On an otherwise uneventful sunny Sunday afternoon, an extremist group enters your city in a large van and drives to the front entrance of the Convention Center where the annual flower show is taking place

Question

The occupants unload large crates resembling flats of assorted flowers, and then drive off. Within minutes the crates explode, showering the visitors with an opaque powder. Medical teams are called to the scene to care for the injured, and CDC officials wearing level 4 containment suits arrive in a few hours to test the contents of the powder for human pathogens using multiplex PCR methodology (a rapid method for identifying pathogens by their DNA). Which of the following potential bioterrorism agents would pose the most serious threat to those exposed?
a. Bacillus anthracis (anthrax)
b. Corynebacterium diphtheriae toxin (diphtheria)
c. Yersinia pestis (plague)
d. variola major (smallpox)
e. Clostridium botulinum toxin (botulism).

Answer 1

Rationale: The correct answer is d. The most serious threat would be posed by the biological agent to which there is no immediate defense or antidote. Antibiotics would be effective against bacterial agents such as Bacillus anthracis and Yersinia pestis, and antitoxin against diphtheria and botulism toxins could be administered to those affected. If the powder contained the smallpox virus, however, the population would be particularly susceptible, because there are no antibiotics available to protect the non-immune population, and vaccination would take time to take effect. Those infected in the initial attack could spread this highly infectious virus, which has severe morbidity and a mortality rate of about 30%.