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A Hypothetical Large-Scale BW Attack
 large-scale BW attack would probably involve the covert release
of a pathogen such as anthrax as an airborne cloud, exposing a large
number of people downwind but giving rise to detectable illness only
after an incubation period (the time period between a person being infected
and the appearance of symptoms) lasting a few days or weeks. For example,
Bacillus anthracis, the bacterium that causes
anthrax, has an incubation
period ranging from two to 42 days, depending on dose and the
immunological competence of the host. Individuals who had been exposed to the invisible
cloud of anthrax spores would probably be unaware at the time that they
had been infected. The first evidence of the bioterrorist attack would
emerge days or weeks later, when the infected individuals, by now possibly
widely dispersed, began to develop nonspecific, flu-like symptoms such
as fever, fatigue, cough, and chest discomfort. A few days later, severe
symptoms would set in, including difficulty breathing, sweating, shortage
of oxygen to the tissues (causing the victim's skin to turn blue), and
death if the disease remained untreated. Because inhalational anthrax
is generally fatal within 24 to 36 hours after the onset of severe symptoms,
antibiotic therapy must begin as soon as possible (preferably combined
with post-exposure vaccination to enhance the patient's immune response).
It would, therefore, be essential to identify an outbreak early, while
the disease was still treatable. Anthrax, though often fatal, is not
transmissible from person to person. A far more challenging scenario
would involve the deliberate aerosol release of a contagious agent (one
that is transmissible), such as the plague bacterium or the
smallpox
virus. Plague has an incubation period of one to six days, while smallpox
has an incubation period of between 7 and 17 days. By the time the first
cases of smallpox were diagnosed, the initial group of cases would probably
have infected close contacts, such as family and friends. In this case,
it would be essential to launch an aggressive vaccination campaign to
contain the outbreak before it spread through the general population
in a series of expanding waves.
See a detailed presentation of a hypothetical Anthrax Attack Scenario in the multimedia section.
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