The Threat of Bioterrorism

The United States remains in a heightened terror threat environment. Domestic actors continue to be mobilized to violence by disinformation, political and personal grievances, reactions to current events, and adherence to violent extremist ideologies, including racially or ethnically motivated or anti-government/anti-authority violent extremism.  In addition, foreign adversaries remain intent on exploiting sociopolitical discord to undermine U.S. democratic institutions, and promote or inspire violence (DHS, 2022). 

Governmental anti-terrorist activities have primarily been directed toward managing a chemical release or explosion. Training for crisis management after spills of hazardous materials, explosions, fires, and other civil emergencies frequently occurs in many communities. The expected scenario after the release of an aerosol cloud of a biological agent would be quite different. An aerosol release would likely be undetected. It may not be known until days or weeks later that an infectious agent or toxin had been released into an unsuspecting civilian population. Depending on the incubation period or the time needed for an agent to produce symptoms, patients would begin appearing in emergency rooms and doctors’ offices with symptoms of diseases that few healthcare professionals have ever seen. Special measures would be needed for patient care, obtaining laboratory confirmation regarding microorganisms unfamiliar to most laboratories, providing vaccines or antibiotics to large segments of the population, and potentially implementing local quarantine measures (BIOTERRORISM-DOMESTIC WEAPONS OF MASS DESTRUCTION, 2000).

The U.S. Centers for Disease Control and Prevention (CDC) has classified the biological diseases and agents most likely to be employed by bioterrorists into three categories.

Category A diseases or agents possessing at least one of the following characteristics:

• They can be easily disseminated or transmitted from person to person.
• They have the potential to cause many deaths.
• They can cause public panic and social disruption.
• They require sophisticated public health preparation and action.
  

Category B are the second highest priority agents include those that:

• are moderately easy to disseminate;
  
• result in moderate morbidity rates and low mortality rates; and
  
• require specific enhancements of CDC’s diagnostic capacity and enhanced disease surveillance.

Category C are the third highest priority agents include emerging pathogens that could be engineered for mass dissemination in the future because of

• availability
• ease of production and dissemination; and
  
• potential for high morbidity and mortality rates and major health impact.

In addition to learning general information about bioterrorism, nurses and other healthcare professionals must be very familiar with the All-Hazard Emergency plan specific to their places of employment. They should be familiar with patient isolation procedures, personal protection, and decontamination procedures.

Health professionals must be mindful of the potential impact of a bioterrorism event and work closely with public health authorities to detect, identify the agent(s) and verify a biological attack as early as possible, to provide effective treatment for patients, and to help control public panic by providing accurate information.

Important resource:  Bioterrorism readiness plan: A template for healthcare facilities - cdc. (1999). Retrieved August 27, 2022, from https://emergency.cdc.gov/bioterrorism/pdf/13apr99apic-cdcbioterrorism.pdf

References:

BIOTERRORISM-DOMESTIC WEAPONS OF MASS DESTRUCTION, 106th Cong. 46-47 (2000) (Statement of Donald A. Henderson)

Department of Homeland Security (DHS) (2022). Summary of Terrorism Threat to the United States. Retrieved 8/5/2022 from
https://www.dhs.gov/ntas/advisory/national-terrorism-advisory-system-bulletin-june-7-2022

Ghahremani, M., Rooddehghan, Z., Varaei, S. et al. (2022). Knowledge and practice of nursing students regarding bioterrorism and emergency preparedness: comparison of the effects of simulations and workshop. BMC Nurs 21, 152 . https://doi.org/10.1186/s12912-022-00917-y 

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