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Epidemiology of Bioterrorism

NCJ Number
Emerging Infectious Diseases Volume: 5 Issue: 4 Dated: July-August 1999 Pages: 528-530
Julie A. Pavlin
Date Published
3 pages
This article explains the basic epidemiologic principles of biological agents used as weapons.
A biological agent is commonly portrayed as a genetically engineered organism resistant to all known vaccines and drugs, highly contagious, and able to harm thousands of people. Because an attack may not follow an expected pattern, the level of suspicion and diligence in identifying and reacting to a biological attack must remain high. A small outbreak of illness could be an early warning of a more serious attack, and recognition and prompt institution of preventive measures could save thousands of lives. Any small or large outbreak of disease should be evaluated as a potential bioterrorist attack. A look at the facts surrounding the outbreak to determine if anything seems unusual or indicative of bioterrorism should suffice as an initial investigation. The basic epidemiologic approach in the evaluation of a potential bioterrorist or biowarfare attack is not different from any standard epidemiologic investigation. The first step is to use laboratory and clinical findings to confirm that a disease outbreak has occurred. Once the case definition and attack rate has been determined, the outbreak can be characterized in the conventional context of time, place, and person. These data will provide crucial information in determining the potential source of the outbreak. Using data gathered on cases over time, an epidemic curve can be calculated. The disease pattern is an important factor in differentiating between a natural outbreak and an intentional attack. A bioterrorism attack is most likely to be caused by a point source, with everyone coming in contact with the agent at approximately the same time. Additional characteristics should be investigated in determining whether it is the result of a biological attack: the presence of a large epidemic; more severe disease than expected for a given pathogen; a disease that is unusual for a given geographic area; and multiple simultaneous epidemics of different diseases. The education of all medical personnel should include these basic epidemiologic principles. 7 references.