Healthcare providers will need to especially vigilant and look for important clues when trying to identify the cause of an unusual infectious outbreak. A biological attack should be considered if any of the following are present:
1. Large epidemic with unprecedented number of ill or dying.
2. Children, elderly, and those with weakened immune systems like HIV(+)individuals, transplant patients, and those on chemotherapy may have first susceptibility. They will likely;y be our “canaries in the coal mine”.
3. Particularly high volumes of patients complaining primarily of respiratory symptoms that are severe and are associated with an unprecedented mortality rate.
4. The cause of the infection is unusual or impossible for the particular region (such as the Ebola virus which is rarely seen outside of Africa). The agent may require clinical and laboratory diagnosis.
5. Multiple, yet simultaneous outbreaks.
6. The epidemic is caused by a multi-drug-resistant pathogen, previously unknown.
7. Sick or dead animals of multiple types are encountered.
8. The delivery vehicle for the agent is identified.
9. Prior intelligence reports or claims by aggressors of a BW attack.