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Emerg Med Clin North Am. 2002 May;20(2):255-71.

The history and threat of biological warfare and terrorism.

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  • 1US Air Force, Epidemiology and Public Health Department, Operational Medicine Division, US Army Medical Research Institute of Infectious Diseases, Fort Detrick, MD, USA.


The inevitable conclusion is that the availability of biological warfare agents and supporting technologic infrastructure, coupled with the fact that there are many people motivated to do harm to the United States, means that America must be prepared to defend her homeland against biological agents. Some have argued to the contrary, that the threat and risks from a biological weapon attack are not to be considered serious, because [39]: They've not been used yet on a large scale so they probably won't be in the near future. Their use is so morally repugnant that they probably won't be used at all. The technologic hurdles associated with isolating, growing, purifying, weaponizing, and disseminating adequate quantities of pathologic agents are so high that only the most advanced laboratories could attempt the process. Similar to a 'nuclear winter,' the aftermath of a biological attack is so unthinkable that none would attempt it. Unfortunately, the trends associated with biotechnology globalization, terrorist group dynamics, and global/regional politics render these beliefs untenable and inappropriate, as recent events have underscored. To that end, the United States has accelerated its program of defense against biological weapons, as it must. Biological weapons are such dreadful weapons of uniqueness and complexity that a specific defense strategy is paramount. Elements of this program include pharmaceutical stockpiles, heightened surveillance systems, energized vaccine development programs, and comprehensive training initiatives. Although the depth and breadth of these efforts are unprecedented, above all these efforts is the absolute necessity for medical and public health care professionals to be educated and actively involved. These professionals are the sine qua non of future defensive readiness. This is just the start; unfortunately, there is no end yet in sight.

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