Ladies and gentlemen, landseer of the Potomac Institute and it is my privilege to welcome you here today with the seminar on combating biological terrorism. I am proud to report for now almost exactly 20 years the Potomac Institute has been involved in the study of this issue of bio terrorism has only grown worse over time and is more threatening and more imminent and certainly those tools for dealing with this is inadequate today is 20 years ago the most political people are distracted from the threats which ships running over each other the pacific that the threats are more as long wolf driving cars to open spaces in your opinion United States and they forget the potential of a lone wolf with the biological realm is still quite possible in some would say likely in the future. The newsletter for eating less and terrorizing as the we are here to take a moment to see if we cannot refocus on the issue of biological terrorism. The works that summarized a lot of activities over the last 20 years of a focus run by professor alexander and how countries around the world focusing on terrorism that uses technology of the modern age as weapons and spend a key focus so as a mark of 20 years studying this issue to highlight the fact the solutions are not getting easier as much focus now is we have never had on the issue of potential of biological tools to kill vast amounts of our population and it makes me very proud the institute has had such of its people to and vice us to revise the politicians and policy makers never a Great Program ahead of you here today into your thoughts and input with question answer i highly encouraged that the engagement of the people in this room in the communities around the country and around the world and dealing with threats like i. R. A. Terrorism is a professor alexander in all of you know before the record publishing over 100 bucks of aspects on terrorism for the academic study of all aspects of terrorism and to give a framework for what were talking about today. [applause] that was very generous social credit does not belong to me but over many decades to evolve that threat of terrorism the different dimensions and what are those responses to address of threats of the future . Submitting to work on everyone here and i would like to do this first working with these other participants to assist us in developing with more clarity so the first speaker really needs no introduction and university of maryland with Johns Hopkins university in the way they distributed them because if we have to deal with the contributions not just two hours but we day fall semester so lets move on to the full speakers from Georgetown University and i recall some of years ago that we met in jerusalem at the of the big at the of medical school from the medical school in nebraska from the Potomac Institute. And last but not least currently a consultant and director of the Intelligence Community center of biological Weapons Program and last but not least of former commandants of the u. S. Marine corps from the Potomac Institute. So the information of the speaker is of course, related to vocable so the members of the u. S. Government who are participating today as well as some members from congress and also a representative of 11 countries with whom are concerned about the threats of terrorism. If i may, i just one footnote and basically we made sure that we have the threat within the proper perspective of the terrorist threat m particularly i think such as the lone wolf the disruptive threat with those weapons of mass destruction and 21 years ago from 1996 to issue the first declaration in to encourage others and members of the International Community as they know they tried also the 1998 with a al qaeda operative than many of you would recall the United States embassies and a few days later and said the United States cruise missiles with those terrorist locations with the retaliation attacks on the embassys. So with this anniversary and with that threat of terrorism. And with this disruption in the United States with the first effect on the World Trade Center in 1993. Sedan for and indeed now and orlando and of course, the most recent attacks in the u. S. And the day before yesterday actually had to close the university and the campus if they have to close the university is and to remember very vividly also london, etc. And barcelona. One important element and specifically in is a target of of of choice with those medical facilities throughout the world the and of course, particularly children so if we let the record and withal this incident 17 years ago than medical aid workers roper by the television and so the question is are we going to remember to express bus sympathy and condolences to the victims and their families but also a comprehensive strategy to deal with terrorism in general so we aim to recognize those governments living with of problem. But i think we are approaching the 100 readier anniversary of the 1918 in plants that epidemic that killed an estimated 50 through 100 Million People as you know so therefore it is important i feet for all of us to assess the potential dangers of Mother Nature of biological terrorism nationally and globally. So to develop a comprehensive via Security Strategy and to address these issues and hopefully these participants with these accommodations to reduce the risk. With this very important introduction. Can we put that back to the beginning . And with these developments of understanding the threats but the wingback at 11 this is the anthrax incident. I was chair of the Interagency Committee as we attempted to root track down the of a perpetrator in from the anthrax that was sent out in the letters a round of Washington Area starting off with the reporter since then we were able to attract down the perpetrators source and since then i have spent all this time in the period of time focused on how we can rapidly identify bacteria and viruses and parasites in a way that is actionable and accurate so let me describe first of all, focusing on those microorganisms all of us in this room that we are 90 bacteria in viruses. Those in our debt produce vitamins and they protect us against invading microorganisms. And with those active commanders and they looked into slow going. In bed with saliva it with those protective microorganisms. But those are associated with disease it is amazing with causation everything from simple lack any an unsold and so forth. The with the First Computer Program in the United States but also of their rorer competition and capability. With us at techniques to the present it with Infectious Diseases and post the 11 the techniques were tedious. And with the serum in the health. In this year after growth of microorganisms but today we have a terrible threat to globally. Running out of antibiotics to be active against the common infectious agent in becoming increasingly resistant to the most powerful of the antibiotics. And this use has led us is a condition a multiply heavy duty resistant microorganisms introduced into a population could create many death especially for children and the elderly. In fact, antibiotic resistance is say causative agent which where i have worked all of my career is only 100,000 deaths so you can see the of magnitude that this provides. What i get after finishing my term was to establish a company and i did that was much easier than to get a grant from the nih even if i did publish a lot of papers so focused intensely on how we could identify bacteria and viruses so the approach taken by that anthrax organism that was right after 9 11 even to edit it six years to accumulate so to determine the source and the perpetrator. So to commit suicide the day the fbi went to arrest him so we will never know if he worked alone. We dont have six years. And infectious agents and food animals and water needs to be treated in a way from being introduced. It can take different profiles and if you isolate the organize and organize some organism but that technique with of described to extract the dna that is a long time period but once we have the sequence that we can identify within 10 minutes down to species and strain for the fund is in the repair sites this is extremely Important Development there are people working as well to those that demonstrated so dramatically that would offer a vacation with his parents he was in and out of hospitals and check the blood sample and found out that it was unusual the visually discharged in the mouse urine and with penicillin was treated because of the inability to identify the organism so fortunately we hideous some examples in calcutta with the Infectious Disease hospital but we did was a very intense study with a standard technique with 50 or 60 patients looking for bacteria that has the patience came in for the stool sample in the analyzed that bias sequencing technique. In those controls and those members of the community so they could haddad pathogen and then in comparison on the western side from nih the micro biome work that is being done. They had about 20 samples i will explain what that means. We could identify all of the bacteria yes we picked up caller of but that there was not a single package gene so this technique that even severe infections were with a single pathogen to survey the entire earth dna we find that those are critical bedmate not be as a single agent. And we are able to identify that is mostly a mixture of equal live ecoli that is already in our debt but those that carry a the pathogens to carry these pathogens this is the good bacteria like if you drink buttermilk so this is consistent ended say mechanism to determine whether an individual that claims to have lived here for it decade that is very different bedded say forensic tool with the technique than the dna analysis and i will have more to say about that at the end of my talk. To identify all of these pathogens you can see clearly these are all kinds of pathogens that are present in the room identified the species and the strain with this elegant technique of sequencing. In the metabolic jeans. I dont have time to go into all of that that we can determine that has a whole lot more carbohydrates but then you now with every meal of rice is served. And to characterize human beings. But mostly of lots of ecoli. So also the antibiotic resistant. Every donate prescription but those that had they known infection they are resistant to tetracycline and a the kind row harder trade. It to spend a lasted years to develop and then to supply and. Fell in the water and ended up whether the fasciitis. Streptococcus is unusual but the race to that time and with those strains of the clyde bader bacteria. Three of those trains are genetically is identical. So to find out why this organism and then to be systematic. But then having arms amputated to the elbow eventually succumbed because it had on systemic. So with the mice to inject all for into the muscle of negative. Looking at the liver and the spleen and individually none of them went but it was such an unusual experiment that if were going to get this published to engineer that one strain and to make a long story short and then to produce a toxin. Because they broke down the tissue said the importance hear it is it just the species now all i will move on quickly. Steadying endocarditis. Working with the Cleveland Clinic and working with heart tissue that cannot be identified by standard techniques but to confirm those samples but what they could not we were still able those that our fastidious this is a very powerful approach to a though standard techniques this is very, very important coming back to the bio forensics approach we have taken all the data that has been published and combined them around the world data from 10 countries and 600 samples to say this might be the global average but when you work at each of the Different Countries but this is quite fascinating what you are from two antonia based on diet, and a culture your genetics, and with that population and these are just of parasites that is say medical tool end to have a forensic tool those have not wasted the last 10 years to identify rapidly and accurately. The sequence of time is getting shorter and shorter. Right now the size of a thumb drive we tied it to that device so i will close by the caveat with this capacity at the ready but we also need to understand that this bio threats it took six years spent the next one might be a whole lot more complicated we need to be vigilant and have that program that is to the moment to wonder states and at the ready to protect our population. [applause] professor alexander correctly pointed of the target of bio terrorism to raise certain extent to protect us the Georgetown MedicalCommunity Center these are a group did that apparently the slides that i brought to day to get the slides i will we get from my notes in the title that i would take is what can the global brandt blood transfusion experience contribute to this subject . Or a subtitle might be, why is blood transfusion on the agenda today . I think there are three reasons that i cannot justify. One. There is an International Network of bio vigilance that is monitoring complications of blood transfusion so that is one topic that professor alexander and his colleagues and the other is every day in the United States, there was about 35,000 tubes of blood so that is quite a network and goes to the cdc on a daily basis so we have then had quite a National Network of Infectious Disease the third reason is more relevant but their 300 medical centers so a few transplant bone marrow you are required to immunosuppressed to the point where any of those lymphocytes, over that technically you can get the disease that the immune system of that donor gets into the person and goes after that person. The only way you can do that is to radiate the lymphocytes coming over with the gamma radiator. So those of the topics that could be pertinent with regard to the International Network of collaboration with the health and Human Services with the International Society of blood transfusion that monitors for infectious agents. So what are those infectious agents we are interested in . And in contrast to what a terrorist would look for r d agents that we are looking at. Syphilis or hepatitis b or hepatitis c was not a real virus, these are all infectious agents of very low community ability. Get that 500 ml of blood or have sex with the infected person or a bit by a mosquito that is the something that will spread the wage terrorist wants to. Bettis is suitable for bio terrorism it is highly communicable. They all wait for a blood transfusion so it is well developed in the western industrialized country and is now down in latin america and the heart of africa and other places where new agents that have historically been in the Animal Kingdom said with the human species like ben gay or ebola. Our network with the newly emerging agent and those low comedic ability and with those categories of agents we get about 300 of these and United States between 2,006,000 kerry saw a the long the wrong person got a hold of around downtown George Washington we could close the town for the rest of our lives because that would not be suitable but unfortunately and i would not be discussing it of the corrective action was not already well in place, we are converting to nonnuclear radiators. We need about 25 of Gamma Radiation to do to the lymphocytes what we need to be done. It would take about 20 minutes for the standard Linear Accelerator if we took the bag down it would take about 20 minutes that is unsuitable for the turnaround time for a blood transfusion. So with the department of energy in the Regulatory Commission industry has done what it can do to miniaturize those accelerators to get the equivalent of 25 grey in about five minutes which is acceptable turn around time and that is happening. The department of energy so that the court can be disposed of safely if they were thrown out in the waste it is highly supervised cannot dispose of it without the federal Agency Oversight to put that into a suitable disposal. I didnt bring this topic in without realizing it is closing down. With that issue aside issue for the future. Thank you. [applause] afternoon. Thank you professor and everybody else for having me here today. I have enjoyed it tremendously to be a part of this organization so thank you so much all three of you. To dave the topic i would be discussing is not as sophisticated as professor as both of them have done a remarkable work i think what you are doing will revolutionize is specifically in the United States is a remarkable effort over the last 10 years and we should acknowledge at and a professor sanders moving from that Current Technology is safe and better for the nations security. My talk is specifically with the Infectious Disease epidemiologist for what is doing to be proactively seeking answers to problems and to doing things very quickly as possible to address that unpredictable future and it has been rather unpredictable with a different challenge is and we have to be ready to make