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Re: Bioterrorism- time to get organised

Dear Editor

Authors had focused on the modus operandi rather than the features that would help to identify the nature of bioterrorism. Current understanding is that infections like anthrax, botuilism, plague, small pox, tularaemia and viral haemorrhagic fever are most likely to be implicated in bioterrorism. Important aspects of these conditions are summarized below-

[A] Anthrax, caused by Bacillus anthracis, is susceptible to penicillin, doxycycline, and fluoroquinolone. There is no need to immunize or treat contacts.;

[B] Botulism can give rise to muscle-paralysis and caused by Clostridium botulinum. Symptoms of food borne botulism begin most commonly between 12 and 36 hours. Anti-botulinum antitoxin is effective in reducing the severity of symptoms if administered early in the course of the disease. Most patients eventually recover after weeks to months of supportive care;

[C] Yersinia pestis is responsible for causing plague. Pneumonic plague is one of several forms of plague. With pneumonic plague, the features of fever, shortness of breath, chest pain and cough can progress for 2 to 4 days. Streptomycin, gentamicin, the tetracycline, and chloramphenicol are all effective and should be given within 24 hours of the first symptom. Antibiotic treatment for 7 days will protect direct and close contacts. Wearing a close-fitting surgical mask also protects against infection;
[D] Smallpox is a serious, contagious, and sometimes fatal infectious disease. The last naturally occurring case in the world was in Somalia in 1977. The only treatment is prevention with vaccine;
[E] Features of tularemia, caused by Francisella tularensis, include muscle and joint pain, progressive weakness, and those of pneumonia. Symptoms usually appear 3 to 5 days following exposure. Tularemia is not known to be spread from person to person, so there is no need for quarantine. Post exposure prophylaxis with antibiotics is essential. A vaccine for tularemia is under review;
[F] Viral hemorrhagic fevers are usually mild, although sometimes they can be severe and life-threatening. Treatment is essentially supportive.

National Center for Infectious Diseases (NCID) is a central organization that is equipped to deal with matters arising out of bioterrorism in America. It has been urged that formation of a similar central European organization would be helpful. European Centre for Infectious Diseases (ECID), although sound like an European counterpart of NCID, is an undertaking supported by a group of scientists and health professionals, and not an official project of any national institution. It is a matter that has to be taken up seriously by the politicians and decision-makers.

References

(1) http://www.sbcphd.org/bt/bio_agent_pub.html

(2) http://www.who.int/health_topics/bioterrorism/en

(3) Tibayrenc M. A European centre to respond to threats of bioterrorism and major epidemics. Bull World Health Organ. 2001;79: 1094.