The ongoing COVID-19 pandemic has made the dangers of biological pathogens undeniable to the general public. However, long before this global outbreak, bioterrorism was recognized as a credible threat. Current global events have highlighted that biological warfare is not a myth but a harsh reality. Successive outbreaks caused by newly emerging diseases, transferred from animals to humans through zoonotic spillover, such as Ebola, SARS, and now COVID-19, as well as recent advances in biotechnology giving rise to dual-use biological agents have highlighted the need for greater capacity in public health preparedness, enhanced rigor of bioengineering research guidelines and potential stricter regulations.

According to the Centers for Disease Control and Prevention (CDC), bioterrorism is the planned and deliberate release of a pathogenic strain of a microorganism such as a virus, bacteria, or biological toxins, that can sicken or kill people, livestock, or crops. An attack against humans could have the aim of illness, death, fear, societal disruption, and economic damage. Targeting livestock and crops has the potential to destabilize food supply chains, resulting in far reaching consequences on human health and economic output of the agricultural sector. The CDC characterizes biothreat agents according to the severity of impact they would have if released during a bioterror attack. For the purpose of understanding the different kinds of mechanisms that can be implemented as control measures, it is also useful to distinguish biological agents based on their means of transmission. Transmissible agents are those which can spread between humans (e.g. Ebola, SARS, smallpox) or between animals (e.g. foot and mouth disease). A subcategory of this classification includes zoonotic diseases, which are infectious agents that have the ability to “spill over” from animals into humans. Non-transmissible agents can cause severe infections but cannot be spread between infected and susceptible individuals.

Bioterrorism is not new. The 2001 Anthrax attacks in the U.S., in which letters laced with anthrax were mailed to U.S. government officials, are no doubt the most famous example of past bioterror attacks. Assaults of this nature, however, date back to the 1300s when Europeans threw plague-infected cadavers over city walls to infect those within. The threat to food supply is no longer an abstract concept either: in the months following the 9/11 attacks, American troops found hundreds of pages of U.S. agricultural documents in al-Qaeda camps. Furthermore, a substantial part of the terrorists’ training manual was reportedly devoted to agricultural terrorism such as the destruction of crops and livestock through pathogens.

While these outbreaks would most definitely have far reaching impacts, those that scientists fear most may come from within our own laboratories. The concern of many scientists, including Professor Julia Higgins of the Royal Society in the U.K., is that the findings of life science research could be used to engineer deadly viruses. Initially it seemed as though cutting-edge work such as targeted genetic modifications of microorganisms were out of reach of those who wanted to misuse these technologies. However, as these technologies have progressed, they have become far cheaper and more accessible. Incredibly rapid and profound changes in genetic modifications in bio-molecular engineering and enhanced bio-production technology may make it easier than ever for terrorists to overcome the barriers that prevented the acquisition of biological weapons in the past. Reflecting the seriousness of this threat, in 2005 the National Institute of Allergy and Infectious Disease (NIAD) received funding of $73 million to study the immune response to infectious agents that could be used as potential bioterror agents.

Due to the multidisciplinary nature of the field, bioterrorism countermeasures require the skills of experts with vastly different backgrounds and knowledge bases. A multilevel defensive strategy to mitigate the threat of a bioterror attack should be undertaken. This should include legal deterrence, prevention and surveillance, medical management, and dissemination of information to the public.

While this is still an emerging field of research and policy development, there are many difficult questions that should be addressed when countering the risk of dual-use biological research. These include: “Should there be regulations on who can access an education in bioengineering or what research the scientific community can publish or even conduct?” There is no easy or clear cut  answer to many of these issues, but it is obvious that effective bioterrorism countermeasures must include expertise from a wide range of fields, including medical, security, military, and regulatory countermeasures.

The expansion of large corporate biotech companies have made genome editing tools available, even to those without any scientific knowledge or laboratory training. Moving forward, regulations on their products will need to be implemented. Companies as well as research institutions must be expected to carry part of the burden of ensuring that these technologies do not fall into the hands of future bioterrorists. Furthermore, creating awareness among the public and doctors, stock-piling drugs and vaccines, and establishing protocols for preparedness are all key elements of countermeasures but the magnitude of research that is yet to be done in this field should not be cause for panic but rather cause for serious, deliberate and long-term international cooperation.

This is by no means a comprehensive summary of the field of bioterrorism, nor was it intended to be. Rather I hope readers have gained an overview of a threat that may have seemed abstract to many. Here I have provided an outline of the main issues surrounding bioterrorism and in the following weeks I will add more entries on specific topics that I have touched on. These will include a more in-depth analysis of the countermeasures that have already been implemented and how these could be further developed, what likely agents of bioterrorism are, what modes of dissemination may be most threatening, and the emerging dangers of dual-use research.