Table 71.1.
Agents of concern for use in bioterrorism
| Highest priority: category A (based upon potential mortality, morbidity, virulence, transmissibility, aerosol feasibility and psychosocial implications of an attack) | |
|---|---|
| Microbe/toxin | Disease |
| Bacillus anthracis | Anthrax: inhalational, cutaneous |
| Variola virus | Smallpox and its variants |
| Yersinia pestis | Plague: pneumonic, bubonic, septicemic |
| Clostridium botulinum toxin | Botulism |
| Francisella tularensis | Tularemia: pneumonic, typhoidal |
| Viral hemorrhagic fevers | |
| Filoviruses | Ebola, Marburg |
| Arenaviruses | Lassa fever, South American hemorrhagic fevers |
| Bunyaviruses | Rift Valley fever, Congo–Crimeanhemorrhagic fever |
| Flaviviruses | Dengue |
| Moderately high priority: category B (based upon potential morbidity, aerosol feasibility, dissemination characteristics, and diagnostic difficulty) | |
|---|---|
| Microbe/toxin | Disease |
| Coxiella burnetti | Q fever |
| Brucella spp. | Brucellosis |
| Burkholderia mallei | Glanders |
| Burkholderia pseudomallei | Melioidosis |
| Alphaviruses (e.g. EEE, VEE) | Viral encephalitides |
| Ricinus communis toxin | Ricin intoxication |
| Staphylococcal enterotoxin B | Staphylococcal toxin illness |
| Salmonella spp., Shigella dysenteriae, Escherichia coli O157:H7, Vibrio cholerae,Cryptosporidiumparvum, Listeria monocytogenes, Campylobacter, jejuni, Yersinia enterocolitica | Food- and waterborne gastroenteritis |
| Rickettsia prowazekii | Epidemic typhus |
| Chlamydiapsittaci | Psittacosis |
| Epsilon toxin of Clostridium perfringens | C. perfringens intoxication |
| Emerging threat agents: category C (based upon potential for production and dissemination, availability, morbidity/mortality) | |
|---|---|
| Microbe/toxin | Disease |
| Hantaviruses | Viral hemorrhagic fevers |
| Flaviviruses | Yellow fever, West Nile virus |
| Mycobacterium tuberculosis | Multidrug-resistant tuberculosis |
| Nipah virus | Systemic flu-like illness |
| Miscellaneous (other examples of candidate threat agents that possess some elements of bioterrorism concern) | |
|---|---|
| Genetically engineered vaccine- and/or antimicrobial-resistant category A or B agents | |
| HIV-1 | |
| Adenoviruses | |
| Influenza | |
| Rotaviruses | |
| Molecular hybrid pathogens (e.g. smallpox–plague, smallpox–ebola) | |
| Severe acute respiratory syndrome coronavirus |
EEE, eastern equine encephalomyelitis; VEE, Venezuelan equine encephalomyelitis.
Adapted from Patrozou & Artenstein.26