title: Animals as sentinels of chemical terrorism agents: an evidence-based review.
abstract: OBJECTIVE
  The goal of this systematic review was to identify evidence that animals could serve as sentinels of an attack with a chemical terrorism agent.
  
  
  METHODS
  The biomedical literature was systematically searched for evidence that wild or domestic animals exposed to certain chemical weapons of terrorism had either greater susceptibility, shorter latency period, or increased exposure risk versus humans. Additionally, we searched for documented reports of such animals historically serving as sentinels for chemical warfare agents.
  
  
  RESULTS
  For a small number of agents, there was limited evidence that domestic and/or wild animals could provide sentinel information to humans following an airborne attack with chemical agents, usually related to increased potential for environmental exposure. Some of this evidence was based on anecdotal case reports, and in many cases high quality chemical terrorism agent evidence regarding comparative susceptibility, exposure, and latency between humans and sentinel animal species was not found.
  
  
  CONCLUSIONS
  Currently, there is insufficient evidence for routine use of animals as sentinels for airborne chemical warfare agents. At the same time, Poison Center surveillance systems should include animal calls, and greater communication between veterinarians and physicians could help with preparedness for a chemical terrorism attack. Further analysis of comparative chemical warfare agent toxicity between sentinel animal species and humans is needed.
authors.affiliation: Yale University School of Medicine, New Haven, Connecticut, USA. peter.rabinowitz@yale.edu
authors.forename: Peter
authors.initials: P
authors.lastname: Rabinowitz
authors.forename: James
authors.initials: J
authors.lastname: Wiley
authors.forename: Lynda
authors.initials: L
authors.lastname: Odofin
authors.forename: Matthew
authors.initials: M
authors.lastname: Wilcox
authors.forename: F Joshua
authors.initials: FJ
authors.lastname: Dein
mesh_terms: D000818:Animals; D051337:Chemical Terrorism / Q000517:prevention & control*; D002619:Chemical Warfare Agents / Q000032:analysis* / Q000506:poisoning; D004198:Disease Susceptibility / Q000139:chemically induced / Q000175:diagnosis; D019317:Evidence-Based Medicine; D006801:Humans; D018571:Sentinel Surveillance / Q000662:veterinary*
chemical_list: D002619:Chemical Warfare Agents