The role of naturally occurring pathogenic Bacillus anthracis in biological incident preparedness and response

Due to the current United States (US) political and social climate, as well as historical uses of biological materials as a means to terrorize and cause illness or death, the Federal government is taking prudent steps and applying resources towards biodefense preparedness. Preparing the US for a domestic biological terrorism event is a challenging task that spans many disciplines and there are innumerable questions and needs to be addressed to assist those responsible for preparing our nation for a large scale or urban biological incident. One such question is what role, if any, does naturally occurring Category A Critical Biological Agents, specifically Bacillus anthracis, in the contiguous US play in the crisis and consequence management phases of a large scale biological incident. Through an extensive literature search, various related working group meetings and conferences, and subject matter expert interviews with 18 biological incident management professionals from three occupational categories (Emergency Management/Homeland Security, Environmental Protection, and Public Health) this study illuminates where there is and is not a consensus among biological incident management professionals on the role of naturally occurring B. anthracis and other Category A Agents in biological incident management preparedness and response and more importantly provides an in-depth analysis of the views held by this community for the purpose of making recommendations to improve biological incident management policies and procedures and assist the national effort underway to prepare the US for biological threats. General conclusions focus on the larger picture of improved national security preparedness while the roles described profile the characteristics of naturally occurring organisms and the corresponding environmental background characterization data that may influence biological incident management policies and procedures. In the context of biological incident management, this study reveals the impact of naturally occurring biothreat agents with regard to notification, detection, characterization, cleanup, and risk communication and also touches on tangential discoveries related to knowledge and technology gaps, as well as needed improvements in policies, interdisciplinary relationships, and funding. Additionally, practitioners from two of the three fields included in this study provide valuable insight on the relevance of environmental background characterization data for their work, while it was discovered that the third discipline would not benefit from this background characterization in a comparable manner during or prior to a large scale biological incident.;Recommendations for further study, as well as for measures to more thoroughly address the needs of those responsible for preparing our nation for a biological incident are presented with the intention of improving biological incident management policies and procedures thereby assisting national efforts underway to prepare the US for biological threats.