Tularemia as a bioweapon
Tularemia, caused by the bacterium *Francisella tularensis*, is a highly infectious disease often referred to as rabbit fever, endemic to North America, Europe, and Asia. Its significance as a potential bioweapon lies in its rapid onset and capability to incapacitate those infected without necessarily leading to high mortality rates. This characteristic makes it particularly concerning for use in civilian populations. The bacteria can be disseminated easily, particularly through aerosolization or contamination of water supplies, posing a serious public health risk, especially in urban areas.
Classified as a Category A biological agent by the U.S. Centers for Disease Control and Prevention (CDC), tularemia has been stockpiled as a weapon by several nations throughout history, including the U.S. and the Soviet Union. The initial symptoms of tularemia can mimic those of common illnesses, which could lead to delayed recognition of an attack and challenge public health responses. Currently, there is no publicly available vaccine against tularemia, although effective antibiotics exist for treatment. Enhanced security measures, such as air monitoring systems in major U.S. cities, have been implemented to detect potential biological threats, highlighting ongoing concerns regarding bioterrorism and public safety.
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Tularemia as a bioweapon
DEFINITION: Infection caused by the bacterium Francisella tularensis.
SIGNIFICANCE: Commonly known as rabbit fever, tularemia is a disease endemic in North America as well as parts of Europe and Asia. Its relevance to forensic science lies chiefly in its potential for use as a bioweapon.
Tularemia is a naturally occurring disease. Its primary hosts are rabbits, prairie dogs, muskrats, and other small mammals, but it can also be transmitted by ticks and deerflies. After infection, onset is rapid. Symptoms include headache, fatigue, dizziness, and nausea. If untreated, tularemia may result in death.
The U.S. Centers for Disease Control and Prevention (CDC) regards Francisella tularensis as a viable bioweapon agent because tularemia is highly infective and incapacitating yet has relatively low lethality, a consideration in its possible deployment near a civilian population. The bacterium is easy to distribute both as an aerosol and in municipal drinking water supplies. Aerosol release would have the most widespread effect on public health, especially if done in urban settings. F. tularensis is classified as a Category A agent, which means it has serious potential for inducing terror in a population (other Category A agents include Yersinia pestis, the bacterium that causes plague; Variola major, the virus that causes smallpox; Bacillus anthracis, the bacterium that causes anthrax; and Clostridium botulinum, the bacterium that causes botulism). Japan, the Soviet Union, and the United States have all stockpiled F. tularensis in the form of offensive weapons at different times in their histories. It is now known that the Soviet army used the pathogen against the Germans during World War II in the Battle of Stalingrad.
Because the early symptoms of tularemia are similar to those of many ordinary or seasonal infections, an attack using F. tularensis on the general population in any given area in the United States could easily take health authorities by surprise. With an incubation range of one to fourteen days and average onset of symptoms taking from three to five days, an attack might not be immediately detected. Security measures that have been taken against this possibility include the installation in thirty U.S. cities of sensors that constantly monitor the air for deadly pathogens. If epidemiologists the deliberate or unexplained release of the tularemia organism, standard practice is for them to contact the appropriate law-enforcement agencies immediately.
One of the things that makes the possibility of the use of the tularemia pathogen as a weapon particularly worrisome is that no vaccine against the disease is available to the general public, in contrast to other possible bioterror agents such as anthrax and smallpox. Some comfort is provided by the availability of potent and effective antibiotics against tularemia. A live attenuated vaccine has been used to protect laboratory workers in the past and is currently under review by the Food and Drug Administration.
Bibliography
Dembek, Zygmunt F., Ronald L. Buckman, Stephanie K. Fowler, and James L. Hadler. “Missed Sentinel Case of Naturally Occurring Pneumonic Tularemia Outbreak: Lessons for Detection of Bioterrorism.” Journal of the American Board of Family Practice 16 (July/August, 2003): 339-342.
Dennis, David T., et al. “Abstract: "Consensus Statement: Tularemia as a Biological Weapon: Medical and Public Health Management.” CDC, emergency.cdc.gov/agent/tularemia/tularemia-biological-weapon-abstract.asp. Accessed 19 Aug. 2024.
Nelson, Christina, et al. "Tularemia: A Storied History, an Ongoing Threat." Clinical Infectious Diseases, Feb. 2024, academic.oup.com/cid/article/78/Supplement‗1/S1/7593852. Accessed 19 Aug. 2024.
Siderovski, Susan Hutton. Tularemia. New York: Chelsea House, 2006.