At the time of
preparing this manuscript, 3 persons have died of Anthrax related
exposure in the USA (October 2001) and several thousand persons were
tested for anthrax exposure. Suddenly, bioterrorism changed from a
possible occurrence to real. Although much of the nation's attention is
centered on anthrax at this time, authorities point out that
introduction of biological agents such as small pox virus will have much
larger consequences. We will take a look at the possible biological and
chemical agents that may be used in bioterrorism. We will also cover the
treatment and management of these attacks for the most important of
An act of
biological or chemical terrorism might range from dissemination of
aerosolized anthrax spores to food product contamination.
pathogens, nerve gas, and a lethal plant toxin (i.e., ricin), have been
used in other parts of the world in biological and chemical threats.
Such agents as the variola virus, the causative agent of smallpox, are
highly contagious and often fatal.
VERSUS COVERT TERRORIST ATTACKS
terrorist attacks involving chemical and biological agents can be
broadly divided into overt attacks and covert attacks.
are apparent immediately after the attack such as in case of bombings.
Chemical terrorism acts are likely to be overt because the effects of
chemical agents absorbed through inhalation or by absorption through the
skin or mucous membranes are usually immediate and obvious. These
attacks elicit immediate response from police, fire, and EMS personnel.
attacks with biological agents are more likely to be covert or hidden.
Covert dissemination of a biological agent in a public place will not
have an immediate impact because of the delay between exposure and onset
of illness (i.e., the incubation period).
agents can also be delivered covertly through contaminated food or
water. This was illustrated in 1999, when chickens in Belgium were
unintentionally exposed to dioxin-contaminated fat used to make animal
feed. Because the contamination was not discovered for months, the
dioxin, a cancer-causing chemical that does not cause immediate symptoms
in humans, was probably present in chicken meat and eggs sold in Europe
during early 1999. This episode also demonstrates how a covert act of
foodborne biological or chemical terrorism could affect commerce and
human or animal health.
Critical biological agents that
may be used in Bioterrorism
Chemical agents that may be used in Bioterrorism
and Chemical Terrorism: Strategic Plan for Preparedness and Response:
Recommendations of the CDC Strategic Planning Workgroup," April 21,
2000 / 49(RR04);1-14, Centers for Disease Control, USA.