Assessing the use of infectious agents in bioterrorism: a narrative review of risks, preparedness, and response strategies

Abstract Background Bioterrorism involves the deliberate use of biological agents as weapons to cause harm or death to humans, animals, or plants. These agents are naturally found in the environment but can be modified into weapons. Identifying unusual patterns in disease outbreak, timing, or geographic location is crucial to identify potential bioterrorism events. Prompt notification of public health authorities is essential for proper investigation. This literature review aims to evaluate the potential use of oncogenic agents in bioterrorism and assess risks, preparedness, and response strategies. Methods This literature review was conducted using Google Scholar, PubMed, and World Health Organization (WHO) reports, using terms such as “bioterrorism”, “bioterror”, “biological weapons”, “oncogenic viruses”, and “oncogenic agents”. Results Biological agents pose a threat through various mechanisms such as chronic inflammation, DNA mutations, and immune evasion, which promote carcinogenesis. Namely, chemical carcinogens and radiological agents have a delayed mechanism, but have a profound impact on carcinogenesis. Advances in genetic engineering, such as Clustered Regularly Interspaced Short Palindromic Repeats (CRISPR), have also raised concerns regarding carcinogenesis due to targeted genetic manipulation of oncogenic viruses. Conclusions Early detection, immediate mitigation measures, and long-term cancer surveillance programs are critical response strategies to bioterrorism threats. Public communication is also essential to mitigate fear and misinformation. Legal measures include victim compensation and ethical considerations, particularly regarding experimental or genetic therapies. Historically documented incidents exemplify cases that expose significant challenges in diagnosis. The potential use of biological, radiological, and chemical agents in bioterrorism highlights the need for multisectoral cooperation to develop comprehensive response strategies.