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The page below is a sample from the LabCE course Preliminary Identification of the Primary Select Agents of Bioterrorism. Access the complete course and earn ASCLS P.A.C.E.-approved continuing education credits by subscribing online.

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Category A Agents: Reasons Why They May be Used to Create Public Health Emergencies

Anthrax (B. anthracis):

  • Inhalation of anthrax spores is virtually 100% fatal
  • Spores can remain infectious for decades


  • Most lethal toxic agent known
  • Toxin could be used to contaminate food supplies
  • Can be aerosolized in enclosed areas

Pneumonic Plague (Y. pestis):

  • Aerosolized in large amounts
  • Short incubation period, usually in less than three days, and invariably fatal without early and effective antimicrobial therapy
  • Untreated, fatality rate exceeds 90%
  • Disease is spread from direct exposure to respiratory droplets of infected humans


  • Highly contagious and deliberate spread by aerosol is extremely infectious
  • Mass panic would be created

Tularemia (F. tularensis):

  • Highly contagious and easily spread
  • An aerosol containing as few as 25 organisms can cause infection
  • Easily penetrates the smallest breaks in the skin

Viral Hemorrhagic Fever:

  • Causes internal and external bleeding and would likely cause great panic and easily spread by direct contact with body fluids or respiratory droplets
  • Outbreak due to bioterrorist attack could lead to mass illness and death