Preparedness for the deliberate use of biological agents : a rational approach to the unthinkable

Overview

Routine surveillance systems for epidemic-prone and emerging infectious diseases enhance the capacity to detect and investigate deliberately caused outbreaks, as the initial epidemiological and laboratory techniques are similar to those used for natural outbreaks. Adequate background data on the natural behaviour of infectious diseases facilitate recognition of an unusual event and help determine whether suspicions of a deliberate cause should be investigated. Preparedness for the deliberate use of a biological agent requires collaboration of the intelligence community, law enforcement agencies, public health professionals, and the biomedical sciences. As these disciplines do not routinely work together, the meaning of some terms, notably surveillance and verification, has different interpretations. Surveillance, as used in public health, pertains to routine systems for monitoring diseases with a high burden, tracking outbreaks of epidemic-prone diseases, and detecting new diseases. Verification pertains to the procedures followed when investigating an outbreak and identifying the causative agent.