Institutional Affiliation
The threat of bioterrorism has significantly increased in the past few decades. CDC describes bioterrorism or biological attack as the calculated release of bioweapons (BW) which include pathogens such as viruses, bacteria, fungi, as well as toxins to bring about diseases or death to humans, livestock or crops. Just like other types of terrorism, biological warfare furthers personal or political goals. The biological agents used as BW mainly occur naturally but they can be genetically improved to increase their virulence, make them more resistant to the available medicine or easily dispersible to the surrounding (Barras, & Greub, 2014).  More so, a large number of them are spread through air, food, water, or soil. They possess various characteristics which make them appealing to the terrorists. For instance, biological agents are inexpensive and easy to obtain and are difficult to detect since it may take hours to weeks for disease symptoms to show up. Moreover, biological attacks can cause widespread morbidity, mortality, and panic.
Nevertheless, one of the limitations associated with the warfare is that is hard to direct the biological weapons to one’s enemies while leaving out one’s friends. CDC developed three categories of microorganisms; A, B, and C which can be used to propagate bio attacks based on the severity of their effects as well as their speed of dispersal (Barras, & Greub, 2014). Those that fall in group A pose the highest risk and are, therefore, considered high priority while category C are viewed as emerging disease hazards. This paper contains a comprehensive discussion of bioterrorism. It will include a historical account of biological attack, factors facilitating the use of BW, the various categories of the biological agents, as well as how they can be spread.
Historical background of bioterrorism
The utilization of various pathogens to cause diseases during a war is not a new practice. Bioterrorism can be traced in as early as the 7th century. During this time, it had been discovered that infectious diseases had the ability to weaken and kill people as well as armies. More specifically, the Assyrians used rye ergot, which is a type of fungus that induces seizures when it is consumed, to toxicate their enemies’ water sources (Barras, & Greub, 2014). Such biological attacks were extensively used to defeat enemies in most different regions including America and Europe.
In the Middle Ages, it was discovered that contaminated bodies and animal carcasses could be used as weapons. In 1346, Tartar army bodies affected with plague around the City of Caffa which is the modern-day Feodosia, Ukraine in an attempt to capture it. This lead to the spread of the disease all over the city making its leaders surrender (Barras, & Greub, 2014). It is believed that the outbreak led to the plague pandemic or the Black Death, which was responsible for widespread deaths across Europe and some parts of Africa in the 14th century.
There are other multiple cases in history that indicate the intentional use of sicknesses during a conflict. For instance, in 1422, corpses of the dead and infected militia were hurled into the premises of the opponent in Karol stein (Barras, & Greub, 2014). Similarly, bodies of plague soldiers were used during the war between Swedish armies and Russian military forces in 1710. Smallpox, another deadly and exceedingly contagious sickness, was weaponized during the New World. On the other hand, Captain Ecuyer, a low-ranking employee at Amherst’s, issued the Native Americans with cloth coverings containing with smallpox, which triggered prevalence of the illness amongst the Indian people in the Ohio River Valley.
Factors facilitating the use of biological weapons (BW)
There is more potential for biological attacks to be carried out today than in the past few decades due to a number of factors. Firstly, there is proof of both historical and existing cases of BW that there are countries and dissident persons as well as groups with easy access to skills necessary for microorganism production and dissemination (Boddie, et al. 2015). Besides, the earlier bio arms institution belonging to the Soviet Union used to develop weaponized transmittable diseases including plague and anthrax, has lost supplies of its biological organisms intended for an attack. Intelligent findings reveal that the stockpiles were peddled to regions in the Middle Eastern. Additionally, the experts who operated for the biological arms program up until the early 18th century migrated to other nations that are known to have interest in generating weapons for mass destruction such as North Korea and Iran. It is alleged that they work together with those administrations to promote their secret bioweapons programs.
Another factor that contributes to bioterrorism is that biotechnology is advanced tremendously one can easily access information on how to create various types of bio arms with at an affordable price on the Internet.  What is more, the fact that there are many scientific publications with information on the guideline to make sophisticated and exceedingly pathogenic agents means that anyone interested in bioterrorism has multiple resources to draw from (Boddie, et al. 2015).  Persons with simple skills in biology or engineering also have the skills to be able to create inexpensive biological weapons which can be effective. People have also turned out to be more susceptible to illnesses in addition to caregivers having little knowledge of the appropriate methods of disease identification and management. This makes BW a perfect alternative for bioterrorists.
Generally, bioweapons are cheap, easy to manufacture, hide and transport, and can yield great harm without complex weaponization. As such, they are attractive to be utilized as attacking agents. The panic attributed to bioterrorism and its effect on public well-being is visible in different states all over the world (Boddie, et al. 2015). In the U.S for instance, after the detection of human anthrax event in 2001, the Illinois Division of Public Health collected hundreds of samples of potential anthrax, which were all harmful. This information on an increased amount of submissions indicates the panic caused by bioterrorism in society.
Categories of the biological agents
Category A bioagents
These microorganisms are effortlessly and quickly spread from a single individual to the other. They are also associated with the highest level of mortality and pose the greatest risk to national health. As such, organisms in this category are considered a high priority and require special consideration for public health readiness (Vilcinskas, 2015). Preparedness strategy for bioterrorism that can result from category A organisms comprises of equipment and environmental disinfection, cleansing the affected people and the surroundings to inhibit and alleviate the dispersal of an illness, gathering medications, and enhancing the diagnostic ability of laboratories so as to determine and isolate bio arms. Some of the category A diseases are anthrax, tularemia, smallpox, plague, botulism, and hemorrhagic fevers such as Ebola.
A bacterium with the ability to form spores which is known as Bacillus anthracis is responsible for causing anthrax. The spores can survive in harsh settings as they are normally hard- coated. The bacterium occurs naturally and can be found naturally in soil (Vilcinskas, 2015). As such, it easily enters animals, both wild and livestock such as goats and sheep. Anthrax is hardly spread between humans but rather, contracted if individuals come into contact with sick animals or people use animal products that have been contaminated, for example, meat or milk.
Anthrax may occur in three forms defined by the diverse manners in which an individual develops an infection. They include cutaneous anthrax, which involves invasion through the skin; inhalation anthrax, that develops when one breathes air contaminated with Bacillus anthracis spores in large amounts; and lastly, gastrointestinal anthrax, which occurs after consumption of food or drinks containing the bacterium. Cutaneous anthrax is characterized by dark-colored sores that change into skin coatings with time (Vilcinskas, 2015). As for inhalation anthrax, infected persons may develop fever, anxiety, head pains, nausea, and vomiting, breathing problems. Even though Gastrointestinal type of the disease is not common, it leads to discomfort in the abdomen, diarrhea, as well as bleeding from the gastrointestinal passage. In all the three categories of Anthrax, symptoms may be experienced as early as within 24 hours of exposure to the bacterium.
If detected early, the three kinds of anthrax are treatable. Various antibiotics such as ciprofloxacin, penicillin, and erythromycin, just to mention a few have proven to be effective in managing the disease in past cases. Nonetheless, if not managed, anthrax, particularly the gastrointestinal and inhalational categories are highly lethal and may cause significant loss of lives in regions that are highly populated (Vilcinskas, 2015). Another form of treatment that can be used on anthrax through vaccination. However, is only availed to people employed in the military and persons who repeatedly deal with livestock such as veterinary officers as they have high probabilities of interacting with ill animals.
The use of anthrax in bioterrorism has existed for almost a century. In 1916, “freedom fighters” in Scandinavia attacked the Russian military with the agent that had been obtained from Germany. Aum Shinrikyo also attempted to retaliate against Tokyo using anthrax in 1933 but the mission failed as no fatality was recorded (Barras, & Greub, 2014). The most recent and successful biological attack that involved the use of anthrax was in 2001. Spores of Bacillus anthracis were purposely placed in between letters in residue used form and posted via the U.S mail system. It led to 22 infections and 5 deaths of infected persons. If a bioterrorist invasion was to occur today, the attacker is most likely to choose anthrax to carry out this mission since the causative bacterium is easy to access. More so, anthrax spores are tiny, have no taste or smell and therefore, they can go unnoticed after dissemination.
This is classified as a deadly viral ailment that develops after being infested by the variola virus which only exists within the body of humans. During the early 1900s, the disease caused widespread mortality. Nonetheless, in 1980, WHO established that smallpox had been eradicated and would be no longer a problem in the society. This was after the NGO carried a comprehensive global vaccination program. Routine immunization to prevent smallpox in America was terminated in 1972, and the latest detected natural incident of the infection was reported in 1977 in East Africa, specifically in Somalia. Currently, only two establishments are known to possess models of the Variola virus: one in Atlanta, run by CDC, and the other in Koltsovo in Russia.
Smallpox is one of the extremely contagious sicknesses known which is spread through direct interaction with the wounds of a diseased person, by breathing in infected particles of moisture disseminated in the atmosphere by coughing victims, or by handling clothing materials that have been contaminated by liquids from smallpox lesions (Vilcinskas, 2015). The pointers of smallpox sickness are high temperatures, head and back pains, vomiting, and a frustrating rash of sores that mostly surfaces in the face and the hands. Variola virus can cause death in approximately 30 out of a hundred cases of infection. There is currently, no medicine that can be utilized in the treatment or cure of smallpox. However, the disease’s vaccination exists and is often administered within 96 hours of contact with the virus.  From time to time, it may stop smallpox from occurring or it might reduce the severity of the symptoms.
The CDC retains stock of the smallpox vaccine in the occasion that biological invasions involving the use of smallpox as the weapon might happen in the U.S. In 2002, several vaccine-manufacturing companies obtained authorization by the CDC to develop an extra stock of the smallpox immunizing agent, in case it would be required on a large scale during an emergency (Vilcinskas, 2015). To safeguard U.S. people from biological warfare, President George Bush declared that a number of members in the U.S. armed forces would be immunized against smallpox and requested the caregivers to offer assistance in giving out the vaccine in 2002.
This is a type of infection that develops after an invasion by Yersinia pestis, a bacterium that has a long history. There are three types of the disease including bubonic, septicemia, and pneumonia. Bubonic plague occurs the most and is characterized by malfunctioning lymph nodes. On the other hand, the septicemic form of the ailment affects the flow of blood, triggering internal hemorrhage and tremor. As for the pneumonic plague, attack by the bacterium affects the respiratory system (Vilcinskas, 2015). Given that Yersinia pestis can stay active in the atmosphere for approximately up to one hour, this makes it an attractive biological weapon as it can be aerosolized without much trouble.
Rodents, and mostly rats are common sources of Yersinia pestis. Diseased rats can cause a plague in humans through bites or vectors such as fleas. Unlike the other groups of plague, the pneumonic type can be passed from one individual to the other. It can be transmitted through direct contact with infected persons who cough or sneeze, contaminating the air with the pathogen. Plague can manifest itself in the form of high body temperatures, anxiety, pain in the head, the abdomen and the chest, coughing, abnormal sputum, and septic shock. The treatment of the disease involves the use of various antibiotics which can be effective if an early detection was made. One cannot be immunized against the plague as there is no existing vaccine.
Francisella tularensis is the bacterium responsible for the development of Tularemia. This pathogen can be found in a large number of rodents including rats, squirrels, and mice. Tularemia cannot be spread among humans but rather, transmitted when people come into contact with diseased animals or water or soil that contain the bacterium. The disease is potentially dangerous as a biological weapon because even small numbers (less than 10 to 50) of the aerosolized bacteria can cause serious disease, such as life-threatening pneumonia (Vilcinskas, 2015). The most common indicators of a Tularemia infection are fever, headache, coughing, and fatigue. Patients might also have hurting sores on the skin; swollen, painful eyes; and abdominal pain. If diagnosed early, Tularemia can be treated with antibiotics which may reduce its progression.
Botulism develops as a result of intoxication by a bacterium known as Clostridium botulinum. The bacteria can be inhaled or swallowed, or they can enter the body through a wound, but the disease is not contagious from person to person (Vilcinskas, 2015). The bacterium produces a toxin which invades the neurotransmitters and this makes the nervous system to malfunction which in turn causes short-term paralysis of various muscles in the body. More so, botulism can trigger breathing complications and is highly fatal. As such, the toxin generated by Clostridium botulinum can be used to propagate bioterrorism. Botulism can be countered using an antitoxin which is accessible at the CDC.
Category B agents
These bioagents are moderately spread from one person to the other, resulting in relatively high disease incidence rates but low death rates, and need special attention from the government for disease management (Vilcinskas, 2015). Some of the biological agents that fall under this category are Clostridium perfringens, Brucella, and Salmonella bacteria, just to mention a few.
Category C bioagents
These bioagents are recently discovered and emerging infectious organisms, which are easily available in the environment, easy to produce on a large scale, and have the potential to cause a major public health impact (Jansen, et al. 2014). NiV and Hantavirus are some of the pathogens in this group.
Manner of dispersal
Aerosol dispersal
Many bioterrorism programs pay more attention to pathogens that can be injected into the air. Bioagents are released through exploding munitions (like bombs) or aerosol sprayers (Ryan, 2016). An aerosol includes a suspension of extremely small liquid precipitations or tiny particles that are disseminated into the atmosphere.
Contaminated water sources is another way that a bioweapon can be spread. However, this technique does not pose a big threat to the public since water systems are structured in a way that they are capable of eliminating dirt that could be carrying the pathogens. One bioterror incident that targeted water supplies was the RISE, or Order of the Rising Sun incident, in 1972 (Barras, & Greub, 2014).
Overall, bioterrorism is more dangerous compared to other types of attacks such as those involving nuclear or chemical agents. The rationale behind this is that pathogens, including viruses, bacteria, fungi, and toxins can reach a wide population and cause large infections and multiple deaths when unleashed into the environment as weapons. Biological agents possess numerous characteristics that make then attractive weapons for bioterrorists. For instance, they can be hardly detected, are inexpensive, and easy to manufacture. They are grouped into categories, A, B, and C based on their virulence. Class A biological agents, such as anthrax, smallpox, plague, and tularemia are highly dangerous while those in group C are less hazardous.
Barras, V., & Greub, G. (2014). History of biological warfare and bioterrorism. Clinical Microbiology and Infection20(6), 497-502.
Boddie, C., Watson, M., Ackerman, G., & Gronvall, G. K. (2015). Assessing the bioweapons threat. Science349(6250), 792-793.
Jansen, H. J., Breeveld, F. J., Stijnis, C., & Grobusch, M. P. (2014). Biological warfare, bioterrorism, and biocrime. Clinical Microbiology and Infection20(6), 488-496.
Ryan, J. (2016). Biosecurity and bioterrorism: containing and preventing biological threats. Butterworth-Heinemann.
Vilcinskas, A. (2015). Pathogens as biological weapons of invasive species. PLoS pathogens11(4), e1004714.