Comprehensive Review of Bioterrorism

Biological weapons are devices or agents used or intended to be used in a deliberate attempt to disseminate disease-producing organisms or toxins using aerosol, food, water, or insect vectors. Their mechanism of action tends to be broadly through infection or intoxication. Bioterrorism involves the deliberate release of bioweapons to cause death or disease in humans, animals, or plants. These biological agents can include bacteria, viruses, toxins, or fungi. Biological weapons may be developed or used as part of a government policy in biological warfare or by terrorist groups or criminals. Biological weapons can initiate large-scale epidemics with an unparalleled lethality, and nation-states and terrorist groups have used dangerous and destructive biological weapons in the past. The degree of the potential damage, coupled with the unpredictable nature of these agents, has led to an increased interest by numerous countries, including the United States, in drawing up policies and guidelines in the event of such an attack to be prepared.  Keeping in mind the horrific nature of these agents, the Geneva protocol, first signed in 1925, and currently signed by 65 out of 121 country states, prohibited the development, production, and use of biological weapons in war. However, not being country states, biological weapons to wage bioterrorism tend to be a relatively common choice for terrorist organizations. The relative ease with which the agents may be deployed, the devastating effects on the victims, and their inexpensive nature make them all more lucrative to these organizations. However, the unpredictable nature of these biological weapons means that they may affect both the intended victims and inadvertently affect friendly forces. Despite this drawback, terrorist organizations favor the use of biological weapons. Healthcare professionals need to be aware of the essentials of bioterrorism and biological weapons, as these may be used as part of a terrorist attack in any part of the world. Thus, healthcare professionals need to be trained and prepared in case of a potentially catastrophic event, where quick action and decision-making may potentially save lives. This article reviews the previous incidents of biological terrorism, types of biological weapons, evaluation of patients exposed to potential biological weapons, and treatment of patients who have been potentially exposed to the various commonly employed biological weapons. This article also aims to discuss an inter-professional team's role in evaluating and managing a bioterrorism attack. For this activity, bioterrorism's biological weapons have been broadly classified under four major headings, including bacterial agents, viral agents, fungal agents, protozoal agents, and toxins.