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BACKGROUND: The effects of chemical, biological, radiological, and nuclear (CBRN) incidents on human society can be irreparable. Preparing the health system for these incidents is essential. This study aims to identify obstacles to hospital preparedness against CBRN incidents and provide solutions. MATERIALS AND METHODS: This qualitative study was conducted using semi-structured interview method in 2022. The research community included experts in the fields of CBRN, and 17 persons were included in the study through purposive sampling. The interviews were collected by interview guide and recorded face-to-face and online and were analyzed using thematic content analysis method in MS Word 2016. RESULTS: The interviews’ analysis was classified into two main categories and 34 sub-categories. Some of the most important obstacles to the hospital preparedness against CBRN incidents were the lack of proper crisis management, the lack of specialist staff, the stress of employees, the lack of turnover and sufficient rest for employees, legal gaps, and so on. The main strategies were determining the type and extent of the risk factor, strong crisis management, the lack of parallelism, continuous monitoring, having a protocol and road map, appropriate training programs, having skilled personnel, rapid response of personnel, positive attitude of the staff, and the favorable condition of the building. CONCLUSION: The appointment of an expert in the field of CBRN and having a specialized unit, the existence of specialized and trained staff along with access to the required facilities, clear instructions, and intra-departmental and inter-departmental cooperation affect the readiness of hospitals against CBRN incidents.

INTRODUCTION. The presented article is devoted to an extremely curious and, without exaggeration, urgent topic. The authors seek to understand the content and legal concept of biosafety in International Law. The researchers seek to list the biosafety issues in order to define concrete aspects related to responsibility of the States for using biological weapons. The authors analyze new legal trends on ensuring the international biosafety. The article is focused on legal issues by raising many questions about what should be considered a just war in the view of international humanitarian law, the issues of fundamental principles in current international law (the principle use of force, the right of States to self-defense in case of a bioattack, the principle of the peaceful settlement of international disputes, the principle of non-interference in the internal affairs of States, arms control, and responsibility). The writers give an overview of new types of sovereignty such as biosovereignty, cyber sovereignty, cyberbiosovereignty, and genomic sovereignty of States, the legal concept of international biocrimes (genomocide), the legal classification of bioterrorism, bioaggression, biopolitics, and bioeconomics. The authors consider the importance of facilitating the broad interpretation of the concept of biosafety.MATERIALS AND METHODS. The research uses general scientific and special cognitive techniques wherein legal analysis and synthesis, systemic, formal-legal, comparative-legal, historical-legal and dialectical methods are applied.RESEARCH RESULTS. The authors found out that despite the prohibition of biological weapon there are still other urgent issues such as an international control mechanism for monitoring the non-proliferation of biological weapons has not been established yet. The Protocol to the Biological and Toxin Weapons Convention (BTWC) has not been adopted yet. The study concludes with an idea that the problem of banning certain types of biomedical research has not been solved in some States and at the international level. The authors note such important problems as the lack of an international control mechanism for monitoring the prohibition of the development, production and stockpiling of bacteriological (biological) and toxin weapons, as well as the threat to the safety of genomic research and confidentiality of genetic data. In this paper, we interpret the concept of biosafety rather broadly, considering the issues typical of allied industries. Biosecurity and biosafety are directly related to ensuring environmental security, marine security, food security and outer space security. The researchers paid attention to the issue of legal regulation of ensuring environmental, biological, and food safety. Due to this fact, it is hard to do so with regard to the causal link between the acts (bioterrorism) of state agencies, the violation of the principles of international law, standards of human rights and the consequences that occurred. It is not clear from the text of the BTWC Convention which international organ/body can investigate such acts in international affairs and which norm of international law directly should be applied.DISCUSSION AND CONCLUSIONS. Following a review of the content, the authors raise possible problems, strategies, suggestions and guidelines for ensuring biosafety in international law. The authors conclude that near future new categories of weapons of mass destruction appear in the world, moreover, genetic weapons should be classified as weapons of mass destruction, along with chemical, biological, bacteriological, and nuclear weapons. Technological developments will trigger the issues of fundamental principles in current international law. The authors came to the conclusion about extension of the universal jurisdiction of the International Criminal Court in case biological and genetic weapons are used. The authors encourage the complement to the international legal regulation the necessity to adopt a Protocol to the Biological and Toxin Weapons Convention (BTWC), establishing an international control mechanism for verifying prohibitions on the development, production, and stockpiling of biological weapons is obvious. The Convention on the Prohibition of the Development, Production, Stockpiling and Use of Chemical Weapons and on their Destruction adopted in 1993, which contains a mechanism for verifying compliance with the prohibitions of the Convention, can be considered a precedent for the effective regulation of the circulation of hazardous substances all over the world.

Abstract Background and purpose Bioterrorism is a global threat. Nurses are one of the first groups that should be ready for it. College years are the best time to educate these issues. This study aimed to compare the effectiveness of simulation and workshop on knowledge and practice of nursing students regarding bioterrorism. Materials and methods This was an experimental study. The study sample consisted of 40 last-year nursing students who were randomly assigned to two groups by using random numbers table. Data was collected using a demographic questionnaire, bioterrorism knowledge scale, and an OSCE checklist. Before the intervention, the students completed the study questionnaires and a six-station OSCE test. The workshop group (20 students) learned how to deal with bioterrorism through lectures. The simulation group (20 students) participated in a simulation learning program. After one month, the students completed the study tools again. Finally, collected data were analyzed using descriptive and inferential statistics in SPSS V.16. Results The difference between the knowledge and performance scores of both groups (workshop and simulation), before and after the intervention, was statistically significant (P

The Covid-19 pandemic has revived interest in the impact of using pathogens as weapons. Bioterrorism is the intentional release of viruses, bacteria or other agents used to cause disease or death in humans, animals or plants. There is the potential for state-sponsored terrorism against strategic targets and the potential for the use of biological agents in committing crimes that have no political goals but are committed for extortion or revenge. This study aims to analyze the threat of bioterrorism in Indonesia using a qualitative descriptive method. This study involved collecting data from various sources, such as related documents and reports, as well as interviews with relevant experts and stakeholders. The results of the study show that Indonesia is facing a real threat of bioterrorism which can endanger national defense and security as well as public health. Like Covid-19, even though it has been declared a pandemic, Covid-19 can also be called a bioterrorism threat even though it is not fully realized. Through this study, researchers want to show that threat identification in Indonesia still needs to be improved. This also needs to be accompanied by optimizing efforts to prevent and deal with bioterrorism, especially in the aspect of inter-agency coordination and increasing state intelligence capabilities. In supporting these efforts, regulations, human resources, technology and infrastructure need to be prepared as early as possible in order to deal with the threat of bioterrorism.

The danger of being exposed to or releasing biological agents that can harm humans, animals, plants, or the environment is referred to as biorisk. Ilnesses that occur naturally, such as chronic and infectious diseases, that can impact humans, animals, plants, or the environment. The biological agent might be a naturally occurring or man-made bacteria, virus, insect, fungus, or toxin. The use of cyber technology to enable or perpetrate biocrimes is referred to as cyber biocrimes. Cyber biocrimes offer significant risks to public health, security, and stability because they may exploit weaknesses in both cyber and biological systems. Weapons of mass destruction like chemical, biological, radiological and nuclear (CBRN) war agents are global concern Biocrimes, which include the bioterrorism, can be difficult to be detected and investigated because they are not always recognized or reported, and they may use uncommon or modified biological agents that are difficult to identify or track. Microfluidics is the manipulation of tiny amounts of fluids in microscale channels or chambers. Microfluidics for biocrime detection are useful since they use less sample and reagent, lowering the cost and environmental effect of the analysis. Also, due to greater analytical speed and efficiency, which enables for faster diagnosis and reaction to biocrimes. Telemedicine refers to the use of technology to provide clinical treatment from a distance. Telemedicine employs electronic and communications technologies to communicate medical information when a patient and their doctor are not in the same room. It can range from as simple as texting medical care to as complex as remotely controlled surgery. Telemedicine can be combined with microfluidics to identify bioterrorism by allowing for remote and quick examination of biological agents or poisons that could be utilized as bioterrorism weapons. This review aims to trigger an awareness rising about the possible uses of microfluidics and telemedicine combination for detection of biorisks. [ABSTRACT FROM AUTHOR]

Introduction: A bioterrorist attack is the intentional release of pathogenic micro-organisms, such as viruses, bacteria, or their toxins, with the aim of causing illness or death in people, animals, or plants. In this study, we investigated the knowledge and practices related to bioterrorism preparedness in Central Portugal. Methods: A descriptive cross-sectional study was performed with a convenience sample in the population of Aveiro, Central Portugal, to assess their knowledge about bioterrorism, self-perceived preparation to act in case of bioterrorism and pet owners' preparation. An online validated questionnaire was completed by 198 participants from January to February 2020. Results: In this study, 46.0% of the respondents answered that they knew nothing about bioterrorism or had never heard about the possibility of bioterrorist attacks. In the case of an attack, 77.8% participants did not consider themselves prepared to act, and 62.1% did not know how to use personal protective equipment. More than half of the respondents (60.6%) were not familiar with the local emergency response system in response to catastrophes/bioterrorist attacks. Almost all respondents (95.6%) assigned high importance to drinking water and food for pets, but only 22.9% of respondents attributed high importance to pet carrier boxes, an item essential for cat evacuation. Conclusion: This is the first survey of this kind in Portugal concerning bioterrorism preparedness in citizens and animals. Results suggest that Portuguese knowledge is limited, and people have inadequate preparedness for a bioterrorist attack. These results reinforce the importance of further studies to better understand the existing gaps in knowledge of Portuguese citizens, strengthen the need to adopt the One Health concept in preparedness plans and emphasize the crucial role of health education in prevention. [ABSTRACT FROM AUTHOR]

Since its first identification in 1894 during the third pandemic in Hong Kong, there has been significant progress in understanding the lifestyle of Yersinia pestis, the pathogen that is responsible for plague. Although we now have some understanding of the pathogen's physiology, genetics, genomics, evolution, gene regulation, pathogenesis and immunity, there are many unknown aspects of the pathogen and its disease development. Here, we focus on some of the knowns and unknowns related to Y. pestis and plague. We notably focus on some key Y. pestis physiologic and virulence traits that are important for its mammal-flea-mammal life cycle, but also its emergence from the enteropathogen, Yersinia pseudotuberculosis. Some aspects of the genetic diversity of Y. pestis, the distribution and ecology of plague, as well as the medical countermeasures to protect our population are also provided. Lastly, we present some biosafety and biosecurity information related to Y. pestis and plague. [ABSTRACT FROM AUTHOR]

Biological terrorism is a terrorist act whose target is the civilian population. After these terrorist acts, diseases and deaths occur that pose a great threat to the health and safety of the individual/community. In order to prevent these threats, all legal and institutional structures should be established by the state in cooperation with the relevant parties. Security is one of the most basic needs for people. Cities and states have emerged as a result of activities and organizations to meet the needs of people in this regard. People have created structures that will ensure both their own security and the security of their living spaces. Refik Saydam Hygiene Center was established in 1928. The institution was established to protect public and environmental health, was restructured in 2012. Presidency until this year; with reference laboratories in the field of environment, public health, vaccine, serum production and public health school; served as the only research and development institution in the field of health. This study was carried out in order to reveal the place and importance of RSHMB in protection against biological agents and bioterrorism that pose a great threat to urban health and safety. [ABSTRACT FROM AUTHOR]

Biotechnology became a paradigm-shifting science among all subfields of biology. The benefits of biotechnology have reached many practical fields, whether human health, animal, and/or agricultural. However, wherever there is a biotechnology practice, there is an associated biohazard with it, and its negative impact may reach all living entities including humans. Therefore, the cooperation of the leading institutions in this field has culminated in creating the concepts and applications of biosafety and biosecurity. The countries of the Middle East are considered biotechnology-practicing and have shown a clear acceptance to this field. But unfortunately, the Middle East region is one that is facing the most multichallenges, which would constitute real and noticeable concern at the local and international levels. Such challenges represented by wars and armed conflicts, deteriorating economic conditions, the large number of refugees, and the spread of many epidemics. Thus, limiting the region's ability to deal with the surrounding biological hazards and struggling the way to the one health concept. Therefore, this article aims to shed light on the activities of the Middle East countries in the field of biotechnology and to address potential biological threats, whether natural such as the spread of viruses, or intentional such as biological attacks and bioterrorism. The article also shows the capacity of the countries of the region in the field of biosafety and biosecurity based on available information. Accordingly, some countries are lacking the required level of preparedness to face potential biological threats. Multi-institutional and international cooperation between the concerned countries will significantly enhance the capacity of the region in biosafety and biosecurity to meet the level of biological risk. Search methodology: wide range of related keywords (based on the section) combined with the name of the region, or one country individually have been searched using available search engines and databases such as google scholar and PubMed. After scanning the content of the found results, irrelevant articles have been excluded. Figures 2, 3, 4, 6, and 7 were created by biorender.com. [ABSTRACT FROM AUTHOR]

Technology advances neither enhances nor detracts from cognitive human bias since its existence over thousands of years. However, skewness in conventional artificial intelligence mechanisms leads to algorithmic mishaps. Understanding the interconnection between human and machine, that algorithms are subject to bias through interactions, and the output of algorithmic bias forms a source of inspiration to the U.S. Intelligence Community (IC). As a result of emerging technologies such as artificial intelligence (AI) and its subset of machine learning, complex cybercrimes raises security concerns and highlights pertinent considerations for national security; infectious diseases can be a national security concern and facilitate bioterrorism and the production of biological weapons; and automation systems in the form of unmanned aerial systems (UAS) can have national security implications as an attractive tool for criminals and nefarious actors. This article uses grounded theory to analyse congressional hearing reports and related official documents. Increasing our understanding of the process leads to output attainment since AI operates at the speed of light and more data than we can humanly manage accessible. The present research intends to contribute to international relations, international studies, security and strategic studies, and science and technology studies. [ABSTRACT FROM AUTHOR]

At the wake of the twenty-first century, Richard Powers updates Shelley's motif for the posthumanist context. His novel Orfeo pictures Peter Els; an aged, American version of Viktor Frankenstein, as he runs away from Homeland Security after 9/11. His crime is having composed the musical masterpiece of his life by altering the DNA of a bacteria, which is mistaken for an act of bioterrorism. Powers' novel looks back at Shelley's existentialist concerns about the ethical dimension of a creative freedom that questions the very limits of humanity. The parallelisms between both novels go beyond the development of this motif and deep into the structural arrangement of plot and character development to suggest that Shelley's narrative lies behind the thematic and compositional arrangement of Powers' work, and evidence the endurance of Shelley's literary impact.1 [ABSTRACT FROM AUTHOR]

Plant toxins – ricin and abrin, obtained in a purified form from the beans of the castor bean and Abrus precatorius respectively, are considered by Western experts as potential damaging agents of a biological nature. The purpose of this work is to consider the danger of using ricin and abrin as agents of biological terrorism, as well as to assess the existing approaches and means for identifying these toxins, treating the intoxication caused by them, as well as the level of development of vaccine preparations. Both toxins have a similar molecular structure and mechanism of action. They consist of two subunits – A and B, resistant to high temperatures and extreme pH values. The mechanism of their damaging action is based on irreversible inhibition of the process of protein synthesis. The LD50 of ricin for humans, according to various sources, is 3 µg/kg for inhalation and intravenous intake, 22–25 µg/kg for enteral intake, and about 500 µg/kg for subcutaneous intake. Abrin is more toxic than ricin, with an LD50 for humans ranging from 0.1 µg/kg to 1 µg/kg depending on the route of entry. In case of enteral poisoning with ricin and abrin, the victims develop symptoms of gastroenteritis within a few hours: nausea, vomiting and pain in the abdominal cavity and chest, diarrhea. Bleeding from various parts of the gastrointestinal tract may be present. In future, general intoxication symptoms (headache, weakness, fever) and symptoms of multiple organ damage (acute renal failure and acute liver failure) develop. In the terminal stage, symptoms of vascular shock and vascular collapse are expressed. Death usually occurs on the third day or later. Cases of the use of ricin and abrin for criminal and terrorist purposes are described in the article. The main approaches and modern means of indication, means of treating ricin and abrine intoxication, as well as the state of development of vaccine preparations are shown. The given data show that the danger of these toxins as damaging agents is underestimated in Russia. It is necessary to develop diagnostic test systems that allow early detection of intoxication with plant toxins in the affected and the toxins themselves on environmental objects, as well as specific means for the treatment and prevention of acute poisoning with ricin and abrin.

• We developed a screen-printed electrode and magnetic bead-based amperometric electrochemical immunosensor for rapid and specific detection of B. anthracis spores. • This method measures changes in current intensity resulting from oxidation and reduction in the working electrode directly to the spore concentrations. • Optimization of newly developed biosensor was performed by using tests with inactive and active spore measurements. • Our results may lead an essential basis for developing Point-of-care (POC) devices that allow on-site and early detection of B. anthracis spores, which are also considered as a biological warfare agent. Due to most likely use of Bacillus anthracis in biological terrorism agents, the rapid and sensitive detection of its spores is crucial in both taking prophylactic measures and proper treatment. This study aimed to develop an amperometric electrochemical immunosensor for the detection of B. anthracis spores. A new amperometric biosensor was designed using a combination of magnetic beads and multiplex screen-printed electrodes. This method measures changes in current intensity resulting from oxidation and reduction in the working electrode directly to spore concentrations. A standard curve was formed to test the number of live spores between 2 × 102-2 × 104 spores/ml concentrations. LOD and LOQ values were found to be 92 and 272 spores/ml, respectively. No cross-reactions were seen for Bacillus subtilis, Bacillus cereus and Bacillus thuringiencis spores. It is shown that the designed Anthrax immunosensor has high sensitivity and selectivity with rapid detection results. [ABSTRACT FROM AUTHOR]

Introduction and objective The aim of the study was to analyze available literature on the development of biological warfare and combating the SARS CoV-2 pandemic. Against the background of contemporary threats from biological factors, the strengths and weaknesses of response in the event of a bioterrorist attack during the ongoing COVID-19 pandemic have been identified. The scope and importance of international cooperation in the fight against the pandemic is assessed. Review methods The more important literature on bioterrorism, biological weapons and the COVID-19 pandemic, both from earlier work and recent publications, was analyzed, emphasizing new threats and adequate defence against them. Brief description of the state of knowledge The bio-warfare threat and the current COVID 19 pandemic that has hit mankind on a global scale has clearly shown how dangerous biological agents are and what effects they can cause, negatively affecting every sphere of human activity with catastrophic consequences. Data on examples of bioterrorist attacks carried out and research on the development of biological weapons and methods of combating pandemic COVID-19, were reviewed. New threats related to technological development,including those resulting from genetic manipulation, biosynthesis, and modern means of delivery, are pointed out. Attention has been paid to the implications of controlling the proliferation of biological weapons and the issues of international cooperation in the fight against bioterrorism and the COVD-19 pandemic. Summary The lesson learned clearly demonstrates the weakness of states in responding to such threats. The risks of uncontrolled scientific advances are still underestimated. Appropriate international control measures must be taken urgently to prepare for new pandemics, bioterrorist attacks, and the possibility of using modern biological weapons.

Biological warfare has attracted people since the earliest times. During the Cold War, bio-weapons were part of the arsenal of both world superpowers. The Convention prohibiting the production, storage, transfer and use of potential biological weapons (BWC) was signed 50 years ago. The question arises how sincere the signatory states were in its implementation. The rapid development of molecular biology has raised awareness about its potential misuse in terms of creating new and more dangerous bio-weapons, as well as the question of ethics in biomedical research. The anthrax campaign in the USA represents a turning point after which the use of weapons of mass destruction (WMD), including biological ones, has become part of the narrative that accompanies each war conflict. Epidemics and pandemics of avian and swine flu, Zika virus, SARS, MERS and COVID-19, as well as their implications, have proved the significance of a multidisciplinary approach to the study of microorganisms, their epidemiological, microbiological, genetic and antigenic characteristics, methods of their diagnosis, prevention and treatment, not only from the biomedical, but also from the security aspect. Perhaps the 50th anniversary is the right time to ask why the International Expert Body for controlling the implementation of the BTWC provisions has not been constituted yet.

The author often mentioned in his works that there is no inhabited territory in the world that is resistant to terrorism, while the roots of terrorism, surrounded by different motives and causes, go far back in history. Therefore, the author identifies terrorism as a world problem, which is never isolated in one environment, but very quickly, like a forest fire, spreads to other areas. In the era of rapid information and technological development, the concept of terrorism terrorism is becoming less and less precise and unambiguous as it is increasingly used. Given that we have seen in the not-so-distant past that terrorist organizations are unscrupulous in their attacks, one of the main concerns of modern times is undoubtedly the possibility of using biological weapons for terrorist purposes. This paper analyzes in detail the somewhat intimidating form of terrorism, known as bioterrorism, a distinction was made between this and other types of terrorism, and we have given a historical view of the use of biological weapons, all with the aim of more precisely defining this extremely complex phenomenon.

Francisella tularensis is the causative agent of tularemia and a Tier I bioterrorism agent. In the 1900s, several vaccines were developed against tularemia including the killed "Foshay" vaccine, subunit vaccines comprising F. tularensis protein(s) or lipoproteins(s) in an adjuvant formulation, and the F. tularensis Live Vaccine Strain (LVS); none were licensed in the U.S.A. or European Union. The LVS vaccine retains toxicity in humans and animals-especially mice-but has demonstrated efficacy in humans, and thus serves as the current gold standard for vaccine efficacy studies. The U.S.A. 2001 anthrax bioterrorism attack spawned renewed interest in vaccines against potential biowarfare agents including F. tularensis. Since live attenuated-but not killed or subunit-vaccines have shown promising efficacy and since vaccine efficacy against respiratory challenge with less virulent subspecies holarctica or F. novicida, or against non-respiratory challenge with virulent subsp. tularensis (Type A) does not reliably predict vaccine efficacy against respiratory challenge with virulent subsp. tularensis, the route of transmission and species of greatest concern in a bioterrorist attack, in this review, we focus on live attenuated tularemia vaccine candidates tested against respiratory challenge with virulent Type A strains, including homologous vaccines derived from mutants of subsp. holarctica, F. novicida, and subsp. tularensis, and heterologous vaccines developed using viral or bacterial vectors to express F. tularensis immunoprotective antigens. We compare the virulence and efficacy of these vaccine candidates with that of LVS and discuss factors that can significantly impact the development and evaluation of live attenuated tularemia vaccines. Several vaccines meet what we would consider the minimum criteria for vaccines to go forward into clinical development-safety greater than LVS and efficacy at least as great as LVS, and of these, several meet the higher standard of having efficacy ≥LVS in the demanding mouse model of tularemia. These latter include LVS with deletions in purMCD, sodBFt , capB or wzy; LVS ΔcapB that also overexpresses Type VI Secretion System (T6SS) proteins; FSC200 with a deletion in clpB; the single deletional purMCD mutant of F. tularensis SCHU S4, and a heterologous prime-boost vaccine comprising LVS ΔcapB and Listeria monocytogenes expressing T6SS proteins.

Due to still current biological threats related to the activities of terrorist groups, crisis situations in many regions of the world, as well as cyclical epidemics, fast and reliable detection of biological contamina-tion is an essential element of ensuring broadly understood safety of the population. The work deals with the sampling and verification procedures. This paper focuses on sample preparation techniques for analysis and details analytical methods for identifying biological agents. Additionally, on-site technologies implemented in military devices for the detection of biological contamination were discussed. The work enables the reader to get acquainted with modern techniques of detection of factors of biological origin and their identification, which is the knowledge necessary when choosing the appropriate equipment depending on the purpose of the contamination recognition sub-unit and the task at hand. Knowledge of sam-pling and preparation of samples for analysis will help to increase the skills of the sampling teams to do so and to achieve reliable results by using appropriate procedures and eliminating the possibility of loss of the analyte or inadvertent contamination of the sample. It will also increase safety at every stage of working with biological samples. All these activities can contribute to the global increase in security of the population around the world. Keywords: chemical sciences, biological weapon, bioterrorism, CBRN, PCR, UV-LIF

Bioterrorism is the intentional dissemination of bio-warfare agents in a population to cause illness or death. Microbial forensics plays an essential role in the investigation of bio-terror attacks. This is a new field of forensic science that is still in the early stages of growth and faces huge theoretical and ethical obstacles. There is a profound concern with current biotechnological developments that bacteria and viruses may be genetically engineered to modify them as biological weapons. Bioterrorism, like other nuclear weapons, has the potential to cause humanitarian disasters. This paper summarizes different detection methods of bio-warfare agents besides highlighting the various phases of bioterror attacks through the investigatory lens of microbial forensics.

Background Bacillus anthracis can cause anthrax and is a potential bioterrorism agent. The 2014 Centers for Disease Control and Prevention recommendations for medical countermeasures against anthrax were based on in vitro data and expert opinion. However, a century of previously uncompiled observational human data that often includes treatment and outcomes is available in the literature for analysis. Methods We reviewed treatment outcomes for patients hospitalized with anthrax. We stratified patients by meningitis status, route of infection, and systemic criteria, then analyzed survival by treatment type, including antimicrobials, antitoxin/antiserum, and steroids. Using logistic regression, we calculated odds ratios and 95% confidence intervals to compare survival between treatments. We also calculated hospital length of stay. Finally, we evaluated antimicrobial postexposure prophylaxis (PEPAbx) using data from a 1970 Russian-language article. Results We identified 965 anthrax patients reported from 1880 through 2018. After exclusions, 605 remained: 430 adults, 145 children, and 30 missing age. Survival was low for untreated patients and meningitis patients, regardless of treatment. Most patients with localized cutaneous or nonmeningitis systemic anthrax survived with 1 or more antimicrobials; patients with inhalation anthrax without meningitis fared better with at least 2. Bactericidal antimicrobials were effective for systemic anthrax; addition of a protein synthesis inhibitor(s) (PSI) to a bactericidal antimicrobial(s) did not improve survival. Likewise, addition of antitoxin/antiserum to antimicrobials did not improve survival. Mannitol improved survival for meningitis patients, but steroids did not. PEPAbx reduced risk of anthrax following exposure to B. anthracis. Conclusions Combination therapy appeared to be superior to monotherapy for inhalation anthrax without meningitis. For anthrax meningitis, neither monotherapy nor combination therapy were particularly effective; however, numbers were small. For localized cutaneous anthrax, monotherapy was sufficient. For B. anthracis exposures, PEPAbx was effective. [ABSTRACT FROM AUTHOR]

Bacillus anthracis , the causative agent of anthrax, is a high-consequence bacterial pathogen that occurs naturally in many parts of the world and is considered an agent of biowarfare or bioterrorism. Understanding antimicrobial susceptibility profiles of B. anthracis isolates is foundational to treating naturally occurring outbreaks and to public health preparedness in the event of an intentional release. In this systematic review, we searched the peer-reviewed literature for all publications detailing antimicrobial susceptibility testing of B. anthracis. Within the set of discovered articles, we collated a subset of publications detailing susceptibility testing that followed standardized protocols for Food and Drug Administration–approved, commercially available antimicrobials. We analyzed the findings from the discovered articles, including the reported minimal inhibitory concentrations. Across the literature, most B. anthracis isolates were reported as susceptible to current first-line antimicrobials recommended for postexposure prophylaxis and treatment. The data presented for potential alternative antimicrobials will be of use if significant resistance to first-line antimicrobials arises, the strain is bioengineered, or first-line antimicrobials are not tolerated or available. [ABSTRACT FROM AUTHOR]

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Bio Terrorism is a form of terrorism in which biological agents such as pathogens, fungi, viruses, and toxins are deliberately unleashed onto the world in order to kill a wide range of humans. Bio punk theory investigates the ramifications that are most commonly associative to the rapid advances made in the field of biotechnology, synthetic biology, and agricultural biotechnology. Bio Punk is the futuristic derivative of cyberpunk theory, subgenre of science fiction. Paolo Bacigalupi's "Windup Girl" depicts the impact of corporate culture and how an advance in biotechnology eventually leads to bioterrorism. This article delves into the topic of Artificial Intelligence, bioterrorism, corporate culture, and its impact on people and society. [ABSTRACT FROM AUTHOR]

Bacillus anthracis, present as a very durable endospore in soil, causes zoonotic illness which is mainly associated with herbivores and domestic animals. Human cases are scarce and often involve populations close to infected livestock. If anthrax is no longer of public health concern in developed countries, B. anthracis is one of the top-tier biological weapon agents. It is classified by the CDC as a category A agent. Since 1994, emerging strains of Bacillus cereus have been associated with anthrax-like disease in mammals. Some clinical strains of B. cereus harbor anthrax-like plasmid genes (pXO1 and pXO2) associated with non-human primate and human infections, with the same clinical presentation of inhalation anthrax and mortality rates. Although currently restricted to certain limited areas of circulation, the emergence of these new strains of B. cereus extends the list of potential agents possibly usable for bioterrorism or as a biological weapon. It is therefore important to improve our knowledge of the phylogeny within the B. cereus sensu lato group to better understand the origin of these strains. We can then more efficiently monitor the emergence of new strains to better control the risk of infection and limit potentially malicious uses. [ABSTRACT FROM AUTHOR]

Francisella tularensis is a virulent bacterium which hijacks the host's immune response, turning cells usually tasked with killing foreign organisms as nutrient-rich receptacles for rapid multiplication. It is designated a Tier 1 Select Agent by the US CDC due to its potential to cause widespread mortality upon deliberate release. In this study, the key biological mechanisms of host infection are modelled as a continuous-time Markov chain (CTMC) and solved via discrete event simulation (DES). The efficacy of various medication strategies at the behest of public health authorities are investigated. Without treatment, the median lethal dose – not previously considered in humans – is estimated at approximately 1,000 organisms. Results suggest that fatality can be averted if antibiotics are administered for at least 7 days, no later than 10 days post exposure. In a mass casualty setting, this can reduce symptomatic cases by 18% from the baseline involving no medication. Reductions of 59% are possible if medication can be disseminated no later than 5 days post exposure, mitigating otherwise severe pressure on healthcare services. Novel use of CTMC and DES highlight the potential for OR in the field of immunology, where further opportunities may present in a post COVID-19 world. [ABSTRACT FROM AUTHOR]

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The wars in Iraq and Afghanistan required that forensic science was used beyond the traditional law enforcement and criminal justice goals and applied to military operations. The 9/11 terror attacks in the United States (US) inspired further attacks in the Western World and highlighted the importance of national and international intelligence sharing for counterterrorism operations. Following the 9/11 attacks, anthrax was disseminated in the US mail system, demonstrating a successful modern use of biological agents. As a result, nations enhanced their Chemical, Biological, Radiological and Nuclear (CBRN) capabilities to prevent, prepare, respond, and recover from CBRN attacks but in the last decade, there has been a decrease in capabilities across military forensic science, counterterrorism, and CBRN. Recent changes in the global and strategic environment such as, the war in the Ukraine, the threat of grey zone conflicts (below the threshold of war) such as the conflict in the Middle East, and strategic competition, indicates international, national, state and local CBRN capabilities need to be reinvigorated in a world under digital transformations. There is a need for a harmonized approach to enhance the integration of military, law enforcement, and CBRN operations to support decision-making. In this paper, we look back to where we have come from and where we are now to make recommendations on where to from here for military forensic science and counterterrorism, including CBRN which intersects both of these systems., Competing Interests: Declaration of Competing Interest None., (Copyright © 2024. Published by Elsevier B.V.)

Bacterial traceability refers to the use of a range of techniques to trace the origins and transmission pathways of bacteria. It is crucial in controlling the spread of diseases, analyzing bioterrorism incidents, and advancing microbial forensics. In recent years, the frequency and scope of bacterial outbreaks have continued to escalate, exerting significant impacts on global biosecurity, public health, and other areas. Consequently, it is required to process traceability of bacteria timely and accurately around the globe. The rapid development of biological and physicochemical traceability techniques provides convenience for tracing bacteria. These techniques not only surpass traditional methods in terms of sensitivity, traceability and throughput, but also find more extensive applications in elucidating bacterial growth mechanisms, transmission routes, and geographical origins. This paper systematically reviews the latest research progress and applications of technologies of bacterial traceability, highlighting key advancements and projecting future trends, with the intent of providing a valuable reference for researchers, facilitating further studies and innovations in this field., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

The purpose of syndromic surveillance is to provide early warning of public health incidents, real-time situational awareness during incidents and emergencies, and reassurance of the lack of impact on the population, particularly during mass gatherings. The United Kingdom Health Security Agency (UKHSA) currently coordinates a real-time syndromic surveillance service that encompasses 6 national syndromic surveillance systems reporting on daily health care usage across England. Each working day, UKHSA analyzes syndromic data from over 200,000 daily patient encounters with the National Health Service, monitoring over 140 unique syndromic indicators, risk assessing over 50 daily statistical exceedances, and taking and recommending public health action on these daily. This English syndromic surveillance service had its origins as a small exploratory pilot in a single region of England in 1999 involving a new pilot telehealth service, initially reporting only on "cold or flu" calls. This pilot showed the value of syndromic surveillance in England, providing advanced warning of the start of seasonal influenza activity over existing laboratory-based surveillance systems. Since this initial pilot, a program of real-time syndromic surveillance has evolved from the single-system, -region, -indicator pilot (using manual data transfer methods) to an all-hazard, multisystem, automated national service. The suite of systems now monitors a wide range of syndromes, from acute respiratory illness to diarrhea to cardiac conditions, and is widely used in routine public health surveillance and for monitoring seasonal respiratory disease and incidents such as the COVID-19 pandemic. Here, we describe the 25-year evolution of the English syndromic surveillance system, focusing on the expansion and improvements in data sources and data management, the technological and digital enablers, and novel methods of data analytics and visualization., (©Alex J Elliot, Helen E Hughes, Sally E Harcourt, Sue Smith, Paul Loveridge, Roger A Morbey, Amardeep Bains, Obaghe Edeghere, Natalia R Jones, Daniel Todkill, Gillian E Smith. Originally published in the Journal of Medical Internet Research (https://www.jmir.org), 17.09.2024.)

This paper reviews the elements and infection mechanisms of bioterrorism, assess North Korea's capability for biological warfare, and propose strategies for South Korea to counter potential bioterrorist threats from the North. The four critical elements of bioterrorism include the biological agent, the weaponization of the agent, the delivery system, and the impact of weather conditions on the attack. The infection routes for biological agents in bioterrorism include inhalation, ingestion, dermal exposure, and injection. The potential agents under development could include anthrax, smallpox, plague, and botulinum toxin, which might be deployed using missiles, artillery shells, or through covert operations. Proximity to North Korea significantly increases vulnerability to biological attacks. Possible methods include contaminating water supplies, food sources, or densely populated areas. Anthrax, smallpox, plague, and botulinum toxin could theoretically be delivered using packages attached to balloons. Minimizing the impact of a bioterrorism event requires strategy that includes four key actions: detection, decision-making, distribution, and dispensation. By integrating these steps, authorities can effectively manage and mitigate the effects of a bioterrorism event. Civilian doctors play a role in the early detection, diagnosis, treatment, and management of biological agents. Educating medical professionals is crucial for preparing against potential biological warfare or bioterrorism threats., Competing Interests: No conflict of interest., (© 2024 by The Korean Society of Infectious Diseases, Korean Society for Antimicrobial Therapy, The Korean Society for AIDS, and Korean Society of Pediatric Infectious Diseases.)