Suspected Intentional Use of Biologic and Toxic Agents

Exposures, illnesses, or outbreaks involving the suspected intentional use of biological or toxic agents require epidemiologists to work with nontraditional partners, specifically law enforcement. To increase effectiveness, public health and law enforcement must collaborate on timely identification, notification, assessment, and investigation. The process begins by establishing relationships between appropriate public health and law enforcement points of contact. Once an event is recognized, and if that threat involves a biological or toxic agent, public health and law enforcement can conduct a joint criminal–epidemiologic (crim–epi) investigation, which increases the effectiveness of the investigation through the exchange of real-time information. Although instances of bioterrorism are infrequent, the potential use of biological or toxic agents for this purpose by individuals and groups can have enormous consequences and are likely to remain a persistent threat. Only through a productive partnership can public health and law enforcement effectively respond to intentional uses of biological and toxic agents.