Comparison of the available methods of differentiation between a biological attack and other epidemics

Abstract

Timely detection of a deliberate epidemic and the engagement of security and law enforcement forces are of crucial importance, because breaking the epidemiological chain does not guarantee that evil human minds will not start another epidemic. There are four available methods of differentiation between a biological attack and other epidemics: Grunow and Finke (Clin Microbiol Infect 8:510–521, 2002), Dembek et al. (Epidemiol Infect 135: 353–371, 2007), Radosavljevic and Belojevic (Public Health 126: 77–81, 2012) and Radosavljevic (Biopreparedness and public health. Springer, Heidelberg, pp 17–32, 2013). The aim of this study is to compare the application of these four methods on three documented bioterrorist attacks (Salmonellosis – The Dalles, Oregon, 1984; Shigellosis – Dallas, Texas, 1996; Anthrax USA – 2001) one accidental release of a weaponized agent (Anthrax – Sverdlovsk, Soviet Union, 1977) and three unusual epidemiological events (West Nile Virus – NYC 1999; Tularemia, Kosovo, 2000; Escherichia coli O104-H4 outbreak in Germany 2011). The results show that four methods are closely related in differentiation between a biological attack and other epidemics. Dembek et al. method and Radosavljevic & Belojevic method are simplier and most effective during an epidemic. Grunow & Finke method is more complex and most effective after an epidemic. Radosavljevic method is most detailed and allows for a further differential analysis of an unusual epidemiological event.