Terrorism and Public Health: A Balanced Approach to Strengthening Systems and Protecting People

DOROTHY MARGOLSKEE

Vaccines, antimicrobials, and antitoxins play important roles in protecting the public from bioterrorism. Timely administration of these agents to affected or at-risk populations can prevent diseases caused by bioterrorist agents or minimize their adverse health effects.

This chapter covers vaccines, antimicrobials, and antitoxins, with a particular focus on potential research opportunities to improve the availability, efficacy, and safety of these medical interventions. Biological agents that could be used in terrorist attacks are covered in Chapter 10. They include the Category A high-priority agents identified by the Centers for Disease Control and Prevention (CDC), which are considered to have the greatest potential adverse impact on public health and require a broad-based level of preparedness to counteract them. Category A pathogens include three bacterial infections (anthrax, plague, and tularemia), one bacterial toxin (botulinum toxin), one specific virus (smallpox), and one disease syndrome (hemorrhagic fever) caused by a collection of viruses.¹Each poses somewhat different scientific opportunities and challenges for those managing the impact of an intentional exposure (see Table 10–1).

Potential interventions for these and other diseases that may be spread through bioterrorism include specific drug therapies; immunological inter

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