Treadwell Tracee A, Koo Denise, Kuker Kathleen, Khan Ali S
Bioterrorism Preparedness and Response Program, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.
Public Health Rep. 2003 Mar-Apr;118(2):92-8. doi: 10.1093/phr/118.2.92.
Public health investigators have successfully carried out epidemiologic investigations of outbreaks of disease for many years. By far the majority of these outbreaks have occurred naturally. With the recent illnesses resulting from deliberate dissemination of B. anthracis on an unsuspecting population, public health investigation of diseases must now include consideration of bioterrorism as a potential cause of outbreaks of disease. The features of naturally occurring outbreaks have a certain amount of predictability in terms of consistency with previous occurrences, or at least biological plausibility. However, with a deliberately introduced outbreak or infection among a population, this predictability is minimized. In this paper, the authors propose some epidemiologic clues that highlight features of outbreaks that may be suggestive of bioterrorism. They also describe briefly the general process of involvement of agencies at various levels of government, public health and non-public health, depending on the extent of an outbreak or level of suspicion.
多年来，公共卫生调查人员成功地开展了疾病暴发的流行病学调查。到目前为止，这些暴发绝大多数是自然发生的。随着最近因向毫无防备的人群蓄意传播炭疽杆菌而导致的疾病出现，现在疾病的公共卫生调查必须将生物恐怖主义视为疾病暴发的一个潜在原因。自然发生的疾病暴发的特征在与以往情况的一致性方面，或者至少在生物学合理性方面，具有一定程度的可预测性。然而，对于人群中蓄意引发的疾病暴发或感染，这种可预测性被降至最低。在本文中，作者提出了一些流行病学线索，这些线索突出了可能提示生物恐怖主义的疾病暴发特征。他们还简要描述了各级政府机构、公共卫生机构和非公共卫生机构根据疾病暴发的程度或怀疑程度而参与的一般过程。
