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What is 'bioterrorism'

Bioterrorism is the overt or covert dispensing of disease pathogens by individuals, groups, or governments for the expressed purpose of causing harm for either ideological, political, or financial gain.

What are biological weapons?

Biological weapons are any infectious agent such as a bacteria or virus when used intentionally to inflict harm upon others. This definition is often expanded to include biologically-derived toxins and poisons. Biological warfare agents include both living microorganisms (bacteria, protozoa, rickettsia, viruses, and fungi), and toxins (chemicals) produced by microorganisms, plants, or animals. Some of these agents are highly lethal; others would serve mainly in an incapacitating role. Some authors have also speculated about the possible terrorist use of new, genetically-engineered agents designed to defeat conventional methods of treatment or to attack specific ethnic groups, for example.

Are biological weapons dangerous?

Biological weapons are immensely destructive. In the right environment they can multiply, and so self-perpetuate. And they can naturally mutate, frustrating protective measures. Chemical weapons, for all their horrors, become less lethal as they are dispersed and diluted. But even the tiniest quantities of disease organisms can be lethal. For example, botulinum toxin has been described as 3 million times more potent than the chemical nerve agent sarin.

Have biological weapons ever been used in warfare or terrorism?

Yes. In warfare, from Persia in the 6th century BCE to the modern Iran-Iraq conflict of the 20th. And even in the civilian public sector, the more notable event occuring in September 1984 when the Rajneesh cult outside of Antelope, Oregon was said to have contaminated salad bars in local restaurants in The Dalles, Oregon, with Salmonella typhi (typhoid), resulting in the poisoning of 750 people, in order to "influence the outcome of a local election".

How likely is a bioterrorist attack?

An attack with bacteria or virus spread in the air would be extremely unlikely. Why? It is difficult to make bacteria or virus that will survive being spread through the air. Terrorists have tried unsuccessfully to attack with biologic agents in the past.

How can I tell a bioterrorist attack from a 'natural' outbreak?

A BW agent attack is likely to be covert. Thus, detection of such an attack requires recognition of the clinical syndromes associated with various BW agents. Physicians must be able to identify early victims and recognize patterns of disease. This requires integrated epidemiologic surveillance systems performing real-time monitoring with information shared at many levels of the health care system. Preliminary criteria for suspicious outbreaks of disease that could provide indications of a possible biological weapons event include the following:

  • Disease (or strain) not endemic
  • Unusual antibiotic resistance patterns
  • Atypical clinical presentation Case distribution geographically and/or temporally inconsistent (eg, compressed time course)
  • Other inconstant elements include: number of cases, mortality and morbidity rates, and deviations from disease occurrence baseline.
How contagious are these pathogens?

Of the potential BW agents, only plague, smallpox, and viral hemorrhagic fevers are spread readily person to person by aerosol and require more than standard infection control precautions (gown, mask with eye shield, gloves). Regardless, as a precaution all potential victims of BW agents should be placed in isolation. Medical personnel caring for these patients should wear a HEPA mask in addition to standard precautions pending the results of a more complete evaluation.

Will the public be notified?

When it is determined that a biologic event has occurred, notification will promptly follow. Public health authorities have been working for the past few years to educate physicians and other health care providers to recognize and report the diseases that would most likely be used in a terrorist attack. An event would most likely be recognized by local health care providers who would then notify state and federal health authorities. Not only will the public be notified, there will be frequent updates of important public health messages. Communication in any disaster, including a bioterrorism event, is of the greatest importance.

Are vaccinations recommended in case of a bioterrorism attack?

There are no vaccines being recommended for the public. Please see below for more specific information on anthrax and smallpox vaccines.

Are vaccines for smallpox available?

Smallpox was wiped out in 1979 after a vaccination program, but existed still in two labs - one at the Centers for Disease Control and Prevention (CDC) and one in the former Soviet Union. The CDC currently has about 15 million doses of smallpox vaccine on hand, to be used if need be for a bioterrorism event. The vaccine would be effective if given even up to four days after exposure. The Federal government, including the CDC, is concerned about the threat of bioterrorism. Plans for a response to such an event are being developed at many levels of the government. These plans do not include widespread use of smallpox vaccine at this point. The benefits and risks of reintroduction of smallpox vaccine are continuing to be examined. For more information on smallpox, click here.

Are vaccines for anthrax available?

Anthrax is a disease found in animals in many places around the world, including the United States. The anthrax vaccine is not available commercially except to the military. For more information on anthrax, click here.

Would gas masks be helpful in the event of a bioterrorist attack?

Because biological or chemical attacks are unlikely to be announced, military gas masks would have to be worn continuously to be protective. For a mask to be effective, it must fit correctly and be worn correctly. A mask cannot be worn with facial hair, since an effective seal between the mask and skin cannot be maintained, which makes the mask ineffective. Additionally, the mask does not protect against skin contact with biological or chemical agents providing no protection against skin absorption. A gas mask makes breathing more difficult, increasing the stress on individuals with pre-existing hearth or lung problems. The design of gas masks reduces the field of vision and makes working more difficult. It is, for example, very dangerous to drive while wearing a gas mask. Furthermore, since the filters and activated carbon discs need changing after use, it is hard to know how effective a gas mask will be.

Should the public have antibiotics on hand in case of a bioterrorist attack?

We do not recommend that the public keep antibiotics on hand for use in a terrorist attack. There would be time after such an attack to treat large numbers of exposed persons, if necessary. The National Pharmaceutical Stockpile consists of plane-loads of medical supplies and antibiotics placed strategically around the country.

What is the National Pharmaceutical Stockpile?

The National Pharmaceutical Stockpile is a large reserve of antibiotics, chemical antidotes and other medical supplies set aside for emergencies. The CDC reports that it has the capacity to move these stockpiled materials to affected areas in the U.S. within 12 hours of notification. There are a number of different stockpiles, strategically located around the country. In addition to the medical supplies already set aside, the federal government has made an agreement with drug manufacturers to make large amounts of additional emergency medicine available.

Is it safe to drink water from the tap?

Public drinking water supplies are safe. It would be VERY difficult for a bioterrorist to contaminate our drinking water supplies to cause widespread illness. There are two reasons. First of all, huge amounts of water are pumped daily from our reservoirs, most used for industrial and other purposes. Anything deliberately put into the water supply would be greatly diluted. Secondly, water treatment facilities routinely filter the water supply and add chlorine to kill germs.

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Date of Last Update: 07/27/12