A Scoping Review on Category A Agents as Bioweapons

Beale, Sarah L; Zolnikov, Tara Rava; Firebaugh, Casey Mace

doi:10.1017/s1049023x21001072

Cited by 8 publications

(5 citation statements)

References 20 publications

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“…Anthrax is a serious, notifiable, non-contagious, toxin-mediated zoonosis. It is caused by Bacillus anthracis ( B. anthracis ), a globally distributed, Gram-positive spore-forming bacterium that has been classified as a category “A” biological agent that poses a massive destructive threat to human health and safety if used in bioweapons [ 1 , 2 ]. In the past, it has also been used in bioterroristic attacks in the USA [ 3 , 4 ].…”

Section: Introductionmentioning

confidence: 99%

Retrospective Analysis of Official Data on Anthrax in Europe with a Special Reference to Ukraine

Kozytska

Bassiouny

Chechet³

et al. 2023

Microorganisms

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Anthrax is an acute infectious zoonotic disease caused by Bacillus anthracis that mostly affects grazing livestock and wildlife. Furthermore, B. anthracis is considered one of the most important biological agents of bioterrorism that could also be potentially misused in biological weapons. The distribution of anthrax in domestic animals and wildlife in Europe with a particular focus on Ukraine as a country of war was analyzed. Between 2005 and 2022, 267 anthrax cases were registered at the World Organization of Animal Health (WOAH) in animals in Europe, including 251 cases in domestic animals and 16 in wildlife. The highest numbers of cases were recorded in 2005 and 2016 followed by 2008, and the highest numbers of registered cases were reported from Albania, Russia, and Italy. In Ukraine, anthrax is currently a sporadic infection. Since 2007, 28 notifications were registered, with isolates mainly from soil samples. The highest number of confirmed anthrax cases was registered in 2018, and Odesa, which is close to Moldova, had the highest number of cases, followed by the Cherkasy region. The presence of thousands of biothermal pits and burial grounds of fallen cattle nationwide favors the re-emergence of new foci. Most confirmed cases were in cattle; however, single cases were confirmed in dogs, horses, and pigs. Further investigation of the disease in wildlife and in environmental samples is needed. The genetic analysis of isolates, investigation of susceptibility to antimicrobial compounds, and determination of virulence and pathogenicity factors are required in this volatile region of the world for awareness raising and preparedness.

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Section: Introductionmentioning

confidence: 99%

Retrospective Analysis of Official Data on Anthrax in Europe with a Special Reference to Ukraine

Kozytska

Bassiouny

Chechet³

et al. 2023

Microorganisms

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“…Tularemia is a rare, life-threatening infection with low naturally occurring transmission rates in the United States [1,2]. Despite the low incidence rate of 2,108 cases in the United States from 2010 to 2019 (range: 124 -314 cases/year) [7], tularemia remains on the list of nationally notifiable diseases due to being highly infectious with the potential to be utilized as a bioterrorism weapon [1][2][3][4]. One would think that a condition of this importance would be quick to diagnose, but due to its non-specific symptoms, the diagnosis can be delayed by even the most skilled clinicians.…”

Section: Discussionmentioning

confidence: 99%

“…This bacterium is highly contagious, needing as few as 10 microorganisms to cause a potentially fatal illness [1][2][3]. Thus, F. tularensis is one of six agents classified as a Category A bioterrorism disease, along with anthrax, botulism, plague, smallpox, and viral hemorrhagic fevers [4]. Considering the fact that this rare disease usually presents with non-specific viral symptomatology such as fever, malaise, chills, headache, and fatigue [5,6], it is of utmost importance to obtain a detailed exposure history for patients with suspected cases of tularemia so that appropriate diagnostic steps can be taken early in the course of illness.…”

Section: Introductionmentioning

confidence: 99%

Tularemia: The Resurgence of a Diagnostic Challenge and Clinical Dilemma in the United States

Kelson¹,

Burnett²,

Girgis³

et al. 2022

Cureus

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Tularemia is a rare, life-threatening zoonotic infection with low, naturally occurring transmission rates in the United States. Classified as a Category A bioterrorism agent, this disease is highly infectious and has the potential to be fatal if left untreated. Making the diagnosis is difficult due to the non-specific symptomatology patients present with. Considering the increase in the prevalence of this diagnosis over the past two decades, this condition has the potential to become a public health crisis. This case report details a pediatric patient who was found to have fever, ulceration, and lymphadenopathy on hospital admission. After a prolonged and protracted course of illness, tularemia was diagnosed with laboratory testing. The purpose of this case report is to increase awareness of tularemia as a potential cause of non-specific flu-like symptoms, especially during the summer months. Moreover, our goal is to propose suggestions for healthcare professionals who encounter patients with clinical suspicion of tularemia.

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“…Owing to the heterogenous nature of PHTs, it is essential to investigate criteria and metrics that support the comparison of threats across various categories. Lastly, the exploration of malicious threats and their considerations must be comprehensively explored ( 51 , 52 ). Research is required to identify security considerations related to information sharing related to malicious threats.…”

Section: Strengths Limitations and Further Researchmentioning

confidence: 99%

A rapid review of best practices in the development of risk registers for public health emergency management

Kostirko,

Zhao,

Lavigne

et al. 2023

Front. Public Health

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IntroductionPublic health organizations (PHO) must prepare to respond to a range of emergencies. This represents an ongoing challenge in an increasingly connected world, where the scope, complexity, and diversity of public health threats (PHT) have expanded, as exemplified by the COVID-19 pandemic. Risk registers (RR) offer a framework for identifying and managing threats, which can be employed by PHOs to better identify and characterize health threats. The aim of this review is to establish best practices (BP) for the development of RRs within Public Health Emergency Management (PHEM).MethodsIn partnership with a librarian from Health Canada (HC), and guided by the Cochrane Rapid Review Guideline, journal articles were retrieved through MEDLINE, and a comprehensive search strategy was applied to obtain grey literature through various databases. Articles were limited to those that met the following criteria: published on or after January 1, 2010, published in the English language and published within an Organisation for Economic Co-operation and Development setting.Results57 articles were included for synthesis. 41 papers specifically discussed the design of RRs. The review identified several guidelines to establish RRs in PHEM, including forward-looking, multidisciplinary, transparent, fit-for-purpose, and utilizing a systems approach to analyze and prioritize threats. Expert consultations, literature reviews, and prioritization methods such as multi-criteria-decision-analysis (MCDA) are often used to support the development of RRs. A minimum five-year-outlook is applied to assess PHTs, which are revisited yearly, and iteratively revised as new knowledge arises.DiscussionBased upon this review, RRs offer a systems approach to PHEM that can be expanded to facilitate the analysis of disparate threats. These approaches should factor in the multidimensionality of threats, need for multi-sectoral inputs, and use of vulnerability analyses that consider inherent drivers. Further research is needed to understand how drivers modify threats. The BPs and recommendations highlighted in our research can be adopted in the practice of PHEM to characterize the public health (PH) risk environment at a given point in time and support PHOs policy and decision-making.

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A Scoping Review on Category A Agents as Bioweapons

Cited by 8 publications

References 20 publications

Retrospective Analysis of Official Data on Anthrax in Europe with a Special Reference to Ukraine

Retrospective Analysis of Official Data on Anthrax in Europe with a Special Reference to Ukraine

Tularemia: The Resurgence of a Diagnostic Challenge and Clinical Dilemma in the United States

A rapid review of best practices in the development of risk registers for public health emergency management

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