4/5 Influenza Pandemic
Descriptive Note: Final rept.
Personal Author(s): DiGiovanni, Clete, Monto, Arnold S, Malone, John D
Report Date: 29 Jan 2007
Media Count: 21   Page(s)
Descriptors: (U) *MILITARY FORCE LEVELS, *MARINE CORPS TRAINING, *PREVENTIVE MEDICINE, *INFLUENZA, THREATS, VULNERABILITY, MARINE CORPS PERSONNEL, VACCINES, ANTIVIRAL AGENTS, RECRUITS, CONTINUITY, RELIABILITY, SAFETY
Identifiers: (U) PANDEMIC INFLUENZA, QUARANTINE
Distribution Statement: Approved for public release; distribution is unlimited.
Abstract: (U) The challenges to continuity of recruit training during a Category 4/5 influenza pandemic are so formidable, and the non- pharmaceutical interventions to counter them so limited, complicated, and prone to error in implementation that we reluctantly conclude that the most sensible course, in the absence of an effective vaccine or reliable and safe antiviral prophylaxis, may be to rely on personnel actions other than recruit input to maintain force levels during a pandemic this severe.

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ADA462111
Pandemic Influenza: Appropriations for Public Health Preparedness and Response
Descriptive Note: Congressional rept.
Personal Author(s): Lister, Sarah A
Report Date: 23 Jan 2007
Media Count: 7   Page(s)
Descriptors: (U) *UNITED STATES GOVERNMENT, *PREPARATION, *INFLUENZA, *EPIDEMICS, CRISIS MANAGEMENT, INFLUENZA VIRUS, THREATS, BUDGETS, PUBLIC HEALTH
Identifiers: (U) H5N1 AVIAN INFLUENZA, BIRD FLU, PANDEMICS, *PANDEMIC FLU, *APPROPRIATIONS, FUNDING
Distribution Statement: Approved for public release; distribution is unlimited.
Abstract: (U) The spread of H5N1 avian influenza ("flu") on three continents, and the human deaths it has caused, raise concern that the virus could morph and cause a global human pandemic. Congress has provided specific funding for pandemic flu preparedness since FY2004, including $6.1 billion in emergency supplemental appropriations for FY2006. These funds bolster related activities to prepare for public health threats, and to control seasonal flu. This report discusses appropriations for pandemic flu, primarily to the Department of Health and Human Services (HHS), and will be updated as needed.

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ADA487213
The Prioritization of Critical Infrastructure for a Pandemic Outbreak in the United States Working Group
Descriptive Note: Final rept.
Personal Author(s): Denlinger, Rebecca F, Marsh, Martha H, Rohde, Bruce A
Report Date: 16 Jan 2007
Media Count: 130   Page(s)
Descriptors: (U) *INFRASTRUCTURE, *EPIDEMICS, COMMUNICATION AND RADIO SYSTEMS, COUNTERMEASURES, INFLUENZA VIRUS, RESPONSE, RECOVERY, PUBLIC HEALTH
Identifiers: (U) *PANDEMIC OUTBREAK, PREPAREDNESS, CRITICAL SERVICES, PRIORITIZATION
Distribution Statement: Approved for public release; distribution is unlimited.
Abstract: (U) Though its timing, severity, and ultimate strain remain a mystery, a pandemic promises to test the critical infrastructure of both the United States and the world. Public health officials have long maintained the potential for pandemic influenza is not a matter of if, but rather a matter of when. To avoid an economic and social catastrophe, pandemic preparedness demands full public- and private-sector participation. With that in mind, U.S. Department of Homeland Security (DHS) Secretary Michael Chertoff joined Secretary Leavitt in May 2006 to ask the National Infrastructure Advisory Council (NIAC) to provide them and President Bush with recommendations regarding the prioritization and distribution of pandemic countermeasures to the essential workers in our nation's Critical Infrastructure and Key Resource (CI/KR) sectors. Given the scope and scale of a pandemic, the Federal government has repeatedly asserted it cannot handle all pandemic preparedness, response, and recovery efforts on its own. In their letter to the NIAC, the Secretaries highlighted the necessity for the public and private sectors to prepare for this serious threat. The Secretaries also emphasized their understanding that successful pandemic planning requires coordination across all CI/KR sectors.

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ADA475052
Biotechnology Industry
Descriptive Note: Final rept.
Personal Author(s): Campbell, Kyle D, Clemen, Gene, Denham, Paul, Dodson, Greg, Flanagan, Denise, Goble, Dale, Mahon, Deirdre, Martin, Joanne, Merrill, Rick, Milford, Mike
Report Date: Jan 2007
Media Count: 31   Page(s)
Descriptors: (U) *BIOTECHNOLOGY, *TECHNOLOGY ASSESSMENT, INDIA, ETHICS, TECHNOLOGY FORECASTING, NANOTECHNOLOGY, EPIDEMICS, BIOTERRORISM, COMMERCIAL LAW, VACCINES, GENETICS, AFRICA
Identifiers: (U) PROJECT BIOSHIELD, EMERGING TECHNOLOGY, CLONING, PERSONALIZED MEDICINE, PHARMACOGENOMICS, PANDEMICS, BIONANOTECHNOLOGY, MEDICAL COUNTERMEASURES, BIOFUELS, PATENT LAW, INTELLECTUAL PROPERTY, GMO(GENETICALLY MODIFIED ORGANISMS)
Distribution Statement: Approved for public release; distribution is unlimited.
Abstract: (U) Biotechnology is a diverse and promising industry, but it is not without challenges. The impact on our lives is already being felt, and all indications point to a future of unprecedented changes. Genetically modified (GM) organisms are being used to increase crop production, bacteria to remediate contaminated areas, and even fetal calf skin to grow human soft tissues. Concurrently our nation is seeking biotechnology answers for a variety of national security issues, including the defense of biological or chemical attack and pandemic influenzas. Biotechnology is rapidly impacting multiple industries including medicine, defense, energy, and agriculture. This paper addresses four general biotechnology areas: medical, emerging technology, biodefense, and agriculture. These discussions range from personalized medicine, pandemics and vaccines to biofuels and Project BioShield. The potential economic impact of the industry is tremendous and leads directly to many of the challenges our nation will face in the future. These challenges include globalization, government regulation, ethical concerns and societal acceptance. As the biotechnology industry continues to mature, we expect to see a bright future where the benefits of biotechnology will outweigh the risks involved in its application.

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ADA471841
Pathology of Inhalational Anthrax Infection in the African Green Monkey
Descriptive Note: Journal article
Personal Author(s): Twenhafel, N A, Leffel, E, Pitt, M L
Report Date: Jan 2007
Media Count: 7   Page(s)
Descriptors: (U) *ANTHRAX, *INHALATION, *MACAQUE MONKEYS, REPRINTS, DOSAGE, PATHOLOGY, BACILLUS ANTHRACIS, LABORATORY ANIMALS, BIOLOGICAL WARFARE AGENTS, PRIMATES, INFECTIOUS DISEASES
Identifiers: (U) VET MED, AGMS(AFRICAN GREEN MONKEYS), NONHUMAN PRIMATES
Distribution Statement: Approved for public release; distribution is unlimited.
Abstract: (U) There is a critical need for an alternative nonhuman primate model for inhalational anthrax infection because of the increasingly limited supply and cost of the current model. This report describes the pathology in 12 African green monkeys (AGMs) that succumbed to inhalational anthrax after exposure to a low dose (presented dose 200-2 x 10(4)colony-forming units [cfu]) or a high dose (presented dose 2 x 10(4)-1 x 10(7) cfu) of Bacillus anthracis (Ames strain) spores. Frequent gross lesions noted in the AGM were hemorrhage and edema in the lung, mediastinum, and mediastinal lymph nodes; pleural and pericardial effusions; meningitis; and gastrointestinal congestion and hemorrhage. Histopathologic findings included necrohemorrhagic lymphadenitis of mediastinal, axillary, inguinal, and mesenteric lymph nodes; mediastinal edema; necrotizing splenitis; meningitis; and congestion, hemorrhage, and edema of the lung, mesentery, mesenteric lymph nodes, gastrointestinal tract, and gonads. Pathologic changes in AGMs were remarkably similar to what has been reported in rhesus macaques and humans that succumbed to inhalational anthrax; thus, AGMs could serve as useful models for inhalation anthrax studies.

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ADA477250
Modeling Influenza Pandemic Response Effectiveness in Canada
Personal Author(s): Jacobson, Zack, Houston, Ben
Report Date: 01 Dec 2006
Media Count: 22   Page(s)
Descriptors: (U) *MEDICAL SERVICES, *INFLUENZA VIRUS, *PREVENTIVE MEDICINE, NATO, UNITED STATES GOVERNMENT, RISK, DECISION MAKING, DISTRIBUTION, ANTIVIRAL AGENTS, CANADA, PATTERNS, ADMINISTRATIVE PERSONNEL, PERSONNEL
Identifiers: (U) NATO FURNISHED, FOREIGN REPORTS
Distribution Statement: Approved for public release; distribution is unlimited. NATO.
Abstract: (U) As the risk of a global influenza pandemic increases there is growing response preparedness efforts within Canada. One question that governmental decision makers have in this context is what is the most effective distribution of anti-virals, such as oral oseltamivir, within the population of first responders, health care workers, administrators and the general public in addition to what extent should the anti-virals be used as prophylactics. To provide an answer to this question, we have developed a Canada-wide influenza pandemic simulator and visualization system that allows for the modeling of various patterns of anti-viral distribution and use.

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ADA466801
Weathering the Storm. Leading Your Organization Through a Pandemic
Personal Author(s): Prior, Stephen, Armstrong, Robert, Rowan, Ford, Hill-Harmon, Mary B
Report Date: Nov 2006
Media Count: 78   Page(s)
Descriptors: (U) *CRISIS MANAGEMENT, *INFLUENZA, PUBLIC HEALTH, SCIENTIFIC ORGANIZATIONS, EPIDEMICS
Identifiers: (U) H5N1
Distribution Statement: Approved for public release; distribution is unlimited.
Abstract: (U) A storm is coming. None of us have ever experienced a storm like this. It could arrive very soon. But, as anyone who makes a living as a forecaster will quickly say, On the other hand . . . The storm is, of course, an influenza pandemic. Much has been written in the past few years about the virus known as H5N1 and its potential to develop into a pandemic. Some in the scientific community are questioning whether that will ever happen.1 If H5N1 does become pandemic, we have no basis for predicting whether it will be this year or 10 years from now. After all, H5N1 was first identified in birds in 1961; the first human cases did not appear until 1997. There is little doubt, though, that eventually something most likely a virus will mutate into a pandemic form. The SARS outbreak in February 2003 is a good example of how a lethal virus can emerge suddenly. We were fortunate that SARS, while contagious, did not become pandemic. The SARS outbreak and the emergence of H5N1 avian influenza provide us with a forewarning of the problems a larger outbreak will pose. It is prudent to use this time before the storm to plan for the societal disruption a pandemic will cause. A pandemic poses problems that most disasters even ordinary public health disasters do not present. First, the time period of the disaster is extended; the 1918 pandemic lasted about 18 months, with three distinct peaks of infection and illness. Another issue with a pandemic is its geographic spread; modern air travel can deliver any pathogen worldwide in a very short time frame. Thus, our planning has to take into account the necessity to change our social behaviors and possibly restrict our movements to limit the pathogen's spread.

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ADA469361
Department of Defense Implementation Plan for Pandemic Influenza
Report Date: Aug 2006
Media Count: 88   Page(s)
Descriptors: (U) *INFLUENZA VIRUS, DEPARTMENT OF DEFENSE, CRISIS MANAGEMENT, EMERGENCIES, VACCINES, HOMELAND SECURITY, OPERATIONAL READINESS, PLANNING, ANTIVIRAL AGENTS
Identifiers: (U) *PANDEMIC INFLUENZA
Distribution Statement: Approved for public release; distribution is unlimited.
Abstract: (U) The Secretary of Defense's principal responsibility in responding to a pandemic will be to protect U.S. interests at home and abroad. This implementation plan sets forth Department of Defense (DoD) guidance and addresses key policy issues for pandemic influenza planning. This guidance will enable the Combatant Commanders, Military Departments, and DoD agencies to develop plans to prepare for, detect, respond to, and contain the effects of a pandemic on military forces, DoD civilians, DoD contractors, dependents, and beneficiaries. Additionally, plans will address the provision of DoD assistance to civil authorities both foreign and domestic. Finally, attention to the key security concerns, such as humanitarian relief and stabilization operations that may arise as a result of a pandemic, will be addressed.

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ADA484151
Changing Homeland Security: What Should Homeland Security Leaders Be Talking About?
Descriptive Note: Journal article
Personal Author(s): Bellavita, Christopher
Report Date: Jul 2006
Media Count: 11   Page(s)
Descriptors: (U) *HOMELAND SECURITY, *PREPARATION, *LEADERSHIP, *STRATEGY, *EMERGENCIES, *VULNERABILITY, *UNITED STATES GOVERNMENT, PUBLIC HEALTH, PREVENTION, TERRORISM, STATE GOVERNMENT, LOCAL GOVERNMENT, INFRASTRUCTURE, MEDICAL SERVICES, ADMINISTRATIVE PERSONNEL, CHEMICAL WARFARE, BIOLOGICAL WARFARE, THREATS, EPIDEMICS, NUCLEAR WARFARE, REPRINTS
Identifiers: (U) *NATIONAL PREPAREDNESS, EMERGENCY PREPAREDNESS, UNPREPAREDNESS, PANDEMICS, POLITICAL OFFICIALS, INTEREST GROUPS, PUBLIC ADMINISTRATORS, ACADEMICS, COMMENTATORS, STAGE FIVE LEADERS, SUBJECT MATTER EXPERTS
Distribution Statement: Approved for public release; distribution is unlimited.
Abstract: (U) Homeland security has spiraled into Stage Five of the Issue Attention Cycle. Stage Five -- the post-problem stage -- means homeland security again operates principally behind the public apron. Stakeholders sedulously sift through the grist of homeland security's congressional, industrial, academic, and bureaucratic complex. The professionals who populate that complex spend their days calibrating the strategies, programs, and institutions disjunctively formed in the earlier stages of the Cycle. Except for an occasional 15 minutes of public attention to dead terrorists, disrupted plots, and grant cuts, homeland security is not an issue high on the public's agenda. It could leap back on top in an instant. But for now most conversations about homeland security take place within a comparatively small community. The issues are largely the same ones talked about for the last 5 years: funding, threats, hazards, borders, interoperability, intelligence, response, transportation, equipment, and recently, pandemics. Unarguable progress has been made in all these domains. We clearly are better prepared for some things than we were in the autumn of 2001. Equally as certain, there are miles to go before most of the nation's jurisdictions get a "Sufficient" rating in future national preparedness assessments. Stage Five in the Issue Attention Cycle means there is little political will to substantially alter the hodgepodge federalism that characterizes U.S. homeland security. The system we have is the one we have to work with, at least until something significant happens: another attack, a catastrophic natural disaster, a national public health emergency, or a new political administration. Until the system is shocked, much homeland security work will be incremental. It will continue to focus on the mundane but institutionally important work of answering "how prepared are we, how prepared do we need to be, and how do we prioritize efforts to close the gap?

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ADA484174
Epidemic Outbreak Surveillance (EOS)
Descriptive Note: Final rept. 1 Jul 2004-30 Jun 2006
Personal Author(s): Scofield, Thomas C, Walter, Elizabeth, Livingstone, Samuel J
Report Date: Jul 2006
Media Count: 17   Page(s)
Descriptors: (U) *EPIDEMICS, *DIAGNOSIS(MEDICINE), *RESEARCH MANAGEMENT, PATHOGENIC MATERIALS, RESPIRATORY DISEASES, SURVEILLANCE, INFECTIOUS DISEASES, MEDICAL RESEARCH
Identifiers: (U) EOS(EPIDEMIC OUTBREAK SURVEILLANCE)
Distribution Statement: Approved for public release; distribution is unlimited.
Abstract: (U) This funding is established to support Operations and Management. The goal of the project is to develop and test new technologies for the diagnosis and surveillance of respiratory tract pathogens. This funding supported purchase of supplies and shipping services necessary to carry out protocols to standardize methods of specimen collection and to optimize processing of these specimens. After these processes were established initial supplies were purchased in order to begin enrollment of healthy ill and recovered Basic Military Trainees (BMTs) in order to compare methods of detection of respirator and host response. This funding enabled successful initiation of the project.

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ADA451348
A Model for the Ordering and Distribution of the Influenza Vaccine
Descriptive Note: Master's thesis
Personal Author(s): Gurr, James R
Report Date: Jun 2006
Media Count: 69   Page(s)
Descriptors: (U) *MANUFACTURING, *DISTRIBUTION, *VACCINES, *INFLUENZA, *MEDICAL SUPPLIES, UNITED STATES, THEORY, COSTS, DEATH, SEASONS, SHORTAGES, DETERMINATION, DOSAGE, THESES, PRODUCTION, POLICIES
Identifiers: (U) *VACCINE SUPPLY, *VACCINE ORDERING, FLU VACCINE, VACCINE SHORTAGE, PANDEMIC
Distribution Statemen: Approved for public release; distribution is unlimited.
Abstract: (U) The system for the production and distribution of the United States supply of influenza vaccine has experienced disruptions during past influenza seasons. The identification of elements of the influenza vaccine is different each year and must be researched and identified each year prior to the influenza season. The manufacturing of the vaccine is a complicated process with many potential problems. This thesis identifies the requirements and constraints of the current manufacturing and distribution system including the annual demand and supply. This information is used to create an illustrative model based on operational research and operational management theory to develop a systematic approach to distribution of the influenza vaccine in a shortage situation. Two different policies are identified for use in a normal influenza season to determine how many companies are required to provide a sufficient amount of influenza vaccine with the understanding that some of the companies might have manufacturing difficulties. These two policies are the percentage distribution policy and the strict priority distribution policy. The model includes a determination of the number of companies that should be available for influenza vaccine production and the amount of vaccine that should be ordered from each company to minimize the total cost. The majority of the influenza seasons could be covered by purchasing fewer than 108 million doses, as in the percentage distribution policy, making sure that the vaccine dose orders are spread out evenly over four companies and distributed evenly by age group percentage, but could be reduced to as little as 24.5 million total vaccine doses if necessary with minimal cost and loss of life using a strict priority distribution policy.

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ADA447939
National Strategy for Pandemic Influenza Implementation Plan
Report Date: May 2006
Media Count: 233   Page(s)
Descriptors: (U) *NATIONAL SECURITY, *HUMANS, *HEALTH, *HOMELAND SECURITY, *INFECTIOUS DISEASE TRANSMISSION, *INFLUENZA VIRUS, EUROPE, GLOBAL, FAMILY MEMBERS, ANIMALS, DRUGS, ANTIVIRAL AGENTS, INFRASTRUCTURE, CATS, ASIA, SOCIOLOGY, BIRDS, PUBLIC HEALTH, IMMUNITY, DEATH, VIRUSES, AFRICA, UNIVERSITIES, HISTORY, ECONOMICS, SOCIETIES, STRATEGY, UNITED STATES
Distribution Statement: Approved for public release; distribution is unlimited.
Abstract: (U) Influenza viruses have threatened the health of animal and human populations for centuries. Their diversity and propensity for mutation have thwarted our efforts to develop both a universal vaccine and highly effective antiviral drugs. A pandemic occurs when a novel strain of influenza virus emerges that has the ability to infect and be passed between humans. Because humans have little immunity to the new virus, a worldwide epidemic, or pandemic, can ensue. Three human influenza pandemics occurred in the 20th century, each resulting in illness in approximately 30 percent of the world population and death in 0.2 percent to 2 percent of those infected. Using this historical information and current models of disease transmission, it is projected that a modern pandemic could lead to the deaths of 200,000 to 2 million people in the United States alone. The animal population serves as a reservoir for new influenza viruses. Scientists believe that avian, or bird, viruses played a role in the last three pandemics. The current concern for a pandemic arises from an unprecedented outbreak of H5N1 influenza in birds that began in 1997 and has spread across bird populations in Asia, Europe, and Africa. The virus has shown the ability to infect multiple species, including long-range migratory birds, pigs, cats, and humans. It is impossible to predict whether the H5N1 virus will lead to a pandemic, but history suggests that if it does not, another novel influenza virus will emerge at some point in the future and threaten an unprotected human population. The economic and societal disruption of an influenza pandemic could be significant. Absenteeism across multiple sectors related to personal illness, illness in family members, fear of contagion, or public health measures to limit contact with others could threaten the functioning of critical infrastructure, the movement of goods and services, and operation of institutions such as schools and universities.

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ADA475294
Asia Pacific Military Medicine Conference (APMMC) Simulation Symposium (16th) Held in New Delhi, India on March 26-31, 2006. Abstracts
Descriptive Note: Conference abstracts
Personal Author(s): Vincent, Dale S
Report Date: Apr 2006
Media Count: 222   Page(s)
Descriptors: (U) *SYMPOSIA, *ABSTRACTS, *MILITARY MEDICINE, SIMULATION, DISASTERS, MILITARY RESEARCH, CASUALTIES, THERAPY, WOUNDS AND INJURIES, MALARIA, INFECTIOUS DISEASES, HUMAN IMMUNODEFICIENCY VIRUSES, MEDICAL PERSONNEL, SURGERY, EPIDEMIOLOGY, NURSES, NURSING, INFLUENZA, TRAUMA, VACCINES, AEROSPACE MEDICINE, ACQUIRED IMMUNE DEFICIENCY SYNDROME, ANTIBIOTICS, MEDICAL EVACUATION, DENGUE, FLIGHT SURGEONS, AVIATION MEDICINE, ACCLIMATIZATION, PULMONARY EDEMA, ENTOMOLOGY, FROSTBITE, HYDRATION, VERTIGO, PEACEKEEPING, BIOTERRORISM
Identifiers: (U) AIR EVACUATION, AIRBORNE MICROPARTICULATES, ANTIRETROVIRAL THERAPY, AVIAN INFLUENZA, CERVICAL DYSPLASIA, COAGULOPATHY, COMBAT MEDICINE, COMBAT STRESS, CORNEAL REFRACTIVE SURGERY, CORONARY ARTERY DISEASE, CRANIOFACIAL INJURIES, DENGUE FEVER, DENTAL SCIENCES, DISASTER MEDICINE, DISASTER RELIEF, DISASTER RESPONSE OPERATIONS, EARTHQUAKE RESPONSE, ENTOMOLOGICAL SURVEILLANCE, ENVIRONMENTAL MEDICINE, EXTREMITY INJURIES, FAMILY MEDICINE, GUNSHOT WOUNDS, HANTAVIRUS, HEAT ACCLIMATION, HEAT STRESS, HEPATITIS B, HIGH ALTITUDE MEDICINE, HIGH ALTITUDE OPERATIONS, HIV/AIDS, HUMANITARIAN MISSIONS, INFECTION CONTROL, INJURY PREVENTION, LIFESTYLE DISORDERS, LIMB SALVAGE, MASS CASUALTY EVACUATION, MENORRHAGIA, MILITARY HEALTH CARE, NAVAL MEDICINE, NAVY MEDICINE, NEUROPSYCHOLOGY, NOISE TRAUMA, OCULAR INJURIES, ORAL RECONSTRUCTION, ORTHOPEDIC MORBIDITY, PANDEMIC FLU, PEACEKEEPING OPERATIONS, PEDIATRICIANS, POLYMICROBIAL INFECTIONS, SIMULATION TRAINING, SMOKING, SPATIAL DISORIENTATION, STROKE, SUBMARINE ESCAPE AND RESCUE, SUICIDAL TENDENCIES, THERAPIES, TRACHEAL INJURIES, TYPE 2 DIABETES MELLITUS, VASCULAR INJURIES, VECTOR BORNE DISEASES
Distribution Statement: Approved for public release; distribution is unlimited.

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ADA448619
Avian Influenza Pandemic May Expand the Military Role in Disaster Relief
Descriptive Note: Research paper
Personal Author(s): Sherod, II, Frank W
Report Date: 15 Mar 2006
Media Count: 27   Page(s)
Descriptors: (U) *MILITARY ASSISTANCE, *INFLUENZA, UNITED STATES, OPERATIONAL READINESS, NATURAL DISASTERS, MILITARY PLANNING, BIRDS
Identifiers: (U) STRATEGY RESEARCH PROJECT, BIRD FLU VIRUS, DISASTER RELIEF
Distribution Statement: Approved for public release; distribution is unlimited.
Abstract: (U) Recent involvement by the U.S. military with hurricane relief and comments by the President on expanding the DOD's role in disaster relief indicates increased missions for an already stretched military. The next national disaster facing the U.S. could be an influenza pandemic. The bird flu virus H5N1 currently threatening Asia and Europe can potentially mutate into a deadly human influenza pandemic with global consequences. The last major flu pandemic in 1918 killed 50 million people worldwide and 600,000 in the U.S. alone. The United States is not prepared for a human pandemic and the military will have a significant role in any national response. While some departmental level planning has been accomplished recently, interdepartmental coordination and clear identification of the lead federal agency is still lacking. This project explains possible effects of a pandemic on the U.S. and current responsibilities of federal departments involved in disaster relief. Analysis is presented on the evolving role the DOD plays should this event become reality and finally recommends preparations that should be accomplished to prepare the nation for this very real threat. An ad-hoc approach to a pandemic will have severe negative and far reaching affects on our nation and must be avoided.

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ADA457443
AIDS in Africa
Descriptive Note: Congressional rept.
Personal Author(s): Cook, Nicolas
Report Date: 09 Mar 2006
Media Count: 20   Page(s)
Descriptors: (U) *SUBSAHARAN AFRICA, *HUMAN IMMUNODEFICIENCY VIRUSES, *ACQUIRED IMMUNE DEFICIENCY SYNDROME, FOREIGN POLICY, FOREIGN AID, PUBLIC HEALTH, RESPONSE
Identifiers: (U) EPIDEMICS
Distribution Statement: Approved for public release; distribution is unlimited.
Abstract: (U) Sub-Saharan Africa ("Africa" hereafter) has been more severely affected by AIDS than any other part of the world. In 2005, the United Nations reports, there were about 25.8 million HIV-positive adults and children in the region, which has about 11.3% of the world's population but over 64% of the worldwide total of infected persons. The overall adult rate of infection in Africa is 7.2%, compared with 1.1% worldwide. Nine southern Africa countries have infection rates above 10%. Ten African countries with the largest infected populations account for over 50% of infected adults worldwide. By the end of 2005, an estimated 27.5 million Africans had died of AIDS since 1982, including 2.4 million in 2005. AIDS has surpassed malaria as the leading cause of death in Africa, and it kills many times more Africans than war. In Africa, 57% of those infected are women. U.S. concern over AIDS in Africa grew in the 1980s, as the epidemic's severity became apparent. Legislation enacted in the 106th and the 107th Congresses increased funding for worldwide AIDS programs. P.L. 108-25, signed into law on May 27, 2003, authorized $15 billion over five years for international AIDS programs. President Bush announced his Emergency Plan for AIDS Relief (PEPFAR) in his 2003 State of the Union message. Twelve of 15 PEPFAR "focus countries" are in Africa. Under the FY2007 budget request, the 12 countries would receive a 61% boost in AIDS-related aid, to $1.99 billion, under the State Department's Global HIV/AIDS Initiative account. Nonetheless, activists and others urge that more be done, given the scale of the African pandemic.

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ADA489558
Civil-Military Medicine: On Dangerous Ground
Descriptive Note: Workshop summary
Personal Author(s): Clunan, Anne L
Report Date: Mar 2006
Media Count: 113   Page(s)
Descriptors: (U) *HUMANITARIAN ASSISTANCE, *EPIDEMICS, *NATURAL DISASTERS, *CONFLICT, *MEDICAL SERVICES, *MILITARY PERSONNEL, *CIVILIAN PERSONNEL, POSTWAR OPERATIONS, COOPERATION, WORKSHOPS, INFLUENZA, CHOLERA, COMMUNITY RELATIONS, COUNTERINSURGENCY, TSUNAMIS, UNITED NATIONS, EARTHQUAKES, GOVERNMENT(FOREIGN), INFORMATION EXCHANGE, UNITED STATES GOVERNMENT, INTERAGENCY COORDINATION, MILITARY FORCES(UNITED STATES), SIMULATION
Identifiers: (U) *INTERNATIONAL ORGANIZATIONS, *NGO(NONGOVERNMENTAL ORGANIZATIONS), CIVIL-MILITARY MEDICINE, CIVILIAN-MILITARY RELATIONS, SRO(STABILITY AND RECONSTRUCTION OPERATIONS), WHO(WORLD HEALTH ORGANIZATION), USAID(US AGENCY FOR INTERNATIONAL DEVELOPMENT), EDUCATIONAL GAMES, UNITED NATIONS FORCES, DISASTER RELIEF
Distribution Statement: Approved for public release; distribution is unlimited.
Abstract: (U) The interaction between armed forces and civilian organizations providing medical and health aid in insecure environments is increasing. Recent examples include a U.S.-led anti-insurgent Joint Task Force providing disaster relief after mud slides in the Philippines, the international response to the Asian tsunami, and operations in Iraq and Afghanistan. Practitioners and scholars alike have noted that the rising incidence of civil-military medical assistance increases the need for better operational coordination and cooperation among the actors in the medical and health sector of humanitarian assistance. From January 29 to February 2, 2006, representatives from the U.S. Government, United Nations, and international nongovernmental organizations (NGOs) participated in an educational game at the Center for Stabilization and Reconstruction Studies (CSRS) at the Naval Postgraduate School in Monterey, California. The game focused on the operational challenges associated with providing medical and health assistance as part of disaster relief and development assistance in regions of conflict or instability. Three scenarios were used, and participants took the role of representing their respective medical communities: military, civilian government, international organization, and international nongovernmental organization. The first scenario focused on disaster relief in a post-conflict setting, the second posed a situation of a natural disaster occurring during ongoing combat operations, and the third concerned an epidemic of avian influenza among a mixed population of civilians and insurgent forces.

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ADA471881
Development of Treatment Strategies to Combat Ebola and Marburg Viruses
Descriptive Note: Journal article
Personal Author(s): Paragas, Jason, Geisbert, Thomas W
Report Date: 02 Feb 2006
Media Count: 11   Page(s)
Descriptors: (U) *HEMORRHAGIC FEVERS, *VIRUS DISEASES, *EBOLA VIRUS, *PREVENTIVE MEDICINE, STRATEGY, THREATS, HUMANS, HEALTH, ARBOVIRUSES, CRITICAL PATH METHODS, BIOLOGICAL WARFARE, THERAPY, ANIMALS, LETHALITY, CHEMICAL ORDNANCE, INFECTIOUS DISEASES
Identifiers: (U) *MARBURG VIRUS, FILOVIRUS, EBOLA, EMERGING DISEASES, TREATMENT, THERAPEUTICS, REVIEW
Distribution Statement:
Approved for public release; distribution is unlimited.
Abstract: (U) Ebola and Marburg viruses are emerging/re-emerging pathogens that pose a significant threat to human health. These naturally occurring viral infections frequently cause a lethal hemorrhagic fever in humans and nonhuman primates. The disastrous consequences of infection with these viruses have been pursued as potential biological weapons. To date, there are no therapeutic options available for the prophylaxis or treatment of infected individuals. The recognition that Ebola and Marburg viruses may be exploited as biological weapons has resulted in major efforts to develop modalities to counter infection. In this review, select technologies and approaches will be highlighted as part of the critical path for the development of therapeutics to ameliorate the invariably devastating outcomes of human filoviral infections.

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ADA459331
Generation of Advanced Diagnostics and Countermeasures for Individuals Most Vulnerable to Biothreats
Descriptive Note: Final rept. 2 Apr 2001-28 Feb 2006
Personal Author(s): Wang, Eugenia
Report Date: Feb 2006
Media Count: 6   Page(s)
Descriptors: (U) *STRAINS(BIOLOGY), *BIOLOGICAL WARFARE, *INFECTIOUS DISEASES, *PATHOGENIC MICROORGANISMS, *VACCINIA VIRUS, *COUNTERMEASURES, *ANTHRAX, PROTEINS, CONSTELLATIONS, DIAGNOSTIC AGENTS, DRUGS, MICE, INFLUENZA, DIAGNOSIS(MEDICINE), RESPONSE
Identifiers: (U) *BIOTHREATS
Distribution Statement: Approved for public release; distribution is unlimited.
Abstract: (U) In the first phase of this proposal, we identified mouse strains differentially resistant and susceptible to infection with three biothreat pathogens, Cowpox, Influenza, and Anthrax. In the second phase, the scope of our project is to identify: 1. Host-Oriented Pathogen Response (HOPR) Signaling Pathways, as the underlying mechanism responsible for host-specific susceptibility; and 2. the specific protein constellations responsible for the resistant or susceptible phenotypes. Pinpointing the specific protein(s) responsible for the host responses will allow us to develop specific drugs to convert susceptible into resistant phenotypes. Out ultimate goal is to use the knowledge and enabling technology gained for advanced diagnosis and countermeasures to biothreats.

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ADA443661
Asymptotic Behavior of an SI Epidemic Model With Pulse Removal
Personal Author(s): Fuhrman, K M, Lauko, I G, Pinter, G A
Report Date: Jan 2006
Media Count: 18   Page(s)
Descriptors: (U) *MATHEMATICAL MODELS, *INFECTIOUS DISEASES, COMPUTERIZED SIMULATION, EPIDEMIOLOGY, ANIMAL DISEASES, TIME INTERVALS, DIFFERENTIAL EQUATIONS
Distribution Statement: Approved for public release; distribution is unlimited. This document is not available from DTIC in microfiche.
Abstract: (U) In this paper we discuss an SI epidemic model with pulse removal from the infective class at fixed time intervals with both exponential and logistic type underlying population dynamics. This model has a significance when dealing with animal diseases with no recovery or when we consider isolation in human diseases. We provide a rigorous analysis of the asymptotic behavior of the percentage of infected individuals, the total number of infected individuals, and the total population in our model. We show that periodic removal/isolation is a feasible strategy to control the spread of the disease.

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ADA444710
Development of a cAdVax-Based Bivalent Ebola Virus Vaccine that Induces Immune Responses Against Both the Sudan and Zaire Species of Ebola Virus, Journal of Virology
Descriptive Note: Journal article
Personal Author(s): Wang, Danher, Raja, Nicholas U, Trubey, Charles M, Juompan, Laure Y, Luo, Min, Woraratanadharm, Jan, Deitz, Stephen B, Yu, Hong, Swain, Benjamin M, Moore, Kevin M
Report Date: 27 Dec 2005
Media Count: 10   Page(s)
Descriptors: (U) *RESPONSE(BIOLOGY), *HEMORRHAGIC FEVERS, *VACCINES, *EBOLA VIRUS, *IMMUNITY, SUBSAHARAN AFRICA, GLYCOPROTEINS, BIOLOGICAL WARFARE, IMMUNIZATION, ANTIPERSONNEL WEAPONS, SUDAN, ZAIRE, LETHAL DOSAGE, MICE, INFECTIOUS DISEASES, VECTOR ANALYSIS, GENES, LETHALITY
Identifiers: (U) FILOVIRUS, EBOLA, SUDAN, ZAIRE, VACCINE, BIVALENT, CADVAX-BASED, IMMUNE RESPONSES, LABORATORY ANIMALS, MICE
Distribution Statement: Approved for public release; distribution is unlimited.
Abstract: (U) Ebola virus (EBOV) causes a severe hemorrhagic fever for which there are currently no vaccines or effective treatments. While human outbreaks have so far been restricted to sub-Saharan Africa, the potential eploitation of EBOV as a biological weapon cannot be ignored. Two species of EBOV, Sudan ebolavirus and Zaire ebolavirus (ZEBOV) have been responsible for all of the deadly human outbreaks resulting from this virus. Therefore, it is important to develop a vaccine that can prevent infection by both lethal species. Here, we describe the bivalent cAdVaxE(GPs/z) vaccine, which includes the SEBOV glycoprotein (GP) and ZEBOV GP genes together in a single complex adenovirus-based vaccine(cAdVAX) vector. Vaccination of mice with the bivalent cAdVaxE(GPs/z) vaccine led to efficient induction of EBOV-specific antibody and cellp-mediated immune responses to both species of EBOV. In addition, the cAdVax technology demonstrated induction of a 100% protective immune response in mice, as all vaccinated C57B1/6 and BALB/c mice survived challenge with a lethal dose of ZEBOV (30,000 times the 50% lethal dose). This study demonstrates the potential efficacy of a bivalent EBOV vaccine based on a cAdVax vaccine vector design.

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ADA450401          
Pandemic Influenza: Domestic Preparedness Efforts
Descriptive Note: Congressional rept.
Personal Author(s): Lister, Sarah A
Report Date: 10 Nov 2005
Media Count: 37   Page(s)
Descriptors: (U) *GLOBAL, *UNITED STATES GOVERNMENT, *PREPARATION, *PLANNING, *INFECTIOUS DISEASES, *INFLUENZA VIRUS, *PREVENTION, DEPARTMENT OF DEFENSE, HISTORY, ANTIVIRAL AGENTS, BIRDS, HOMELAND SECURITY, STATE GOVERNMENT, VACCINES, REGULATIONS, PUBLIC HEALTH, DOMESTIC, SUPPLIES, RESPONSE, HUMANS, CRISIS MANAGEMENT, STRATEGY
Identifiers: (U) *FLU PANDEMICS, GLOBAL PANDEMICS, DOMESTIC PREPAREDNESS, AVIAN FLU, AVIAN INFLUENZA VIRUS, H5N1, PANDEMIC INFLUENZA, WHO(WORLD HEALTH ORGANIZATION), HHS(DEPARTMENT OF HEALTH AND HUMAN SERVICES), NRP(NATIONAL RESPONSE PLAN)
Distribution Statement: Approved for public release; distribution is unlimited.
Abstract: (U) In 1997, a new avian influenza virus (H5N1 avian flu) emerged in Hong Kong, killing 6 people. This was the first time that an avian influenza virus was shown to be transmitted directly from birds to humans. The virus persisted in the region, and has since spread to a number of Asian and European countries where it has infected more than 120 people, killing more than 60. The severity of this strain is similar to that of the deadly 1918 Spanish flu, which caused a global pandemic. Though influenza pandemics occur with some regularity, and the United States has been involved in specific planning efforts since the early 1990s, the H5N1 situation has created a sense of urgency among the world's public health officials. Global pandemic preparedness and response efforts are coordinated by the World Health Organization (WHO). The U.S. Department of Health and Human Services (HHS) released a draft pandemic flu preparedness and response plan in August 2004, and a final plan in November 2005. President Bush announced a national strategy to coordinate pandemic preparedness and response activities across federal agencies. Domestic response activities will be carried out under the broad, all-hazards blueprint for a coordinated federal, state, and local response laid out in the National Response Plan, released by the Department of Homeland Security (DHS) in 2004. If a flu pandemic were to occur in the next several years, the U.S. response would be affected by the limited availability of a vaccine (the best preventive measure for flu), as well as by limited availability of certain drugs used to treat severe flu infections, and by the general lack of surge capacity within the healthcare system. The U.S. healthcare system is largely private, while the public health system is largely based in state, rather than federal, authority. This structure creates numerous challenges in assuring the needed response capacity, and coordinating the various response elements.

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ADA441180
The Bug Stops Here: Force Protection and Emerging Infectious Diseases
Descriptive Note: Monograph
Personal Author(s): Thompson, Donald F, Swerdlow, Joel L, Loeb, Cheryl A
Report Date: Nov 2005
Media Count: 71   Page(s)
Descriptors: (U) *MILITARY FORCES(UNITED STATES), *DEPARTMENT OF DEFENSE, *POLICIES, *PROTECTION, *INFECTIOUS DISEASES, *PREVENTIVE MEDICINE, *MANAGEMENT PLANNING AND CONTROL, LESSONS LEARNED, MILITARY COMMANDERS, SURVEILLANCE, RISK ANALYSIS, INFECTIOUS DISEASE TRANSMISSION, COOPERATION, MEDICAL PERSONNEL, THERAPY, STRATEGY, MONITORING, TRACKING, DIAGNOSIS(MEDICINE), CASE STUDIES
Identifiers: (U) *FORCE HEALTH PROTECTION, CIVILIAN MILITARY COOPERATION, PATIENT MANAGEMENT, CASUALTY MANAGEMENT, DISEASE PREVENTION, CLINICAL MANAGEMENT, EXPEDITIONARY MEDICAL SUPPORT, INFECTION CONTROL, EPIDEMIC PREVENTION, DISEASE CONTROL, CLINICAL DIAGNOSIS, TREATMENT, ENVIRONMENTAL SURVEILLANCE, REGIONAL COMBATANT COMMANDS
Distribution Statement: Approved for public release; distribution is unlimited.
Abstract: (U) Despite significant advances in medical research and treatment in the past century, infectious diseases remain among the leading causes of death worldwide. These diseases are appearing in places they have never been seen before or were thought to have been eradicated, are spreading faster and more frequently, and are posing an increasing global health threat that will affect national and international security in both the near- and long-term future, even affecting the success of U.S. military missions and operations. Force health protection is an urgent priority for the Department of Defense (DoD), as increasing threats of natural outbreaks of infectious disease could seriously undermine mission readiness and success. U.S. national security might be impacted by military operations in regions with endemic and epidemic occurrences of infectious disease, where disease activity may prevent the successful completion of a mission or operation or may even result in infected soldiers carrying a contagious disease back to the United States. Changing military doctrine and tactics call for a fresh approach to force protection. The purpose of this paper is to review important lessons that have been learned in the past, and to revisit the older but proven principles of force protection that are in danger of being forgotten in today's technology-focused military environment. Recognizing that infectious diseases could have a significant impact on military operations, this report provides a series of case studies that analyze health threats to each regional combatant command and presents both tactical and strategic recommendations that will better prepare the entire DoD for future outbreaks of disease. These recommendations focus on procedural changes that will allow the U.S. military to regain its competitive advantage.

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ADA449913
Use of DNA Microarrays to Identify Diagnostic Signature Transcriptional Profiles for Host Responses to Infectious Agents
Descriptive Note: Final addendum rept. 29 Sep 2004-30 Sep 2005
Personal Author(s): Ellner, J J, Connell, N D, Gallagher, G, Raveche, E
Report Date: Oct 2005
Media Count: 15   Page(s)
Descriptors: (U) *INFECTIOUS DISEASES, *BIOLOGICAL WARFARE AGENTS, CLINICAL MEDICINE, DEOXYRIBONUCLEIC ACIDS, IMMUNITY, TRANSCRIPTION(GENETICS), HOSTS(BIOLOGY), DIAGNOSIS(MEDICINE), PHYSIOLOGICAL EFFECTS, RESPONSE(BIOLOGY)
Identifiers: (U) MICROARRAYS
Distribution Statement: Approved for public release; distribution is unlimited.
Abstract: (U) Infections by agents of bioterrorism, especially bacterial agents such as Bacillus anthracis and Yersinia pestis present their initial symptoms in a way that does not reveal their identity or permit rapid diagnosis. However, as was shown in the recent anthrax attacks on the United States, rapid diagnosis can make the difference between life and death for the patient. Bacteria especially virulent bacteria, have a profound effect on the immune system of the human host. Cellular and physiological studies have shown that while many similarities exist in the host immune response to bacterial infection, there are distinctive features that represent classes of organism and, in some cases, individual organisms themselves. The current proposal was designed to use advanced techniques in molecular analysis to analyze the effect of individual biothreat agents on the human immune system.

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ADA449751
Distributed Biosurveillance Systems Using Sensible Agent Technology to Improve Coordination and Communication Among Decision-Makers
Descriptive Note: Conference paper
Personal Author(s): Barber, K S, Fullam, Karen, Graser, Thomas J, Han, David C, Kim, Joonoo, Lam, Dung, McKay, Ryan M, Park, Jisun, Vanzin, Marcelo
Report Date: 01 Oct 2005
Media Count: 8   Page(s)
Descriptors: (U) *COMMAND CONTROL COMMUNICATIONS, *DECISION MAKING, SYMPOSIA, HEALTH, RELIABILITY, BIOLOGICAL WARFARE, CHEMICAL WARFARE, INFECTIOUS DISEASES, EPIDEMIOLOGY, CHEMICAL AGENT DETECTORS, EARLY WARNING SYSTEMS
Identifiers: (U) BIOSURVEILLANCE, SA(SENSIBLE AGENT), MAS(MULTI-AGENT SYSTEM), COMPONENT REPORTS
Distribution Statement: Approved for public release; distribution is unlimited.
Abstract: (U) Protecting the population from chemical-biological attacks and outbreaks of infectious disease is a fundamental goal of health agencies, and early warning is critical for an effective response. However, such biosurveillance activities are inherently challenging due to the complexities involved in coordinating participants; determining the reliability of information; and drawing epidemiological conclusions. By applying Sensible Agent (SA) multi-agent system (MAS) technology to the biosurveillance domain, we can reduce the burden on the TDH epidemiologist by distributing and coordinating decision-making, as well as help the TDH manage the uncertainty of incoming data and understand how that uncertainty impacts resulting epidemiological assessments.

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ADA466189
Analytical and Characterization Studies of Organic Chemicals, Drugs and Drug Formulations
Descriptive Note: Annual rept. 11 Sep 2004-21 Sep 2005
Personal Author(s): Lim, Peter
Report Date: Oct 2005
Media Count: 11   Page(s)
Descriptors: (U) *PHYSICAL PROPERTIES, *FORMULATIONS, *INFECTIOUS DISEASES, *ORGANIC CHEMISTRY, *CHEMICAL ANALYSIS, *DRUGS, DEFENSE SYSTEMS, PARASITIC DISEASES, CHEMICAL WARFARE, DOSAGE, BIOLOGICAL WARFARE, CHEMICAL PROPERTIES
Identifiers: (U) ANTIPARASITIC DRUGS, CHEMICAL DEFENSE AGENTS, CHEMICAL ANALYSES, STABILITY STUDIES, FORMULATION DEVELOPMENT, DOSAGE FORMULATION MANUFACTURE
Distribution Statement: Approved for public release; distribution is unlimited.
Abstract: (U) During the annual contract period, September 22, 2004 to September 21, 2005, the project personnel continued to perform chemical/physical analyses on bulk pharmaceutical substances and formulated drug products, and to develop and (with borrowed labor) manufacture dosage formulations of interest to the USAMRMC Drug Development Program for parasitic and infectious diseases, chemical and biological defense, etc. Specific objectives were to design, develop, validate, and apply methods to determine chemical and physical characteristics of the bulk drugs, drug products, and to determine their stability under defined conditions, and to develop and to manufacture dosage formulations.

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ADA463824
Novel Therapeutic and Prophylactic Modalities to Protect the United States Armed Forces Against Major Biological Threat Agents
Descriptive Note: Annual rept. 29 Sep 2004-28 Sep 2005
Personal Author(s): Popov, Serguei G, Bradburne, Chris, Chung, Myung-Chul, Millis, Bryan, Nazarenko, Svetlana, Popova, Taissia G
Report Date: Oct 2005
Media Count: 78   Page(s)
Descriptors: (U) *BIOLOGICAL AGENTS, *BIOLOGICAL WARFARE, *BACILLUS ANTHRACIS, MILITARY FORCES(UNITED STATES), ACTIVATION, MOLECULES, THERAPY, LETHALITY, INFECTIOUS DISEASES, ANTHRAX, PEPTIDE HYDROLASES, HEMORRHAGE, TYROSINE, ABDOMEN, PHARMACOLOGY, TOXINS AND ANTITOXINS, PATHOGENESIS, CELLS(BIOLOGY), VIRULENCE, PHOSPHORUS TRANSFERASES, EDEMA, HEMOLYSIS, INHIBITION, HYPOTHESES, CYTOPLASM, SPORES, SUBSTRATES, THREATS, EPITHELIUM
Identifiers: (U) BIOLOGICAL WEAPONS, LETHAL TOXIN BLOCKERS, PROTEASE INHIBITORS, TOLL-LIKE RECEPTORS
Distribution Statement: Approved for public release; distribution is unlimited.
Abstract: (U) Secreted virulence factors in addition to lethal toxin (LT) play an important role in anthrax and have previously been identified by us as candidate targets of post-exposure therapies. However the molecular substrates and specific pathogenic mechanisms of these factors remain largely unknown. During the year 2005 the data generated using epithelial cells in culture and mice challenged with B. anthracis spores allow conclude that acceleration of ectodomain shedding by LT other proteolytic proteins and hemolysis represents a new previously unknown feature of anthrax infection. Secreted pathogenic factors of B. anthrax can cause ectodomain shedding likely resulting in protective barriers disruption and tissue penetration by bacilli. In addition proteolysis of the extracellular matrix can play signaling role as a mediator of lethality perturbing different mechanisms of the host defense response including the activation of TLRs. Data on pharmacological inhibition of shedding favor a hypothesis that activities of tested bacterial shedding inducers converge on the stimulation of cytoplasmic tyrosine kinases of the Syk family ultimately leading to activation of cellular sheddase. Both LT and poreforming hemolysin 0 transiently modulate ERK1/2 and p38 MAPK signaling pathways while JNK pathway seems to be irrelevant to accelerate shedding. The concerted acceleration of shedding by several virulence factors could represent a pathogenic mechanism contributing to hemorrhage edema and abdominal cell signaling during anthrax infection.

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ADA442945
The Thermal Stabilization of Vaccines Against Agents of Bioterrorism
Descriptive Note: Final rept. 4 Aug 2003-3 Aug 2005
Personal Author(s): Middaugh, C R
Report Date: Sep 2005
Media Count: 292   Page(s)
Descriptors: (U) *THERMAL STABILITY, *INFECTIOUS DISEASES, *ANTHRAX, *ADENOVIRUSES, *BIOLOGICAL WARFARE AGENTS, *VACCINES, *CLOSTRIDIUM BOTULINUM, *BIOTERRORISM, *BACTERIAL TOXINS, TERRORISTS, LIGHT SCATTERING, MILITARY PERSONNEL, FEVERS, PHASE DIAGRAMS, TULAREMIA, VARIOLA VIRUS, THERMAL INSTABILITY, VENEZUELAN EQUINE ENCEPHALOMYELITIS VIRUS, PLAGUES, STABILIZATION SYSTEMS, TOXINS AND ANTITOXINS, DICHROISM, BOUNDARIES, CHEMICAL ORDNANCE, FLUORESCENCE, BATTLEFIELDS, PHYSICAL PROPERTIES
Identifiers: (U) VALLEY FEVER, EXCIPIENTS
Distribution Statement: Approved for public release; distribution is unlimited.
Abstract: (U) Vaccines are without doubt the most powerful approach currently available for the prevention of the deleterious effects of toxins and infectious agents that might be used in a bioterrorism against civilians or military personnel. Recent disclosures have indicated that numerous countries/or terrorists organizations may possess biological weapons that could indeed be used for this purpose. Likely, agents include anthrax, botulinum toxin, smallpox, tularemia, plague, and Venezuelan equine encephalitis. With the exception of plague, vaccines exist for all these agents. Unfortunately, at least in the case of anthrax, the vaccine is very unstable and is inactivated at 37C, limiting the ability to deliver the vaccine under battlefield conditions. It is probable the other vaccines will display similar instability. It is believed that this stability issue needs to be addressed by a systematic, molecular approach. The work in this grant investigated a systematic approach to the stabilization of vaccines utilized for the protection of civilians and military personnel against potential bioterrorism agents. Adenovirus was used as a model organism to study degradative pathways in viruses that could be responsible for thermal instability. Recombinant protein vaccine candidates against anthrax and valley fever were studied as the initial candidates for stabilization. This approach utilized a variety of physical methods (2nd derivative UV absorption spectroscopy, intrinsic and extrinsic fluorescence, circular dichroism, dynamic light scattering, differential scanning calorimetry etc.) to identify the molecular event(s) responsible for degradation of the vaccine components. This information was used to generate empirical phase diagrams that define different stability states for each vaccine. Once regions of stability were identified, high-throughput screening assays were developed based on phase boundaries and used to screen libraries of excipients to identify potential stabilizers.

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ADA460105
Epidemic Outbreak Surveillance (EOS)
Descriptive Note: Annual rept. 1 Jul 2004-30 Jun 2005
Personal Author(s): Scofield, Thomas C
Report Date: Jul 2005
Media Count: 5   Page(s)
Descriptors: (U) *DIAGNOSIS(MEDICINE), *RESEARCH MANAGEMENT, *INFECTIOUS DISEASES, *PATHOGENIC MICROORGANISMS, *RESPIRATORY DISEASES, *EPIDEMICS, *SURVEILLANCE, RECRUITING, COMPUTER PERSONNEL, MEDICAL TECHNICIANS, NURSES, EPIDEMIOLOGY, COLLECTING METHODS, MEDICAL RESEARCH, PERSONNEL SELECTION, STANDARDIZATION, ADMINISTRATIVE PERSONNEL
Identifiers: (U) *EOS(EPIDEMIC OUTBREAK SURVEILLANCE), HEALTH SURVEILLANCE, SPECIMEN COLLECTION, SPECIMEN PROCESSING, RESPIRATORY INFECTIONS, RESPIRATORY TRACT PATHOGENS
Distribution Statement: Approved for public release; distribution is unlimited.
Abstract: (U) This funding was granted to The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc. (HJF) to provide the administrative, management, logistical, and programmatic services in collaboration with HQ, USAF/SGR in accordance with the statement of work and with tasks developed by the research. The goal of this project is to develop and test new technologies for the diagnosis and surveillance of respiratory tract pathogens. The funding supported the hiring of technical and administrative personnel necessary to carry out protocols to standardize methods of specimen collection and to optimize the processing of these specimens. After these processes were established, initial enrollment of healthy, ill, and recovered Basic Military Trainees (BMTs) began. In accordance with the statement of work, HJF successfully established administrative and programmatic support services to support the operations and management of the Epidemic Outbreak Surveillance (EOS) project. HJF continues to provide administrative, management, and programmatic support services as deemed necessary for implementation and as requested by HQ, USAF/SGR for the development of an integrated health surveillance venue focused upon epidemic outbreaks of acute respiratory disease (ARD) and other endemic and seasonal respiratory infections.

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ADA434626
International Biodefense Enhancement Capabilities from a Policy Perspective
Descriptive Note: Final rept. 18 Dec 2003-30 Apr 2005
Personal Author(s): Onaral, Banu
Report Date: May 2005
Media Count:91   Page(s)
Descriptors: (U) *THREATS, *INTERNATIONAL, *EARLY WARNING SYSTEMS, *HEALTH CARE MANAGEMENT, *BIOTERRORISM, SCENARIOS, OPTIMIZATION, POLICIES, EMERGENCIES, COMMUNITIES, STRATEGIC ANALYSIS, MODELS, CASUALTIES, CIVILIAN POPULATION, ARGENTINA
Identifiers: (U) SELF-ASSESSMENT, PREPAREDNESS, PANDEMIC
Distribution Statement: Approved for public release; distribution is unlimited.
Abstract: (U) Civilian populations across the world have a great deal to accomplish in the effort to enhance preparedness against potential mass casualty incidents. Strategies for Incident Preparedness: A National Model and the online Hospital Self-Assessment Tool (developed by CIMERC) will be made available in the Spanish language to address this global need. The need to provide strategic assessment and preparedness enhancement tools in diverse language sets was further underscored at the 2003 American Telemedicine Association meeting in Orlando, Florida. Major General Martinez-Lopez, during his speech at the International Day meeting, requested and encouraged international partnerships and ventures in the spirit of advancement. A partnership between CIMERC and eSalud Americas (formerly ERA Digital) to provide the Hospital Self-Assessment Tool and the Strategies for Incident Preparedness: A National Model for an international community represents one such opportunity. The proposed translation and adaptation effort and the implementation networking effort by eSalud Americas and CIMERC complements present efforts within Argentina. This collaboration and interaction with the Pan-American Health Organization will provide a major dissemination window starting with Argentina to the rest of Latin American cultures. Provision of the identified strategic tool will have an immediate impact on domestic and international preparedness for mass casualty incidents. CIMERC, presently a national biodefense repository, will begin to develop an international component that will invariably serve to complement both domestic and international emergency response practices.

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ADA471654
Maximum Utility for Limited Vaccine Stocks - A Case Study using Agent-based Modelling
Descriptive Note: Briefing charts
Personal Author(s): Forsyth, Adam, Fry, Ash
Report Date: 01 Oct 2003
Media Count: 23   Page(s)
Descriptors: (U) *COMPUTERIZED SIMULATION, *OPTIMIZATION, *VACCINES, *INOCULATION, SYMPOSIA, EPIDEMICS, INFECTIOUS DISEASE TRANSMISSION, CASE STUDIES, AUSTRALIA, IMMUNIZATION
Identifiers: (U) FOREIGN REPORTS, COMPONENT REPORTS
Distribution Statement: Approved for public release; distribution is unlimited.
Abstract: (U) Briefing on using agent-based modelling to determine the maximum utility for vaccine stocks.

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ADA419551
Use of DNA Microarrays to Identify Diagnostic Signature Transcriptional Profiles for Host Responses to Infectious Agents
Descriptive Note: Annual rept. 29 Sep 2002-28 Sep 2003
Personal Author(s): Ellner, Jerrold J,
Report Date: Oct 2003
Media Count: 32   Page(s)
Descriptors: (U) *INFECTIOUS DISEASES, *BIOLOGICAL WARFARE AGENTS, DEOXYRIBONUCLEIC ACIDS, DIAGNOSIS(MEDICINE), GENES, RESPONSE(BIOLOGY), INFLAMMATION, TUBERCULOSIS, YERSINIA PESTIS, BACILLUS ANTHRACIS, FRANCISCELLA TULARENSIS, BIOTERRORISM
Abstract: (U) Most of the likely agents of bio-terrorism have profound effects on the host and, in particular, on the immune and inflammatory responses. We have proposed a broad-based approach to identify the unique "signatures" of infectious agents using host DNA microarrays. Because of the known diverse patterns of host cell interactions with these organisms, examination of the host transcriptional response has enormous potential to allow rapid diagnosis of infectious diseases in general and agents of bio-terrorism in particular. Key signature genes will serve as the basis for rapid diagnostic approaches that could be accessed when an outbreak is suspected. The agents under initial investigation are Bacillus anthracis, Burkholderia Mallei, Francisella tularensis, multi- drug resistant Mycobacterium tuberculosis and Yersinia pestis. We have developed appropriate human and mouse models to explore the interactions of host cells with the pathogen.

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ADA421477
Was Smallpox Airborne? Implications for Biodefense
Descriptive Note: Briefing charts
Report Date: 10 Jun 2003
Media Count: 26   Page(s)
Descriptors: (U) *INFECTIOUS DISEASE TRANSMISSION, *VARIOLA VIRUS, SYMPOSIA, PREPARATION, AIRBORNE, INFECTIOUS DISEASES, HOSPITALS, BIOLOGICAL WARFARE AGENTS, BIOTERRORISM
Identifiers: (U) BRIEFING CHARTS, SMALLPOX, BIODEFENSE
Distribution Statement: Availability: This document is not available from DTIC in microfiche.
Abstract: (U) Presentation on the means of transmission in the case of an airborne version of the smallpox virus.

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ADA421476
Agents of Bioterrorism: Argument For and Against a List That Needs Cropping
Descriptive Note: Briefing charts
Personal Author(s): Weinberg, Arnold N
Report Date: 10 Jun 2003
Media Count: 10   Page(s)
Descriptors: (U) *BIOLOGICAL AGENTS, *CLASSIFICATION, SYMPOSIA, PREPARATION, BIOLOGICAL WARFARE, INFECTIOUS DISEASES, PATHOGENIC MATERIALS, BIOTERRORISM
Identifiers: (U) BRIEFING CHARTS
Abstract: (U) Presentation on the categorization of various pathogens which could be used as biological warfare agents.

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ADA432737
Rapid Identification and Strain-Typing of Respiratory Pathogens for Epidemic Surveillance
Personal Author(s): Ecker, David J, Sampath, Rangarajan, Blyn, Lawrence B, Samant, Vivek, Russell, Kevin, Freed, Nikki, Barrozo, Chris, Wu, Jianguo, Rudnick, Karl, Desai, Anjali
Report Date: 08 Apr 2003
Media Count: 13   Page(s)
Descriptors: (U) *STRAINS(BIOLOGY), *RESPIRATORY SYSTEM, *INFECTIOUS DISEASES, *PATHOGENIC MICROORGANISMS, *EPIDEMIOLOGY, TEST AND EVALUATION, MILITARY PERSONNEL, REAL TIME, BACTERIA, IDENTIFICATION, ETIOLOGY, RECURSIVE FUNCTIONS, SAMPLING, IONIZATION, GENES, PATIENTS, CIVILIAN POPULATION, AMPLIFICATION, MEDICAL SERVICES, SURVEILLANCE, RESPIRATORY DISEASES, PNEUMONIA, MASS SPECTROMETRY, LOCUS
Identifiers: (U) 6609
Distribution Statement: Approved for public release; distribution is unlimited., Availability: This document is not available from DTIC in microfiche.
Abstract: (U) Epidemic respiratory infections are responsible for extensive morbidity and mortality within both military and civilian populations. We describe a methodology to examine respiratory samples that simultaneously identifies broad groups of bacteria. The process uses electrospray ionization mass spectrometry and base composition analysis of broad-range PCK amplification products. The base composition analyses from a small set of broad-range primer pairs are used to "triangulate" the identity of pathogenic organisms present in the sample. Once a species has been identified, the rapid recursive use of species-specific primers to housekeeping genes allows strain-typing. This strategy was used to examine samples from military recruits sickened in a recent Group A streptococcal (GAS) pneumonia outbreak (MMWK 52, 6, p106-109, 2003). The strain-typing results were essentially identical to those obtained using classic emm typing and Multi Locus Sequence Typing. This method allows real-time evaluation of patient samples and will make possible more rapid and appropriate treatment of patients in an ongoing epidemic, regardless of the etiology, in a time frame not previously achievable.

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ADA410758
Rapid Detection of Cellular Responses to Biological Agents
Descriptive Note: Annual rept. 1 Oct 2001-30 Sep 2002
Personal Author(s): Williams, Bryan R G
Report Date: Feb 2003
Media Count: 14   Page(s)
Descriptors: (U) *BIOLOGICAL WARFARE AGENTS, DETECTION, BACTERIA, PROTEINS, ARRAYS, GENES, EXPOSURE(PHYSIOLOGY), RESPONSE(BIOLOGY), INFECTIOUS DISEASES, VIRUSES, CELLS(BIOLOGY)
Identifiers: (U) SIGNAL TRANSDUCTION, MICROARRAYS, TRANSCRIPTS
Abstract: (U) Our program objective is to develop simple and rapid methods for detecting, at a cellular level, individual responses to environmental stresses elaborated by exposure to infectious agents such as bacteria and viruses. Our methods are based on transcript profiling and post-translational modification of proteins involved in signal transduction. Our hypothesis is that human cells respond to infectious insults to a genetically predetermined extent by stimulating the expression of sets of genes and activating signaling pathways that provide a specific signature for a given agent. We propose that this response will determine the outcome of the infection. We will test this hypothesis by developing custom cDNA and protein arrays designed to detect cellular responses to infectious agents. These will be tested using RNA and protein isolated from tissues sources most likely to be exposed. Our methods will allow development of rapid quantitative detection devices to measure exposure and response to biological warfare, bioterrorism or emerging agents enabling appropriate triaging and medical intervention to save lives and to avoid unnecessary treatments.

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ADA410484
Development of Potent Orally Active Agents for Prevention and Treatment of Poxvirus Infection
Descriptive Note: Annual rept. 1 Oct 2001-30 Sep 2002
Personal Author(s): Hostetler, Karl Y, Beadle, James R
Report Date: Nov 2002
Media Count: 67   Page(s)
Descriptors: (U) *INFECTIOUS DISEASES, *ANTIVIRAL AGENTS, *POX VIRUSES, NORTH KOREA, IRAQ, SAFETY, RUSSIA, IRAN, TERRORISM, IMMUNIZATION, PROTECTIVE TREATMENTS, VARIOLA VIRUS, INTERCONTINENTAL BALLISTIC MISSILES
Abstract: (U) Smallpox (variola major) is estimated to have killed a billion persons over the past 200 years. Vaccination eliminated the disease from the earth in the late 1 970s (WHO) but stocks of smallpox have been retained by the US and Russia at safe locations. However, rogue states such as Iraq, North Korea, Iran or terrorist groups may also have stocks of smallpox which could be used in biowarfare or bioterrorism. In the late 80s, Russia produced tons of variola, India-i, for use in long range ICBMs (Alibek) and it is uncertain what has become of those stocks and the thousands of persons trained to produce the variola virus.

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ADA480091
Federal and State Responses to Biological Attacks: Isolation and Quarantine Authority
Personal Author(s): Welborn, Angie A
Report Date: 22 Jul 2002
Media Count: 12   Page(s)
Descriptors: (U) *BIOLOGICAL WARFARE, *FEDERAL LAW, *STATE LAW, *QUARANTINE, UNITED STATES GOVERNMENT, BIOLOGICAL AGENTS, FOREIGN, SKILLS, INFECTIOUS DISEASES, LAW ENFORCEMENT, COMMUNICABLE DISEASES, LOCAL GOVERNMENT, EPIDEMIOLOGY, TERRORISM, REGULATIONS, ATTACK, DISEASES, POPULATION, RESPONSE
Identifiers: (U) MODEL STATE EMERGENCY HEALTH POWERS ACT
Distribution Statement: Approved for public release; distribution is unlimited.
Abstract: (U) In the wake of the September 11 attacks, federal, state and local governments have become increasingly aware of the need for an effective response to future terrorist activities. Of significant concern is the government's ability to respond to a biological attack, including the introduction of an infectious or contagious disease into a population. An effective response could include the isolation of persons exposed to infectious biological agents or infected with a communicable disease as a result of the attacks, as well as the quarantine of certain states, cities, or neighborhoods. Currently, state and local governments have the primary authority to control the spread of dangerous diseases within their jurisdiction, with the federal government's role limited to interstate and foreign quarantine. However, many states have inadequate procedures in place for isolating individuals who are infected or believed to be infected and quarantining areas that are or may be infected. Generally, the laws currently in effect do not address the spread of disease resulting from a biological attack, and for the most part only address specific diseases that were the cause of past epidemics. In light of recent events, many states are reevaluating their public health emergency response plans and are expected to enact more comprehensive regulations relating to isolation and quarantine in the event of a biological attack. Public health experts have developed a Model State Emergency Health Powers Act to guide states as they reevaluate their plans. This report provides an overview of federal and state quarantine laws as they relate to the isolation or quarantine of individuals, as well as a discussion of the relevant case law. The Model State Emergency Health Powers Act is also discussed.

 

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ADA403988
Epidemics Don't Cause Wars, But They Can End 'Em
Descriptive Note: Student research paper
Personal Author(s): Carlberg, Matthew A
Report Date: Jul 2002
Media Count: 51   Page(s)
Descriptors: (U) *BIOLOGICAL WARFARE, *EPIDEMIOLOGY, MILITARY FORCES(UNITED STATES), DEPLOYMENT, NATIONAL SECURITY, SUBSAHARAN AFRICA, THREATS, CHEMICAL ORDNANCE, INFECTIOUS DISEASES, MEDICAL RESEARCH, ANTIBIOTICS
Abstract: (U) Epidemics are a recognized threat to national security. It is assumed that an epidemic can spark a war. The causes of war are complex. There is little evidence to support the concept of disease being a direct cause. History suggests that wars cause epidemics. War cause theorists propose numerous social, political, and economic causes for war, without postulating that epidemics lead to war. Epidemics do cause MOOTW. In an era of concern over biological and chemical weapons, naturally occurring diseases remain a serious threat to deployed military forces. Epidemics threaten national security by impacting the economic, political, and social aspects of national power. The AIDS epidemic in Sub-Saharan Africa bears stark witness to the magnitude of this threat. It also offers the opportunity for prospective study of the relationship between epidemics, state failures, and wars. There are roughly 54 million deaths annually worldwide from infectious diseases. Half of these deaths occur in Sub-Saharan Africa. The litany of resurgent and emerging infectious diseases, coupled with the phenomenon of antibiotic resistance, bring to light the magnitude of the threat both to national security and deployed forces.

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ADA406608
Bioterrorism - Medical Preparedness
Descriptive Note: Research rept.
Personal Author(s): Atkins, Garry F
Report Date: 09 Apr 2002
Media Count: 40   Page(s)
Descriptors: (U) *MEDICAL SERVICES, *BIOLOGICAL WARFARE AGENTS, *DOMESTIC TERRORISM, LOGISTICS SUPPORT, DEPARTMENT OF DEFENSE, DETECTION, LEADERSHIP, PREPARATION, INFECTIOUS DISEASES, ANTHRAX, PUBLIC HEALTH, VARIOLA VIRUS, INFRASTRUCTURE, HEALTH CARE MANAGEMENT
Identifiers: (U) *BIOTERRORISM, *MEDICAL PREPAREDNESS, STRATEGY RESEARCH PROJECT
Abstract: (U) This strategic research paper re-enforces the urgent need for preparing our medical health care infrastructure to be able to respond effectively against a bioterrorist attack. This paper further isolates shortcomings in the health care system and identifies where the Department of Defense can assist our federal, state, and local communities with their preparedness issues and their ability to respond to a bioterrorist attack. The recommendations include a discussion outlining potential improvements in the key health community issue areas of Leadership, Policy and Communication; Facilities and Logistics; Training and Education; and Detection and Response.

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ADA468243
Next Generation Bioweapons: The Technology of Genetic Engineering Applied to Biowarfare and Bioterrorism
Personal Author(s): Ainscough, Michael J
Report Date: Apr 2002
Media Count: 49   Page(s)
Descriptors: (U) *BIOLOGICAL AGENTS, *GENETIC ENGINEERING, *BIOTERRORISM, WARFARE, COMBAT EFFECTIVENESS, DISEASES, HISTORY, GENES, LOSSES, CHEMICAL ORDNANCE, DRUGS, NONCOMBATANT, INFLUENZA, CATASTROPHIC CONDITIONS, INFECTIOUS DISEASES, TRANSFER, WOUNDS AND INJURIES, BIOLOGICAL WARFARE, DEOXYRIBONUCLEIC ACIDS, SURVIVABILITY, GLOBAL
Distribution Statement: Approved for public release; distribution is unlimited.
Abstract: (U) The history of warfare and the history of disease are unquestionably interwoven. Throughout the history of warfare, disease and non-battle injury have accounted for more deaths and loss of combat capability than from actual battle in war itself. The most striking example is the great influenza pandemic during World War I that killed 20 million people or more worldwide in 1918. Although this was a naturally occurring event, what if a country could create a biological agent that could yield the same catastrophic loss of life on the enemy? That, in essence, is the potential effect of applying genetic engineering for biological warfare (BW) or bioterrorism (BT). Today, we face not only natural diseases (including emerging infectious diseases), but also threats of BW or BT, possibly with genetically engineered agents, that may resist known therapies. In simple terms, genetic engineering is the process of human%an intervention to transfer functional genes (DNA) between two biological organisms. In the BW/BT context, it is the manipulation of genes to create new pathogenic characteristics (increased survivability, infectivity, violence, drug resistance, etc). Organisms with altered characteristics are the "new generation" biological weapons.

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ADA429519
Transporting Patients with Lethal Contagious Infections
Descriptive Note: Journal article
Personal Author(s): Swartz, Colleen
Report Date: Apr 2002
Media Count: 4   Page(s)
Descriptors: (U) *MILITARY MEDICINE, *INFECTIOUS DISEASES, *AEROMEDICAL EVACUATION, MILITARY FORCES(UNITED STATES), REPRINTS, MILITARY PERSONNEL, BIOLOGICAL AGENTS, ARMY FACILITIES, TEAMS(PERSONNEL), ISOLATION, IDENTIFICATION, LETHALITY, PATIENTS, MEDICAL SERVICES, BIOLOGICAL WARFARE AGENTS, AIR TRANSPORTATION, COMMUNICABLE DISEASES
Identifiers: (U) *CONTAGIOUS INFECTIONS, AIT(AEROMEDICAL ISOLATION TEAM), AIR EVACUATION, HEALTH CARE PROFESSIONALS
Distribution Statement: Availability: This document is not available from DTIC in microfiche.
Abstract: (U) The Aeromedical Isolation Team (AIT) is maintained undet the command of COL Edward M. Eitzen, Jr., at the United States Army Medical Institute of Infectious Diseases (USAMRIID), located at Fort Detrick, Maryland. The AIT is a unique military medical team capable of worldwide air evacuation and management of a limited number of patients who are potentially exposed to known and unknown lethal communicable diseases or biological agents. The mission of the AIT is worldwide air evacuation of these types of patients under the highest level of biological containment to USAMRIID for definitive medical treatment. using a specialized method of air evacuation, the team assists with the early identification of highly contagious diseases or suspected biological warfare agents and provides information used to develop early treatment recommendations for health care professionals.

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ADA419113
Large Epidemic of Respiratory Illness Due to Adenovirus Types 7 and 3 in Healthy Young Adults
Descriptive Note: Rept. for Aug-Dec 1997
Personal Author(s): Ryan, Margaret A, Gray, Gregory C, Smith, Besa, McKeehan, Jamie A, Hawksworth, Anthony W
Report Date: 01 Mar 2002
Media Count: 8   Page(s)
Descriptors: (U) *ADENOVIRUSES, *RESPIRATORY DISEASES, LABORATORY TESTS, NAVAL PERSONNEL, INFECTIOUS DISEASES, NAVAL SHORE FACILITIES, ADULTS, EPIDEMIOLOGY, VACCINES, MORBIDITY, ILLINOIS
Identifiers: (U) NAVAL RECRUIT TRAINING COMMAND, GREAT LAKES(ILLINOIS), WU6609
Abstract: (U) This epidemic at the Naval Recruit Training Command in Great Lakes, IL in 1997, was the largest outbreak of adenovirus types 7 and 3 reported in recent history. Surveillance for disease, special laboratory testing, and linking of many large data sources allowed for clinical characterization and description of epidemiologic risk factors for adult adenovirus infections. The outbreak also portends challenges for the military until adenovirus vaccine production is reestablished.

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ADA402898
Modeling Man-Made Epidemics
Descriptive Note: Master's thesis
Personal Author(s): Paterson, Ryan
Report Date: Mar 2002
Media Count: 76   Page(s)
Descriptors: (U) *MATHEMATICAL MODELS, *BIOLOGICAL WARFARE, *EPIDEMIOLOGY, LAND WARFARE, STOCHASTIC PROCESSES, INTERACTIONS, THESES, MANMADE, HETEROGENEITY, POSTURE(GENERAL), HEMORRHAGIC FEVERS, MILITARY ORGANIZATIONS, IMMUNIZATION, FORMULAS(MATHEMATICS), QUARANTINE, POX VIRUSES
Identifiers: (U) GCE(GROUND COMBAT ELEMENT), MEU(MARINE EXPEDITIONARY UNIT)
Abstract: (U) This thesis develops a mathematical model to explore epidemic spread through the Ground Combat Element (GCE) of the Marine Expeditionary Unit (MEU). The model will simulate an epidemic caused by a biological attack using an agent that has the ability to spread through person-to-person contact (small pox hemorrhagic fever, etc.) A stochastic modeling process will be used along with widely accepted mathematical formulas an SEIR (Susceptible- Exposed-Infectious-Removed) epidemic model. A heterogeneous population composed of numerous homogenous subgroups with varying interaction rates simulates the unique structure of military combat units. The model will be evaluated to determine which units facilitate the most rapid spread of the epidemic. The model will then test a number of different scenarios to determine the effects of varying quarantine techniques, vaccination strategies and protective postures on the spread of the diseases.

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ADP013456
Protecting First Responders to Act of Terrorism
Personal Author(s): Deitchman, Scott
Report Date: Sep 2001
Media Count: 7   Page(s)
Descriptors: (U) *CRISIS MANAGEMENT, *PUBLIC SAFETY, *BIOTERRORISM, *CHEMICAL AGENT TERRORISM, PREPARATION, TRAINING, RESPONSE, INFECTIOUS DISEASES, HAZARDOUS MATERIALS
Identifiers: (U) COMPONENT REPORT, FIRST RESPONDERS
Abstract: (U) An act of chemical or biological terrorism will require appropriate measures to protect first responders from exposure to hazardous substances or infection by biological agents. Some of the safety challenges are common to more conventional disasters such as industrial chemical spills or natural disease outbreaks, although terrorism response pose some unique challenges as well. These challenges can be met, but require advance planning to ensure that the necessary equipment, procedures, and collaborative relationships are available in the time of crisis.

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ADP013431
The Need for Creation of the International Center in Novosibirsk, Russia for Combating Infectious Diseases and Bioterrorism Threat in Asia
Personal Author(s): Netesov, Sergey V, Sandakhchiev, Lev S
Report Date: Sep 2001
Media Count: 10   Page(s)
Descriptors: (U) *INFECTIOUS DISEASES, *BIOLOGICAL WARFARE AGENTS, CONTROL CENTERS, RUSSIA, INTERNATIONAL, VIRUSES, ASIA, VIROLOGY
Identifiers: (U) COMPONENT REPORTS, FOREIGN REPORTS, BIOTERRORISM
Abstract: (U) Our State Research Center of Virology and Biotechnology VECTOR was established back in 1974 as an All-Union Scientific Research Institute of Molecular Biology 1. Its task was to conduct basic and applied research on extremely pathogenic viral agents such as less- studied Marburg, Ebola, Lassa and other viruses related to potential BW agents in order to evaluate the potential threat posed by these agents and develop means of their diagnostics, prevention, and therapy. Maximum biological containment laboratory facilities, the most modem in Russia, were built as well as an engineering infrastructure and a set of scientific and supporting capabilities. The total area of existing buildings and facilities amounted to 250,000 square meters.

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ADP013442
Rehabilitation After a Chem/Bio Incident
Personal Author(s): Webber, June
Report Date: Sep 2001
Media Count: 2   Page(s)
Descriptors: (U) *BIOLOGICAL WARFARE AGENTS, *REHABILITATION, *CHEMICAL WARFARE AGENTS, CASUALTIES, PHOSGENE, WOUNDS AND INJURIES, INFECTIOUS DISEASES, MEDICAL SERVICES, CATASTROPHIC CONDITIONS, NERVE AGENTS, BURNS(INJURIES), CHOKING AGENTS
Identifiers: (U) COMPONENT REPORTS
Abstract: (U) After a chemical/biological incident, triage and initial treatment will need to be followed by extensive periods of rehabilitation, in respiratory, cardiac, wound care, pain and psychiatry orthopedic, stroke, spinal cord, and head injury. The areas of most concern will be dependent on the agent used. If mustard is used, rehabilitation will be similar to burn patients with the emphasis on care of the skin, respiratory function and eye care. The effects on heart muscle and therefore cardiac function will also be a priority, but this care will be similar to those with cardiac problems without a chemical/biological event. As the skin is the first barrier to infection, care of wounds will be ongoing until healed. Skin heals in a progressive, structured way, and again this will be the same without a chemical/biological event. If phosgene or choking agents were used, respiratory care will be a priority, and an ongoing rehab concern. Respiratory care will be a continuation of initial treatments, with the addition of breathing exercises to enhance the ability of remaining lung tissue to be productive. Cardiac rehab will be essential to enhance the viable heart muscle with the goal of improving cardiac output. If nerve agents are used the effects on behavior including paranoia, as well as catastrophic victim behaviors of shock, depression, helplessness, and loss of life as it was prior to the incident.

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ADA398223
Analytical and Characterization Studies of Organic Chemicals, Drugs, and Drug Formulation
Descriptive Note: Annual rept. 1 Jul 2000-30 Jun 2001
Personal Author(s): Lim, Peter
Report Date: Jul 2001
Media Count: 8   Page(s)
Descriptors: (U) *CHEMICAL ANALYSIS, *FORMULATIONS(CHEMISTRY), *ANTIPARASITIC DRUGS, DEFENSE SYSTEMS, CHEMICAL PROPERTIES, PHYSICAL PROPERTIES, BIOLOGICAL WARFARE, CHEMICAL WARFARE, INFECTIOUS DISEASES, PHARMACOLOGY, VACCINES, PARASITIC DISEASES
Identifiers: (U) STABILITY STUDIES
Abstract: (U) During the annual contract period, 1 July 2000 to 30 June 2001,the project personnel continued to perform chemical/physical analyses on bulk pharmaceutical substances and formulated drug products of interest to the USAMRMC Drug Development Program for parasitic and infectious diseases, chemical and biological defense, etc. Specific objectives were to design, develop, validate, and apply methods to determine chemical and physical characterisitics of bulk drugs, drug products, and to determine their stability under defined storage conditions. Special projects include verification of the absence of squalene in vaccine products.

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ADA407578
The Anthrax Vaccine Debate: A Medical Review for Commanders
Descriptive Note: Counterproliferation paper
Personal Author(s): Hersack, Richard A
Report Date: 01 Apr 2001
Media Count: 71   Page(s)
Descriptors: (U) *ANTHRAX, *IMMUNIZATION, *VACCINES, MILITARY PERSONNEL, DEPARTMENT OF DEFENSE, POLICIES, AEROSOLS, RISK, DECISION MAKING, EXPOSURE(GENERAL), BACTERIA, CLINICAL MEDICINE, SIGNS AND SYMPTOMS, SAFETY, BIOLOGICAL WARFARE, LETHALITY, INFECTIOUS DISEASES, DRUGS, MEDICAL RESEARCH, MILITARY COMMANDERS, ANTIGENS, INHALATION, SKIN DISEASES
Identifiers: (U) USAF COUNTERPROLIFERATION CENTER, THE COUNTERPROLIFERATION PAPERS SERIES
Abstract: (U) There are two distinct yet related aspects to the debate over the safety and efficacy of the anthrax vaccine. An assessment of the clinical safety and efficacy of the anthrax vaccine. The policy level decision to vaccinate military personnel based on intelligence reports and assessments. The policy decision to vaccinate is based on an assessment of relative risk. The risk to an individual of developing side effects and complications after vaccination versus, the risk that Defense Department (DoD) personnel may be exposed to anthrax during an attack. Anthrax causes disease in humans through three mechanisms: cutaneous, gastrointestinal, inhalation. Cutaneous anthrax occurs primarily in unvaccinated workers in goat hair and wool factories. Veterinary practices and vaccination have eliminated anthrax infection as an occupational risk. Inhalation anthrax is the most lethal. Death occurs in nearly 100 percent of victims with symptoms. Inhalation anthrax is the 100% most likely to be used in biological weapons. Requires aerosolization of anthrax spores down to the proper particulate size for inhalation. Aerosolization of anthrax spores is technically difficult to achieve.

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