A procedure for differentiating between the intentional release of biological warfare agents and natural outbreaks of disease: its use in analyzing the tularemia outbreak in Kosovo in 1999 and 2000

摘要: The events of 11 September and the subsequent anthrax outbreaks in USA have opened world's eyes to threat posed by terrorist groups, criminal organizations lone operators who will stop at nothing achieve their goals. open or covert use pathogens toxins as biological warfare agents can no longer be ruled out. Against this background, appearance an unusual disease must studied order clarify whether it is a natural artificially caused occurrence. This issue was recently raised discussions with local representatives relief during tularemia epidemic Kosovo from October 1999 May 2000. paper present procedure which attempts certain criteria identify rule out event outbreak disease. Data findings gathered routine epidemiologic microbiological studies often provide only indirect answer problem. For reason, various were formulated points allocated represent importance, allowing us deduce semiquantitative manner degree possibility artificial genesis outbreaks. significance characterization each criterion are discussed. An analysis based on described here indicates that deliberate release causative agent tularemia, Francisella tularensis, doubtful. In paper, approach discriminate between intentional infectious diseases. developed model flexible considers political, military social crisis-afflicted region, specific features pathogen, clinical characteristics epidemic.