Vigilance is essential if we are to be prepared against biological threats stemming from bioterrorist attacks to emerging infectious diseases. Surveillance can provide valuable information for risk assessment and to make decisions on which pathogens to target with the most attention to development and stockpiling of pre- and post-exposure prophylactic vaccines, drugs, or therapies. However, deciding on what probable bioweapon threats and emerging infectious diseases to invest time and resources on poses a challenge, especially during harsh economic times or in poorer regions. Should we thus, attempt to focus on the most plausible threat or the most devastating threat to occur even if it appears to be less probable?
The U.S. Centers for Disease Control and Prevention (CDC) states that an airborne biological agent has the greatest potential to massively spread with an overwhelming impact. Indeed, some of the agents classified as high priority biological threats to national security, or Category A agents can be transmitted through an inhalational route. Category A agents are those that can be easily dispersed or transmitted, have high mortality rates, can cause public panic, and thus require public health preparedness. Category A agents that can be transmitted through inhalational route or can be aerosolized includeBacillus anthracis (anthrax), Yersinia pestis (plague), Variola major (smallpox), Francisella tularensis (tularemia) andfiloviruses (viral hemorrhagic fevers).
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