Planning against Biological Terrorism: Lessons from Outbreak Investigations
Epidemic Intelligence Service investigations in which bioterrorism or intentional contamination was considered a cause
||Salmonellosis, Oregon, 1984
||A total of 751 persons became ill with salmonella gastroenteritis. Religious group deliberately contaminated salad bars. Salmonella enterica Typhimurium strain found in laboratory at commune was indistinguishable from outbreak strain (5).
||Shigella dysenteriae type 2, Texas, 1996
||Diarrheal illness in hospital laboratory workers who ate pastries, anonymously placed in break room. Identical strains of S. dysenteriae type 2 were isolated from stool cultures of case patients, from recovered muffin, and from laboratory stock culture, part of which was missing.
||S. sonnei, New Hampshire, 1997
||Seven laboratory workers at local hospital became ill with gastroenteritis. Most cases caused by strain of S. sonnei that was highly related to a stock culture strain maintained by the hospital laboratory. Possibility that first two cases were caused by intentional contamination could not be excluded.
||Anthrax hoaxes, 1998
||Centers for Disease Control and Prevention received reports of alleged anthrax exposure; letters were sent to health clinics in Indiana, Kentucky, and Tennessee and to private business in Tennessee; three telephone threats of anthrax contamination of ventilation systems were made to public and private buildings; all threats were hoaxes.
||Unexplained critical illness, New Hampshire, 1999
||A 38-year-old woman was admitted to a hospital with fever, myalgia, and weakness; severe illness and death occurred 32 days after hospital admission; serum specimens indicated Brucella species. Patient’s history of multiple febrile illnesses suggested unspecified autoimmune process.
||Encephalitis cluster, New York City, 1999
||Several residents were hospitalized with illness of unknown etiology characterized by fever, encephalitis, axonal neuropathy, and flaccid paralysis (unpublished data: Epi-1 report); increase in deaths of New York City birds, especially crows; human and bird tissue samples were positive for West Nile-like virus.