Unusual epidemic events: a new method of early orientation and differentiation between natural and deliberate epidemics.

OBJECTIVE

To develop a model for quick and accurate evaluation of unusual epidemic events (UEE), based on the original model of bioterrorism risk assessment.

METHODS

A new scoring system was developed for quick differentiation between a biological attack and other epidemics, using eight qualitative and six quantitative indicators.

RESULTS

A new scoring system was applied to three UEEs: (1) a spontaneous outbreak of a new or re-emerging disease ('swine flu'); (2) a spontaneous outbreak following accidental release of a pathogen (Sverdlovsk anthrax); and (3) a spontaneous natural outbreak of a known endemic disease that may mimic bioterrorism or biowarfare (Kosovo tularaemia). The disease agent was found to be the most important and the most informative UEE component of the scoring system.

CONCLUSIONS

This new scoring system may be useful for public health institutions and federal civil and military officials responsible for bio-attack investigations.