Bio-Terrorism Hypothetical Scenario Patients Who Were Admitted

¶ … Bio-Terrorism

Hypothetical scenario

Patients who were admitted in medical facilities complained of muscle paralysis. This was suspected to be the reason behind the blockage of the release of the acetylcholine. The patients also suffered from diplopia, blurred vision, dysphasia, and had dry mouths. Symmetrical descending muscle weakness was also registered in a number of patients who were admitted in different hospital facilities.

This eventually led to loss of diaphragmatic functions and respiratory failure. General body paralysis ensued. The patients were nevertheless sensational and had intact mental status. Symmetric descending flaccid paralysis, lack of fever, and clear sensorium made the physician believe that the patients were in deed suffering from botulism attack. The outbreak of botulism was traced back to a city suburb. The outbreak exposed over a 100, 000 people to Clostridium botulinum for an estimated 2 hours.

A half of this population was diagnosed with the infectious dose of botulism. Such a massive population of the city residents has never before been diagnosed with botulism. There were concerns that terrorists could have had a hand in that. Public health authorities suspected that terrorists might have generated an aerosol of botulism toxin along a direction of an oncoming wind under optimal meteorological conditions.

A lethal dose of LD50 botulinum toxin delivered during the incident resulted in a 60% case fatality for patients after inhalation. These patients could not be adequately treated with ventilatory assistance, not even trivalent antitoxin. The rate of decay for airborne particles of trivalent antitoxin suspended in the air was too negligible for botulinum toxin hence the viability and virulence of botulism was not lost (St. John, Finlay & Blair, 2001).

Outbreak characteristics

The etiological agent of botulism can enter the body through several mechanisms. For instance, in infants, it arises due to intestinal colonization of C. botulinum after ingestion of spores and subsequent toxin production. It can also occur in the wounds. However, this form is very rare. It results when the etiological agent of botulism is introduced into the wound from skin abscesses or traumatized tissues. Food-borne botulism is the most common form of the disease. It results from ingestion of improperly prepared food that contains C. botulinum that produces the toxin. This route is used for small scale bioterrorism attack. All a bioterrorist does is adding a botulinum toxin to a food supply.

The toxin can however hardly survive long periods in large volume of foods. This makes this mechanism unlikely for large scale bioterrorist attack. This bioterrorist settled on inhalation because it was the most effective when masses are targeted. Botulism that is food borne is the most natural form of botulism despite the fact that the toxin can also find its way into the human system through open wounds and colonization of intestine of the infants by Clostridium botulinum. This potent botulinum neurotoxin attack must have been instigated by terrorists because of the mode of exposure that was used, that is inhalation (Wein & Liu, 2005).