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14 : Bioterrorist Threats: What the Infectious Disease Community Should Know about Anthrax and Plague
This chapter addresses the following questions: If anthrax or plague were used as a biological weapon, what would be the expected epidemiology? What would be the clinical manifestations? How would a diagnosis be made? What is the recommended treatment? And what is the role of vaccination? Anthrax and plague are widely and appropriately considered two of the most serious potential biological weapons. A World Health Organization analysis of 1970 described the destructive capacity of anthrax and plague. Inhalational anthrax is the least common important manifestation of the naturally occurring form of this disease. A national working group called the Working Group on Civilian Biodefense has published consensus guidelines on the treatment and public health management of anthrax and plague as biological weapons. Given that the chance for survival from inhalational anthrax diminishes with time after symptom onset, antibiotic prophylaxis is advised as early as possible. Secondary pneumonic plague occurs as often as 10 to 12% of the time following primary bubonic or septicemic plague. This chapter concludes by stating that it is clear that the technology supporting the development of mass casualty- producing biological weapons has existed for some time and is now becoming more accessible and less expensive. It is clear that biological weapons have the potential to cause tremendous illness and death. Thus it is evident that infectious diseases specialists and the broader biological sciences community have the responsibility to engage in the challenges posed by biological weapons.