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Medical Author:

Edmond Hooker, MD, DrPH

Edmond Hooker, MD, DrPH

Dr. Eddie Hooker is currently an Assistant Professor in the Department of Health Services Administration at Xavier University in Cincinnati, Ohio. He is also an Associate Clinical Professor in the Department of Emergency Medicine at the University of Louisville and at Wright State University. His areas of expertise include emergency medicine, epidemiology, health-services management, and public health.

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Medical Editor:

Melissa Conrad Stöppler, MD

Melissa Conrad Stöppler, MD

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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In this Article

• What is bioterrorism?
• What are the biological agents that can be utilized for bioterrorism?
• What are the causes of bioterrorism in food?
• What are the sources for detailed information on bioterrorism?
• How can I prepare myself for a bioterrorism attack?
• What are the warning signs of a bioterrorism attack?
• What should I do if there has been a bioterrorism attack?
• How do I know if I have been exposed to a bioterrorism agent?
• Should I have some antibiotics on hand just in case I get exposed?
• Bioterrorism Index

There are a number of bacteria and bacterial toxins that could potentially be used to infect the food supply. These include Clostridium botulinum toxin, Clostridium perfringens toxin, Salmonella species, Escherichia coli O157:H7, Shigella, and Staphylococcal enterotoxin B. The one that is most dangerous and most likely to be used in bioterrorism is Clostridium botulinum toxin, which causes botulism.

There are many different government-based web sites that have up-to-date information on bioterrorism. These include the following:

U.S. Centers for Disease Control and Prevention
http://www.bt.cdc.gov/bioterrorism

United States Food and Drug Administration
http://www.fda.gov/oc/opacom/hottopics/bioterrorism.html
http://www.fda.gov/Drugs/EmergencyPreparedness/
BioterrorismandDrugPreparedness/UCM072261

United States Department for Homeland Security
http://www.ready.gov/be-informed

The American Red Cross, in cooperation with the CDC, has developed a detailed plan that gives people the proper steps to take to prepare in the event there is a bioterrorism attack (http://www.redcross.org/preparedness/
cdc_english/home.asp). The first step starts long before there is an attack. People must have appropriate supplies stored in a safe place in their house, where they work, and even in their cars. Although individuals may want to vary the list based on their particular needs, the list taken from the American Red Cross' web site (see below) is a good place to start. A similar list can be found on the U.S. Homeland Security web site (http://www.ready.gov/build-a-kit). These supplies may also be invaluable to have on hand during natural disasters, which are actually more likely to occur than a terrorist attack.

• Water: 3 gallons for each person who would use the kit and an additional 4 gallons per person or pet for use if you are confined to your home
• Food: a three-day supply in the kit and at least an additional four-day supply per person or pet for use at home (You may want to consider stocking a two-week supply of food and water in your home.)
• Items for infants, including formula, diapers, bottles, pacifiers, powdered milk, and medications not requiring refrigeration
• Items for seniors, disabled people or anyone with serious allergies, including special foods, denture items, extra eyeglasses, hearing aid batteries, prescription and nonprescription medications that are regularly used, inhalers, and other essential equipment
• Kitchen accessories: a manual can opener, mess kits or disposable cups, plates and utensils, utility knife, sugar and salt, aluminum foil and plastic wrap, resealable plastic bags
• A portable, battery-powered radio or television and extra fresh batteries
• Several flashlights and extra fresh batteries
• A first aid kit
• One complete change of clothing and footwear for each person, including sturdy work shoes or boots, rain gear, and other items adjusted for the season, such as hats and gloves, thermal underwear, sunglasses, and dust masks
• Blankets or a sleeping bag for each person
• Sanitation and hygiene items: shampoo, deodorant, toothpaste, toothbrushes, comb and brush, lip balm, sunscreen, contact lenses, any medications regularly used, toilet paper, towelettes, soap, hand sanitizer, liquid detergent, feminine supplies, plastic garbage bags (heavy-duty) and ties (for personal sanitation uses), medium-sized plastic bucket with tight lid, disinfectant, and household chlorine bleach
• Other essential items: paper, pencil, needles, thread, small A-B-C-type fire extinguisher, medicine dropper, whistle, and emergency-preparedness manual
• Entertainment: including games, books, favorite dolls, and stuffed animals for small children
• A map of the area marked with places you could go and their telephone numbers
• An extra set of keys and IDs: including keys for cars and any properties owned and copies of driver's licenses, passports, and work-identification badges
• Cash, coins, and copies of credit cards
• Copies of medical prescriptions
• Matches in a waterproof container
• A small tent, compass, and shovel