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Volume 29.Pdf CBRNE-Terrorism Newsletter (Vol 37 – 2009) 2 «Η Δημοκρατία μας αυτοκαταστρέφεται διότι κατεχράσθη το δικαίωμα της ελευθερίας και της ισότητας, διότι έμαθε τους πολίτες να θεωρούν την αυθάδεια ως δικαίωμα, την παρανομία ως ελευθερία, την αναίδεια του λόγου ως ισότητα και την αναρχία ως ευδαιμονία» Ισοκράτης (436 π.Χ-338 π.Χ.) ΠΑΝΔΗΜΙΑ ΓΡΙΠΗΣ ΜΕΞΙΚΟΥ Στις 30 Απριλίου 2009 ο Παγκόσμιος Οργανισμός Υγείας (WHO) ανέβασε την Κατάσταση Συναγερμού Πανδημίας (Pandemic Alert Status) στο Επίπεδο 5. Η μετάβαση από το ισχύον επί μακρόν Επίπεδο 4 στην παρούσα κατάσταση έγινε εντός μιας εβδομάδας λόγω της ταχύτατης εξάπλωσης της γρίπης των χοίρων (swine flu) που ξεκίνησε από το Μεξικό και διαδόθηκε αρχικά στις ΗΠΑ και Καναδά και στη συνέχεια σε όλες τις ηπείρους (18 χώρες μέχρι σήμερα). Πρόκειται για ιό που www.rieas.gr CBRNE-Terrorism Newsletter (Vol 37 – 2009) 3 παρεπιδημεί στους χοίρους αλλά φαίνεται ότι εξελίχθηκε περαιτέρω με προσθήκη γενετικού υλικού από το ανθρώπινο ιό της εποχικής γρίπης (seasonal flu) και το ιό της γρίπης των πτηνών (avian influenza). Μέχρι σήμερα ο ιός έχει προκαλέσει τον θάνατο άνω των 160 ατόμων στο Μεξικό και στις ΗΠΑ (1 θάνατος). Η πανδημία της Ισπανικής γρίπης (1918-19) είχε θνητότητα 2.5% αλλά προκάλεσε τον θάνατο δεκάδων εκατομμυρίων ατόμων καθώς διαδόθηκε με απίστευτους ρυθμούς. Η γρίπη των πτηνών προκάλεσε 257 θανάτους σε σύνολο 421 προσβληθέντων (θνητότητα 61%) ενώ το Σύνδρομο Σοβαρής Αναπνευστικής Ανεπάρκειας (SARS) που ξεκίνησε το 2003 από το Χονγκ-Κονγκ ευθύνεται για τον θάνατο 299 ατόμων σε σύνολο 1.755 προσβληθέντων (θνητότητα 17%). Το ανησυχητικό στην παρούσα πανδημία είναι ότι προσβάλλει άτομα ηλικίας 25 έως 45 ετών (χωρίς να διαφεύγει κάποια άλλη ηλικιακή ομάδα) σε αντιδιαστολή με την εποχική γρίπη που στοχεύει κατά κύριο λόγο πολύ νεαρά άτομα και ηλικιωμένους. Ο χρόνος επώασης του ιού των χοίρων (Η1Ν1) είναι 2-7 ημέρες και σε σοβαρές περιπτώσεις προκαλεί πνευμονία και θάνατο. Η κατανάλωση χοιρινού κρέατος είναι ασφαλής καθώς το μαγείρεμα (700C) σκοτώνει τον ιό. Η λήψη σχολαστικών μέτρων ατομικής υγιεινής και η αποφυγή συγχρωτισμού σε περιβάλλοντα με μεγάλο αριθμό ατόμων αποτελούν αποτελεσματικά μέτρα περιορισμού της επιδημίας. Τα υπάρχοντα εμβόλια κατά της γρίπης δεν είναι γνωστό εάν προσφέρουν προστασία ενώ ο γενικός πληθυσμός δεν έχει αναπτύξει ανοσία έναντι του ιού των χοίρων. Ιδιαίτερη ανησυχία προκαλεί το ενδεχόμενο εξάπλωσης του ιού των χοίρων σε χώρες που ήδη έχουν ενεργό επιδημία γρίπης των πτηνών (πχ. Αίγυπτος). Εχει ήδη δρομολογηθεί η διαδικασία παραγωγής εμβολίων για την αντιμετώπιση της πανδημίας της γρίπης του Μεξικού (ο όρος γρίπη των χοίρων δεν αποδίδει ορθά την πραγματικότητα) πλην όμως η όλη διαδικασία θα απαιτήσει χρονικό διάστημα 4-6 μηνών (περί τον Σεπτ 09 αναμένεται η κυκλοφορία του εμβολίου) Τα υφιστάμενα φάρμακα για την αντιμετώπιση της ανθρώπινης γρίπης (Tamiflu™ και Relenza™), φαίνεται ότι είναι δραστικά έναντι του ιού των χοίρων. Παράδειγμα προς μίμηση Τα διδάγματα από τις προηγούμενες πανδημίες κινητοποίησαν έγκαιρα τις αρχές του Χογκ-Κονγκ (που βρέθηκε στο δύνη του κυκλώνα κατά την πανδημία της γρίπης των πτηνών www.rieas.gr CBRNE-Terrorism Newsletter (Vol 37 – 2009) 4 το 2003), και σήμερα με την νέα πανδημία από τον ιό των χοίρων προ των πυλών, είναι πανέτοιμο να αντιμετωπίσει αποτελεσματικά τη νέα απειλή. Ενδεικτικά αναφέρονται τα παρακάτω: • Μέχρι την Πέμπτη 30 Απρ 09, η χώρα θα διαθέτει έξι νοσοκομεία που θα μπορούν να διενεργούν διαγνωστικές δοκιμασίες σε γενετικό επίπεδο σε δείγματα ύποπτων ασθενών • Χιλιάδες ιατροί και νοσηλευτές, συμπεριλαμβανομένων και των συνταξιούχων και των φοιτητών ιατρικής/νοσηλευτικής καθώς και εκείνων που διαθέτουν υγειονομική εκπαίδευση και έχουν μεταταχθεί σε άλλα επαγγέλματα έχουν συμπεριληφθεί σε βάσεις δεδομένων και είναι έτοιμοι προς κινητοποίηση • Υπάρχουν έτοιμα σχέδια για τη συνέχιση λειτουργίας των μέσων μαζικής μεταφοράς, των εγκαταστάσεων παραγωγής ηλεκτρισμού, των εργοστασίων τροφίμων, των τηλεπικοινωνιών και άλλων ζωτικών υπηρεσιών ακόμη και όταν μεγάλο ποσοστό εργαζομένων θα απουσιάζει. • Η πόλη διαθέτει 1.400 κλίνες σε μονάδες αναπνευστικής απομόνωσης που κατασκευάστηκαν κατά την τελευταία εξαετία για το φόβο της γρίπης των πτηνών ή του SARS ενώ οι διαθέσιμες κλίνες σε καθημερινή βάση είναι 15πλάσιες των αναγκών των κατοίκων. • Για πληθυσμό 7 εκατομμυρίων κατοίκων υπάρχουν διαθέσιμες 20 εκατομμύρια δόσεις του φαρμάκου Tamiflu (έναντι του οποίου ο ιός των χοίρων δεν έχει εισέτι αναπτύξει αντίσταση) • Η χώρα διαθέτει τους καλύτερους ειδικούς ιολόγους στην Ασία και εξαιρετικά ερευνητικά εργαστήρια • Σε νομικό επίπεδο έχουν καθοριστεί ήδη όλες οι διαδικασίες που επιβάλλουν υποχρεωτικά τη δήλωση ύποπτων κρουσμάτων γρίπης των χοίρων από το ιατρο- νοσηλευτικό προσωπικό στους αρμόδιους φορείς • Έχουν καθοριστεί επίσης οι νομοθετικές ρυθμίσεις που αφορούν περιπτώσεις απομόνωσης (quarantine) πιθανών περιστατικών και αναστολής ορισμένων ελευθεριών των πολιτών προκειμένου να καταστεί δυνατή η ανίχνευση όλων όσων ήρθαν σε επαφή με φορέα μεταδοτικής νόσου. Τα παραπάνω αποτελούν λαμπρό παράδειγμα για την πιστοποίηση των ανθρώπων και των κοινωνιών σε αυτούς που μαθαίνουν (lessons learned) και δίνουν λύσεις (πχ. Χονγκ-Κονγκ) και σε αυτούς που απλά αναγνωρίζουν (lessons identified) τα σύγχρονα προβλήματα και κάθε φορά εκφράζουν την έκπληξη τους γιατί το «ανεπάντεχο συνέβη» ξεχνώντας ότι «το αναπάντεχο ΠΑΝΤΑ συμβαίνει!». Κατ’ επανάληψη από το CBRNE-Terrorism Newsletter έχει τονιστεί εμφατικά. ότι η προληπτική οργάνωση δομών και μέτρων που βασίζονται σε αφοσιωμένους και καλά ενημερωμένους/εκπαιδευμένους ΑΝΘΡΩΠΟΥΣ είναι μονόδρομος για την αντιμετώπιση των σύγχρονων απειλών. Εξάλλου, μια πανδημία έχει τα ίδια χαρακτηριστικά με την απελευθέρωση βιολογικού όπλου σε αστικό περιβάλλον. Απλά στη περίπτωση της γρίπης του Μεξικού την ευθύνη ανέλαβε η Φύση ενώ στη δεύτερη περίπτωση θα πρόκειται για τρομοκρατική επίθεση με σκοτεινούς στόχους. Μήπως όμως η διάκριση των δύο «ενόχων» δεν είναι τόσο ξεκάθαρα διακριτή ; Δεν θα υιοθετήσουμε πρόωρα και άκριτα την αναδυόμενη στο διαδίκτυο τρομολαγνεία περί ανθρώπινης παρέμβασης στον ιό της χοίρων. Όμως, θα πρέπει να συνυπολογήσουμε σοβαρά την απορία ειδικών, έγκριτων ιολόγων παγκοσμίως, που εκφράζουν την έκπληξη τους για την ιδιόμορφη και περίπλοκη δομή του γονιδιώματος του ιού. Η πρόσφατη περίπτωση της εταιρείας παραγωγής εμβολίων Baxter στα προϊόντα της οποίας – με τελικούς αποδέκτες μεγάλο αριθμό χωρών – διαπιστώθηκε η παρουσία ζώντων ιών H5N1 (που προκαλεί τη γρίπη των πτηνών) σε www.rieas.gr CBRNE-Terrorism Newsletter (Vol 37 – 2009) 5 συνδυασμό με την ανάθεση από τον ΠΟΥ στην ίδια εταιρεία της παρασκευής εμβολίου κατά της γρίπης του Μεξικού, επιβάλλει εγρήγορση και το πιο σημαντικό: ευρύτητα πνεύματος και αποφυγή δογματισμών – για να μην εκπλαγούμε για μια ακόμη φορά (καθώς αναμένεται εντός του Μαΐου 2009 η αναβάθμιση του συναγερμού σε Επίπεδο-6). Χημικός πόλεμος στην αρχαιότητα Πάντα η αναδρομή στην αρχαιότητα καθησυχάζει τη συνείδηση μας ότι η φρίκη των χημικών όπλων δεν αποτελεί διαταραγμένη σκέψη των σύγχρονων ανθρώπων αλλά διαχρονική διαστροφή που μεταφέρθηκε γονιδιακά μέχρι των ημερών μας. Στο άρθρο που ακολουθεί παρουσιάζονται τα νεώτερα ευρήματα επί του θέματος από την εποχή των Ρωμαίων αποτέλεσμα έρευνας του University of Leicester στη Μ Βρετανία. Early chemical warfare comes to light Roman soldiers defending a Middle Eastern garrison from attack nearly 2,000 years ago met the horrors of war in a most unusual place. Inside a cramped tunnel beneath the site’s massive front wall, enemy fighters stacked up nearly two dozen dead or dying Romans and set them on fire, using substances that gave off toxic fumes and drove away Roman warriors just outside the tunnel. The attackers, members of Persia’s Sasanian culture that held sway over much of the region in and around the Middle East from the third to the seventh centuries, adopted a brutally ingenious method for penetrating the garrison wall, reported Simon James of the University of Leicester in England on January 10 at the annual meeting of the Archaeological Institute of America. “In my view, this is the earliest archaeological evidence for the use of chemical warfare, which was later used by the ancient Greeks,” James said. The Roman garrison at Dura (now called Dura-Europos) was located in what is now Syria and sat on a cliff overlooking the Euphrates River. The massive Sasanian siege of the garrison occurred in 256, give or take a few years. No historical records exist of this battle. Archaeological work conducted since 1920 at the ancient garrison has provided glimpses of the fierce conflict, although much remains unknown about precisely what happened. James’ new findings vividly illustrate that “you can create a real story out of battlefield patterns that archaeologists find,” remarks Melissa Connor of Nebraska Wesleyan University in Lincoln. James, who has conducted fieldwork at Dura-Europos for 30 years, examined a group of about 20 men’s skeletons adorned with military equipment that lay in a tunnel the Romans had dug to intercept Sasanian invaders, who were digging underneath the garrison wall via another tunnel. French investigators at the site have suggested that when the Romans reached the subterranean Sasanians, the mouth of the Roman tunnel collapsed. Trapped Romans were then killed and fell on top of one another. Although debris indeed blocked the entrance to the Roman tunnel, James doubted that explanation. First, he analyzed the positions of Roman soldiers’ bodies in the tunnel and determined that they had been deliberately
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