Epidemiology And Bioterrorism
What is 'bioterrorism'?
The term bioterrorism refers to the deliberate spread of an infectious disease by a terrorist who wants to endanger the health of the population. Several years ago, an unknown person introduced anthrax spores into the mail system of the United States, and then this caused several cases of illness and several deaths. This is a prime example of bioterrorism.
How are epidemiologists helping to fight against bioterrorism?
Epidemiologists provide the tools and mechanisms for investigating disease outbreaks that might have an origin in bioterrorism. An example is systems of surveillance. In many cases they also form a part of an investigative team that is investigating outbreaks of disease that might have been or suspected to be associated with bioterrorism.
How does epidemiology determine the difference between a naturally occurring disease and a bioterrorist attack?
In general, it is difficult to detect a disease that is occurring naturally in the community, and which has occurred as a result of a bioterrorism incident. In some cases, a disease caused by bioterrorism might be an unusual disease that is rarely observed, or that occurs in very low frequency. An example of that was the diseases caused by anthrax. Usually, anthrax is associated with certain occupations where people might be handling animal hides or animal products, but in this case, the disease occurred among mail handlers, so that was a very unusual situation. In other cases, they might be looking for a rapid increase in the number of cases of disease that is detected by their surveillance system.
How does epidemiology propose to manage a bioterrorist attack?
Epidemiology, in itself, won't manage the attack but it will contribute to the determination of whether the outbreak or the attack has occurred, and suggest methods for prevention of the attack. The epidemiologist, in a sense, can be a sentinel for observing when and where the attack has occurred, and then provide this information to government officials who are responsible for determining the response to the event.
What are the most likely biological agents to be used as weapons?
Examples of biologic agents that could be used as agents are those that have a high rate of spread in a population that can be spread fairly easily, and for which treatment is difficult. I can name certain agents, for example, the anthrax outbreak that occurred several years ago. Anthrax is a very serious illness and some forms of it are highly fatal. Other agents might relate to the ability of our society to respond. An example would be smallpox. If a bioterrorist had access to smallpox, an individual terrorist could be infected with the agent, fly on a plane, and then spread it to many other individuals, and then these cases in turn could spread very easily all over the world, because immunization for smallpox has not taken place for many years. A large proportion of the population isn't immune, and those who have already been immunized are also probably susceptible to smallpox.
