Bioterror-related diseases are illnesses contracted as a result of the deliberate release of disease-causing agents (e.g., bacteria, viruses, other germs and toxins). These biological agents can be released into the air or placed in water or food. When ingested, inhaled or exposed to the skin or eyes, the agents can cause serious illness or death. Some of the diseases (smallpox, plague and typhoid fever) are highly contagious and can quickly spread to others who come into close contact with infected persons.

There are many types of bioterror-related diseases, which are categorized by the U.S. Centers for Disease Control and Prevention (CDC) into the following three groups:

• Category A (e.g., anthrax, botulism, smallpox, plague). Pose the highest threat to public health and national security because they can be easily transmitted and can result in high death rates.

• Category B (e.g., salmonella, typhoid fever, viral encephalitis and cholera). Moderately easy to spread and may cause moderate illness rates and a low death toll.
  
  
• Category C (e.g., Nipah virus and hantavirus). Emerging infections that could be altered or engineered in a laboratory for mass distribution and dissemination. Category C agents have the potential for high disease and death rates and causing a major impact on public health.

Some of these potential bioterror agents are diseases that occur naturally in outbreaks of varying severity. Others rarely occur as natural outbreaks and could only cause disease as a result of deliberate manipulation and dissemination.

Bioterror-related diseases can cause numerous bodily malfunctions, including gastrointestinal distress and spasms, diarrhea, hemorrhaging, fever, vomiting, pneumonia, respiratory distress, sepsis, and skin eruptions and lesions.

The CDC monitors public health through a national surveillance system, which is designed to signal when disease outbreaks occur in higher-than-normal levels. Physicians and hospitals are required by law to report cases of communicable diseases to state and federal public health officials.

Many bioterror-related diseases can be effectively treated with antibiotics or a combination of supportive therapy, antibiotics and post-exposure vaccination. The CDC maintains an arsenal of emergency vaccines, antibiotics and medical supplies ready for shipment and use in a matter of hours in the event of a biological attack.

There may be little an individual can do to prevent infection in a deliberate bioterror-related attack. Vaccinations against diseases such as smallpox or anthrax exist but they have potentially adverse side effects and are not given to the general public. Special population groups – such as some healthcare workers and emergency services personnel who must respond in such events – are asked to voluntarily take the inoculations.

Military personnel deployed to areas vulnerable to biological warfare are required to have anthrax and smallpox vaccinations. Postal workers, who may be exposed to anthrax or other agents deliberately placed in mail, may also take special precautions (e.g., wearing gloves and other protective gear).