Noah D L, Sobel A L, Ostroff S M, Kildew J A
Air Force Medical Operations Agency/SGPA, Bolling Air Force Base, DC 20332-6188, USA.
Mil Med. 1998 Apr;163(4):198-201.
The threat of biological terrorism and warfare may increase as the availability of weaponizable agents increases, the relative production costs of these agents decrease, and, most importantly, there exist terrorist groups willing to use them. Therefore, an important consideration during the current period of heightened surveillance for emerging infectious diseases is the ability to differentiate between natural and intentional outbreaks. Certain attributes of a disease outbreak, although perhaps not pathognomonic for a biological attack when considered singly, may combine to provide convincing evidence of intentional causation. These potentially differentiating criteria include proportion of combatants at risk, temporal patterns of illness onset, number of cases, clinical presentation, strain/variant, economic impact, geographic location, morbidity/mortality, antimicrobial resistance patterns, seasonal distribution, zoonotic potential, residual infectivity/toxicity, prevention/therapeutic potential, route of exposure, weather/climate conditions, incubation period, and concurrence with belligerent activities of potential adversaries.
随着可制成武器的病原体供应增加、这些病原体的相对生产成本降低，以及最重要的是，存在愿意使用它们的恐怖组织，生物恐怖主义和生物战的威胁可能会增加。因此，在当前加强对新发传染病监测的时期，一个重要的考虑因素是区分自然爆发和故意爆发的能力。疾病爆发的某些特征，虽然单独考虑时可能并非生物攻击的特征性表现，但可能综合起来提供故意致病的令人信服的证据。这些潜在的区分标准包括有风险的战斗人员比例、发病的时间模式、病例数量、临床表现、毒株/变体、经济影响、地理位置、发病率/死亡率、抗菌药物耐药模式、季节性分布、人畜共患病潜力、残余传染性/毒性、预防/治疗潜力、暴露途径、天气/气候条件、潜伏期以及与潜在对手的敌对活动同时发生的情况。
