Case Study

Laundry List for Bioterrorism Response Planners

The scope and magnitude of a bioterrorist attack is limited only by the imagination of a perpetrator and his/her technical ability to pull it off. A particularly challenging element of bioterrorism planning is that there is a wide range of scenarios to consider:

• Threats or scares, such as the increasingly frequent anthrax "hoaxes"
• Assassination of individuals—such as the ricin poisoning of Bulgarian defector Georgi Markov
• Discrete, nonlethal attacks—such as the 1984 Rajneesh contamination of salad bars, when hundreds became ill
• Incidents that produce few cases and deaths but that are still profoundly disruptive—such as the anthrax letter attacks
• Localized lethal outbreaks, comparable to the accidental 1979 anthrax release from Soviet bioweapons facility
• Campaign of mass casualty attacks in different cities, at different times—such as featured in the Dark Winter exercise
• Lethal pandemic (or global outbreak) through an unchecked reintroduction of smallpox.
  

References

Cole LA. Bioterrorism threats: Learning from inappropriate responses. J Public Health Manag Pract 2000;6:8-18

Franz DR, Jaax NK. Ricin toxin. In: Sidell FR, Takafuji ET, Franz DR, eds. Textbook of Military Medicine: Medical aspects of chemical and biological warfare. Washington, DC: Office of the Surgeon General; 1997:631-42.

Torok TJ, Tauxe RV, Wise RP, et al. A large community outbreak of salomnellosis caused by intentional contamination of restaurant salad bars. J Am Med Assoc. 1997;278(5):389-95.

Meselsohn M, Guillemin J, Hugh-Jones, M, et al. The Sverdlosk anthrax outbreak of 1979. Science. 1994; 266:1202-8.

O'Toole T, Mair M, Inglesby TV. Shining Light on Dark Winter. CID. 2002;34(7):972-83.