Barros, Cesar Augusto Castro de. Biosecurity and Bioterrorism: developing institutional contingency plan for the 2014 FIFA ® World Cup and the 2016 Summer Olympics [thesis]. São Paulo: Instituto de Infectologia Emílio Ribas, 2012.
The sending of letters filled with Bacillus anthracis spores, from New Jersey (USA) in October 2001, was a landmark in raising concern about bioterrorism. Despite Brazil being considered a very low risk country for terrorist attacks, its increased participation in the international arena of political conflicts, and the hosting of two maximum relevance sporting events in the next few years exponentially increases the chances of an attack. However, the most likely hypothesis to justify a possible bioterrorist incident during the 2014 FIFA® World Cup and 2016 Summer Olympics would be an attack on foreign delegations. There is evidence of activity of five terrorist groups in the country, including Al Qaeda, recruiting militants, promoting operations, and planning attacks. Adding to the facts cited, the lack of specific legislation to prosecute and punish terrorist acts creates a favorable environment for radical group actions in Brazil. The Emílio Ribas Infectious Diseases Institute (IIER), located in São Paulo, is currently one of the largest hospitals for infectious diseases in the world and the national center for medical care during epidemics. Inferring that IIER will be the first destination of biological warfare victims, this thesis aims to draw up an institutional contingency plan for CDC category A bioterrorism agents. The following diseases were revised in the medical literature from electronic databases (PubMed, Web of Science, Scopus, Cochrane Library and Google Scholar): Anthrax, Botulism, Smallpox, Plague, Tularemia and Viral Hemorrhagic Fevers group. The first part, besides presenting a review of each disease on clinical manifestations, diagnosis and treatment is also discusses practical considerations such as post-exposure prophylaxis, isolation measures, transport of clinical samples, laboratory specimen handling, handling of corpses, control of environmental infections, and waste management. A separate chapter, deals with the rules of transportation of Infectious Substances is discussed in accordance with the World Health Organization regulations (Guidance on Regulations for the Transport of Infectious Substances 2011-2012 - WHO). The second part traces the contingency plan according to the IIER profile and reality: establishment of a disaster and bioterrorism committee; information management (early rapid response and activation of the emergency plan); triage and patient management; epidemiological and government notification; facilities care; emergency supplies; psychological warfare; communication with patients, the public and media.
Descriptors: 1. Bioterrorism 2. Contingency plans 3. Exposure to biological agents 4. World Cup 5. Olympic Games 6. International terrorism 7. Viral hemorrhagic fevers 8. Anthrax. 9. Botulism 10. Smallpox 11. Plague 12. Tularemia 13. Transport of substances, products and materials
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