title: [General procedures in response to suspected attacks with highly contagious and pathogenic agents].
abstract: The discovery of undefined powders that are content of letters or parcels with or without threats in writing addressed to institutions, groups or persons, often raises the suspicion of an attack involving biological agents such as anthrax. Subsequent investigations and analyses by local authorities often aim at excluding anthrax or anthrax spores. Suspicion and actions are then mistakenly justified by referring to the 2001 anthrax letter attacks in the USA, which now lie more than 10 years in the past. In Germany to date there has never been a terrorist attack involving dangerous biological agents, neither in letters nor in any other possible form. In addition, it cannot be assumed that anthrax bacteria or spores will be used again in a bioterrorist event. In the case of a valid suspicion of a threatening letter, neither analyses to exclude only a certain group of substances (e.g. biological, chemical or radiological) nor analyses to exclude only one biological agent (e.g. anthrax) in particular would provide sufficient information for decision makers to conduct further actions in coping with the given situation. Moreover, a sequence of procedures such as consultation, exclusion, and analyses should be followed in order to systematically exclude all relevant threats. Therefore, and in respect to the current CBRNE threat assessment for Germany, the following article provides recommendations of actions to be taken for coping with a valid suspicion of an intentional release of biological agents utilizing powder letters as an example.
authors.affiliation: Zentrum für Biologische Gefahren und Spezielle Pathogene, Informationsstelle des Bundes für Biologische Gefahren und Spezielle Pathogene, Robert Koch-Institut, Berlin, Deutschland, RichterMar@rki.de.
authors.forename: Martin
authors.initials: M
authors.lastname: Richter
authors.forename: Christian
authors.initials: C
authors.lastname: Herzog
mesh_terms: D000354:Africa, Western; D023482:Bioterrorism / Q000517:prevention & control*; D003140:Communicable Disease Control; D019091:Critical Pathways / Q000592:standards; D003666:Decontamination / Q000592:standards; D005858:Germany; D055819:Hospitals, Isolation / Q000592:standards*; D006801:Humans; D017146:Models, Organizational; D010356:Patient Isolation / Q000592:standards*; D010357:Patient Isolators; D011159:Population Surveillance / Q000379:methods; D017410:Practice Guidelines as Topic; D014187:Transportation of Patients / Q000592:standards*