A Global Health Issue: Bioterrorism

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A Global Health Issue: Bioterrorism

Being one of the most hazardous and widespread global health issues, bioterrorism is based on the release of a dangerous biological agent in order to result in mass panic, diseases, and deaths. Terrorism that became an acute problem in the USA after September 11 actualizes the necessity of studying this issue thoroughly. This type of terrorism is widespread within America and the world’s different places, including Japan and Africa. The anthrax letters in the USA and the attack of a cult in Japan, that used anthrax spores, can exemplify the issue. Hence, it is essential to research contributing factors, prevention strategies, rapid diagnostic methods crucial within the fieldwork, effective management strategies, and the role of nurses regarding a bioterrorism attack.

Contributing Factors

With regard to contributing factors that might influence bioterrorism’s emergence, it is necessary to mention some factors that broaden the availability of technologies and materials for producing biological weapons. Although “the Biological Weapons Convention prohibits the manufacture and use of biological weapons”, some groups of terrorists are still a serious concern with regard to bioterrorism (Green et al., 2018, p. 1). The danger of bioterrorism might increase by reason of the biotechnology industry’s development, the technical capabilities’ improvement, and the expansion of networks of transnational terrorist groups, which are interested in bioterrorism.

Prevention Strategies

The primary prevention of infectious diseases that are used as forms of biological weapons is possible through several measures. They are prevented by immunizations for those diseases, which are considered vaccine-preventable, such as smallpox, monitoring blood-borne pathogens, and giving advice regarding vector-borne diseases’ prevention (Edelman et al., 2014). However, a bioterrorist attack is a more dangerous and quickly spreading disease case. Although it has several similarities with naturally occurring emergencies associated with infectious diseases, there are some differences. For example, “the infectious agent used is likely to be uncommon and possibly not endemic to the region” (Green et al., 2018, p. 2). What is more, the agent could have been changed so as to be resistant to current vaccines. Thus, the prevention of bioterrorism is more complex than for naturally occurring infections and includes strengthening the specific infrastructure, which is needed for treatment within a short time period. What is more, a developed collaboration of laboratories from different countries can also contribute to responding to intentional outbreaks since it would help to improve diagnostic methods and, consequently, provide additional time.

Signs and Symptoms

Given the specific characteristics of the agents used within bioterrorism coupled with the lack of knowledge regarding the issue by health care emergency crews, the threat of biological weapons is especially serious. Early detection might be crucial with regard to a bioterrorism attack. According to Edelman et al. (2014), bioterrorism is related to “the intentional release of a biological agent” (p. 298). These agents should have the potential for high lethality and easy dissemination so as to lead to social fear and chaos. Thus, health care workers have to know the epidemiology of the diseases, which can be used in bioterrorism. They should be aware of some signs and symptoms that might indicate an uncommon infectious disease burst relating to the planned release of a biological agent.

Given that the most widespread agents used as weapons are anthrax, plague, smallpox, tularemia, and hemorrhagic viruses, specialists need to identify these diseases’ symptoms, especially if they are more dramatic or develop too quickly. For example, anthrax, which is one of the most frequently used biological weapons, might be manifested through the syndromes, such as “cutaneous, gastrointestinal, and respiratory or inhalational” (Edelman et al., 2014, p. 298). It should be mentioned that initial symptoms are not extremely specific and may contain fever, cough, and pain in the chest. Regarding smallpox, which is in the number of the prime agents for bioterrorism, it is essential to be knowledgeable of its symptoms due to the fact that many specialists have never seen this eradicated disease. The symptoms of smallpox include sudden onset of fever, abdominal pain, and vomiting; two days after the fever begins, a rash arises. Primary plague signs are myalgia, fever, and sore throat; progressive symptoms include bubo or swollen node. The tularemia’s symptoms are high fever, headache, and nausea, and often an ulcerative lesion appears at the place of inoculation and lymph nodes swell.

Diagnostic Tests

Rapid diagnostics regarding a bioterrorism event is of high importance since it might provide essential time. For example, highly sensitive PCR-based systems help to make sequencing technologies cheaper and more portable (Green et al., 2018). For diagnostic of anthrax antibodies, traditional ELISA tests are used. However, a modern compact system that includes PCR amplification and sample processing can reach a result in 90 minutes (Green et al., 2018). Other rapid diagnostic methods are diagnostic electron microscopy for detecting the smallpox virus and advanced proteomics.

Advanced Practice Nursing Role and Management Strategies

Provided that health care emergency response teams are the first to eradicate potential causalities, they should be able to prevent, detect and respond to bioterrorist attacks. All the diseases used as a method of bioterrorism are communicable diseases, such as anthrax, plague, and botulism. Nurses play an important role in the primary prevention of such illnesses, which, as was mentioned above, includes vaccination. Regarding management strategies, if it was not possible to prevent the spread of bioterrorism, then pharmacological methods of treatment have to be implemented. To identify the first signs of such diseases, which may be similar to common influenza, health care first responders should refer the case to a public health research laboratory for confirmation.

Pharmacological Management

With regard to pharmacological treatment, it depends on the disease’s specific characteristics. For example, anthrax is treated with antibiotics, such as penicillin or ciprofloxacin. Treatment of plague also comprises antibiotics, including the tetracycline and fluoroquinolone classes. Pharmacological management of tularemia is administering the same classes of antibiotics. Thus, it can be seen that the most widespread measure against biological agents used in bioterrorism is antibiotics.

Follow-Up Care

As for bioterrorism, follow-up care implies constant supervision of the further development of the disease in patients, as many of the primary symptoms, such as headache, are similar to non-dangerous diseases, for example, the flu. According to Pal et al. (2017), methods of dissemination of biological agents “include oral, intentional contamination of food or water supply, per-cutaneous, infected animal vector” (p. 25). Given that, follow-up care suggests also paying attention to the food and places of stay of patients to prevent their re-infection.


To conclude, the thread of bioterrorism actualizes the necessity for preparing for such events. Those who give emergency medical treatment, including nurses, should be qualified enough to detect, diagnose and respond properly to biological agents in order to reduce adverse health effects and prevent fatalities. Thus, the health care providers have to act quickly in conditions of lack of time and chaos. At the first symptoms of one of the diseases that can be used as bioweapons, report this to the local authorities and refer the case to a laboratory.


Edelman, C. L., Mandle, C. L., & Kudzma, E. C. (2014). Health promotion throughout the life span (8th ed.). Elsevier Mosby.

Green, M. S, LeDuc, J., Cohen, D., & Franz, D. R. (2018). Confronting the threat of bioterrorism: Realities, challenges, and defensive strategies. The Lancet Infectious Diseases, 19(1), 1–12. Web.

Pal, M., Tsegaye, M., Girzaw, F., Bedada, H., Godishala,V., & Kandi, V. (2017). An overview on biological weapons and bioterrorism. American Journal of Biomedical Research, 5(2), 24-34. Web.

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