BIOLOGICAL WARFARE TRAINING - INFECTIOUS-DISEASE OUTBREAK DIFFERENTIATION CRITERIA

The threat of biological terrorism and warfare may increase as the ava ilability of weaponizable agents increases, the relative production co sts of these agents decrease, and, most importantly, there exist terro rist groups willing to use them, Therefore, an important consideration during the current period of heightened surveillance for emerging inf ectious diseases is the ability to differentiate between natural and i ntentional outbreaks, Certain attributes of a disease outbreak, althou gh perhaps not pathognomonic for a biological attack when considered s ingly, may combine to provide convincing evidence of intentional causa tion, These potentially differentiating criteria include proportion of combatants at risk, temporal patterns of illness onset, number of cas es, clinical presentation, strain/variant, economic impact, geographic location, morbidity/mortality, antimicrobial resistance patterns, sea sonal distribution, zoonotic potential, residual infectivity/toxicity, prevention/therapeutic potential, route of exposure, weather/climate conditions, incubation period, and concurrence with belligerent activi ties of potential adversaries.