Bio-Terrorism: Neurological Context
In the recent years, we have been hearing of events of terrorism attacks, mail-borne biological agents' exposure and war which have caused an increase in awareness of these attacks in all parts of the world including the most developed nations like USA and Canada. Scientists, physicians and the relevant health care officials play a vital role in the identification of potential attacks and curbing them (Han & Zunt, 2003). Early and timely recognition of bioterrorism related illnesses through preparedness is quite essential for neurologist as it has been discovered lately that, bio-terror agents affect the nervous system either directly or indirectly. Nearly all bioterrorism agents result to neurological manifestations, and therefore require expert diagnosis and treatment by neurologists. It is true that there is no terrorist threat which fosters more horror than biological attack. This is even more worsened by the fact that little is understood about this type of terrorism and even more less understanding of the neurological involvement exists.
Neurology is one of the most vital concerns in bioterrorism. Center of Disease Control (CDC) has listed biological Agents based on their harmfulness or lethalness. Of those listed as the most critical biological agents or Category A biological agents, tularemia, anthrax, encephalitis, plague, small pox, brucellosis, botulism and Venezuelan fall in this category. All these diseases affect the nervous system in one way or the other resulting to neurological manifestations (Han & Zunt, 2003). In fact, the Centers of Disease Control in conjunction with various governments have embarked in the implementation of bioterrorism response programs and the necessary preparedness strategies including surveillance, detection, planning and response with nerves system in mind. More than any other medical specialist, neurologists are in a position to raise alarm in case of any attack and should therefore be conversant with clinical syndromes and manifestations caused by biological agents used in terrorism.
Critical biological agent like anthrax usually presents itself as hemorrhagic meningitis in severe cases and has a high mortality rate (Dennis et al., 2003). A disease like small pox although it first presents itself as a febrile illness together with a simple rash, it ends up as meningoencephalitis with severe damage to the brain. Other disease like botulism presents itself main mainly with neurological symptoms. Consequently, most vaccines administered against these biological attack agents trigger neurological side effects. A good example is encephalitis which results from small pox vaccine or optic neuritis resulting from an anthrax vaccination (Judith et al., 2002). Neurologists are therefore forced to treat neurological complications of the disease as well as the vaccine.
Biological agents which do not trigger neurological involvement or manifestations are often more easier to treat, curb or prevent. Most of category B agents do not trigger neurological involvement. Agents like Vibrio cholera, Ricin, E coli, and Q fever have known antidotes ot treatment which normally works effectively. They also don't persist in the population for extended period of time and have a lower death rate as compared to the Category A agents. These agents are not widely used by terrorists because of their mildness in display of the attacks.
As bioterrorists attack are becoming clearer, it has become evident that neurology is of paramount concern of should be focused on with unswerving search for further knowledge (Judith et al., 2002). In the building of each nations defense against bioterrorism, all aspects of the neurological implications need to be put in to consideration as it is not only involved in detection of the threats and diagnosis of the diseases involved but also in treatment and identification of potential bioterrorist attacks.
Han M. H. & J. R. Zunt (2003). Bioterrorism and the nervous system. Journal Current Neurology and Neuroscience Reports. Current Medicine Group LLC. Vol 3
Dennis J. C., Francisco J. V., & Richard B. P., (2003) Smallpox, Bioterrorism, and the Neurologist. Arch Neurol. 2003;60:489-494.
Judith M., Stephen E., William B., & William J. B. (2002) Germs: biological weapons and America's secret war. Simon & Schuster, 2002