Bioterrorism anthrax

Unfortunately, terrorism and counterterrorism are enormous subjects that are not only vitally important, but are also urgent. A terrorist attack can come in many forms the most worrisome of these is airborne bioterrorism. Anthrax distributed upwind of a city is a serious threat that could kill 100,000 people or more. More frightening, however, is an agent like smallpox that is not only infective, but contagious. Past experience with smallpox has proven its efficiency at causing tens of millions of deaths around the world. 

Events involving deliberate or accidental distribution of bacterial pathogens into our everyday environment have clearly defined the need for a sensitive, specific, and rapid method of bacterial detection. Bioterrorism was first introduced in the United States in 1984 with the Salmonella typhimurium attack in The Dalles, Oregon, by a cult group attempting to affect a local election.1 As a result of this act 751 people contracted salmonellosis, which totally overwhelmed the hospitals and medical clinics with patients. Later our society became keenly aware of the potential of bioterrorism during the last four months of 2001 when Bacillus anthracis (anthrax) spores were sent through the US mail in an envelope to several locations. These events had... 

Bacillus anthracis Not published yet Anthrax first use of proven bioterrorism in the United States... 

Until October 2001, no deaths from bioterrorism were reported in the U.S. On September 11, 2001, after the attacks on New York City and Washington, the Centers for Disease Control recommended that the nation increase its surveillance for unusual disease occurrences or clusters, asserting that they could be sentinel indicators of bioterrorist attacks. As predicted, cases of anthrax were reported in Florida, New York City, the District of Columbia, and New Jersey. Over the years, it has become evident that not only is biological warfare attractive to governments, it is equally attractive to terrorist cells because the agents are relatively inexpensive and easy to make. 

Tiemo, P.M., Jr., Protect Yourself against Bioterrorism Everything You Need to Know about Anthrax, Plague, Botulism, Smallpox, Encephalitis, Cholera, Hemorrhagic Fevers, Ricin, and More, Pocket Books, New York, 2002. 

Second we have the issne of bioterrorism. There are many other potential threats smallpox, anthrax, tularemia, plague, a family of viral hemorrhagic fevers, among others. In addition, there are a limitless number of virulent bacteria that might be constructed employing the modem techniqnes of genetic engineering. 

Anthrax, a disease caused by infection by Bacillus anthracis via spores, can be transmitted to humans or animals ruminants such as sheep, goats, cattle, and deer are most susceptible. The handling of infected animals or animal products may also lead to human infection. Recently, anthrax has been considered to be a potential candidate for bioterrorism activity. The spores are extremely hardy and may come into contact with humans through a cut or abrasion, through consumption of infected meat, or by inhalation. The Center for Disease Control (CDC) lists anthrax as a category A disease, and the only vaccine that currently exists has a number of drawbacks and health risks. 

As we learned after the anthrax attacks in 2001, the ability to rapidly detect and to identify a bioterrorism agent is critical. A variety of methods are used for this purpose, including DNA fingerprinting, DNA sequencing, PCR, and ELISA immunoassays. As students read about how these methods are utilized in fighting terrorism, they learn how the methods work. It is even better if they can actually apply at least some of the methods in the laboratory. A number of suppliers provide kits designed for educational use,25 and in most cases, it is possible to use these activities in a way that simulates a bioterrorism scenario. 

Ricchiardi, S. (2001). The anthrax enigma Bioterror and the media. American Journalism Review, December, 23(10), 18-23. Suskind, R. (2006). The one percent doctrine. New York Simon Schuster. 

The events of 9/11 and subsequent anthrax attacks underscored the need for U.S. health care organizations and public health agencies to be prepared to respond to acts of bioterrorism and other public health emergencies. Many states and health care organizations and systems have developed preparedness plans that include enhancing surge capacity to respond to such events. 

An often over-looked aspect of surveillance for bioterror events is surveillance of animal populations. Several of the agents considered to have bioterror potential are diseases of animals, for example, anthrax and brucellosis (Franz et al., 2001 Inglesby et al., 1999 USAM-RIID, 2005). A covert attack may first become apparent when animals become ill. The need to coordinate information from medical and veterinary sources was illustrated by the epidemiologic investigation during the 1999 West Nile Virus outbreak in New York City. Investigators found that there had been an outbreak in birds several weeks prior to the human outbreak (Fine Lay-ton, 2001). The current surveillance plan for monitoring West Nile Virus infection in the U.S. includes sentinel surveillance of several animal populations (CDC, 2003). 

Jernigan, J. A., Stephens, D. S., Ashford, D. A., Omenaca, C., et al. (2001). Bioterrorism-related inhalational anthrax The first 10 cases reported in the United States. Emerging Infectious Diseases, 7, 933-944. 

Agency for Healthcare Research and Quality. (2003). Anthrax summary Types of clinical anthrax. Retrieved March 25, 2007 from http //www.bioterrorism.uab.edu/EIPBA/Anthrax/summary. html... 

Mayer, T. A., Bersoff-Matcha, S., Murphy, C., Earls, J., Harper, S., Rauze, D., et al. (2001). Clinical presentation of inhalational anthrax following bioterrorism exposure Report of 2 surviving patients. Journal of the American Medical Association, 286, 2549-2553. 

Acute Care Settings. The hospital emergency department is likely to be an imtial setting in which the victims of bioterror events first seek medical care. This was illustrated in the anthrax outbreak in October-November 2001. Of the 11 patients with inhalational anthrax, 9 presented for initial care to a hospital emergency department (ED), and the remaining 2 patients ultimately sought care in an ED as their symptoms worsened (Barakat et al., 2002 Jernigan et al., 2001). Clearly, health care providers in the ED and other acute health... 

Even before the anthrax attack in 2001, a variety of detection systems had been developed for potential bioterror agents. A systematic review published in January 2004 identified publicly available articles on 55 such systems (Bravata et al., 2004). Various technologies were represented, including biomass indicators and identification systems targeting toxins, metabolic byproducts, antigens or DNA for selected agents. A key point made by the authors was that only eight of the published articles included evaluation data, and they identified system evaluation as an important area for further research. 

This is the Web site on bioterrorism developed by the Centers for Disease Control and Prevention. Go to http //www.bt.cdc.gov/bioterrorism. Select List of Agents by Category under Specific Bioterrorism Agents. On that next page, select Anthrax under Category A. Review the material under What You Need to Know and any other Specific Topics of interest. 

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