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What is Bioterrorism?
The intended use of biological weapons to
cause disease in humans, animals, and plants,
as an act of war. Biological weapons
deliberately disseminate disease-producing
organisms or toxins and achieves this effect
through multiplication within a target host.
Against persons and institutions.
Directed against consumer/commercial products
• Agents of bioterrorism which include microorganisms (bacteria,
viruses, and fungi) that are capable of entering the human body by
inhalation or digestion, and thereafter multiplying – causing illness
• Capable of causing epidemics.
• Include toxins produced by microorganisms, plants and animals
• Or synthetic analogues of naturally occurring toxins
• Chemicals that regulate biological functions
* Incubation period
Centres for DiseaseControl have categorised the level of threat of biological
agents based on their above mentioned features into 3 categories.
Investigation on three levels:
Epidemiologic clues for Bioterrorism:
Tight cluster of cases
High infection rate
Unusual or localized geography
Unusual clinical presentation
Unusual time of year
Aerobic, gram positive rod, spore-forming, non-motile
Virulence requires an antiphagocytic capsule and 3 toxin
compounds, namely protective antigen, lethal factor and
It exists in soils worldwide
Primarily it was a disease of herbivores and exists naturally as
a zoonotic disease
Human infection through contact with infected animals or
Three Anthrax disease types: cutaneous, gastrointestinal and
inhalational (seen in US in 2001)
Produces hemorrhagic mediastinitis (bleeding into the mid-
chest) which rapidly progresses into a systemic infection
Incubation lasts 3 - 60 days
Secondary septasemia has a mortality rate estimated to be
Initial symptoms are abrupt and develop after 72 hours. Non-
specific fever, dyspnea, cough, headache and vomiting
Death can occur within hours of exposure. (Average 3 days
from onset of signs in Sverdlovsk)
Drug of choice for chemoprophylaxis is Oral
flouroquinolones, given to known or high risk exposures
Active immunization (vaccines) – Exists for smallpox,
anthrax, botulinum toxin, and others
Smallpox has been successfully eradicated. – Milestone in
Chemoprophylaxis (antibiotics) – Given BEFORE the disease
manifests eg. Anthrax
Personal protection – HEPA type filters (HEPA masks) for
most agents (respiratory)
Treatment of the infection
Active vaccination not cost-effective for routine use
Insufficient supplies or distribution for chemoprophylaxis
(leads to prioritized treatment, reserved only for known (VIP)
or high risk exposures)
Treatment of the infection is limited for most agents
High mortality (>80%) even for aggressive treatment
Many vaccines have been produced but do not meet required levels of
efficacy and safety and another problem facing vaccines is acceptance by
people.A problem evident with the current flu vaccine. DDT
Vol. 9, No. 5 March 2004
BiologicalWeapons Convention, to monitor the use and deployment of
so-called dual-use technologies, which can mean almost anything, and to
ensure greater scrutiny of scientists and the communication of scientific
methodologies and data.
Problems arise with psychological trauma and post-traumatic stress-
patients displaying a lot of symptoms of mental disorder rather than
those of the disease and this can undermine effective treatment of those
directly affected by the disease. Mass hesteria etc.
Over the next five years, the US National Institutes of Health
(NIH) plan to spend hundreds of millions of dollars to discover
and develop or improve treatment and prevention modalities
for agents of bioterrorism.The NIH has recently funded eight
centers designated as ‘Research Centers of Excellence.’These
centers have been awarded $350 000 000 to develop new
antibiotics and vaccines to protect the US population from
agents of bioterrorism, as well as novel means to detect
US government signed legislation providing $2.9 billion to
enhance bioterrorism preparedness, including public health
and medical strategies.
Providing a need for more extensive research into
antimicrobial agents against Bacillus anthracis, Yersinia pestis
and Francisella tularensis, as well as the toxins produced by
Clostridium botulinum, which are believed to pose the
greatest threat as bacterial bioterrorism agents.
Use of prophylactic antimicrobials- naturally occurring and
engineered antimicrobial resistance. Hence we need to
improve detection of antimicrobial resistance in bioterrorism
agents and we must also use our understanding of the
molecular pathogenesis of these three organisms to identify
potential targets that can be used in the development of
novel antimicrobial agents.