Also Known As
Biological Warfare
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This article waslast modified on February 2, 2018.
What are bioterrorism agents?

Bioterrorism agents are living organisms, such as bacteria, viruses, or fungi, or toxins that are deliberately used to sicken and kill. They may be used by terrorists partially because of their psychological impact on the public and partially because they can be deadly, are easy to distribute, are a relatively inexpensive weapon, and are difficult to detect. Bioterrorism agents have been used in acts of warfare for thousands of years. This has included dipping arrows into toxins, poisoning food and water supplies, and deliberately spreading deadly infections. Bioterrorism agents can be carried in food products, dispersed into the air or drinking water, introduced into crops and livestock, or even sent through the mail as was done in the U.S. in 2001.

Most potential bioterrorism agents are natural substances or microorganisms that normally cause a small number of deaths each year and/or during periodic outbreaks. They enter the body primarily by being inhaled into the lungs, ingested, through breaks in the skin, or through contact with the mucous membranes of the eyes and nose.

Agents may be genetically altered by those seeking to use them as a weapon. They may be concentrated, made easier to disperse (aerosolized), made more likely to infect, and/or made more resistant to treatment. Some agents cause infections that can be passed easily from person-to-person and would need to be quickly contained, while others, such as anthrax, typically affect only the person exposed but can be deadly without prompt treatment.

Accordion Title
About Bioterrorism
  • Types

    The Centers for Disease Control and Prevention (CDC) identifies potential bioterrorism agents according to the risk they pose to the public. The table below gives examples of select agents and toxins. For more information, see the CDC Select Agents and Toxins List.

    Disease Agent Agent Type
    Anthrax Bacillus anthracis Bacteria
    Botulism Clostridium botulinum toxin Bacterial toxin
    Plague, Pneumonic Yersinia pestis Bacteria
    Smallpox Variola major Virus
    Tularemia Francisella tularensis Bacteria
    Viral Hemorrhagic Fevers Arenaviruses (Lassa, Machupo)
    Bunyaviruses (Congo-Crimean, Rift Valley)
    Filoviruses (Ebola, Marburg)
    Viruses
    Brucellosis Brucella species Bacteria
    Q-Fever Coxiella burnetii Bacteria
    Typhus Rickettsia prowazekii Bacteria
    Glanders Burkholderia mallei Bacteria
    Melioidosis Burkholderia pseudomallei Bacteria
    Ricin Toxin From Ricinus communis Toxin from castor beans
    Viral Encephalitis Eastern equine encephalitis
    Western equine encephalitis
    Venezuelan equine encephalitis
    Viruses

    For more specific information on agents of bioterrorism and emergency preparedness plans the U.S. government has in place in the event of another bioterrorist attack, visit the CDC's bioterrorism web site.

  • Tests

    There are no reliable tests available to screen asymptomatic people who may have been exposed to a bioterrorism agent. For people who are showing signs and symptoms, there are rapid molecular assays available to help detect the agent.

    Not every laboratory is equipped to test for bioterrorism agents. In 1999, the Centers for Disease Control and Prevention (CDC), with its founding partners the Federal Bureau of Investigation and the Association of Public Health Laboratories, established the Laboratory Response Network (LRN), an integrated national and international group of clinical, public health, environmental, food, water, veterinary, military, and agriculture laboratories that can respond quickly to bioterrorism, chemical terrorism, and other public health threats.

    The network includes thousands of routine clinical laboratories (sentinel laboratories) that perform preliminary testing to rule out bioterrorism agents and refer suspect agents to regional reference laboratories. Regional reference laboratories can confirm the identity of organisms referred to them by sentinel labs. Regional labs also handle environmental samples (powders, dust, soil and water) determined to be credible threats by the law enforcement/public health communities. At the national level are specialized laboratories that are equipped and designed to grow and contain high concentrations of highly infectious biological agents and identify specific agent strains. These national labs also provide standardized reagents, protocols, training, and a secure electronic communications system to designated LRN laboratories.

    Today, the U.S. government as well as the research community and industry are working aggressively to develop quick and effective methods to protect people against agents such as Bacillus anthracis (the cause of anthrax) that could be used in another bioterrorist attack. In addition, where possible, research is being focused on developing and/or improving vaccines as an effective public health protective measure.

    Laboratories are better prepared than ever before to respond quickly to bioterrorism with the appropriate tests, identifying the causes of illnesses and coordinating with local and state health departments, law enforcement, the CDC, and other government agencies so that containment and rapid treatment can follow.

View Sources

NOTE: This article is based on research that utilizes the sources cited here as well as the collective experience of the Lab Tests Online Editorial Review Board. This article is periodically reviewed by the Editorial Board and may be updated as a result of the review. Any new sources cited will be added to the list and distinguished from the original sources used.

Sources Used in Current Review

(© 2014). Bioterrorism. The National Academy of Sciences [On-line information]. Available online at http://needtoknow.nas.edu/id/challenges/bioterrorism/ through http://needtoknow.nas.edu. Accessed June 2014.

(Updated 2013 May 11) Bioterrorism. Healthychildren.org [On-line information]. Available online at http://www.healthychildren.org/English/health-issues/conditions/infections/pages/Bioterrorism.aspx through http://www.healthychildren.org. Accessed June 2014.

Sarkar-Tyson, M. and Atkins, H. (2011). Antimicrobials for Bacterial Bioterrorism Agents. Medscape Multispecialty from Future Microbiol. 2011;6(6):667-676. [On-line information]. Available online at http://www.medscape.com/viewarticle/745637 through http://www.medscape.com. Accessed June 2014.

Jagminas, L. and Mothershead, J. (Updated 2013 October 14). CBRNE - Biological Warfare Mass Casualty Management. Medscape Reference [On-line information]. Available online at http://emedicine.medscape.com/article/831529-overview through http://emedicine.medscape.com. Accessed June 2014.

Jagminas, L. (Updated 2013 October 14). CBRNE - Evaluation of a Biological Warfare Victim. Medscape Reference [On-line information]. Available online at http://emedicine.medscape.com/article/830992-overview through http://emedicine.medscape.com. Accessed June 2014.

Dire, D. (Updated 2013 September 3). CBRNE - Biological Warfare Agents. Medscape Reference [On-line information]. Available online at http://emedicine.medscape.com/article/829613-overview through http://emedicine.medscape.com. Accessed June 2014.

(Updated 2013 February 11). Biological Threats. Ready.gov [On-line information]. Available online at http://www.ready.gov/biological-threats through http://www.ready.gov. Accessed June 2014.

(© 2014) Select Agents and Toxins List. CDC Federal Select Agent Program [On-line information]. Available online at http://www.selectagents.gov/SelectAgentsandToxinsList.html through http://www.selectagents.gov. Accessed February 2015.

Sources Used in Previous Reviews

Rapid Anthrax Test, Discovery's Edge. Mayo Clinic Online Research Magazine (accessed December 2006). Available online at http://discoverysedge.mayo.edu/rapid_anthrax_test/ through http://discoverysedge.mayo.edu.

Medical Laboratory Observer. The Observer, News: Polonium-210 (Accessed January 2007). PDF file available for download at http://www.mlo-online.com/articles/0107/0107observatory.pdf through http://www.mlo-online.com.

Center for Disease Control and Prevention. Emergency Preparedness and Response, Information about Polonium-210 in Recent Events in the United Kingdom (Online information, accessed January 2007). Available online at http://www.bt.cdc.gov/radiation/isotopes/polonium/qa.asp through http://www.bt.cdc.gov.

CDC. Emergency Preparedness and Response, Bioterrorism Agents/Diseases by category (Online information, accessed February 2007). Available online at http://www.bt.cdc.gov/agent/agentlist-category.asp#a through http://www.bt.cdc.gov.

(2011 January 5). Bioterrorism FAQs. American Medical Association [On-line information]. PDF available for download at http://www.ama-assn.org/ama1/pub/upload/mm/415/bioterrorism_faqs.pdf through http://www.ama-assn.org. Accessed January 2011.

(2011 January 5). Bioterrorism 101. American Medical Association [On-line information]. PDF available for download at http://www.ama-assn.org/ama1/pub/upload/mm/15/toolkit_bioterrorism.pdf through http://www.ama-assn.org. Accessed January 2011.

(Updated 2010 August 12). Bioterrorism. American Academy of Pediatrics, healthychildren [On-line information]. Available online at http://www.healthychildren.org/English/health-issues/conditions/infections/pages/Bioterrorism.aspx through http://www.healthychildren.org. Accessed January 2011.

Tunkel, A. (Revised 2009 December) Biological Warfare and Terrorism. Merck Manual for Healthcare Professionals [On-line information]. Available online at http://www.merckmanuals.com/professional/sec14/ch167/ch167i.html?qt=bioterrorism&alt=sh through http://www.merckmanuals.com. Accessed January 2011.

(Updated 2011 January 21). Building a Stronger Defense Against Bioterrorism. U.S. Food and Drug Administration, Consumer Update [On-line information]. Available online at http://www.fda.gov/ForConsumers/ConsumerUpdates/ucm048251.htm through http://www.fda.gov. Accessed January 2011.

Dire, D. (Updated 2008 July 31). CBRNE - Biological Warfare Agents. eMedicine [On-line information]. Available online at http://emedicine.medscape.com/article/829613-overview through http://emedicine.medscape.com. Accessed January 2011.

Jagminas, L. (Updated 2011 January 12). CBRNE - Evaluation of a Biological Warfare Victim. eMedicine [On-line information]. Available online at http://emedicine.medscape.com/article/830992-overview through http://emedicine.medscape.com. Accessed January 2011.

Wright, J. et. al. (2010 July 23). Use of Anthrax Vaccine in the United States, Recommendations of the Advisory Committee on Immunization Practices (ACIP), 2009. CDC, Morbidity and Mortality Weekly Report 59(rr06);1-30 [On-line information]. Available online at http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5906a1.htm?s_cid=rr5906a1_w through http://www.cdc.gov. Accessed January 2011.

(Updated 2006 December 6). Facts About the Laboratory Response Network. CDC Emergency Preparedness and Response [On-line information]. Available online at http://www.bt.cdc.gov/lrn/factsheet.asp through http://www.bt.cdc.gov. Accessed January 2011.

Pagana, K. D. & Pagana, T. J. (© 2011). Mosby's Diagnostic and Laboratory Test Reference 10th Edition: Mosby, Inc., Saint Louis, MO. Pp 158-163.