Accounting

In order to combat bribery of foreign public officials effectively, each Party shall take such measures as may be necessary, within the framework of its laws and regulations regarding the maintenance of books and records, financial statement disclosures, and accounting and auditing standards, to prohibit the establishment of off-the-books accounts, the making of off-the-books or inadequately identified transactions, the recording of non-existent expenditures, the entry of liabilities with incorrect identification of their object, as well as the use of false documents, by companies subject to those laws and regulations, for the purpose of bribing foreign public officials or of hiding such bribery.

Each Party shall provide effective, proportionate and dissuasive civil, administrative or criminal penalties for such omissions and falsifications in respect of the books, records, accounts, and financial statements of such companies.

Official Commentaries

Article 8 – Accounting

Article 8 is related to section V of the 1997 OECD Recommendation, which all Parties will have accepted and which is subject to follow-up in the OECD Working Group on Bribery in International Business Transactions. This paragraph contains a series of recommendations concerning accounting requirements, independent external audit and internal company controls the implementation of which will be important to the overall effectiveness of the fight against bribery in international business. However, one immediate consequence of the implementation of this Convention by the Parties will be that companies which are required to issue financial statements disclosing their material contingent liabilities will need to take into account the full potential liabilities under this Convention, in particular its Articles 3 and 8 , as well as other losses which might flow from conviction of the company or its agents for bribery. This also has implications for the execution of professional responsibilities of auditors regarding indications of bribery of foreign public officials. In addition, the accounting offences referred to in Article 8 will generally occur in the company's home country, when the bribery offence itself may have been committed in another country, and this can fill gaps in the effective reach of the Convention.

INTRODUCTION

Smallpox is caused by variola viruses, which are large, enveloped, single-stranded DNA viruses of the Poxvirus family and the Orthopoxvirus genus. Variola major strains cause three forms of disease (ordinary, flat type, and hemorrhagic), whereas variola minor strains cause a less severe form of smallpox. Vaccination with vaccinia virus, another member of the Orthopoxvirus genus, protects humans against smallpox because of the high antibody cross-neutralization between orthopoxviruses.

The Working Group for Civilian Biodefense considers smallpox a dangerous potential biological weapon because of “its case-fatality-rate of 30% or more among unvaccinated persons and the absence of specific therapy.” Of the potential ways in which smallpox could be used as a biological weapon, an aerosol release is expected to have the most severe medical and public health outcomes because of the virus's stability in aerosol form, low infectious dose, and high rate of secondary transmission. A single case of smallpox would be a public health emergency.

EPIDEMIOLOGY

Smallpox as a Biological Weapon

Smallpox has been used as a biological weapon in the distant past and has recently been a focus of bioweapons research. In the 18th century, British troops in North America gave smallpox-infected blankets to their enemies, who went on to suffer severe outbreaks. Defecting Russian scientists describe covert Russian operations during the 1970s and 1980s that focused on the development of more virulent smallpox strains and of missiles and bombs that could release smallpox.

INTRODUCTION

Plague is an acute bacterial infection caused by Yersinia pestis, a member of the family Enterobacteriaceae. Y. pestis is a pleomorphic, nonmotile, nonsporulating, intracellular, gram-negative bacillus that has a characteristic bipolar appearance on Wright, Giemsa, and Wayson's stains. There are three virulent biovars – antiqua, mediaevalis, and orientalis – and a fourth avirulent biovar, microtus. The orientalis biovar is thought to have originated in southern China and caused the most recent pandemic.

The Working Group for Civilian Biodefense considers plague to be a potential biological weapon because of the pathogen's availability “around the world, its capacity for its mass production and aerosol dissemination, and the difficulty in preventing such activities, high fatality rate of pneumonic plague, and potential for secondary spread of cases during an epidemic.” Of the potential ways in which Y. pestis could be used as a biological weapon, aerosol release would be most likely. This method has been successfully demonstrated to cause disease in Rhesus macaques.

EPIDEMIOLOGY

Plague as a Biological Weapon

In the 20th century, countries including the United States, the former Soviet Union, and Japan developed ways for using Y. pestis as a weapon. Creating aerosolized plague is technically challenging; however, if an intentional release of aerosolized plague were to take place, an outbreak of pneumonic plague would be likely. This would be of serious concern because of the high case-fatality rate and the potential for person-to-person transmission.

INTRODUCTION

Botulism is a disease caused by exposure to botulinum toxin produced from Clostridium species, mainly Clostridium botulinum. Clinical forms of the disease include foodborne, inhalational, wound, infant, adult intestinal toxemia, and iatrogenic. C. botulinum is a gram-positive, strictly anaerobic, spore-forming bacillus naturally found in soil and aquatic sediments. There are seven types of the toxin based on antigenic differences, labeled A through G. Types A, B, and E (and rarely, F) are pathogenic in humans. Types C, D, and E cause illness in other mammals, birds, and fish. Botulinum toxin lacks color, odor, and taste and is the most lethal toxin known. Death is caused by doses of less than 1 μg. Antibiotics have no activity against the toxin itself.

In response to unfavorable environmental conditions (changes in pH, temperature, and water or nutrient availability), C. botulinum bacteria “sporulate.” C. botulinum spores are hardy, resistant to desiccation, heat, ultraviolet (UV) light, and alcohols, and can survive boiling for up to 4 hours; however, they are readily killed by chlorine-based disinfectants. Once spores encounter more favorable conditions, such as are found in human tissues, they “germinate,” producing growing cells that are capable of reproducing and elaborating toxin.

The Working Group for Civilian Biodefense considers botulism to be a dangerous potential biological weapon because of the pathogen's “extreme potency and lethality; its ease of production, transport, and misuse; and the need for prolonged intensive care among affected persons.”

INTRODUCTION

Tularemia is a zoonotic disease caused by Francisella tularensis, a nonsporulating, nonmotile, aerobic, gram-negative coccobacillus. There are several subspecies of F. tularensis, with the biovars tularensis (type A) and holarctica (type B) occurring most commonly in the United States. The clinical syndromes caused by tularemia depend on the route of infection and subspecies of the infecting organism. Tularemia is highly infectious, requiring inhalation or inoculation of as few as 10 organisms to cause disease. Although its virulence factors are not well characterized, type A is generally thought to be the more virulent subspecies. However, the virulence of type A subspecies may vary between geographic regions within the United States, with the midwestern and eastern states having more severe infections.

The Working Group for Civilian Biodefense considers tularemia to be a dangerous potential biological weapon because of its “extreme infectivity, ease of dissemination, and its capacity to cause illness and death.” Of the potential ways that F. tularensis could be used as a biological weapon, an aerosol release is expected to have the most severe medical and public health outcomes.

EPIDEMIOLOGY

Tularemia as a Biological Weapon

Weaponized F. tularensis was developed and stockpiled by the U.S. military, though the supply was destroyed in the 1970s. The Soviet Union is reported to have developed antibiotic- and vaccine-resistant strains of weaponized F. tularensis.

Experts believe that an aerosolized release is the most likely intentional use of F. tularensis organisms.

INTRODUCTION

Viral hemorrhagic fevers (VHFs) refer to a group of illnesses caused by several families of viruses, including:

• Filoviridae (Ebola and Marburg viruses)

• Arenaviridae (Lassa fever and New World hemorrhagic fever)

• Bunyaviridae (Rift Valley fever, Crimean-Congo fever, and agents of “hemorrhagic fever with renal syndrome” [HFRS])

• Flaviviridae (yellow fever, Omsk hemorrhagic fever, Kyasanur Forest disease, and dengue)

Many VHF viruses are virulent, and some are highly infectious (e.g., filoviruses and arenaviruses) with person-to-person transmission from direct contact with infected blood and bodily secretions. Effective therapies and prophylaxis are extremely limited for VHF; therefore, early detection and strict adherence to infection control measures are essential.

The Working Group for Civilian Biodefense considers some hemorrhagic fever (HF) viruses to pose a serious threat as potential biological weapons based on their risk of morbidity and mortality, feasibility of production, and their ability to cause infection through aerosol dissemination. These include Ebola, Marburg, Lassa fever, New World arenaviruses, Rift Valley fever, yellow fever, Omsk hemorrhagic fever, and Kyasanur Forest disease. This chapter will focus only on these VHF viruses and will not include a discussion of dengue fever (see Chapter 54, Fever in the Returning Traveler), hemorrhagic fever with renal syndrome (see Chapter 70, Hantavirus), and Crimean-Congo hemorrhagic fevers.

INTRODUCTION

Anthrax is an acute infection caused by Bacillus anthracis, a large, gram-positive, spore-forming, aerobic, encapsulated, rod-shaped bacterium. Spores germinate and form bacteria in nutrient-rich environments, whereas bacteria form spores in nutrient-poor environments. The anthrax bacillus produces high levels of two toxins: Edema toxin causes massive edema at the site of germination, and lethal toxin leads to sepsis. Severity of anthrax disease depends on the route of infection and the presence of complications, with case fatality ranging from 5% to 95% if untreated.

The Working Group for Civilian Biodefense considers B. anthracis to be one of the most serious biological threats. Anthrax has been weaponized and used. It can be fairly easily disseminated and causes illness and death. Of the ways that B. anthracis could potentially be used as a biological weapon, an aerosol release would be expected to have the most severe medical and public health outcomes.

EPIDEMIOLOGY

Anthrax as a Biological Weapon

Anthrax was successfully used as a biological weapon in the United States in October 2001. Cases resulted from direct or indirect exposure to mail that was deliberately contaminated with anthrax spores. In total, 22 cases were identified, 11 with inhalational (five fatal) and 11 with cutaneous anthrax (seven confirmed, four suspected).

Several countries, including the United States, have had anthrax weaponization programs in the past.

Introduction

Procedures for the relaxation of body and mind have been known for thousands of years. In some cultures relaxation methods have even become an integral part of philosophical, religious value systems. In view of this it is perhaps surprising that relaxation techniques have gained clinical interest only fairly recently. Early pioneers include J.H. Schultz (autogenic training; e.g. Schultz & Luthe, 1959) and Edmund Jacobsen (progressive muscle relaxation; Jacobson, 1929). Davidson and Schwartz (1976) found it surprising that the subject had been absent from psychological examination for so long, despite obvious links between psychological and physiological arousal and emotional disorders.

Furthermore, perhaps as a result of its varied nature and ideographic meaning for different individuals, there were no generally agreed definitions of the concept. Jacobson attempted to define relaxation by describing its effects thus: ‘respiration loses the slight irregularities, the pulse rate may decline to normal, the knee jerk diminishes or disappears along with the pharyngeal and flexion reflexes and nervous start, the esophagus … relaxes in all its parts, while mental and emotional activity dwindle or disappear for brief periods’ (Davidson & Schwartz, 1976, p. 400).

In modern clinical psychotherapy and behavioural medicine the focus for relaxation is on emotional and health problems which are perceived to be associated with increased levels of tension. In such clinical contexts therapists make frequent use of stress reduction or relaxation techniques.