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PubMed2001

The threat of smallpox and bioterrorism.

Smallpox (variola) was a devastating disease with a high case-fatality rate. Although the disease was eradicated in 1977, the remaining stocks of smallpox virus constitute one of the most dangerous threats to humanity. The smallpox virus is highly specific for humans and non-pathogenic in animals. There is no antiviral treatment and a vaccine is active only if administered in the first four days post-exposure. Smallpox virus represents a potential biological weapon that could be used by terrorists, and the destruction of stocks raises political, social, scientific and ethical issues.

Biological Warfare↗
PubMed2003

Prevention and treatment of bacterial diseases caused by bacterial bioterrorism threat agents.

There is general consensus that the bacterial agents or products most likely to be used as weapons of mass destruction are Bacillus anthracis, Yersinia pestis, Francisella tularensis and the neurotoxin of Clostridium botulinum. Modern supportive and antimicrobial therapy for inhalational anthrax is associated with a 45% mortality rate, reinforcing the need for better adjunctive therapy and prevention strategies. Pneumonic plague is highly contagious, difficult to recognize and is frequently fatal. Therefore, the development of vaccines against this agent is crucial. Although tularemia is associated with low mortality, the highly infectious nature of aerosolized F. tularensis poses a substantive threat that is best met by vaccine development. Safer antitoxins and a vaccine are required to meet the threat of the use of botulinum toxin as a weapon of mass destruction. In this article, the current status of research in these areas is reviewed.

Adjuvants, Immunologic↗
PubMed2002

[Prevention of bioterrorism by vaccines].

Prevention against the weapons of bioterrorists is limited by the multiplicity of agents that could be used. Against smallpox, stocks of the classical vaccine must be prepared, but this vaccine is dangerous and we must look for a new and safer vaccine. A vaccine against anthrax is probably possible relatively soon. One may be less optimistic concerning plague, since it is not sure that we could protect against the pulmonary plague, but research in this field is an emergency. The large number of viruses capable of inducing haemorrhagic fevers makes especially difficult the preparation of vaccines against these infections. We must also make available monoclonal antibodies that could be used as therapies against toxin, notably botulism, or against antibiotic-resistant bacteria.

Anthrax↗
PubMed2002

Testing a symptom-based surveillance system at high-profile gatherings as a preparatory measure for bioterrorism.

We tested symptom-based surveillance during the G8 conference in 2000 as a means of detecting outbreaks, including bio-terrorism attacks, promptly. Five categories of symptoms (skin and haemorrhagic, respiratory, gastrointestinal, neurological and unexplained) were adopted for the case definition of the surveillance. The surveillance began I week before the conference, and continued until 1 week after the conference ended. We could not detect any outbreaks during this surveillance. Compared to the existing diagnosis-based surveillance system, symptom-based surveillance has the advantages of timeliness and simplicity. However, poor specificity and difficulties in determining epidemic threshold were important limitations of this system. To increase the specificity of surveillance, it is essential to incorporate rapid laboratory diagnoses into the system.

Bioterrorism↗