Other subsequent cases involving the attempted use of biological agents for terrorist purposes have triggered a flood of publications and numerous scientific conferences and have spurred many countries, especially the United States, to institute many legislative, legal, organizational, medical, and other measures aimed at countering bioterrorism. The United States has devoted substantial sums to the problem of fighting bioterrorism, including on matters of “internal preparedness,” inasmuch as expert analyses, evaluations, and inspections have led to the conclusion that in most cases, public service agencies are not prepared to respond to terrorist attacks involving the use of biological weapons. Efforts are under way to implement a program to develop and create stockpiles of 18 new vaccines, including a new smallpox vaccine. In addition, funds have been allocated to create a stockpile of medicines and antibiotics, which are intended primarily for use by police, fire, and emergency medical personnel. Appropriate attention is being focused on the fight against terrorism in Russia as well. The Interagency Antiterrorism Commission was created in 1997, the State Duma passed the Law on Combating Terrorism in July 1998, and the Government of the Russian Federation issued a resolution establishing a federal targeted program in 1999.

Although many countries have well-prepared systems for combating ordinary terrorism and dealing with emergency situations (floods, earthquakes, accidents, and catastrophes), none has put in place a complete set of measures for meeting this new threat. This is because for many reasons it is extremely difficult to combat the use of biological agents for terrorist purposes (the large number of potential agents, the long incubation period, the lag time before symptoms of illness appear, the possibility of secondary infection and the further spread of the disease, and so forth).

Medical personnel must also play a special role when bioterrorist acts are carried out. They must understand the epidemiological situation and know the potential biological agents and the symptoms of the infectious diseases they cause, which as a rule would differ from those of naturally occurring illnesses. They must also be aware of treatment protocols and measures for preventing the spread of epidemics. However, the current state of affairs is such that most clinical microbiological laboratories have neither the capabilities nor the experience in real-life detection and identification of infectious agents from a list of those that might be used by bioterrorists, such as anthrax, brucellosis, botulism, cholera, plague, smallpox, hemorrhagic fever viruses, and others.

Biological agents of critical importance from the standpoint of civilian public service preparedness may be divided into the following three categories based on their characteristics:

1. Category A

   • smallpox (Variola major)

   • anthrax (Bacillus anthracis)