1. Theoretical and methodical bases of epidemiology of extreme situations. Definition of military epidemiology

2. Рісture 1. When loaded with diseased bodies, wood-frame catapults were biological weapons.

3. Рісture 2. Gen. Jeffrey Amherst, in a letter dated 16 July 1763, approved the plan to spread smallpox to Delaware Indians.

4. Рісture 3. After the war, cavalries were trained to expect attacks with chemical and biological weapons.

5. 4. The Japanese army used Chinese prisoners to test bioweapons. (These particular men may not have been subjects.)

6. Рісture 5 Weapons production at Fort Detrick, Maryland, the U.S. Army's base for biowarfare research.

7. Рісture 6. During Operation Desert Storm, the U.S. military feared that Scud missiles might contain biological agents.

8. Рісture 7. The Aum Shinrikyo cult claimed tens of thousands of members.

9. China Signatory state to the Biological Weapons Convention Bioweapons status: Believed to secretly possess offensive bioweapons program Possible agents: Unknown Egypt Bioweapons status: Known to be actively researching biological agents for offensive and defensive programs Possible Agents: Anthrax, botulinum toxin, plague, cholera, tularemia, glanders, brucellosis, melioidosis, psittacosis, Q fever, Japanese B encephalitis, Eastern equine encephalitis, influenza, smallpox, mycotoxins

10. India Signatory state to the Biological Weapons Convention Bioweapons status: Known to be actively conducting biological weapons defense research Possible agents: Unknown Pakistan Signatory state to the Biological Weapons Convention Bioweapons status: Probable research and development of bioweapons Possible agents: Unknown

11. Iran Bioweapons status: Known to be actively researching and possibly producing offensive biological weapons Possible agents: Unknown Iraq Signatory state to the Biological Weapons Convention Bioweapons status: Previously actively researching and producing biological weapons. Highly likely to be continuing bioweapons program today. Possible agents: Anthrax, botulinum toxin, gas gangrene, aflatoxin, trichothecene, mycotoxins, wheat cover smut, ricin, hemorrhagic conjunctivitis virus, rotavirus, camel pox

12. Signatory state to the Biological Weapons Convention Bioweapons status: Conducting defensive bioweapons research, possibly working beyond legitimate defense activities to offensive activities Possible agents: Anthrax, tularemia, brucellosis, plague, Venezuelan equine encephalitis, typhus, Q fever, botulinum toxin, smallpox, glanders, Marburg infection, Ebola, Machupo virus, Argentinian hemorrhagic fever, yellow fever, Lassa fever, Venezuelan equine encephalomyelitis, Japanese encephalitis, Russian spring-summer encephalitis, psittacosis, rinderpest, African swine fever virus, wheat stem rust, rice blast Russia

13. An anthrax-tainted letter, while able to kill and spread terror, is not the most dangerous anthrax weapon.

14. C. botulinum produces the potent nerve toxin that causes botulism. Incubation period before symptoms Generally 12-72 hours Symptoms nausea and vomiting (occurs in natural cases when bacteria are ingested; may not appear if purified toxin is spread on food) difficulty speaking, seeing, and/or swallowing drooping eyelids muscle weakness starting in the trunk and moving to the limbs muscle paralysis and difficulty breathing How it would be spread Aerosol or food. The disease is not contagious.

15. In cases of cholera, comma-shaped bacteria lodge in the small intestines, causing inflammation and a slew of related symptoms. Incubation period before symptoms 12 hours - 5 days Symptoms severe diarrhea, vomiting, and weakness leg cramps rapid fluid loss that can lead to shock How it would be spread Food or water. It is not contagious with proper hygiene. Treatment Rehydration is essential. A variety of antibiotics shorten the course of illness and reduce its severity.

16. Incubation period before symptoms 1-14 days Symptoms General symptoms: fever and headaches muscle aches, muscle tightness, chest pain Other symptoms vary according to how the organism enters the body -- through the skin, eyes, nose, or respiratory tract -- but include: pustular lesions that develop 1-5 days after bacteria enter breaks in the skin swollen lymph nodes tearing of the eyes, light sensitivity increased mucus in the eyes, nose, and respiratory tract pneumonia How it would be spread Aerosol. Human-to-human transmission is possible, but the disease is not considered highly contagious. Glanders

17. Allied cavalries, such as this Belgian convoy, may have been the target of glanders attacks in World War I.

18. Incubation period before symptoms 2-3 weeks Symptoms high fever, chills, and throbbing headache profuse sweating visual and auditory hallucinations pneumonia hepatitis How it would be spread Aerosol or food. Human-to-human transmission is rare. Treatment Even untreated, most people with Q fever will recover. Treatment with a variety of antibiotics shortens illness and results in fewer complications. Q Fever

19. Sheep and other livestock could be the source of Q-fever for bioterrorists as well as the target of terrorist attacks.

20. The Black Death of the 14th century was only one of three great plague pandemics that killed tens of millions of people.

21. Incubation period before symptoms 1-6 days Symptoms fever, chills, headache, weakness nausea, vomiting, and abdominal pain extreme lymph node pain (bubonic) chest pain, cough, bloody or watery sputum (pneumonic) septic shock How it would be spread Aerosol or person-to-person. Pneumonic plague is contagious through respiratory droplets. Treatment A variety of antibiotics can treat the disease but must be given soon after symptoms appear. Antibiotics given immediately after exposure may prevent disease onset. Plague

23. Incubation period before symptoms 10-14 days Symptoms high fever headache, backache, and vomiting rash (pox) on the face and arms that spreads to the trunk How it would be spread Aerosol or person-to-person, potentially by a terrorist-"martyr." It is highly contagious. However, smallpox victims show clear signs of the disease, and anyone who came in contact with them could be vaccinated post-exposure. Treatment There is no current treatment against the smallpox virus. Vaccination given 3-5 days post-exposure can prevent the disease. Vaccine Vaccine exists but is currently not recommended for the general public. Stockpiles of vaccine are being increased. No one in the U.S. has been vaccinated since 1972, and people vaccinated before then have likely lost immunity. Smallpox

24. While highly infectious, smallpox carries clear signs that may prevent the spread of an epidemic.

25. Incubation period before symptoms 1-14 days. Following a terrorist attack, cases would likely be reported in 3-5 days. Symptoms Various forms of the disease all begin with the sudden onset of flu-like symptoms: fever, chills, headache, cough, and lethargy Additional symptoms depend on the form but include: swollen and sore lymph nodes skin ulcers red and sore eyes abdominal pain, diarrhea, and vomiting pneumonia How it would be spread Aerosol or food. Human-to-human transmission has not been documented. Treatment Early antibiotic therapy is effective, and if started within 24 hours of exposure, may prevent disease. A variety of antibiotics can be used, although some antibiotics may be powerless against strains genetically engineered to be resistant. Tularemia

26. Deer flies can carry tularemia and cause natural cases of human infection.

27. Antibiotic-resistant anthrax. Plague-Ebola hybrids. Soviet researchers used genetic engineering to try to create such "superbugs" in the 1980s. What could defend against them?

28. Could a single vaccine guard against an onslaught of various different germs? Fragments of "naked DNA" from pathogens are today being tested as a new form of vaccine. Recent biotechnology allows the "re- shuffling" of genes to make proteins unknown in nature -- and of potential use in battling germs.

29. Sprays are now available to decontaminate workers cleaning up hazardous materials. Someday aerosol vaccines might protect people before, or immediately after, a bioweapons attack. Defense researchers in the 1960s struggled to make devices that could rapidly detect and analyze germ attacks. Today mobile labs, such as Idaho Technology's RAPID, pinpoint germs in minutes.