The threat to Emergency Departments from bioterrorism in Australia

Abstract

The Commonwealth Department of Health (DoHA) has recently developed two lists of threat agents in consultation with relevant stakeholders around Australia. These have been labeled Tier 1 and Tier 2 agents. This list includes bacteria, viruses, and toxins derived from bacteria and plants. Legislation will soon be introduced to introduce controls on laboratories who store these agents. This presentation will look at the agents on these two lists and examine those that represent the biggest threat in the Australian context, detailing their clinical presentation, their mode of spread and how they might be used as bioterrorist agents. A number of these agents produce flu-like symptoms initially, making diagnosis difficult. This has important ramifications for patients, who will die unless antibiotic therapy is initiated rapidly. The discussion will concentrate on the threat theses agents pose to emergency staff when receipting patients exposed to a deliberate release of agent. An attack of this nature would quickly overwhelm even large Emergency Departments, not only from presentations of seriously ill patients but also from the large numbers of worried well who will present. Whether the agent is infectious or not will have serious ramifications for ongoing spread of the agent throughout the community.