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Showing posts with label Annals of Emergency Medicine. Show all posts
Showing posts with label Annals of Emergency Medicine. Show all posts

Monday, December 29, 2014

Sick to Death: Biological Weapons 101 with Dr. Judith Lucci


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English: Color-enhanced electron micrograph of...
English: Color-enhanced electron micrograph of Ebola virus  (Photo credit: Wikipedia)
I had a lovely luncheon the other day with the fascinating Dr. Judith Rocchiccioli, and she promised to come and share her expertise with you.
True to her word, this morning we're going to be talking about viruses and sabotage/terrorism. 

Fiona - 
Judith, please take a moment and introduce yourself. Can you please give us your background/credentials about why you are an expert on this subject?

Judith -
Hi, Fiona, many thanks for inviting me. I have a PhD in nursing and have written a few scholarly papers on the subject of infectious diseases.

Judith Lucci

I am a nurse and have many years of clinical practice in addition to teaching. For a long time I taught Infection and Immunity and that piqued my interest in these subjects. I can remember when we got our first case of HIV to a small hospital in Richmond where I worked at the ICU. It was so scary and hush, hush and nobody knew what in the world we were dealing with. 

Since then, I have written my third novel, Viral Intent, where I used a virus as part of my plot


 


Fiona - 
You just finished a scholarly paper on Ebola for a healthcare organization didn't you?

Judith - 
Yes, it was a commissioned book, primarily meant to quell the fear and miscommunication that was permeating America during the fall.

When we talk about biologics as weapons of mass destruction, we are actually talking about any organism from nature that can be packaged to kill i.e. a virus, bacteria or fungi.

Fiona -
The thought of a deadly virus with no known cure and highly contagious in nature is terrifying to people. And you used this as a plot line in your book - can you tell a little more about your novel?

Judith -
I write the Alexandra Destephano series of medical thrillers and the third one, Viral Intent, opens in the ED when several patients are admitted with what looks like a hemorrhagic disease. It turns out they are political operatives who are front men, setting up for a political convention, Operation Fix America, where the national leadership and President will be meeting the next day. The disease is Ebola-like, but infection docs and CDC cannot truly diagnose the illness because it is replicating so quickly.



As the book progresses, one of the operative dies and things in New Orleans, just continue to go south.

Fiona -
ED for those of you who don't recognize the term is the Emergency Department the new name for the ER.

Judith explain the issue with the CDC and replication, please.

Judith -
Well, one of the problems with any type of virus or bacteria is how quickly they reproduce and replicate. Bacteria/virus that replicate and mutate quickly are more virulent and make it more difficult to diagnose and treat. 


Think of how we have to change the flu vaccine every year because the virus constantly outsmarts us and every year we have to anticipate and examine how the virus has replicated.

then we try to create a vaccine for the next few years...

Fiona - 
And the scientists are working hard on an ebola vaccine.

Judith -
Oh, yes for sure, and we will see one soon. I think they are pretty close based on the research from my ebola book.

Fiona - 
If we are writing a plot line, and we want to include germ terrorism, how hard would that be to develop a do-able plot that would pass scientific muster.

Judith -
I think the possibilities for a plot line in germ warfare, WMD, chemicals, and other noxious substance are as active a possibility as the research skill and imagination of the author.

I think, in all honestly, ebola is probably more difficult to use to kill large numbers of people because it is spread by body fluids. The scientific community is actively discussing this now. 

However, as a very imaginative person, I would consider a unique way to project the virus into/ on to someone's flesh, kind of like they did with the plague with poison arrows years ago.

Remember how the Persians and Romans used to kill people by dipping their arrows into a dead carcass of an animal or person?

Fiona - 

...and also catapulting dead animals over the curtain wall into the bailey of the castles.

Judith - 
I think it was Barbossa that did this.

He used decomposing bodies, yes, animals into their castles. Yuk, but smart back then.
You know, there is history that during the Civil War in America and the French American War, both sides used the blankets and clothing of dead soldiers who'd died from smallpox in an effort to decimate the troops.

In fact, every war probably used some type of biologic weapon to kill. The Germans used anthrax and cholera in WWI...Viet Cong used needle sharp sticks dipped in infected feces and left them in the ground to gas disease and death.

Fiona - 
When the soldiers walked through, they would pick up the  micro-organisms

Judith - 
Yes, I would imagine it was most likely cholera since that's the worse GI (gastrointestinal) organis. Cholera is also good to infect the water supply.

Fiona - 
With a biologic, what considerations must an author keep in mind - off the top of my head I'm thinking - the life of the germ, the necessary temperatures for stability... can you help us with a partial list?

Judith -
I think, overall, you have to look at who is the enemy and how many they want to kill. Do they want to terrify or have mass casualties. The best agents are those that will spread via the air and is breathed in. So, you have to think about your vehicle of delivery. How can you deliver the most devastating blow...with the least amount of detection.

Cost is a factor as well. Poor terrorist organizations (I personally not sure if there is a poor terror group) use the cheap stuff. Homeland Security report a potential of 1200 biologic agents that are possibilities.

Fiona - 
1200??? Yipes!

Judith -
There is a debate about whether ebola would be a good agent for suicide bombers. The fragments of the blast could cause a spread of the disease.

I think your best airborne weapon is anthrax...remember that from the postal letters after 9/11? Anthrax becomes entrenched in the human host and a lethal poison develops. You could use crop dusters, small planes, and other mobile agents for that. Remember, anthrax comes from cattle, sheep, goats. It is a Category A agent.

Others could be Yellow fever or Q fever.

Fiona - 
So say it is airborne - what would they do just uncap a vial - have some kind of aerosol contraption - stick it in vent systems?...

Judith - 
I could see releasing a potent poison in an aerosol can and releasing it on a train or subway. Even a perfume atomizer could do real damage. Boy, I am a sick, perverted person to think of these things....

Fiona - 
The NSA will be following up. While we wait for their knock on your door, can you tell me your favorite scar story?

Judith -
My scar story... 

Four years ago, I was teaching abroad and was in Rome. I was with my friend, Crazy Patty at the Coliseum and short on time, we started running down the cobblestone street (I think the Appian Way) where I fell on my wrist. I remember a collective gasp and lots of people looking at me on the ground, but everyone seemed paralyzed to help. 

My hand was virtually on top of my wrist, my friend, who was running for the tour bus had left me. Suddenly, the most handsome man EVER appeared out of nowhere and bent down and gave me a big of ICE...no one has ice in Italy, particularly at the Coliseum in June. The man was dressed in tight black jeans, a white flowing poet shirt, and he held the ice on wrist, helped me up, kissed me on both cheeks, flagged a taxi, and disappeared.

It was amazing. I am sure he was an angel. His voice was incredible, melodious. Anyway, that was it for him, I spent 16 hellish hours at the Vatican Hospital and flew home for surgery. Everytime I see the scar, I remember the angel and how lucky I was to meet him.

Fiona -
I want a story like that and a friend named Crazy Patty - at first I was upset that she left you - but whoop! She left you, and that gave your angel a chance to flutter down to Earth and do his gallant act.

Judith -
Anyway, made a believer out of me! He was totally the best looking thing I have ever seen.

Fiona -
Lucky girl.

Any last advice for medical terror writers?

Judith - 
As authors, the best thing to do with this content is to use your imagination, check out the authenticity and go with it....

Thank you kindly for your help. 

You can catch up to Judith here:
Chaos at Crescent City Medical Center  http://amzn.to/1cvmNLt
The Imposter  http://bit.ly/U5GjbG
Viral Intent  http://bit.ly/1sbIk5k
Alexandra Destephano Novels  http://on.fb.me/1lxeDr5
Author Interview  http://bit.ly/1sbIk5k


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