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Bioterrorism is the use of bacteria, viruses, or germs to purposely harm large quantities of people or communities. These “weapons” are spread through air, water, or food sources. Bioterrorism is rare and is used to threaten people, governments, and countries. In bioterrorist attacks, usually only a small number of people may be injured or affected. However, many more become afraid. They change their behavior because of their fear.

Path to improved health

There are some things you can do to prepare for a bioterrorist attack. For example, take reasonable steps to prepare, just as you would for a tornado or hurricane. It is a good idea to have enough food, water, money (cash), and supplies (including any regular medications you may need) on hand to last you 3 or 4 days. You should also keep emergency contact information at home, work, and school.

Do not take antibiotics unless your doctor tells you to. Antibiotics prevent very few illnesses. They can have serious side effects. Overuse of antibiotics can actually make certain forms of bacteria difficult to treat. Also, antibiotics may interfere with medicines you are already taking.

While toxic gasses are used in bioterrorist attacks, you do not need to buy gas masks. They are intended only for short-term use when a deadly gas is released. They are not practical for use at all times. They are effective only if properly fitted. When not used properly, the masks can be dangerous. They can result in injury or suffocation, especially in people who have heart or lung problems.

Things to consider

Certain bioterrorism “weapons” include:

Anthrax. Anthrax is an infection caused by bacteria. Anthrax most commonly occurs in cattle and sheep. It is rare in humans. It is usually seen only in people who have contact with infected animals or who work with animal products such as wool, or hides. Anthrax can be a form of bioterrorism if someone deliberately spreads the bacteria in public places.

Anthrax takes 3 forms in humans, all of which are caused by the same bacteria. The form of anthrax infection depends on how the bacteria enter the body:

  • Cutaneous (skin) infection caused by touching infected animal products, contaminated soil containing anthrax bacteria or the bacteria itself. It is the most common form of anthrax.
  • Gastrointestinal (stomach and intestine) infection is caused by eating undercooked meat that is contaminated with anthrax bacteria.
  • Inhalation infection is caused by breathing in anthrax bacteria.

None of the forms can spread from person to person. It is caused only by direct exposure to the anthrax bacteria. Anthrax symptoms can be similar to other illnesses. Symptoms include:

  • Cutaneous anthrax starts as a red area on the skin, similar to an insect or spider bite. It may itch. Over a few days, the area becomes larger. Blisters may form, followed by a deep, black scab. The area is usually painless.
  • Gastrointestinal anthrax typically causes vomiting, nausea, fever, and loss of appetite. It is followed by severe stomach pain, bloody diarrhea, and vomiting with blood.
  • Inhalation anthrax starts out like the flu, with a fever, sore throat, dry cough, and muscle aches. Inhalation anthrax does not cause a runny nose. The symptoms are usually mild for a few days (and may even get better). The symptoms get much worse. People who have inhalation anthrax often have stomach pain. Within a few days, they will have difficulty breathing and go into shock.

If you have symptoms, call your doctor. If he or she thinks there is a possibility your symptoms are caused by anthrax, he or she will ask about your job and any travel. This information, plus an exam and possibly some lab tests or X-rays, will help your doctor decide whether you have anthrax infection. It is unlikely that the general public is in danger of anthrax exposure.

Fortunately, anthrax can be treated with antibiotics. The treatment and its success depend on the form of anthrax. Cutaneous anthrax is the least serious form. People can sometimes recover even without treatment. Gastrointestinal and inhalation anthrax are more serious and may cause death if not treated.

Anthrax gets the most news attention. However, other agents used in bioterrorism include botulism, plague, and smallpox. Some other agents have also been studied for use as biological weapons, such as tularemia, brucellosis, Q fever, and viral hemorrhagic fevers.

Smallpox: Smallpox is thought to be another more likely agent to be used in a bioterrorist attack. Smallpox is an illness caused by the variola virus.

Smallpox can be spread from person to person, once a fever and rash have developed. If you were vaccinated before 1972, you are not still protected. It is uncertain how long the vaccine is effective. There is no specific drug to treat smallpox. However, a vaccine given even a few days after exposure may prevent death. It’s important to get prompt medical attention if you think you’ve been exposed to smallpox.

  • Fever.
  • Headache.
  • Fatigue.
  • Diarrhea.
  • Vomiting.
  • A specific rash.

The rash starts out as flat red spots and turns into blisters. The blisters contain clear liquid and then progresses to pus. Routine vaccination for smallpox was stopped in 1972 in the U.S. The disease had been wiped out.

Botulism: This rare but serious illness is a bacterial poison that is often distributed through food sources. It forms in the soil.

Botulism symptoms include:

  • Double or blurred vision.
  • Drooping eyelids.
  • Slurred speech.
  • Difficulty swallowing.
  • Dry mouth.
  • Muscle weakness.

Ebola: Ebola is a severe and often fatal virus. It spreads from an infected animal to a human and then from human to human through direct contact with a patient’s blood or secretions.

Ebola symptoms include:

  • Fever.
  • Headache.
  • Joint and muscle aches.
  • Weakness.
  • Diarrhea.
  • Vomiting.
  • Stomach pain.
  • Loss of appetite.

Plague: Plague is a bacterial infection. The bacteria are found mainly in rats and in the fleas that feed on them. There are three types of plague. However, pneumonic plague is the most common bioterrorist agent. It can spread from person to person.

Plague symptoms include:

  • Fever.
  • Headache.
  • Weakness.
  • Chest pain.
  • Cough.
  • Bloody mucous discharge.

Vaccines for anthrax and smallpox are not available at this time. However, smallpox vaccines have been made so that supplies are available to high risk groups if needed. Because there are some risks with the smallpox vaccine, the Centers for Disease Control and Prevention (CDC) will decide if it should be given on an individual basis. The anthrax vaccine is controlled by the U.S. Department of Defense. It is only available for military personnel at high risk of exposure in combat settings. Also, it’s available to people who work with anthrax in a laboratory setting.

Questions to ask your doctor

  • How quickly do symptoms appear after exposure to anthrax or smallpox?
  • If I am pregnant and exposed, can it harm my unborn baby?
  • Do all military personnel receive smallpox and anthrax vaccines?


Centers for Disease Control and Prevention: Bioterrorism

National Institutes of Health, MedlinePlus: Biodefense and Bioterrorism

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