Defence against Bioterrorism

Radosavljevic V, Banjari I, Belojevic G (eds): Defence against Bioterrorism

Methods for Prevention and Control. NATO Science for Peace and Security. Series A: Chemistry and Biology. 272 p., 24 fig., 30 tabs. ISBN 978-94-024-1265-9. Springer Science+Business Media B.V, part of Springer Nature 2018.

Civilian and military communities are challenged by climate changes, globalization, refugee crisis, terrorism and regional military conflicts with damage of eco-systems and infrastructure impairing the socio-economic and health situation. New and re-emerging natural and anthropogenic (accidental or intentional) biological threats such as epidemics (e.g. Cholera, Ebola and Zika disease) or bioterrorist acts may become the consequence.   

During a multidisciplinary NATO Advanced Research Workshop (ARW) held at 16 to 17 March 2017 in Belgrade (Serbia) civilian and military experts from 11 countries presented their special knowledge and professional experience discussing actual problems and ways to improve the prevention and control of bioterrorism on international and national levels. 

The book offers in 16 chapters the ARW contributions covering political, security, legal, scientific, ethical, medical, psychological, and environmental aspects of bioterrorism.  
 Two chapters address the risks and ethical dilemma modern life sciences (e.g. synthetic biology, dual use research, gene editing technology) and biotechnology pose. Thereby, chances to advance countermeasures against biological weapons, the possible misuse in order to harm humans and animals and the responsibility of the scientific community are considered.
 The spectrum of natural or anthropogenic biological threats, legal frameworks and non-legally binding instruments to strengthen non-proliferation of biological weapons, biosafety, biosecurity and food safety in order to protect against bioterrorism are outlined in five chapters. Therein, the authors discuss role and importance of international and national activities such as the Biological Weapons Convention, Proliferation Security Initiative, International Health Regulations of the WHO, EU regulations and directives, EU CBRN Action Plan, Good Practice Guidelines, ISO and standards of the Food and Agriculture Organization (FAO) or the Global Food Safety Initiative.

Two chapters inform on results of research in medical countermeasures such as rapid diagnostics and plant-derived vaccines against dangerous infectious diseases such as smallpox, monkeypox, Ebola disease and SARS.
 Based on the expertise and experiences of the US Intelligence Community the crucial role of a comprehensive intelligence on tactical, operational and strategic level cooperating nationally and internationally is described in detail which will help to identify and assess potential biological threats and to enable the own biodefense to react prior an attack.

The book offers also a critical analysis of several informal digital surveillance systems to detect disease outbreaks in real-time such as ProMED-mail, Global Public Health Intelligence Network (GPHIN), HealthMap, Medical Intelligence System (MedISys), Argus or Google Flu Trend. 

A chapter is addressed to Medical Services of NATO Armed Forces to develop capacities of medical bio-reconnaissance and bioforensics using mobile field laboratories and modern molecular typing methods to rapidly identify, to confirm and to verify causative agents in order to provide investigative evidence in case of deliberate biological events.  The valid discrimination of the nature of such events is very difficult because biological attacks may mimic natural or accidental disease outbreaks. In a special article several methods to assess and differentiate between natural, accidental or intentional origin of real outbreaks and biological attacks are compared and evaluated on real events such as the tularaemia and salmonellosis outbreaks in Kosovo 1999 and in the USA 1984, respectively.

Two chapters cover psychological and psychiatric problems (panic and panic disorders) caused by biological attack and the correlation between environmental factors and bioterrorism. 

A further article demonstrates by demographical and epidemiological data the potential threat the European refugee crisis of 2015-2016 posed to the public health of a country and how possible health risks can be mitigated.

Two special chapters present a unique approach of biothreat and bioterrorism prevention on primordial, primary and secondary levels. The idea is to coordinate all preventive activities (intelligence, law enforcement, surveillance, monitoring, epidemiological, epizootological, microbiological and forensic investigations, and medical counter-measures etc.) forming a “bioshield” to control the key elements of any epidemic process such as perpetrator/source of infection, reservoir of pathogen, biological agent/pathogen, means/mechanisms of delivery/factors of transmission, and target/susceptible population.
 In all chapters interested readers will find a representative number of references for more information on the appropriate topics. 

 Resume: From military medical point of view the book may serve medical services of Armed Forces as very useful source of state-of the art knowledge, new strategies, policies, and methods to assess biological risks and to improve and strengthen the prevention, management and countering of biological attacks or natural and accidental disease outbreaks. 

Date: 06/27/2018