Bioterrorism: A Threat To The Healthcare And Global Peace

The spread of Covide-19 pandemic has brought significant attention from the government and healthcare bodies around the world towards the threat of biological agents (bacteria, viruses or toxins). Over the course of one year, Covid-19 has created serious health challenges and economic destruction around the world. Motivated by the havoc caused by Covid-19, terrorists in the future might deliberately-induced the disease outbreaks in the countries and regions opposing their ideology. From the present experience with the Covid-19 management, we can say protecting its citizens, and the economy against biological aggression can be a difficult task for the governments. These biological pathogens are relatively low cost, can easily replicate and are transported as these are difficult to detect.

The development in science and technology has significantly improved the quality of life but at the same time, the misuse has led to the development of mass destruction agents such as viruses and bacteria. The deliberate use of viruses and bacteria to harm people or communities is called Bioterrorism. while the intentional use of biological agents in the war scenarios is commonly referred to as Biowarfare. 

As per the CDC, “bioterrorism or biological attack, is the intentional release of viruses, bacteria, or other germs that can sicken or kill people, livestock, or crops”. These viruses, bacteria, or other germs are often found in nature. However, with the intention to cause severe life-threatening impact their ability is intentionally increased to resist medical treatment. Sometimes these microbes are hard to detect and in some cases, they don’t show any sign, symptoms or any form of illness for days and weeks, which is the most worrisome factor. Among all the biological agents,  Bacillus anthracis, the bacteria that causes anthrax, is one of the most likely agents to be used in a biological attack, owing to the properties such as long shelf life and easy production process. 

What is the purpose of bioterrorism? And how is it achieved?

The main goal of bioterrorism is to create social, political and economical unrest in the country or region through the mortality, morbidity and panic in the public. Within the country, a dissenting group or rival, based on their religious, political and ideological differences may use bioterrorism to intimidate established governments. Another less suited purpose for bioterrorism can be to gain media attention and spread fear in the society. Gaining monetary benefit through extortion, taking revenge or targeting the high profile celebrity or leaders can also be a reason for the use of bioterrorism at the individual level. 

Sing and symptoms caused by exposure to biological material may vary significantly. However, some of the most common signs and symptoms include sore throat, fever, diarrhoea, blurred vision, coughing, exhaustion, confusion, muscle pain and weakness, nausea, abdominal pain, vomiting, encephalitis/meningitis and many others. 

Biological agents can easily spread through the air, water, or food. There are various possible ways such as contaminating the city’s water supply, agricultural crops, kitchen accessories, cash, coins, credit cards and many others. Today, due to globalization the risk of bioterrorism is much higher. Due to global connectivity, transmission from person to person can easily spread it from one part of the world to another.

When Bioterrorism has been used?

The use of microorganisms as war-weapons has been in practice since prehistoric times. Among all the past events, the American civil war and the world wars had observed its devastating effects. After that, it is mainly employed at a very small level due to the rising consensus and efforts put forward by the health bodies and the Biological Weapons Convention at the global level. The most recent use was in 2001 in the United States when anthrax was delivered by mail to several U.S. news agencies and government offices. Around 19 people were delivered anthrax infected mail, that resulted in 5 deaths in the country. 

What are the 3 bioterrorism threat levels? 

According to the transmissibility, severity of illness & mortality and response requirements, the Centres for Disease Control and Prevention (CDC) has categorized bioterrorism threat agents in three Categories, namely A, B and C. 

Category A –  The Category A includes high priority agents (organisms) that pose a severe risk to national and public security of the country. The organisms in Category A are easily disseminated and can cause high mortality and public panic and social disruption. Bacillus anthracis (anthrax) is one of the most likely agents to be used in case of bioterrorism as the spores of Anthrax are easily found in nature and can be prepared in the lab. Along with it can also remain in the environment for a long time. Apart from anthrax, some other agents that can be used as a potential medium to spread bioterrorism include Variola major (smallpox), Francisella tularensis (tularemia), Yersinia pestis (plague), Filoviruses and many others. 

Category B – The Category B agents are moderately easy to disseminate in the environment and can cause moderate morbidity. It includes agents such as Alphaviruses, Brucella species (brucellosis), Coxiella burnetii (Q fever) and many others. 

Category C – This category includes the third-highest priority agents. These infectious agents could be a potential threat in future and can be engineered for mass spread. Hantaviruses, Tickborne, Yellow fever, Nipah virus are some of the agents of this category. 

Medical Care and preparedness required to handle bioterrorism

Worldwide, the expert has different views on the possibility of bioterrorism. Some consider it a more real threat as compared to the nuclear threat. While some see the rare possibility of its occurrence, assuming that If there is a chance it would be at a smaller scale owing to the challenges in the development, production, maintenance and transmission of biological weapons. Despite various opinions, government and health bodies worldwide take bioterrorism seriously and consider it a real threat to society. To handle any public health emergency, the government regularly conducts monitoring, surveillance and risk assessment for the possible attack. The risk assessment task includes focusing on various aspects such as diagnostic and therapeutic capabilities, education and training to front line healthcare providers, rapid surveillance system between hospitals, emergency rooms, laboratories and many others. 

Owing to the huge political and economical destruction that the fear of bioterrorism can cause, countries today have come together to prohibit the development of mass destruction weapons including the biological warfares. Biological Weapons Convention (BWC), the first multilateral disarmament treaty prohibits the development, production and stockpiling of bacteriological (biological) and toxin weapons. BWC at the global level reduces the chance of biowarfare between countries. However, owing to the political and ideological differences between radical and fringe groups in society, the threat of bioterrorism is likely going to remain in the future also.