An overview on the use of a viral pathogen as a bioterrorism agent: why smallpox?

BWJ Mahy - Antiviral research, 2003 - Elsevier
BWJ Mahy
Antiviral research, 2003Elsevier
Although the recent bioterrorist attacks in North America demonstrated the effectiveness of
Bacillus anthracis as a biological weapon capable of severely disrupting the public health
system (Jernigan et al., 2001), there are a number of viral pathogens that are candidates for
use in a biological attack. These include the filoviruses, Ebola virus and Marburg virus,
arenaviruses such as Lassa fever virus, and most important of all, variola virus which causes
smallpox in humans. In 1999, a group of academic infectious disease experts, national …
Although the recent bioterrorist attacks in North America demonstrated the effectiveness of Bacillus anthracis as a biological weapon capable of severely disrupting the public health system (Jernigan et al., 2001), there are a number of viral pathogens that are candidates for use in a biological attack. These include the filoviruses, Ebola virus and Marburg virus, arenaviruses such as Lassa fever virus, and most important of all, variola virus which causes smallpox in humans. In 1999, a group of academic infectious disease experts, national public health experts, civilian and military intelligence experts and law enforcement officials met to review and comment on the threat potential of various agents to civilian populations in the USA (Rotz et al., 2002). They divided the potential threat agents into categories A, B, and C, category A containing those with the greatest potential for large scale dissemination or a heightened general public awareness that could cause mass public fear and civil disruption (Table 1). Smallpox (Variola major, Fig. 1) tops the list, and some viral pathogens which can cause severe hemorrhagic fever are also included. The availability of these potential biological warfare agents varies widely. Smallpox is now an eradicated disease, and work in the two facilities where it exists, in America and Russia, is strictly controlled by the WHO. The filoviruses exist in an unknown reservoir species, but cause occasional dramatic outbreaks of disease with high (up to 80%) mortality in Africa. The outbreaks are frequently hospital based and originate from an unknown source, or from an infected non-human primate, but can be effectively controlled once the diagnosis is confirmed by isolating infected persons, and preventing spread of the disease by close contact between infected and susceptible individuals. The hemorrhagic dis-
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