Bioterrorism: The Attack You Didn’t See Coming
Inhale. Exhale. That single gasp of air could possibly be your last. You won’t be able to see it, feel it, or even smell it, but it could be the demise of everyone in that area. Now, look at your hands, that door handle you just touched, was infected with a biological agent that has left you with only 10 hours to live. There is no one that can help you at this point. This a biological attack happening right there on your hand, and you are unaware of what is occurring, so you shake someone else’s hand, and from there it spreads like wildfire. It’s not your fault but you have unintentionally helped cripple our country. This is bioterrorism. This could occur at any moment and no one would have a clue it is happening. This kind of terrorism isn’t visible, but it is real threat to those effected, therefore it is imperative that we increase the effectiveness of our prevention and diagnosis strategies to eradicate such diseases. Throughout this essay I plan on giving a brief background on what exactly bioterrorism is, specifying the problem it presents to our population, then indicate a solution to this issue, and lastly supporting this thesis with ethical theories.
According to Dr. Edmond Hooker, an Assistant Professor in the Department of Health Services Administration at Xavier University, bioterrorism is a form of terrorism where there is the intentional release of biological agents such as bacteria, viruses, or other germs (Hooker, 2018). Bioterrorism became recognized in the 20th century, and reached an all time high 2001, shortly after the 9/11 attacks (Khalezov, 2011).
In “2001 anthrax attacks”, this issue is explained more in depth:
The 2001 anthrax attacks in the United States, also known as “Amerithrax” from its FBI case name, occurred over the course of several weeks beginning on September 18, 2001. Letters containing anthrax spores were mailed to several news media offices and two Democratic U.S. Senators, killing five people and infecting 17 others. The anthrax attacks came in two waves. The first set of anthrax letters had a Trenton, New Jersey postmark dated September 18, 2001, exactly one week after September 11, 2001 attacks. Five letters are believed to have been mailed at this time, to ABC News, CBS News, NBC News and the New York Post, all located in New York City; and to the National Enquirer at American Media, Inc. (AMI) in Boca Raton, Florida. (Wikipedia, 2008).
The main objective that bioterrorism holds for terrorists is to further their social and political goals by making their civilian targets feel as if their government cannot protect them (Hooker, 2018). This manipulative tactic has been used by terrorists for years to infiltrate the government and coerce government systems into making decisions that are not well thought out. According to Bartlett and colleagues (2002), “high priority agents include organisms that pose a risk to national security because they can be easily disseminated or transmitted person-to person; cause high mortality, with potential for major public health impact; might cause public panic and social disruption; and require special action for public health preparedness”. (Bartlett et al., 2002). The US Centers for Disease Control and Prevention (CDC) identified bacteria, viruses, and toxins that could potentially be weaponized. In 2002, they categorized them into three groups; A, B, and C. Classification is based on ease of dissemination, severity of illness caused, and ability to cause death with Category A agents holding the greatest risk to public and national security (Roltz 2002).
The most common types of biological agents include anthrax, botulism, plague, smallpox, and tularemia (Adalija et al, 2015). Each biological agent stated is classified as Category A agents. These kinds of biological agents can be very contagious and adversely affect a whole population if contracted, and some can even cause death, if not treated promptly or effectively. As stated briefly previously, the problem with the U.S. is that we direct the majority complete focus towards overt attacks such as bombings, and chemical terrorism where the effect is evident and obvious. In contrast, we are nowhere near as prepared concerning attacks that are covert and undercover, which is a common feature of bioterrorism. This presents different problems and area concerns that must involve the entire healthcare organization.
Henderson (1998) states that “covert dissemination of a biological agent in a public place will not have immediate impact due to the delay between exposure and illness”. Individuals exposed to agents may display hidden symptoms such as backache, headache, and nausea that mimic many other viral infections and therefore difficult to diagnose. As a result, if physicians do not recognize the initial symptoms of a disease observed through an attack, the disease has more opportunity to spread (Henderson 1998). Consequently, it is imperative that we remain alert and observant of these specific biological attacks because they can occur out of nowhere. Minor breakouts can lead to more severe attacks, therefore; diagnoses and prevention strategies are essential. This could be the difference in saving one million people or one hundred.
Bioterrorist agents can be spread through various ways, but the aerosol route is most likely to maximize exposure. Contagious agents could produce a large number of second and later generation cases, factoring in the number of people initially exposed. This is the average number of people who acquire the disease from one infected individual, and the disease generation time in humans (Gani 2004). Aerosolized agents are currently the threat of most concern, but safety and security of food and water supplies are also important components of primary prevention (Sobel 2002).
Prompt diagnostics of a bioterrorist event is essential when looking at health and security concerns. Since the 2001 anthrax letters, there have been major advancements in diagnostic capabilities. Technological advancements in recent years have allowed for greater speed and reduced cost of sequencing capabilities. Patient-side diagnostics and sequencing outputs directly connected via cloud-based networks health-care providers globally can make decisions more rapidly and respond more quickly for individual care or outbreak detection. (Pennisi 2016). Effective global surveillance of infectious diseases is essential to control both intentional and naturally occurring epidemics (Moore 2006). Surveillance data can be used to monitor the progress of an outbreak, and for risk communication. To identify information effectively, the ongoing collection of health-related data has been introduced to monitor patterns of symptoms and signs that are suggestive of an outbreak (Kaufman 2007).

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