The setting which you would come across Biological agents is likely to be different when compared to Chemical agents as there will be a time period for the infection to spread and for symptoms to arise. Whereas a Chemical attack would affect a large number of patients in one place at one time, Biological agents would affect patients in the days and weeks to come from the initial exposure likely in their homes and communities. A number of bioterrorism attacks have been conducted and attempted in recent years:

In 1984, followers of Bhagwan Shri Rashneesh sprinkled homegrown salmonella bacteria on supermarket produce, door handles, and restaurant salad bars in Oregon. Nobody died, but 751 people became ill.

In 1994, two members of an anti-government militia, the Minnesota Patriots Council, were arrested due to planning to use biological weapons for terror attacks. The men were stockpiling ricin.

In 2001, the United States (U.S.) Postal service and a number of media outlets received letters containing Anthrax. 22 people were infected, of which 5 died. More letters were intercepted, some addressed to prominent U.S. Politicians at the time.

The list of potential Biological agents is vast due to the numerous microorganisms and toxins that can potentially be reproduced for harmful intent. These microorganisms can be classed in different risk categories depending on a number of features or characteristics they may possess. The higher risk agents often have characteristics which make them more efficient in their harm or terror, these characteristics include; easy dissemination or transmission from person to person, a high mortality rate and the potential for a major public health impact, can cause panic and social disruption, and require special action for public health preparedness. Here we will cover some of the more likely agents that could be used in bioterrorism:

Anthrax:

Anthrax is an acute infectious disease caused by the bacteria Bacillus Anthracis (BA). BA is particularly dangerous as it is normally found as microscopic endospores. These spores are dormant structures that can survive for many years even when exposed to very hot or cold climates, dry conditions, chemicals, radiation, and/or other factors. Contact with BA bacteria or viable BA spores can awaken their dormant state and lead to severe infection.

Although anthrax is a very serious disease, it is not contagious like a cold or flu. People and animals can be infected through different routes of exposure. When the Anthrax bacteria is in the body, it can multiply and spread through numerous tissues and systems. The bacteria produce 2 toxins, Lethal toxin and Edema toxin, that can cause serious illness and even death.

Symptoms can vary depending on the initial infection route:

• Cutaneous anthrax infection symptoms
  • A group of small blisters or bumps form that may itch
  • Swelling can develop around the sore
  • A painless skin sore (ulcer) forms with a black centre that appears after the small blisters or bumps. Most often the sore will be on the face, neck, arms, or hands
• Inhalation anthrax infection symptoms
  • Fever and chills
  • Chest discomfort
  • Shortness of breath
  • Confusion/dizziness
  • Nausea/vomiting/stomach pains
  • Headache
  • Sweating
  • Lethargy
  • Body aches
• Gastrointestinal anthrax infection symptoms
  • Fever and chills
  • Swelling of the neck or neck glands
  • Sore throat
  • Painful swallowing
  • Hoarseness
  • Nausea and vomiting, including haematemesis
  • Diarrhoea or bloody diarrhoea
  • Headache
  • Flushing of face and red eyes
  • Stomach pain
  • Episodes of loss of consciousness
  • Swelling of abdomen

Symptoms of Anthrax can take anywhere between 1 day and 2 months to appear. Its’ deadliness depends on a number of factors, such as initial infection site, number of spores in the contamination, wellness of the patient, and if they receive medical treatment. All forms are capable of causing death, however, inhalation is the is the most serious form and can kill quickly if not treated. Death can occur within 3 days of onset of symptoms from inhalation anthrax.

Within a bioterrorism event, this can make it a significant threat: it can be easily spread in numerous forms (e.g., spores released in the air, placed in food and water, etc.,), people will not know initially that they are infected, symptoms will develop at different stages, and the symptoms of inhaled anthrax are very similar to that of seasonal flu, meaning many people may not seek help.

As Anthrax is a bacteria treatment involves antibiotics. Depending on how far along the patient is and what symptoms they are displaying, they can be treated further with antitoxin. If the patient is severely affected, then they may need supportive treatment in hospital.