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Bioterrorism Definition and Agents Used

What is bioterrorism?

  • Bioterrorism is a form of terrorism where there is the intentional release of biological agents (bacteria, viruses, or other germs). This is also referred to as germ warfare.
  • Terrorism is defined by the United States government as the "unlawful use of force and violence against persons or property to intimidate or coerce a government, the civilian population, or any segment thereof, in furtherance of political or social objectives." The term "terrorism" does not imply what weapon is being used.
  • In addition to biological agents, terrorists can also utilize traditional weapons (guns), chemical agents and nuclear bombs.
  • While a biological agent may injure or kill people, animals, or plants, the goal for the terrorist is to further their social and political goals by making their civilian targets feel as if their government cannot protect them.
  • Many biological agents are found in nature; however, they can be modified by the terrorist to make them more dangerous. Some of these agents can be transmitted from person to person, and the infection may take hours or days to become apparent.

What are the biological agents that can be utilized for bioterrorism?

While any germ, bacteria, or virus could potentially be utilized by terrorist, there are a number of biological agents that have been recognized as being more likely to be utilized. The reason for these agents being of concern is based on their availability to terrorists and the ease by which these agents can be disseminated. The U.S. Centers for Disease Control and Prevention (CDC) has developed a classification system for biological terror agents, which is available on their web site (Categories). The classification is based on the likelihood of the agent being used and the risk posed by each agent. The agents (and the diseases they cause) are listed in table 1, including hyperlinks for those wishing to learn more about a specific agent or disease. However, it is almost impossible for most people to memorize all the details about each of these agents. It is more important for the general public to understand the risk of bioterrorism and the appropriate response to a terrorist attack.

Table 1: BIOTERRORISM AGENTS AND THE DISEASES THEY CAUSE Biologic agentDisease caused by the agent Bacillus anthracisAnthraxClostridium botulinum toxinBotulismYersinia pestisPlagueVariola majorSmallpoxFrancisella tularensisTularemiaFiloviruses (for example, Ebola, Marburg) and arenaviruses (for example, Lassa, Machupo)Viral hemorrhagic feversBrucella speciesBrucellosisEpsilon toxin of Clostridium perfringensFood poisoningSalmonella species, Escherichia coli O157:H7, ShigellaFood poisoningBurkholderia malleiGlandersBurkholderia pseudomalleiMelioidosisChlamydia psittaciPsittacosisCoxiella burnetiiQ feverRicinus communis (castor beans)Ricin toxin poisoningStaphylococcal enterotoxin BFood poisoningRickettsia prowazekiiEpidemic typhusVibrio choleraeCholeraCryptosporidium parvumCryptosporidiosisAlphaviruses (for example, Venezuelan equine encephalitis, eastern equine encephalitis, western equine encephalitis) and flaviviruses (for example, West Nile encephalitis, Saint Louis encephalitis, dengue fever)Viral encephalitisInfluenza virusInfluenzaMycobacterium tuberculosisMDR TB and XDR TB

Learn about the causes, symptoms, treatment, and trasmission of anthrax.

Anthrax, Then and Now

Medical Author: Michael C. Fishbein, MD
Medical Editor: Leslie J. Schoenfield, MD, PhD
Revising Medical Editor: Jay W. Marks, MD

Experts have said that it is a matter of when, not if, a large scale act of bioterrorismis carried out in the U.S. Why “bio” terrorism? Biologic weapons are cheaper and more devastating than chemical weapons and maybe even nuclear weapons. Deadly quantities of infectious agents are easy to hide, transport, and spread throughout the population. Indeed, the U.S. already experienced a bioterrorism attack. In 2001, powder containing the bacterium called anthrax was distributed through the U.S. mail. All together, 22 people became infected with anthrax. These people lived in South Florida, New York City, New Jersey, Maryland, Connecticut, Pennsylvania, Virginia, and Washington, DC. Eleven people seem to have inhaled the anthrax, and 11 others were infected through the skin. The FBI and CDC (Center for Disease Control) are still investigating this outbreak.

Because of this outbreak, most Americans are now aware of the infectious disease called anthrax. Most are also aware that it is usually a disease of animals and that it is a rare cause of disease or death in humans. Prior to the outbreak in 2001, the last case of fatal anthrax in the United States was in 1976. Moreover, no fatal cases occurred in the preceding 10 years. What may not be as widely known, however, is that the 1976 case occurred in California. This was not a case of bioterrorism. The patient did die of the infection, and the autopsywas performed at UCLA Medical Center. The details of this case have been described in a medical journal called Human Pathology (Volume 9, pages 594-597, September, 1978).

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    How do I know if I have been exposed to a bioterrorism agent?

    The symptoms of illness caused by the different bioterrorism agents are frequently very nonspecific. Many of the agents cause a "flu-like" illness. These symptoms would include fever, cough, nausea, vomiting, and headache. It is very hard to differentiate many of the different diseases initially, and tests to confirm the diagnosis often must be done at specialized state laboratories and may require weeks until the results are received.

    It is best to stay informed through news media on what symptoms to look for and when to seek medical care. The health care system simply cannot handle every member in the community demanding to be tested for the disease. Many diseases do not even have a treatment other than supportive care which can often be done at home.

    Should I have some antibiotics on hand just in case I get exposed?

    While there are a few biological agents that can be prevented by taking antibiotics (for example, anthrax), it is not recommended that you stockpile antibiotics. Antibiotics have a limited shelf life and would likely be unusable by the time an attack might occur. Also, there are many different types of infectious agents, each requiring different antibiotics. All drugs, including antibiotics, have side effects, and taking them inappropriately could cause more harm than good.

    Because the likelihood of a biological attack is small, it is better to wait until there has been an attack before getting medications. The U.S. government has stockpiles of drugs that will be immediately flown into a community that has experienced a biological attack (these supplies are rotated to keep them current). Additionally, many large communities also have stockpiles of medications for emergency use.

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