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The below summarizes 66 presentations from podium and poster provided in 5 Sectors containing 14 Sessions. Formatting for each summary was at the discretion of each Sector Chair. It took many professionals working many, many "volunteer" hours to make this 16th meeting the success that it was. In addition to the Sector Chairs/Co-Chairs, other "volunteers" are listed following the summaries. Our most sincere CBMTS thanks to all of them.The CBMTS Industry VI and the 5th World Congress CBR and Terrorism; 5-10 April 2009, Cavtat, Dubrovnik, CroatiaExecutive Summary
SECTOR 1: Chemical Threats The Chemical Threats Sector was comprised of 4 Sessions, #s 1, 2, 5, 9.Session 1 opened with a discussion on how the United Nations responds to allegations of chemical and biological weapons use. The OPCW investigates alleged use of chemical weapons and in case the alleged use involves a State not Party to the CWC, the OPCW would closely cooperate with the Secretary-General of the United Nations. With the current focus in the biological weapons area, the UN roster for BW investigations of alleged use includes 96 scientists and medical professionals and several laboratories. The second speaker described how the US EPA's approach to decontamination and consequence management has evolved. The speaker highlighted some of the difficulties in determining scientifically, economically, and politically how clean is clean enough and the importance of risk communication to the process. The concept of "message mapping" was presented as an example of improved risk communication. The next speaker provided an update on the status of the US Strategic National Stockpile, which has expanded tremendously since its inception in 1999. Government-private entity partnerships have allowed critically-needed supplies to be maintained under continuously monitored conditions and delivered rapidly when needed. The final speaker of this Session described changes in the CBRN military threat. While the threat of chemical, biological or radiological terrorism has dramatically increased over the past 15 years, the threat of chemical weapons use against military units has decreased. This decreased use is due to improved detection, physical protection devices and the Chemical Weapons Convention. The biggest deterrent to CW use now is the fact that the troops are protected, rendering their use of limited value. The speaker concluded that due to the decreased risk, costs could be decreased, for example, by soldiers carrying fewer replacement filter cartridges. Session 2Our first speaker in Session 2 discussed the inadequacies of current emergency exposure guidelines, which consider the most vulnerable populations and build in orders of magnitude of protection factors for uncertainties between animal studies and human risk. New models focusing on effects of chemicals on the average person predict far fewer casualties and less toxicity in chemical release scenarios. The second speaker provided an overview of the Czech oxime development program. A unique 3 chambered auto-injector oxime has been developed and is undergoing final certification. Another oxime/ K027, has proven to be an excellent antidote for all OP pesticides tested. The next talk focused on the use of small quaternary AChE inhibitors. These compounds can reduce mortality when provided prophylactically. While roughly 60 compounds have been synthesized, there are still problems with poor selectivity between AChE and BChE. Toxicity evaluations are underway with several compounds. The following speaker discussed the limitations of the current knowledge set regarding long-term effects of nerve gents, particularly at exposures insufficient to cause convulsions, and described the US Army's program at behavioral research in non-human primates exposed to nerve agents. The last speaker in this Session discussed the use of fire-fighting foams to cover CW agents and their efficacy in preventing air dispersal of the agents. In selected cases, the foams can neutralize nerve agents, rendering them non-toxic. The advantage of such foams is that they are routinely carried by fire-fighting units and thus widely available. Session 5 The first speaker addressed the protection measures necessary while treating CWA casualties. Over time, CW vapors can build up in collective protection (COLPRO) environments. Methods to keep concentrations low include: improved decontamination of casualties before they arrive at the COLPRO decon line; improved COLPRO ventilation, and regeneration of cleaner air inside the COLPRO through use of active charcoal. Charcoal-containing curtains, blankets, shower caps and surgical masks can be used to decrease CW vapor exposures to both casualties and personnel. Field tests of such devices have been successful. The second speaker discussed the long-term effects of chemical weapons on health in Kurdistan, Iraq. He discussed the various classes of chemical agents employed against the population along with the acute effects and presented evidence of CW use in the area. He confronted the audience with a study of long tern effects of CWA on a woman who went through a series of heavy health problems finally leading to her death. The final speaker described a system of chemical sensing underclothing for the testing of personal protection equipment (PPE) and for training. The system employs fluorescein and KBr, which change colors upon contact with CW/Sim vapors. The advantage over traditional discrete samplers is that the clothing continuously serves to detect CW/Sim having broken through PPE. A sophisticated optical measuring system called LUCY is well suited for testing parts or whole systems of PPE, clearly demonstrating the hazard generated by wearing PPE trousers over boots. The system could improve confidence among personnel who must wear PPE in hazardous surroundings. Session 9 The first speaker in the last Chemical Threats session spoke about the problems surrounding dumped chemical munitions in large bodies of water around the globe. He addressed shortages in record keeping, the problems posed by great depths, and the fact that archival documents are in many languages. He discussed the impact of these munitions on the laying of pipelines in the sea and some of the environmental and physical chemistry issues surrounding these arms, as well as delivery techniques. The next presenter discussed native and tab-inhibited cholinesterase interactions with oximes and noted the differences in active sites of AChE versus BChE. The Croatian research program has tested has tested numerous oximes with varying ring structures. Oximes with para-structures show high reactivation. Reactivation of AChE is generally faster and more complete than that of BChE. Tabun-inhibited BChE is resistant to reactivation. The last speaker of this session addressed the role that toxic industrial chemicals (TICS) may play in asymmetric warfare. TICS may be readily employed against urban targets. Unfortunately, lists of high threat chemicals and publication of accident investigations may actually facilitate the choices of substances for terrorist use. While there are relatively few reports of TICS used in terrorism to date, Bhopal, the chlorine rail car accident in South Carolina and the Russian military assault on a Moscow theater demonstrate how such agents may be used in asymmetric warfare. Computer modeling of outdoor releases demonstrates how an attack might take stand-off distance and dilution into consideration. SECTOR II: Biological/Radiological Threat (Bio/Rad) For the purposes of this summary, the presentations from Sessions 3 and 10 will be grouped into four major areas with an additional short summary on Croatian Nuclear Regulations:
Diagnosis/Detection:The technologies applicable to the identification of biological threat agents are continually expanding and include the use of phage as an indicator and the real-time measurement of electron transfer reactions using cytochrome as an indicator. Specific phage strains have a long history of application as a simple, rapid procedure for the confirmatory identification of anthrax strains in mammalian and environmental samples. Recent advances in real-time polymerase chain reactions (real-time PCR) have tended to eclipse the use of phage, but anticipated cost savings related to PCR have not been realized. PCR, while extremely sensitive, remains a relatively expensive, sophisticated technique which is not relevant to all identification situations. The use of phage typing procedures will be able to augment PCR for certain uses. Phage techniques require the identification of stable, lytic phage strains with the proper specificity for the intended use. The selection of a phage strain with either a narrow or a broad host range within the species of bacterium is possible depending on the intended purpose of the phage. A number of physiologically active compounds including toxins and endocrine disrupters can react with cytochrome P450 to produce an electrical signal. This observation was optimized to detect 2, 4-dichlorophenol in real time. The device was fabricated with genetically engineered cytochrome imprinted on carbon electrode chips modified with polypyrrole-gold nanoparticles. The device was able detect 2,4-dichlorophenol at a level of 43 ng/L. This is lower than both the EU's published limits for ground water and the USA limits for drinking water. This device offers significant advantages in time and ease of sample preparation over the current chromatographic methods. Treatment/Prevention:Several strategies have been proposed to reduce the occurrence of disease and death following a bioterrorism/biowarfare attack. Prominent among these are active and passive immunization. The use of vaccines to produce active immunity has a number of pitfalls: predicting the agent to be used far in advance of the attack, the cost of vaccinating large populations, compliance of the target population in receiving the immunization(s), and the adverse publicity following the occurrence of temporally, rather than casualty, related adverse events. A more politically and economically feasible strategy would be the targeted delivery of immune antibodies to exposed individuals. By using a patented procedure fully human monoclonal antibodies have been produced. They have known optimal specificity and affinity properties and should reduce the opportunity for antigenic cross reactions in the recipient. Currently, monoclonals for anthrax and orthopox viruses are in development with the antibodies for the lethal factor of Bacillus anthracis (LF) scheduled to enter phase 1 clinical trials in the near future. The orthopox antibody is expected to be broadly reactive against members of this group of viruses including both smallpox and monkeypox. A synergistic effect has occurred when antibodies against protective factor and lethal factor are combined to treat infected experimental animals. Decontamination:The use of aqueous solutions treated with a low temperature plasma source so that the solution contained peroxides and active radicals resulted in the solution developing decontamination and neutralization properties. The solution was able to decontaminate aqueous media inoculated with pathogenic microorganisms and viruses. The system can be tailored for the specific intended application thus minimizing the power requirement. Combined with filtration, this will provide a reliable, low cost procedure for the decontamination of a broad range of aqueous solutions and thus improve the safety and health of populations. Both bacteriophage and phage lytic enzymes offer promise for the decontamination of hospital, jail and other areas proven or suspected to be contaminated with a specific bacterial species. TB and MRSA are examples. Bacteriophage are very specific, highly active viruses which only infect bacteria. They are active against antibiotic resistant strains of bacteria, and bacteria have not been proven to develop resistance to the phage. In another potential application, if phage and/or lytic enzymes can be used to replace antibiotics in animal feed and in aquaculture as a decontaminant to reduce disease one of the major sources of antibiotic resistant bacteria will be eliminated. Pathology/Agent Delivery:A serious emerging pathogen is the H5N1 strain of highly pathogenic avian influenza virus (HPAI). Its pandemic potential has been compared to the 1918 Strain which killed millions of humans in a world-wide epidemic. The HPAI virus has not yet developed the capability to spread from person-to-person which is the only attribute necessary to initiate a new influenza pandemic. The virulence of the H5N1 Strain equates with that seen with the 1918 Strain. Mice infected with three Russian strains of H5N1 by the intranasal route showed severe leucopenia and generalized damage to the hemapoetic system. The lung lesions were focal in nature and consisted of alterations to the vasculature and severe damage to the epithelium. The virus produced little direct damage to the lung indicating that the principal cause of the observed pathogenesis was a result of host response to the virus. An analogous observation has been made following inoculation of the 1918 Strain in experimental animals. The anticipated dispersion of a toxic substance following a release is critical to providing effective, prompt response to victims and individuals living or working in the affected area. Predictive models have been generated in the past but were controversial and lacked the necessary precision to guide first responders. The Hazard Prediction and Assessment Capability (HPAC) software system incorporates high-resolution weather forecasts and atmospheric transport and dispersion analyses to model the extent of the hazardous area. By incorporating the physical, chemical, and biological characteristics of the biotoxin of interest into the HPAC the concentration of the toxic substance within the area can be estimated. Since increased levels of contamination in certain areas would be expected to produce more casualties, the use of the HPAC system will allow for a more efficient application of the first responder assets. Nuclear Safety Regulations:The Nuclear Safety Regulations of Croatia have been a set of Acts and Ordinances evolving over the past three years. They have been promulgated and are being enforced by the State Office on Nuclear Safety (SONS). The existing laws cover the requirements for the control of nuclear material, filing for a license to conduct nuclear activities, guidance for keeping records of nuclear material, nuclear activities, and special equipment. SONS also enforces laws on safety and security as they apply to siting, design, construction, use and decomissioning of a facility where nuclear activity is performed. According to the current Acts and Ordinances, the SONS has a complete overview of facilities where nuclear activities are performed from the initiation of the concept through its life until the decomissioning and decontamination are complete. SECTOR III: Emerging Threats, Medical, Biosafety/Biosecurity Sector III with Sessions 6, 8, and 13, included presentations on topics covering emerging infectious diseases and medical countermeasures research and development, institutional biosafety and biosecurity programs, threat posed by advanced biotechnology research, and a private sector technology showcase. Presentation summaries are provided by the Sector topical areas that include (a) Emerging Threats and Medical Countermeasures, (b) Biosafety/Biosecurity, and (c) Technical Advances in the Private Sector. Emerging Threats and Medical Countermeasures:Presentations covering public health related CBRNE challenges as they pertain to medical countermeasures development and management touched a broad array of topics ranging from emerging infectious diseases and re-emerging infectious diseases; approaches to develop and deploy an integrated disease surveillance systems that covers the broader biological threats related challenges such as dual use, biosecurity and bioterrorism; current status in the deployment of large-scale medical countermeasures in the public health networks; biotechnology, and in specific, synthetic biology driven new and future challenges to biosecurity and biosafety; and biopharmaceutical and biosimilars related process development challenges, including handling, storage. Notably, presentations and discussions on emerging threats recognized the enormous burden on the public health systems from new emerging infectious disease, together with the re-emerging infectious diseases such as multi-drug resistant TB and Malaria. Technology enablers such as biosurveillance systems for tracking and reporting emerging threats recognized a general lack of a formalized approach and the need for a systems-centric, layered architecture involving all stake-holders in disease surveillance and the creation of a bio-community taskforce. A presentation on medical countermeasures deployment by the Centres for Diseases Control and Prevention, Strategic National Stockpile program, focussed on the use of DTPA, a chelating agent, for the treatment/containment of radiation related to Plutonium, Americium, and Curium exposure. Presentations covering the cutting-edge biotechnology programs outlined current advance in biotechnology and synthetic biology, such as the role of biology in the synthesis of the entire influenza genome in 2005. The possible risks associated with nanotechnology were also mentioned. Finally, unique challenges posed by biopharmaceuticals were outlined, and in particular the new category of biosimilars on the handling, storage and stability. Several presentations covered the protective measures, which are commercially available, or under development to protect the population and the especially the protection of the first responders. One presentation was dedicated to the care of animals (pets), which are victims as well in the case of a CBRNE terrorism incident or natural disasters. Data collected on pet victims during the 2005 Atlantic Hurricane Katrina disaster in New Orleans was presented. One presentation outlined a unique secondary metabolites derived from a plant source with potentials for infection control, management and effective treatment protocols. Active chemicals extracted from the water extract of parts of Horseradish tree (Moringa oleifera), native to Kenya and other tropical regions of the world, demonstrate significant antimicrobial efficacy when tested using microbial assay. Biosafety/Biosecurity:Biosecurity is a topic of growing importance to both the industry and the academia. Presentations under this sector gave further credence to this problem, and placed considerable emphasis on an integrated approach that includes biosafety and biosecurity. Whereas institutional measures relating to biosafety are reasonably well known and best practices understood as such, biosecurity related institutional measures are still under various stages of implantation with no clear best practices implementation. Several presentations concluded that rapid developments in biotechnology, which has a huge impact on society, poses new and greater challenges by way of pathogen protection, export control, code of conduct and broad measures to implement institutional biosecurity program. Given the possibility that biotechnology could be misused with nefarious intent, the need for tracking dual-use technologies in this area was considered essential. Presentations involved in sessions under this sector described several misuse scenarios involving pathogenic microorganisms, biological substances and biological toxins. These scenarios not only involved industry and academic institutions, but government organizations involved in biodefense related programs, as well. Environmental monitoring technologies that could detect even the lowest concentrations of biological agents/substances in the media samples were described. The existing methods and innovative technologies used to detect these ultra low levels of pathogens were presented by the industry and new technologies still in early development or research phase. Also some future concepts related to pathogen detection and identification, which are not fully tested yet, were discussed at these sessions. Technical Advances - Private Sector: Included under this session was a series of presentations from the industry with specialized products and technical capability in the CBRNE domain. The following presentations were made;
SECTOR IV: Dual Use Items Dual Use refers to the possible application or diversion of legitimate chemical, biological, or radiological technology (whether equipment or know-how) to the development or use of weapons of mass destruction (WMD). In the CBMTS symposia series, there is a strong connection between the Dual Use Sector and the Emerging Threat Sector since positive advancements in technology and know how are often accompanied by parallel and possibly nefarious developments about their application by terrorist or criminal acts. The Dual Use Items Sector was delivered through two oral sessions consisting of 10 papers and a poster session where ten posters were presented. This is the third year for the Sector (including the SPIEZ LABORATORY sister symposium), inaugurated in 2007, and as with it predecessors, it delivered a rich program that addressed a spectrum of issues from counter-proliferation through risk assessment, preparation for and countermeasures against WMD terrorism and the roles played by a variety of agencies in transportation of hazardous substances, the prevention and mitigation of directed actions to induce accidents involving hazardous substances. Rounding out the topic areas was an analysis of the effectiveness of border controls on WMD proliferation and the operationalising of UNSCR 1540. Session 4 began with a presentation that provided an update on the activities of the Journal of Medical, Chemical, Biological & Radiological Defense, an online journal that is committed to providing high quality scientific information and critical analysis. We were reminded that the JMedCBR provides a central international forum for the publication of current research and development information on medical chemical, biological and radiological defense, as well as training, doctrine, and problems related to chemical, biological and radiological casualties. The balance of the Session was devoted to issues around counter-proliferation of WMD, and approaches to mitigate the WMD threat, crisis management and preparedness measures aimed at consequence reduction. We were provided with an example of how the Republic of Georgia established a regulatory body, worked out national legislation, developed licensing and inspection activities, and has nearly finished installation of radiation portals at the whole perimeter of the country. It was pointed out that several successful interdictions of illicit trafficking of nuclear materials through the borders of Georgia demonstrated the country's ability to contribute to the overall effort on global nuclear security. The Aum Shinrikyo incident in Japan in 1995 provided a pointed example of an actual WMD incident (which fortunately was not "mass" in human loss) and provided valuable insights into the incident and lessons learned on prevention and crisis and consequence management. The presentation delved into the chemical and biological weapon programs of the Aum Shinrikyo, especially focusing on intent and capability of the sect, its weapon systems and mode of attacks, including their target selections finished off by the provision of lessons learned that can inform the broader discussion on prevention and consequence management in the event of CBW terrorism. The final presentation of Session 4 brought some closure to the discussion, pointing out that - with respect to CBRN events and the potential for mass casualties - that mitigation of the threat should be foremost in our minds. On a positive note, it was pointed out that significant progress is being seen through the integration of a number of approaches that are essential in assessing the risk and mitigating the threat. Preparedness measures and procedures, engineering, science and technology, policy, medical, and emergency response are all essential elements of threat reduction. A scientific approach to risk assessment and an integrated approach to mitigating the CBRN threat, crisis management and preparedness measures for prevention and reduction of potential consequences was discussed. Session 11 was delivered though 10 posters covering a range of topic areas including occupational exposure to toxins through the role of industry in the prevention of chemical terrorism. Pesticide and OP intoxication therapies were addressed as was the larger issue of the development of a capability to collect, analyze and unambiguously identify chemical warfare agents and the challenges these efforts present. I am happy to note that the Session was well attended and the posters provided opportunities for significant discussion Session 12 began with an overview of the regulations which control the conditions and means for transporting hazardous substances that included the documentation requirements for storage, forwarding and transport. The importance of information availability on hazardous substances from the points of view of the producer, transporter and because the the potential for accidents with these materials must be familiar with emergency procedures and be trained in responding to hazardous events. The second speaker spoke of the historic, limited role that Poison Control Centers (PCCs) have played in the management of CBRN incidents. Although PCCs are frequently called for advice by the public or health care providers when such incidents occur, in many cases they are not considered an integral part of the CBRN disaster emergency response team simply because they lack a "place" in the Incident Command Structure (ICS). The speaker argued that the combination of expertise and information available at PCCs prepares them to advise on decontamination and treatment of CBRN-contaminated victims and that their trusted role in the community, enhances their role in risk communication. A program that provides guidance on the activation of PCCs by the Region 6 Regional Response Team (RRT6) was described, and described how PCCs could function within the ICS structure. The United Nations Security Council Resolution 1540 (2004), encourages enhanced international cooperation on efforts in the chemical and biological weapon-related areas. Most analyses on the implementation of the resolution have focused on nuclear issues, In this presentation select activities in the chemical and biological weapon-related areas, including chemical product classification and identification, biosafety and biosecurity practices and criminal prosecutions for unauthorised chemical transfers were addressed. We are moving forward and UN member states are continuing to take measures to establish and effectively implement controls to prevent the proliferation of nuclear, biological and chemical weapons and their means of delivery. The final paper of the session, discussed the implementation of the SEVESO II Directive. The two primary thrusts within the Directive address major accident prevention and the mitigation of consequences for human health and the environment brought about be terrorist actions or military activities. We were provided with the Croatian experience in implementing the UNEP APELL Programme, and how it is connected with the SEVESO II activities. To mitigate consequences of accidents, emergency planning, land-use planning and risk communication are necessary as is the participation of stakeholders such as industry, public authorities and the community. In summary, the dual-use subset of the emerging threat spectrum is varied and in flux. CBRN and security professionals everywhere need to be cognizant of and recognize emerging threat and note solutions that have worked or are being developed against weapons of mass destruction (WMD) whether formulated by terrorists, domestic or foreign. SECTOR V: The Exercise and Special Events Sector V consisted of Session 7 and "The Exercise and Special Events". Due to time constraints related to the conduct of the exercise, only two formal presentations were made in Session 7 and these were followed by introduction to, and conduct of, the demonstration exercise. The first presentation gave the CBMTS Industry VI an outline of a very practical approach to the protection of VIPs from CBRN materials. This proposal provided some basic principles to be used by security details. First - detailed advanced preparations are essential. This includes analysis of potential threats, development of site-specific operations plans, and understanding local support capabilities. During the incident, the focus should be on moving the principal away from the threat, immediate donning of appropriate protection, and preliminary identification of the threat agent based on observable behavior of the material as well as signs and symptoms. Based on this situational awareness, emergency medical intervention and emergency decontamination measures are initiated. The presenter emphasized the "golden minute" of response, within which actions are accomplished which strongly impact on the ultimate success or failure of the protection mission. He also addressed the need for secondary support teams in the areas of detection, medical, decontamination and liaison with local support agencies. The second presentation was made by the Commander of the US State of Georgia National Guard 4t Civil Support Team (Weapons of Mass Destruction). He outlined the Incident Command System and the role and functions of the CBRN Support Element within that system. He focused on the initial information exchange which must take place between Incident Command and the supporting teams, to include site location and organization, scene security status, type of incident, weather, casualties, signs and symptoms and preliminary agent identification. As the response evolves, there needs to be frequent exchange of information related to anticipated resource and logistical requirements, appropriate protection levels, mission objectives, decontamination, scene security, communications adequacy and medical support, among others. The use of checklists and Standard Operating Procedures (SOP) were emphasized, as was the need for section leaders to be accompanied by note takers during coordination meetings. The next event was the demonstration exercise, in which we saw extensive resources from multiple organizations working together as a team to resolve the problems resulting from an explosion and release of chlorine in a populated area. The demonstration showed very well the numerous actions which must take place, many simultaneously, during an incident response: scene size-up, establishing hot, warm and cold zones; security of the scene and entry points; determining and donning protective gear; rescue of victims; preliminary identification of the hazard; sampling; conduct of more detailed analysis of the causative material; evidence collection; set-up and operation of the decontamination corridor; decontamination of victims and responders; and medical triage, treatment and transport. In addition to being a great example to the CBMTS participants, I am sure that it also served as an incredible training exercise for the emergency responders in working together across organizational lines and with multiple response agencies, which included fire, police, hazardous material, and medical units, and even an international special team. Finally, since this Sector also included "Special Events", I would be remiss in not commenting on the "Host Country Dinner".
CBMTS Industry VI / The 5th World Congressunder the auspices of the Government of CroatiaThe International Organization: Symposium Co-Directors: The International Executive Planning and Science Review Committee: The Technical Program: |
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