Chemical Agents of Opportunity for Terrorism: TICs & TIMs

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Chemical Agents of Opportunity for Terrorism Training Support Package Participant Guide Slide 34 In the model just depicted, the authors note that infiltration of the system anywhere on the “left-hand side of the bow-tie” with only 1-10 grams of botulinum toxin has the potential to poison 100,000 people to more than 5 times that number (i.e. all of the tainted milk consumers), if undetected. If a clinical surveillance system notes a signal and is correctly interpreted, 2/3 of the cases could be prevented by public notification and milk recall, yet 100,000 people could still be poisoned. The authors estimate the cost to care for 100,000 botulinum poisoned patients (even if that number of ICU-equivalent beds, ventilators, and anti-toxin were available) would be 17.2 million dollars December 2008 Version 2.0 Page 290
Chemical Agents of Opportunity for Terrorism Training Support Package Participant Guide Slide 35 Chemical Agents of Opportunity for Terrorism: TICs & TIMs Inactivating Botulinum Toxin • Botulinum toxin cannot be completely inactivated by radiation or any heat treatment that does not adversely affect the milk ’s taste. • Ultrahigh -temp pasteurization (UHT) can inactivate botulinum toxin but has not been embraced by U.S. consumers. Module One - Chemical Contamination of Food, Water, and Medication 35 Botulinum toxin is difficult to destroy. Remember- in this model - it is not the bacteria (Clostridium botulini ) that needs to be killed, but the toxin itself that was maliciously added to the milk. In Ultra High temperature processing, the milk is heated using commercially sterile equipment and then placed into hermetically-sealed (airtight) containers under aseptic conditions. This high temperature is sufficient to inactivate practically all botulinum toxin. December 2008 Version 2.0 Page 291
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Chemical Agents of Opportunity for Terrorism: TICs & TIMs

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