Bacteriological warfare and bioterrorism: still a public health challenge

Introduction: According to the American CDC, bioterrorism is defined as "release of viruses, bacteria and other agents with the aim of causing disease or death in the population, as well as animals and plants". Since ancient times, the potential of biological agents as a weapon was recognized, but it was not until the discoveries of Kock and Pasteur in the 19th century that it became possible to speak more properly of "bacteriological warfare". The purpose of this work was to study and compare all the most modern scientific evidence on bioterrorism, to assess the state of the art in the field and provide a useful tool for the prevention and management of a possible biological threat. Methodology: The study was conducted by searching the scientific literature through the PUBMED database. It was based on the use of different search strings using keywords that could well center the topic of interest. This was also supplemented by consulting Centers For Disease Control and Prevention databases that focused on the topic. Results: The case of the "anthrax letters" demonstrated how bioterrorism still remains a danger to the entire community, and must be taken seriously at the individual and policy level. The basic requirement for a biological attack is first of all the availability of the pathogen or toxin in sufficient quantity to affect the human organism and cause disease. Terrorists, however, do not need agents of mass destruction for their purposes and this opens up a wider range of possibilities, preferring readily available agents, first of all castor bean toxin. Adequate preparation for clinical microbiologists and health care personnel to identify and treat implicated biological agents in a timely manner, and maintenance of emergency stockpiles of drugs, is therefore necessary. Conclusions: Although bioterrorism represents a marginal form when compared with traditional forms of terrorism involving weapons and explosives, it is critical that Public Health respond appropriately to this potential threat: prompt recognition of the event is the key step in ensuring that the number of casualties is contained.