Introduction
"Bioterrorism refers to the intentional release of biological agents or toxins for the purpose of harming or killing humans, animals or plants with the intent to intimidate or coerce a government or civilian population to further political or social objectives" (INTERPOL, n.d.).
Bioterrorism is no longer a subject of speculation; it is a reality that the American health system must anticipate. In September and October 2001, at least five envelopes containing significant quantities of Bacillus anthracis were mailed to United States Senators Patrick Leahy and Thomas Daschle in the District of Columbia and to media organizations located in New York City and Boca Raton, Florida.
At least 22 victims contracted anthrax as a result of the mailings. Eleven individuals contracted inhalational anthrax by inhaling Bacillus anthracis spores and another 11 suffered cutaneous anthrax by absorbing it through the skin.
Five of the inhalational victims died from their infections:
(1) Robert Stevens, 63, photo editor, AMI, Boca Raton, Florida, died on October 5, 2001;
(2) Thomas L. Morris, Jr., 55, postal worker, Brentwood Post Office, Washington, D.C., died on October 21, 2001;
(3) Joseph P. Curseen, Jr., 47, postal worker, Brentwood Post Office, Washington, D.C., died on October 22, 2001;
(4) Kathy T. Nguyen, 61, hospital employee, New York City, died on October 31, 2001;
(5) Ottilie Lundgren, 94, 2 Oxford, Connecticut, died on November 21, 2001.
Another 31 people tested positive for exposure to anthrax spores. Ten thousand more people, deemed “at risk” from possible exposure, underwent antibiotic prophylaxis (Amerithrax, n.d.).
In 2007, the FBI Laboratory, determined that the spores in the letters were derived from a single spore-batch of Ames strain anthrax called “RMR-1029.” RMR-1029 had been created and maintained by Dr. Bruce E. Ivins at USAMRIID (Amerithrax, n.d.).
Despite worldwide efforts, the recurrent discovery of foreign and domestic caches of dangerous biological specimens suitable for weaponizing raises the probability that terrorists will gain access to dangerous biological agents again. In addition to Bacillus anthracis, undocumented vials labeled smallpox virus (Variola major), have been found unguarded.
Even small outbreaks caused by weaponized agents require a rapid mobilization of public health workers, emergency responders, and private healthcare providers. Large-scale outbreaks will require unprecedented mobilization, procurement and distribution of large quantities of drugs and vaccines. These drugs and vaccines must be dispensed quickly if they are to have any effect.
Emergency Medical Services, hospitals, clinics, and laboratories will play a crucial role in event detection and activation of the public health response. Professionals associated with these delivery systems must be prepared to implement their facility's Bioterrorism Readiness Plan. Bioterrorism Readiness Plans should encourage a low threshold of suspicion by carefully and explicitly identifying the role that each designee must take in the event of a bioterrorism emergency. The plan should prominently list contact information for in-house infection control professionals and local, state, and federal departments (including the FBI).
References
Amerithrax Investigative Summary - United States Department of Justice. (n.d.). Retrieved August 8, 2022, from https://www.justice.gov/archive/amerithrax/docs/amx-investigative-summary.pd
Bioterrorism. INTERPOL. (n.d.). Retrieved August 8, 2022, from https://www.interpol.int/en/Crimes/Terrorism/Bioterrorism
CDC Newsroom (2014) CDC Media Statement on Newly Discovered Smallpox Specimens. Retrieved 9/1/2022 from https://www.cdc.gov/media/releases/2014/s0708-NIH.html
CDC Newsroom (2021). CDC Testing Shows Commercial Lab Vials Contain No Trace of Virus Known to Cause Smallpox. Retrieved 9/1/2022 from https://www.cdc.gov/media/releases/2021/s1119-smallpox-vials.html
Federal Bureau of Investigation. What We Investigate. WMD. News and Press Releases. Retrieved 8/7/2022 from: https://www.fbi.gov/investigate/wmd/news
Global Biodefense. (2021). U.S. Army Medical Research Institute of Infectious Diseases (USAMRIID, 2021) - Directory of Organizations and Experts. Retrieved August 8, 2022, from https://globalbiodefense.com/directory/name/u-s-army-medical-research-institute-of-infectious-diseases-usamriid/
TFAH’s Ready or Not 2022: Protecting the Public’s Health from Diseases, Disasters, and Bioterrorism report calls for urgent investment to create a public health system able to protect all Americans’ health during emergencies. https://www.tfah.org/wp-content/uploads/2022/03/2022_ReadyOrNot_Fnl.pdf