Chemical Agents of Opportunity for Terrorism: TICs & TIMs

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Chemical Agents of Opportunity for Terrorism Training Support Package Participant Guide Slide 30 Chemical Agents of Opportunity for Terrorism: TICs & TIMs Botulism Threat • Potency: “Most Lethal Substance ” – 70 ug Lethal Oral Dose – 70 gm Could Kill 1,000,000 People • Prolonged ICU Requirement – May Exhaust Supply of Ventilators • Easy to Mass Produce – Russia, Iraq, Iran, Syria, North Korea – 1991 “Iraqi Stockpile ”: 19,000 L Module One - Chemical Contamination of Food, Water, and Medication 30 Let’s use botulinum toxin (produced by the bacterium, Clostridium botulini) as an example of a potent toxin being introduced into the food supply. Although not an industrial material (and considered as a Class A biological weapon by the CDC), it is produced in large quantities and available as a medication (Botox – botulinum A toxin). Because of the muscle paralysis (particularly respiratory muscle failure) that occurs with botulism, it has been estimated that 60% of botulinum poisoned individuals would require mechanical ventilation. Given the small number of ventilators and limited amount of antitoxin in the national stockpile, the death rate from a large attack would likely be closer to the pre-1950s mortality rate of 60%, or perhaps the 25% rate that occurred in the 1950s, rather than to the 6% death rate experienced in the 1990s. This agent has been weaponized by a number of nation-states, so we will use it as an example of a potential food contaminant similar to its use in the water portion of this module. December 2008 Version 2.0 Page 286
Chemical Agents of Opportunity for Terrorism Training Support Package Participant Guide Slide 31 This slide depicts the mechanism of action of botulinum toxin – the end result being inhibition of acetylcholine (neurotransmitter) release. The toxin, once taken up by the nerve fibre (axon) ending, prevents the fusion of presynaptic vesicles containing acetylcholine (the neurotransmitter responsible for sending signals between the brain and the muscle) with the nerve membrane at the synapse (connection point between nerve and muscle). If no acetylcholine is released, then coordinated muscle activity does not occur. Thus patients with botulism have paralysis, and this paralysis lasts a long time (weeks - months) even with use of the botulinum antidote (antitoxin antibodies). December 2008 Version 2.0 Page 287
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