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p. 113–114. Furthermore, the United Nations Model regulations contain packing instructions for primary, secondary and outer packaging of hazardous goods. See Model Regulations Id. Volume 11, Instruction P620 at p. 70. Specimens (human, animal, food, environmental, etc.) known or reasonably expected to contain pathogens are now to be classi.ed as infectious substances. When
provisions for the carriage by air are formulated in the packing of samples of infectious pathogens for transportation by air. The shipment of infectious agents or diagnostic specimens by air must comply with local, national and international regulations. International air transport regulations are contained in various docu-mentation of the International Civil Aviation Organization and Dangerous Goods Regulations – an annual publication of the International Air Transport Association published in January, and usually revised on a yearly basis. These ICAO and IATA documents will be discussed in some detail later in this article.
Dangerous Goods Regulations are implicitly accompanied by the requirement that anyone requesting samples should provide the necessary evidence that they are registered with their government for the receipt of such substances and that they have the appropriate facilities, staff and security measures in place to carry out work on the samples received.
There are four diseases recognized as most likely to be associated with bioter-rorism potential: anthrax; botulism; plague; and smallpox. Although these agents are considered to be the most likely to be used in bioterrorism they are not usually prioritized in any order of importance. There are other agents which offer potential to bioterrorism such as those causing tularemia, brucellosis, Q fever, viral hemor-rhagic fevers, viral encephalitis, and a disease associated with staphylococcal enterotoxin B.
There are others which cause security experts concern as emergent threats to security through bio terrorism. These are Severe Acute Respiratory Syndrome (SARS), monkeypox and pandemic in.uenza. These are naturally occurring dis-eases,35
which are of concern because they are new and/or epidemic.36
Outbreaks of dangerous pathogens may occur naturally or as covert or overt events. An outbreak is suspected only upon recognition of unusual disease clusters or symptoms.37
For example, SARS was recognized as a naturally occurring event initially from Southeast Asia in February 2003.
these specimens are transported/shipped for any purpose, including initial or con.rmatory testing
for the presence of pathogens, they are to be packaged and shipped as infectious substances. 35It is widely recognized that SARS is not a disease but a syndrome. See generally, Abeyratne (2002, pp. 53–80).
36Rapid response to a dangerous pathogen event requires prompt identi.cation of its onset. Because of the rapid progression to illness and potential for dissemination of some of these agents, it may not be practical to await diagnostic laboratory con.rmation. Instead, it is necessary to initiate a response based on the recognition of high-risk syndromes, i.e., typical combination of clinical features of the illness at presentation that might alert healthcare practitioners to the possibility of an outbreak. Examples of syndromes potentially resulting from infections with dangerous pathogens include: encephalitis/meningitis, hemorrhagic mediastinitis, severe pneumo-nia, papulopustular rash, hemorrhagic fever, descending paralysis and nausea/vomiting/diarrhoea.
37An outbreak is usually identi.ed consequent to a rapidly increasing disease incidence (e.g., within hours or days) in a normally healthy population, such as unexplained death with fever in a non-trauma patient, or a botulism-like syndrome, meningitis or encephalitis in more than one patient.
C. Emerging Threats
A bioterrorism attack is the deliberate release of viruses, bacteria, or other germs
(agents) used to cause illness or death in people, animals, or plants. These agents are typically found in nature, but it is possible that they could be changed to increase their ability to cause disease, make them resistant to current medicines, or to increase their ability to be spread into the environment. Biological agents can be spread through the air, through water, or in food. Terrorists may use biological agents because they can be extremely dif.cult to detect and do not cause illness for several hours to several days. While some bioterrorism agents, such as the smallpox virus, can be spread from person to person some agents such as anthrax are incapable of doing so.
　
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