Research Biological Warfare Article 1 Probiotics Basics The Decontamination of Anthrax and Other Biological Agents Testimony of Lynn R. Goldman, MD, MPH Professor, Environmental Health Sciences Johns Hopkins Bloomberg School of Public Health Baltimore, MD Thursday, November 8, 2001 2318 Rayburn House Office Building Part 3 How can we kill anthrax?

Biological warfare table of contents 14 anthrax smallpox 13 anthrax 12 bioweapons 11 tularemia 10 biological war 9 bioterror agents 8 biological war 7 anthrax detect 6 anthrax decont. 5 anthrax clean 4 decontaminate 3 bioterrorism 2 symptoms 1 decontaminate 1 anthrax 2 success 3 kill anthrax 4 challenges 5 questions 6 public health

1. Heat: Anthrax spores on contaminated materials can be destroyed steam under pressure (autoclave) for one hour; dry heat above 1590C; or boiling water for 30 minutes with disinfectants
2. Radiation: Ionizing radiation (including X-rays, UV light and electron beams) are known to destroy anthrax spores, if delivered at a high enough dose.
3. Disinfectants: A number of disinfectants have been used including: peracetic acid; formaldehyde; chloride solution; potassium permanganate; hydrogen peroxide; sodium hypochlorite; and iodine
   • Antimicrobial agents utilized in biomedical research facilities: A number of such agents may be of use including: Chlorine as Cl2 or as sodium hypochlorite (water); and chlorine dioxide, iodophors, phenolic compounds, quaternary ammonium compounds, alcohols, glutaraldehyde, and paraformaldehyde (hard surface disinfecting and sterilizing

Therefore, there are a number of agents that possibly could be used. However, none of these have been developed or tested for the current situation. Moreover, a number of them have obvious shortcomings and are not relevant to decontamination of buildings and the mail.

In any crisis, it is important to step back and consider how science can best inform the decision making process. How do we assess the risks and potential benefits of multiple alternatives in this kind of situation? First, this problem should be defined as one of safety assessment. By safety assessment I mean an assessment that considers three important factors: the efficacy of the agent or agents in destroying viable anthrax spores to which people might be exposed, the safety of the agent or agents to health and the environment, and the feasibility in terms of time, cost, and destruction of property.

The first issue -- that of protection of people from viable spores -- is not as easy to tackle as it might appear on the surface. The disinfectant needs to be able to deactivate anthrax spores; to do so it needs to reach spores in any locations where humans may be exposed. This is challenging since such spores may be in paper, in ventilation ductwork, and on various surfaces, some of which might be difficult to treat with chemicals. Efficacy should be a given.

Second, there is the issue of risks to health and the environment. Most of the alternatives that I listed are associated with potential health risks. For chemicals, there are considerations of avoiding spills during transport, assuring that no one can enter the facility during treatment, airing out the residues post treatment, and so forth. There are similar safety issues for radiation. Low levels of risk might be tolerable in a situation where a rapidly fatal disease can be prevented. Such tradeoffs need to be carefully considered since prompt antibiotic treatment can be effective.

Finally, there are issues of feasibility. Some possible alternatives require considerable time and effort. Others may cause damage to computers, furniture, artwork, and so forth. There could well be tradeoffs between time, expense, and damages versus the need to reoccupy buildings to continue vital government functions.

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