St John R, Finlay B, Blair C
Centre for Emergency Preparedness and Response, Population and Public Health Branch, Health Canada, Ottawa, Ontario;
Can J Infect Dis. 2001 Sep;12(5):275-84. doi: 10.1155/2001/904148.
The present paper calculates the human and economic consequences of a bioterrorist attack on Canadian soil using aerosolized Bacillus anthracis and Clostridium botulinum. The study assumed that 100,000 people in a Canadian suburban neighbourhood were exposed over a 2 h period to an infectious dose of one of the agents. Using an epidemic curve based on the epidemiology and management of anthrax and botulinum poisoning, the costs of intervention and treatment after an attack were compared with the costs of preparedness before a bioterrorist attack. The results show that an investment in planning and preparedness to manage the consequences of an attack can reduce morbidity, mortality and economic costs. The sooner that an intervention program is instituted, the more significant are the health and economic benefits. The greatest benefits were realized when postattack intervention was initiated before day 3 after the event. The economic impact of a bioterrorist attack in Canada could range from $6.4 billion/100,000 exposed to B anthracis to $8.6 billion/100,000 exposed in an attack using C botulinum. Without the benefit of an effective consequence management program, predicted deaths totalled 32,875 from anthrax and 30,000 from botulinum toxin. Rapid implementation of a postattack prophylaxis program that includes the stockpiling of antibiotics, vaccines and antitoxins; training of first responders in the diagnosis, handling and treatment of pathogens; and the general enhancement of Canada's response capability would reduce both human and economic losses.
本文计算了使用雾化炭疽芽孢杆菌和肉毒杆菌对加拿大本土发动生物恐怖袭击所造成的人员伤亡和经济后果。该研究假设，加拿大一个郊区社区的10万人在2小时内接触到其中一种病原体的感染剂量。利用基于炭疽和肉毒中毒的流行病学及管理情况的流行曲线，将袭击后干预和治疗的成本与生物恐怖袭击前的防范成本进行了比较。结果表明，对管理袭击后果的规划和防范进行投资，可以降低发病率、死亡率和经济成本。干预计划启动得越早，健康和经济效益就越显著。在事件发生后第3天之前启动袭击后干预措施时，能实现最大效益。在加拿大，生物恐怖袭击的经济影响可能从每10万名接触炭疽芽孢杆菌的人64亿美元到每10万名接触肉毒杆菌的人86亿美元不等。如果没有有效的后果管理计划，预计因炭疽死亡32875人，因肉毒毒素死亡30000人。迅速实施袭击后预防计划，包括储备抗生素、疫苗和抗毒素；对急救人员进行病原体诊断、处理和治疗方面的培训；以及全面提高加拿大的应对能力，将减少人员伤亡和经济损失。
