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  • image The majority of emerging pathogens associated with public health outbreaks are zoonotic infections, passed from animals to humans.

  • image Due to the high mortality rates with inhalation anthrax, postexposure prophylaxis may need to be rapidly offered to all people who were potentially exposed.

  • image Pneumonic plague, one of the most lethal forms of plague, develops through primary (direct inhalation of infected droplets) or secondary exposure.

  • image Rapid recognition of Ebola virus disease (EVD) is essential to initiate supportive care and infection control procedures.

  • image While the incidence of measles-related deaths has, overall, significantly declined as the result of major global vaccination efforts, vigilance is still critical, since measles is extremely contagious and there are some gaps in vaccine coverage.

  • image Middle Eastern Respiratory Syndrome (MERS) is an emerging viral respiratory illness, which can cause severe respiratory distress and has been fatal in one third of all patients who have contracted the disease.

  • image A pertussis vaccination booster is recommended for all women during weeks 27 to 36 of gestation of each pregnancy to allow maximal maternal antibody response and passive in utero transfer of antibodies.

  • image Infectious disease outbreaks following a natural disaster are common and usually attributable to critical infrastructure damage, limited access to quality healthcare, displacement, environmental and human condition changes, and vulnerability to pathogens.

Bioterrorism is characterized by an intentional exposure to animals or humans of an organism or toxin, which subsequently causes disease and/or death. Historically, these acts were planned and carried out against military personnel or directed towards select segments of the civilian population. Examples include diseased bodies flung over city walls, poisons added to drinking water, bacteria used to taint salad bars, and weaponized ricin and anthrax.1,2 In general, while there is no catastrophic destruction of property associated with most acts of bioterrorism, there usually is fear, anxiety and confusion, some ensuing morbidity and mortality, economic disruption, and definite pressure on healthcare and public health systems.

After the intentional release of anthrax in 2001 public health officials, first responders, healthcare workers, employers, school officials, parents and community members incorporated the term bioterrorism in their emergency and disaster preparedness and response vocabulary. Subsequently, these groups wrote plans, conducted response exercises for potential scenarios, such as smallpox outbreaks and mass exposures of plague, that have, thankfully, not occurred. While these traditional bioterrorism agents are still threats, public health officials and healthcare professionals are starting to turn their focus on new or re-emerging concerns, many tied to Mother Nature or unintentional human acts.

image Similar to intentional acts of bioterrorism, disease outbreaks of Ebola and Middle Eastern Respiratory Syndrome Coronavirus (MERS) are a threat to global health security, associated with social unrest or instability and major economic disruption, in addition to significant morbidity and mortality.3 The emergence and spread of these infectious diseases (ID) and the growing prevalence of drug resistance; ease of trade and travel; and rise of laboratories ...

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