34.2 Biological and Technological Disasters

Influenza

Commonly referred to as the flu, influenza remains a significant public health concern globally, affecting millions of individuals each year (Gaitonde et al., 2019). This highly contagious respiratory illness is caused by influenza viruses that infect the nose, throat, and sometimes the lungs. Influenza viruses are notorious for their ability to mutate rapidly, leading to the emergence of new strains and seasonal outbreaks. Nurses play a vital role in influenza prevention, diagnosis, and treatment, particularly during flu season. They advocate for vaccination, educate the public on hygiene practices to reduce transmission, and provide care to those who become ill from the virus.

In health-care settings, nurses implement infection control measures to prevent the spread of influenza among patients, staff, and visitors. Additionally, they closely monitor patients with influenza-like symptoms, administer antiviral medications when appropriate, and offer supportive care to alleviate symptoms and prevent further complications. The most important intervention is handwashing. Through their expertise in infection prevention and patient care, nurses contribute significantly to reducing the burden of influenza and safeguarding public health.

The H1N1 influenza virus, commonly known as swine flu, emerged as a global health concern in 2009, triggering a pandemic that swept across continents. A subtype of the influenza virus, H1N1 was characterized by its rapid spread and ability to infect individuals of all ages. H1N1 presented unique challenges to health-care systems worldwide. The virus caused severe respiratory illness and, in some cases, led to fatal complications, particularly among at-risk populations (Centers for Disease Control and Prevention [CDC], 2019). The high morbidity and mortality associated with H1N1 underscores the devastating and lasting effect that biological disasters can have on public health.

Nurses play a pivotal role in response efforts, providing care to affected individuals while implementing stringent infection control measures to limit transmission. The H1N1 pandemic highlighted the importance of preparedness, collaboration, and adaptability in the face of emerging infectious diseases. Nurses were at the forefront of vaccination campaigns, community outreach initiatives, and patient education efforts, helping to mitigate the impact of H1N1 and protect at-risk populations. Through their expertise in epidemiology, patient care, and public health, nurses continue to play a crucial role in monitoring for potential outbreaks, advocating for vaccination, and ensuring swift and effective responses to infectious disease threats like H1N1.

Anthrax

Caused by the bacterium Bacillus anthracis, anthrax is a rare but potentially deadly infectious disease that can affect humans and animals. While naturally occurring anthrax infections in humans are uncommon, the bacterium has been weaponized in bioterrorism attacks, leading to heightened concerns about its potential use as a biological weapon. Anthrax can infect humans through inhalation, ingestion, or direct contact with infected animals or contaminated animal products. Common animal vectors (carriers) for anthrax include livestock such as cattle, sheep, goats, and horses, as well as wild animals like deer and other herbivores. Inhaled anthrax, the most lethal form, presents with flu-like symptoms initially but can rapidly progress to severe respiratory distress and systemic illness. The average fatality rate of the different forms of anthrax is approximately 44.75 percent (Manish et al., 2020). Nurses collaborate with public health authorities to educate communities on recognizing the signs and symptoms of anthrax, implementing appropriate infection control measures, and administering prophylactic antibiotics or vaccines when indicated. Nurse should educate the community on vaccines and therapeutic antibodies as the most crucial components of anthrax prophylaxis (pre- and post-exposure) and treatment (Manish et al., 2020). Signs and symptoms of anthrax include:

• Cutaneous anthrax
  • Painless skin sore with a black center, often appearing after the blisters or bumps
  • Small blisters or bumps that may itch
  • Swelling around the sore
• Inhalation anthrax
  • Body aches
  • Chest pain
  • Cough
  • Extreme fatigue
  • Fever and chills
  • Headache
  • Nausea and vomiting
  • Shortness of breath
  • Sweating (usually drenching)
• Gastrointestinal anthrax
  • Diarrhea or bloody diarrhea
  • Fever and chills
  • Hoarseness
  • Nausea and vomiting, especially bloody vomiting
  • Painful swallowing
  • Sore throat
  • Stomach pain
  • Swelling of neck, neck glands, and/or abdomen (stomach)
• Injection anthrax
  • Fever and chills
  • Itchy blisters or bumps where the drug was injected
  • Skin sore and/or abscess with swelling and a black center, appearing after the blisters or bumps

In the event of a bioterrorism attack involving anthrax, nurses are on the front lines of emergency response efforts, triaging and treating affected individuals while coordinating with interdisciplinary teams to contain the spread of the disease. Through their expertise in infection control, emergency preparedness, and patient care, nurses play a vital role in mitigating the impact of anthrax and protecting public health.

Nursing Roles and Responsibilities

Nurses play indispensable roles in biological disaster preparedness, response, and recovery efforts. With their diverse skill sets and frontline presence, they are integral to the health-care system's ability to effectively address the complexities of such crises. In the preparatory phase, nurses contribute to developing and implementing emergency response plans, conducting drills, and ensuring health-care facilities are equipped with the necessary supplies and protocols. These supplies include personal protective equipment (PPE) such as masks, gloves, gowns, and face shields; medical supplies such as bandages, antiseptics, and medications; emergency medical equipment such as defibrillators, ventilators, and first aid kits; and logistical supplies including communication devices, backup power sources, and sufficient stock of essential medicines and medical consumables.

Nurses need to remember cultural diversity impacts disaster preparedness and response efforts by influencing communication styles, belief systems, and help-seeking behaviors within communities. Having a strong understanding of the community’s cultural norms and values is essential for developing culturally sensitive plans and interventions that effectively reach and support diverse populations.

During a biological disaster, nurses are often among the first responders, providing immediate medical care, triaging patients, and implementing infection control measures to prevent further transmission. They play key roles in surveillance, rapidly identifying and reporting cases to public health authorities to facilitate early intervention. In the aftermath of a biological disaster, nurses continue to support recovery efforts, offering ongoing medical care, psychological support, and community health services. Their resilience, adaptability, and commitment to patient-centered care are essential in navigating the challenges posed by biological disasters and ensuring the well-being of affected individuals and communities.

Chemical Hazards

A chemical hazard encompasses a diverse array of substances that can pose risks to human health and the environment. Toxic chemicals include substances such as pesticides, heavy metals, and industrial solvents. Exposure to toxic chemicals can lead to acute or chronic health effects, ranging from irritation and respiratory problems to neurological damage and cancer (such as mesothelioma, which is commonly caused by chemical exposure) (CDC, 2023).

Another category of chemical hazards are corrosive chemicals, which have the potential to cause severe damage to skin, eyes, and respiratory tissues upon contact. Examples include strong acids, alkalis, and oxidizing agents commonly found in industrial settings. Additionally, there are flammable and combustible chemicals, which pose fire and explosion risks if mishandled or improperly stored. These substances include fuels, solvents, and gases that can ignite when exposed to heat, sparks, or open flames.

Finally, there are reactive chemicals, which can undergo spontaneous reactions or produce hazardous byproducts when exposed to other substances or conditions. Examples include peroxides, oxidizers, and unstable compounds commonly used in laboratory and manufacturing processes. Understanding the characteristics and hazards associated with these types of chemicals is essential for effective risk assessment, mitigation, and emergency response efforts.

Radiation Emergencies

Radiation emergencies include several types radioactive exposure, which vary by source and damage. A radiological disaster encompasses a range of events involving the release of radioactive materials into the environment, posing risks to human health and the ecosystem. These disasters can be categorized into several types based on their sources and impacts. First, there are nuclear accidents, which involve the release of radioactive materials from nuclear power plants or research facilities due to equipment malfunctions, human error, or natural disasters. Examples include the Chernobyl disaster in 1986 and the Fukushima Daiichi nuclear disaster in 2011. Second, radiological terrorism involves deliberate acts to release radioactive materials with the intent to cause harm or create fear. This may include the use of radioactive sources in explosive devices or dispersal devices such as "dirty bombs." Third, radiological incidents can occur in health-care settings, such as accidental exposure to radiation during medical procedures or the mishandling of radioactive materials in laboratories during x-rays, radiation therapy, chemotherapy, and radioactive medication creation. Finally, environmental contamination from historical activities such as mining, waste disposal, or military testing can lead to long-term radiological hazards in communities. Ecosystems that support human society can experience devastating contamination, as radioactive particles can permeate soil, water, and food chains. When animals and plants are exposed to radiation, they become rendered unsafe for human consumption, which can have negative effects on agriculture and food supplies (Obrador et al., 2022).

Although the effects are not always readily or immediately visible, radiological disasters can pose significant harm to the environment and human health. The effects of radiological disasters are also not just an immediate concern, as they are often felt for decades. In terms of morbidity and mortality, radiation can penetrate the body, damaging cells and DNA, leading to acute conditions such as radiation sickness (characterized by nausea, vomiting, skin burns, and even death in severe cases). There are also long-term risks associated with exposure, including increased cancer rates (e.g., leukemia, thyroid cancer), genetic mutations, and birth defects in future generations (CDC, 2018).

A nuclear disaster (or nuclear incident) refers to the catastrophic release of radioactive materials, typically the result of a detonation or explosion. The most dangerous type of nuclear disaster is nuclear weapons detonation, involving the deliberate use of atomic bombs or other nuclear devices, resulting in devastating immediate and long-term consequences, as seen in the atomic bombings of Hiroshima and Nagasaki during World War II. Nuclear terrorism poses a significant threat, with the potential for malicious actors to acquire or construct improvised nuclear devices or dirty bombs, dispersing radioactive materials to cause harm and instill fear.