Bioterrorism—Types of epidemics, new epidemiological paradigm and levels of prevention

Abstract

Biological attacks can cause both an epidemic of infectious disease and of fear and panic. Epidemiological triangle chain models can be used to present both these types of epidemic. By merging these two triangles we suggest a new four-sided pyramidal model of bioterrorism attack and appropriate levels of prevention. Primordial prevention of biological attacks should comprise the impeding of access of both terrorists and biological agents to the territory. The primary prevention level should comprise internal surveillance of potential sources of agents and terrorists. Secondary prevention activities should be directed toward breaking both the epidemic of infectious disease and that of fear and panic. Tertiary prevention should include measures for repair following the attack. This is a task mainly for mental health professionals, curing and rehabilitating those affected by the epidemic of fear and panic. The suggested epidemiological model can be implemented into training programmes for detecting and responding to bioterrorist attacks around the world.

Biochemical and structural characterization of alanine racemase from Bacillus anthracis (Ames)

“…The high mortality rate, the existence of a respiratory route of infection and the great resistance of its spores has made B. anthracis the subject of biological warfare research programs in many countries for over 60 years [ 4 ]. The United States Centers for Disease Control and Prevention (CDC) has classified anthrax as a category A bioterrorism agent, posing the greatest possible threat to public health and with the ability to spread across large areas [ 5 ]. In 2001, the Ames strain of B. anthracis was used in a series of bioterrorist attacks that resulted in five fatalities and cost billions of dollars to the US economy [ 6 , 7 ].…”

Strategies in Fighting Bioterrorism

“…A four levels paradigm of prevention has been proposed [5]. Prevention efforts provide only partial barriers and deterrence against biological attacks.…”

A Risk Assessment Scheme of Infection Transmission Indoors Incorporating the Impact of Resuspension

“…The anthrax letter incidents of 2001 in the United States raised an additional concern about the spread of infection by bioterrorist attacks. Bioterrorist attacks by the intentional release of aerosolized biological agents are characterized by their relatively low costs and technical challenges, the capability of causing injury and death in strange and prolonged ways, and their potential to inflict huge economic loss . It was estimated that the postattack cost could be as high as $26.2 billion per 100,000 persons exposed to biological agents …”

“…Bioterrorist attacks by the intentional release of aerosolized biological agents are characterized by their relatively low costs and technical challenges, the capability of causing injury and death in strange and prolonged ways, and their potential to inflict huge economic loss. (4) It was estimated that the postattack cost could be as high as $26.2 billion per 100,000 persons exposed to biological agents. (5) People spend most of their time (70%-90%) indoors; therefore, it is important to develop the capability to analyze human exposure to pathogens and thus infection risk for indoor environments.…”