Public Health Assessment of Potential Biological Terrorism Agents

Lisa D. Rotz

, Ali S. Khan, Scott R. Lillibridge, Stephen M. Ostroff, and James M. Hughes

Author affiliations: Centers for Disease Control and Prevention, Atlanta, Georgia, USA;

Table 2

Criteria and weighting^a used to evaluate potential biological threat agents

Disease	Public health impact		Dissemination potential		Public perception	Special preparation	Category
Disease	Disease	Death	P-D^b	P - P^c	Public perception	Special preparation	Category
Smallpox	+	++	+	+++	+++	+++	A
Anthrax	++	+++	+++	0	+++	+++	A
Plague^d	++	+++	++	++	++	+++	A
Botulism	++	+++	++	0	++	+++	A
Tularemia	++	++	++	0	+	+++	A
VHF^e	++	+++	+	+	+++	++	A
VE^f	++	+	+	0	++	++	B
Q Fever	+	+	++	0	+	++	B
Brucellosis	+	+	++	0	+	++	B
Glanders	++	+++	++	0	0	++	B
Melioidosis	+	+	++	0	0	++	B
Psittacosis	+	+	++	0	0	+	B
Ricin toxin	++	++	++	0	0	++	B
Typhus	+	+	++	0	0	+	B
Cholera^g	+	+	++	+/-	+++	+	B
Shigellosis^g	+	+	++	+	+	+	B

^aAgents were ranked from highest threat (+++) to lowest (0).
^bPotential for production and dissemination in quantities that would affect a large population, based on availability, BSL requirements, most effective route of infection, and environmental stability.
^cPerson-to-person transmissibility.
^dPneumonic plague.
^eViral hemorrhagic fevers due to Filoviruses (Ebola, Marburg) or Arenaviruses (e.g., Lassa, Machupo).
^fViral encephalitis.
^gExamples of food- and waterborne diseases.

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Footnote: Participants are listed in Acknowledgments.

The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.

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Volume 8, Number 2—February 2002

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