PerspectivesAre you interested in submitting a Perspective Article? Be sure to read The Science Advisory Board's Editorial Guides for Perspective Articles. Click here. The Evolution of Bioterrorism: The Agents Remain Constant but the Terrorist Profile Has Changed by Mark Sorrentino, M.D., M.S. Bioterrorism seems to be the current "buzz word." We have suddenly become inundated with comments by the so-called media "experts." What do we really know about bioterrorism? The FBI admitted in its 1997 annual "Terrorism in the United States" report that "there is no single, universally accepted definition of terrorism." We do know that bioterrorism has changed the nature of terrorism. Many bioterrorists have taken college-level courses in science related subjects, they are educated, and able to tackle the technological challenges of biological terrorism. As modern terrorist groups become decentralized and many self-declared terrorists work alone it has become increasingly difficult for law-enforcement agencies to counter effectively. The CDC has ranked biological agents of concern to public health into three categories. Category A contains agents with the greatest threat in terms of their ability to cause mass morbidity and mortality. The diseases include smallpox (Variola major), anthrax (Bacillus anthracis), plague (Yersinia pestis), botulism (Clostridium botulinum), tularemia (Francisella tularensis), and hemorrhagic fevers (filoviruses/arenaviruses). Category B agents are considered to have potential for transmission/illness, but don't carry the same need for immediate public health action that the Category A agents have. They include Q fever (Coxiella burnetii), brucellosis (Brucella species), glanders (Burkholderia mallei), melsosdosis (Burkholderia pseudomallei), viral encephalitis (alphaviruses), typhus (Rickettsia prowazekii), toxin syndrome (toxins (ricin, Epsilon, toxin of Clostridium, perfringens, staphylococcal enterotoxin B)), psittacosis (Chlamydia psittaci), foodborne disease agents, waterborne disease agents. Finally, the Category C agents are those considered as possible emerging public health risks and include any agent identified by the CDC Emerging Infectious Disease Program such as hantavirus. One can get detailed information about all of these agents from two excellent websites with public access that are dedicated to bioterrorism. Both of these are kept by Johns Hopkins University. The first can be found at http://www.hopkins-biodefense.org. Here you will find proceedings from bioterrorism symposia, educational materials, links to other sites of interest. In addition, go to http://www.hopkins-abxguide.org where you can search treatment options for a variety of infectious diseases by diagnosis, pathogen, or antibiotic. Remember that in the event of a bioterrorism attack, first responders will be physicians, medical clinics, pubic health offices and emergency rooms. Awareness, education and preparedness are the keys to a successful response. A member of the Irish Republican Army once said, "You have to be lucky all the time -- we have to be lucky just once." ### Mark Sorrentino, M.D., M.S. MedImmune, Incorporated SAB member since November 1998 ### << Previous Next >> [ View All Perspectives ] |
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