Biological warfare training. Infectious disease outbreak differentiation criteria

Area of Science:

• Biosecurity
• Epidemiology
• Public Health

Background:

• The increasing availability and decreasing cost of weaponizable agents, coupled with terrorist willingness to use them, elevate the threat of biological warfare.
• Heightened surveillance for emerging infectious diseases necessitates the ability to differentiate between natural and intentional outbreaks.

Purpose of the Study:

• To identify key criteria that, when considered in combination, can provide convincing evidence for the intentional causation of disease outbreaks.

Main Methods:

• Review and analysis of specific outbreak attributes that may indicate intentionality.
• Evaluation of criteria including, but not limited to, proportion of combatants at risk, temporal patterns, clinical presentation, and geographic location.

Main Results:

• While no single criterion may be pathognomic, a combination of factors can strongly suggest a biological attack.
• Key differentiating criteria include: proportion of combatants, temporal patterns, number of cases, clinical presentation, strain/variant, economic impact, geographic location, morbidity/mortality, antimicrobial resistance, seasonality, zoonotic potential, residual infectivity/toxicity, prevention/therapeutic potential, route of exposure, weather/climate, incubation period, and concurrence with belligerent activities.

Conclusions:

• A multi-faceted approach analyzing various outbreak characteristics is essential for detecting bioterrorism and biological warfare.
• Effective differentiation between natural and intentional outbreaks enhances biosecurity and public health preparedness.