Global & Disaster Medicine

Archive for the ‘Chemical Threats’ Category

Chemical terrorism in Syria: A Chronology

NY Times

Chlorine Sarin Mustard

NY Times

NY Times

 

 


On Saturday, April 7th, at 7:45 PM local time, amidst continuous bombardment of residential neighborhoods in the city of Douma, more than 500 cases -the majority of whom are women and children- were brought to local medical centers with symptoms indicative of exposure to a chemical agent.

NY Times

SAMS

“Following a brief ceasefire that only lasted for a couple of days, the city of Douma, East Ghouta, was again subjected to heavy shelling that resulted in dozens of casualties and hundreds of injuries. The attacks included the systematic targeting of medical centers and civil defense teams, resulting in the  the destruction of the majority of the civil defense centers and a large number of ambulances and rescue vehicles, heavily paralyzing the medical capacity of the city

On Saturday, April 7th, at 7:45 PM local time, amidst continuous bombardment of residential neighborhoods in the city of Douma, more than 500 cases -the majority of whom are women and children- were brought to local medical centers with symptoms indicative of exposure to a chemical agent. Patients have shown signs of respiratory distress, central cyanosis, excessive oral foaming, corneal burns, and the emission of chlorine-like odor.

During clinical examination, medical staff observed bradycardia, wheezing and coarse bronchial sounds. One of the injured was declared dead on arrival. Other patients were treated with humidified oxygen and bronchodilators, after which their condition improved. In several cases involving more severe exposure to the chemical agents, medical staff put patients on a ventilator, including four children. Six casualties were reported at the center, one of whom was a woman who had convulsions and pinpoint pupils. 

Civil Defense volunteers have reported more than 42 casualties found dead in their homes, with similar clinical symptoms of cyanosis and corneal burns. Civil defense volunteers were unable to evacuate the bodies due to the intensity of the odor and the lack of protective equipment. The reported symptoms indicate that the victims suffocated from the exposure to toxic chemicals, most likely an organophosphate element.

Following the chemical attack, the target site and the surrounding area of the hospital receiving the injured were attacked with an explosive barrel, which hindered the ability of the ambulances to reach the victims.

The Syrian American Medical Society (SAMS) and the Syrian Civil Defense (White Helmets) have documented nearly 200 uses of chemical weapons in Syria since 2012. Previous United Nations Security Council Resolutions on this matter have failed in stopping the use of chemical weapons in Syria.……”


The highest concentration of the agent used against Sergei and Yulia Skripal was found on their front door.

BBC

BBC

  • The pair were found collapsed on a bench in Salisbury on 4 March.
  • They remain in a critical condition.
  • Traces of Novichuk had been found at other sites in the city, but they were at lower concentrations.
  • About 250 counter terrorism officers continue to work on the case
  • 5,000 hours of CCTV footage and 1,350 items have been seized and examined.
  • Timeline of events
  • 3 March:  Yulia Skripal flew into London’s Heathrow Airport on a flight from Russia at about 14:40 GMT
  • 4 March, 09:15 GMT:  Mr Skripal’s car was seen in Salisbury in the area of London Road, Churchill Way North and Wilton Road
  • 4 March, 13:30 GMT:  His car was seen driving down Devizes Road, towards the town centre
  • 4 March, 13:40 GMT:  Mr Skripal and his daughter arrived at the Sainsbury’s upper level car park at the Maltings shopping precinct.
  • 4 March, between 41:20 GMT and 15:35 GMT:  Police said the pair went to The Mill pub before going to Zizzi restaurant
  • 4 March, 16:15 GMT:  Emergency services received the first report of an incident
  • 4 March:  Police found the pair on a bench outside Zizzi in an “extremely serious condition”
  • 4 March:  Det Sgt Nick Bailey fell ill after attending the incident – – was treated in hospital but discharged on 22 March
  • 48 people were assessed in hospital in relation to the incident
  • Only Mr Skripal and his daughter Yulia remain in hospital
  • Investigators have identified 131 people who have potentially been in contact with the nerve agent.
  • None has shown symptoms

 


Several packages of deadly sarin gas are set off in the Tokyo subway system killing twelve people and injuring over 5,000.

History Channel

 


Chemical agents: Live, Binary, and Dusty; what’s the difference?

ASIA Times

Binary: Chemical weapons wherein the toxic agent is not in its active state, but rather, the toxin is in the form of chemical  precursors that are physically separated within the weapon and combine after deployment to the active state.

A dusty agent is the dried powder form of a poison.

A “live” agent is fully mixed and fully activated once loaded into warheads or bombs.

 


The nerve agent Novichok is believed to be orders of magnitude more lethal than sarin or VX.

NY Times

“…..Novichok nerve agent, a weapon invented for use against NATO troops, was released in the quiet town of Salisbury, its target a former Russian spy named Sergei V. Skripal. Mr. Skripal and his daughter, Yulia, collapsed onto a bench in a catatonic state on March 4, and remain hospitalized, in critical condition.……”

 


Brits: A former Russian spy and his daughter were poisoned by a nerve agent in Britain this week

NY Times

“…..On Sunday afternoon, he and his daughter became severely ill at a mall in the quiet cathedral town of Salisbury, England. They lost consciousness and remain in critical condition.

Some of the emergency workers who went to the scene also became ill, and one police officer has been hospitalized in serious condition….”


Syrian government forces defied a new U.N. Security Council resolution calling for a cease-fire on Sunday by launching a ground offensive, sustaining their airstrikes and allegedly dropping at least one bomb laden with chlorine against a rebel-held enclave outside Damascus.

Washington Post


PHEMCE High-Priority Threats

PHEMCE High-Priority Threats

The PHEMCE will continue to address MCM needs to protect against high-priority threats for which the Secretary of Homeland Security made a determination pose a material threat sufficient to affect national security or PHEMCE leadership determines to have the potential to threaten national health security.

This year, the PHEMCE added three chemical agents (chlorine, phosgene, and vesicants); otherwise, the high-priority threats are unchanged from those listed in the 2016 PHEMCE SIP. The PHEMCE high-priority threats are (in alphabetical order by threat area):

Biological Threats

  • Bacillus anthracis (anthrax)* and
  • Multi-drug resistant B. anthracis (MDR anthrax)*
  • Burkholderia mallei (glanders)* and
  • Burkholderia pseudomallei (melioidosis)*
  • Clostridium botulinum toxin (botulism)*
  • Ebola virus (Ebola hemorrhagic fever)*
  • Emerging infectious diseases4
  • Francisella tularensis (tularemia)*
  • Marburg virus (Marburg hemorrhagic fever)*
  • Pandemic influenza
  • Rickettsia prowazekii (typhus)*
  • Variola virus (smallpox)*
  • Yersinia pestis (plague)*
  • Chemical Threats
  • Acetylcholinesterase inhibitor nerve agents*
  • Chlorine5
  • Cyanide salts (potassium and sodium cyanide)*
  • Hydrogen cyanide*
  • Phosgene5
  • Vesicants*
  • Radiological* and Nuclear* Threats(*) indicates threats identified under the following authorities related to MCMs: (1) emergency use authorities that rely on section 564(b)(1)(D) of the Federal Food, Drug, and Cosmetic Act (FD&C Act); (2) priority review vouchers PRVs) under section 565A of the FD&C Act;6 and, (3) procurements of security countermeasures under section 319F-2 of the PHS Act.

 

4 EIDs continue to remain a high-priority threat for the PHEMCE. The PHEMCE developed a risk assessment framework to assess whether specific emerging pathogens should be included explicitly as a high-priority threat. These pathogens may be included if PHEMCE leadership determines they have the potential to affect national health security.

5 The PHEMCE added additional chemical threat agents to the high-priority threat list after considering multiple factors, including recent reported intentional use of agents as weapons, accidental releases, availability of agents in industry, and health impacts of exposure.

6 It is possible that a drug product meeting the requirements of section 565A (material threat MCM priority review vouchers (PRVs)) also may meet the requirements of section 524 of the FD&C Act (which enables sponsors of certain tropical disease applications to receive PRVs). However, under section 565A(e), the same application is not permitted to receive more than one voucher. U.S. Food & Drug Administration (2017). Tropical Disease Priority Review Voucher Program. https://www.fda.gov/aboutfda/centersoffices/officeofmedicalproductsandtobacco/cder/ucm534162.htm and U.S. Food & Drug Administration (2017). 21st Century Cures Act: MCM-Related Cures Provisions. https://www.fda.gov/EmergencyPreparedness/Counterterrorism/MedicalCountermeasures/MCMLegalRegulatoryand PolicyFramework/ucm566498.htm#prv.


What is the PHEMCE?

The PHEMCE is an interagency coordinating body led by the HHS Assistant Secretary for Preparedness and Response, comprising the Centers for Disease Control and Prevention, the National Institutes of Health, the Food and Drug Administration, and interagency partners at the Departments of Defense, Veterans Affairs, Homeland Security, and Agriculture. It coordinates the development, acquisition, stockpiling, and recommendations for use of medical products that we need to effectively respond to a variety of high consequence public health emergencies, whether naturally occurring or intentional.

 

EXECUTIVE SUMMARY

The 2017-2018 Public Health Emergency Medical Countermeasures Enterprise (PHEMCE) Strategy and Implementation Plan (SIP) describes the priorities that the U.S. Department of Health and Human Services (HHS), in collaboration with its interagency partners, will implement over the next five years. This strategy updates the 2016 PHEMCE SIP and fulfills the annual requirement established by Section 2811(d) of the Public Health Service (PHS) Act, as amended by the Pandemic and All-Hazards Preparedness Reauthorization Act (PAHPRA). The annual PHEMCE SIP provides the blueprint the Enterprise will use to enhance national health security through the procurement and effective use of medical countermeasures (MCM). Starting with this iteration of the SIP, the PHEMCE is retitling its SIP to reflect a more forward-focused strategic document by referring to the year the PHEMCE developed it as well as the following year. For example, the PHEMCE developed this SIP in 2017; therefore, it is the 2017-2018 PHEMCE SIP. The PHEMCE examines the SIP goals and objectives annually by taking into consideration the progress achieved and the remaining strategic gaps in MCM preparedness. During the development of the 20172018 PHEMCE SIP, the PHEMCE examined the goals and objectives articulated in the 2016 PHEMCE SIP and determined that no changes were necessary at this time.

The streamlined 2017-2018 PHEMCE SIP provides:

1) a summary of the major recent accomplishments;

2) new activities;

3) updates to the activities from the 2016 PHEMCE SIP; and

4) specific information required annually under PAHPRA reporting mandates.

The 2016 PHEMCE SIP identified priority activities in the near-term (fiscal year (FY) 20172018), mid-term (FY 2019-2020), and long-term (FY 2021 and beyond) timeframes. The PHEMCE maintained these timeframes in the 2017-2018 PHEMCE SIP. The PHEMCE is still pursuing activities detailed in the 2016 PHEMCE SIP unless otherwise noted in this document. All activities described are contingent on available appropriations.

 


Categories

Recent Posts

Archives

Admin