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PubMed2000

Bioterrorism threats: learning from inappropriate responses.

Between April 1997 and June 1999, some 200 mailed or telephoned bioterrorism threats were received at a variety of locations. Usually claiming that anthrax had been released, the threats all proved to be hoaxes. In many instances, local emergency responders treated the more than 13,000 potential victims inappropriately, in particular requiring victims to strip and undergo decontamination with bleach solutions. Narratives of several incidents indicated that many victims were distressed and embarrassed by their treatment. Their experiences underscore the need for improved local response actions and the formulation of a uniform response protocol for public health agencies.

Anthrax↗
PubMed1999

The looming threat of bioterrorism.

Biological weapons have recently attracted the attention and the resources of the nation. Discerning the nature of the threat of bioweapons as well as appropriate responses to them requires greater attention to the biological characteristics of these instruments of war and terror. The dominant paradigm of a weapon as a nuclear device that explodes or a chemical cloud that is set adrift leaves us ill-equipped conceptually and practically to assess and thus to prevent the potentially devastating effects of bioterrorism. Strengthening the public health and infectious disease infrastructure is an effective step toward averting the suffering that could be wrought by a terrorist's use of a biological agent.

Anthrax↗
PubMed2000

The next target of bioterrorism: your food.

One of the many forms that biological warfare may take is the targeting of major food crops. In a poor country where millions of citizens depend on staple crops such as rice, an act of bioterrorism that destroys the crop would create a famine, resulting not only in malnutrition and starvation but also in reduced immune resistance to a range of common illnesses. To reduce the potential of deliberate introductions of crop pathogens as acts of terrorism, researchers must be able to "fingerprint" pathogens at the molecular level and discriminate between naturally occurring and deliberately introduced outbreaks. Several domestic and international surveillance, tracking, and reporting efforts are under way.

Biological Warfare↗
PubMed2005

Laboratory exposures to brucellae and implications for bioterrorism.

Brucellae are class 3 organisms and potential agents of bioterrorism. Because of effective public health measures, brucellosis has become a rare disease in industrialized countries, and clinical microbiology laboratories are frequently unfamiliar with the genus. A low index of suspicion by physicians or failure to notify the laboratory, equivocal Gram-stain results, misidentification of the organism by commercial systems, unsafe laboratory practices, and laboratory accidents have been responsible for numerous cases of exposure to the organism and laboratory-acquired disease in recent years. Discovery of a laboratory exposure to brucellae should prompt an exhaustive investigation of the event and its circumstances, definition of the population at risk, enforcement of safe laboratory practices, and antimicrobial drug prophylaxis for exposed persons. Inadvertent exposures to brucellae in the clinical laboratory indicate a widespread lack of preparedness to cope with eventual biologic threats involving use of the organism.

Brucella↗
PubMed2000

Bioterrorism: an overview.

How real is the threat of bioterrorism? Experts may disagree on the likelihood of use, but the possibility cannot be totally dismissed. Complacent ignorance of a low-probability, high-cost risk is dangerous and can result in devastating global consequences.

Biological Warfare↗
PubMed2000

A national laboratory network for bioterrorism: evolution from a prototype network of laboratories performing routine surveillance.

The need for an enhanced network of laboratories to respond to a bioterrorism attack has been realized. Therefore, the Association of Public Health Laboratories and the Centers for Disease Control are developing a system involving civilian public health and private laboratories that builds on the existing network for routine disease surveillance. It is anticipated that most bioterrorist attacks will not be immediately recognized, so increased laboratory capabilities and communications are necessary. The laboratory network has four categories with different biosafety levels assigned to clearly delineate the correct referral route. Improving communications through World Wide Web-based systems will allow test results, surge capacity, and training and identification algorithms to be shared instantly. There are plans to expand the network to include standard public health surveillance and emerging infectious diseases.

Biological Warfare↗
PubMed2002

Biological weapons and bioterrorism in the first years of the twenty-first century.

This paper evaluates four recent developments in biological-weapons politics and bioterrorism. First is American opposition to finalization of a verification protocol for the Biological Weapons Convention; second, a successful attempt at mass-casualty terrorism; third, an ongoing investigation into the bioterrorist capabilities of the al Qaeda network; and, fourth, a series of fatal anthrax attacks in the United States. The first of these evaluations is informed by interviews conducted between 2000 and 2002 with policy principals in the United States and elsewhere.

Journal Article↗
PubMed2001

Clinical presentation of inhalational anthrax following bioterrorism exposure: report of 2 surviving patients.

The use of anthrax as a weapon of biological terrorism has moved from theory to reality in recent weeks. Following processing of a letter containing anthrax spores that had been mailed to a US senator, 5 cases of inhalational anthrax have occurred among postal workers employed at a major postal facility in Washington, DC. This report details the clinical presentation, diagnostic workup, and initial therapy of 2 of these patients. The clinical course is in some ways different from what has been described as the classic pattern for inhalational anthrax. One patient developed low-grade fever, chills, cough, and malaise 3 days prior to admission, and then progressive dyspnea and cough productive of blood-tinged sputum on the day of admission. The other patient developed progressively worsening headache of 3 days' duration, along with nausea, chills, and night sweats, but no respiratory symptoms, on the day of admission. Both patients had abnormal findings on chest radiographs. Non-contrast-enhanced computed tomography of the chest showing mediastinal adenopathy led to a presumptive diagnosis of inhalational anthrax in both cases. The diagnoses were confirmed by blood cultures and polymerase chain reaction testing. Treatment with antibiotics, including intravenous ciprofloxacin, rifampin, and clindamycin, and supportive therapy appears to have slowed the progression of inhalational anthrax and has resulted to date in survival.

Anthrax↗