Planning against biological terrorism: Lessons from outbreak investigations Review uri icon


MeSH Major

  • Bioterrorism
  • Communicable Disease Control
  • Disaster Planning
  • Disease Outbreaks
  • Population Surveillance


  • We examined outbreak investigations conducted around the world from 1988 to 1999 by the Centers for Disease Control and Prevention's Epidemic Intelligence Service. In 44 (4.0%) of 1,099 investigations, identified causative agents had bioterrorism potential. In six investigations, intentional use of infectious agents was considered. Healthcare providers reported 270 (24.6%) outbreaks and infection control practitioners reported 129 (11.7%); together they reported 399 (36.3%) of the outbreaks. Health departments reported 335 (30.5%) outbreaks. For six outbreaks in which bioterrorism or intentional contamination was possible, reporting was delayed for up to 26 days. We confirmed that the most critical component for bioterrorism outbreak detection and reporting is the frontline healthcare profession and the local health departments. Bioterrorism preparedness should emphasize education and support of this frontline as well as methods to shorten the time between outbreak and reporting.

publication date

  • May 2003



  • Review



  • eng

PubMed Central ID

  • PMC2972753

PubMed ID

  • 12737732

Additional Document Info

start page

  • 515

end page

  • 9


  • 9


  • 5