The AbCs of bioterrorism for veterinarians, focusing on Category B and C agents.

I n 1999, the Centers for Disease Control and Prevention (CDC) brought together a group of experts to assess and categorize agents that could be used in bioterrorism attacks. The Category A, B, and C biological bioterrorism agent list (Appendix 1) was derived from a consensus of that group. 1 Nearly all of these potential bioterrorism agents are zoonotic in nature. Veterinarians are considered to be experts in zoonotic agents and diseases; therefore, veterinarians should be familiar with the agents on this list and the clinical signs of the diseases they cause in animals and humans. Moreover, all veterinarians should know what to do if they suspect infection with these agents in an animal or human. The purpose of this article is to provide such information, discuss what is being done to address bioterrorism in the United States, and identify what challenges still need to be met. Selected Category B and C agents will be reviewed here; Category A agents have been discussed previously. 2 Agents in Categories B and C Compared with Category A agents, those belonging to Categories B and C are less likely to cause large-scale illness and death, but still have potential for widespread dissemination and require little preparedness measures beyond those implemented for agents in Category A. 1 Category B agents are less familiar to the general public than those in Category A, and their impact on public health would be less severe. Category C agents are those that are believed not to pose a high risk for bioterrorism; their use as bioterrorism agents can be addressed through preparedness planning for agents in Categories A and B. Given these caveats, some agents in Categories B and C do have potential for massive economic disruption and large numbers of human deaths if used for bioterrorism. Brucellosis—In humans, brucellosis (also known as undulant fever) is associated with a fever that waxes and wanes over a period of weeks to months if untreated and can affect almost any organ system. Osteoarticular involvement is the most frequent complication , occurring in as many as 40% of cases, and may manifest as arthritis of peripheral joints, spondyli-tis, osteomyelitis, or bursitis. 3 Other effects may involve the gastrointestinal and genitourinary tracts and the hepatobiliary, pulmonary, neurologic, and car-diovascular systems. Illness can be debilitating, and relapse may occur if treatment is incomplete or there is an isolated site of infection that requires …