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Chemical Terrorism

By James A. Geiling, MD, FCCP

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Table 8—Clues to a Potential Chemical or Biological Terrorist Event*
  1. Large number of ill persons with a similar syndrome
  2. Large number of cases of unexplained diseases or deaths
  3. Unusual illnesses in a population
  4. Higher morbidity or mortality in a common disease or syndrome
  5. Single case of a disease caused by an uncommon agent
  6. Several unusual or unexplained diseases occurring in the same patient
  7. Disease with an unusual geographic or seasonal distribution
  8. Illness that is unusual for a given population or age group
  9. Unusual disease presentation
  10. Similar genetic type among agents isolated from distinct sources at different times or locations
  11. Unusual, atypical, genetically engineered, or antiquated agent strain
  12. Stable endemic disease with an unexplained increase in incidence
  13. Simultaneous clusters of similar illness in noncontiguous areas
  14. Atypical disease transmission through aerosols, food, or water
  15. Point source of disease outbreak with compressed epidemic curve
  16. Patterns of illness related to ventilation systems
  17. Unusual animal deaths or illness preceding or accompanying human disease
Reprinted with permission from Cieslak.4

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