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Histopathology and Immunohistochemistry in the Diagnosis of Bioterrorism Agents

Jeannette Guarner and Sherif R. Zaki

Infectious Disease Pathology Activity, National Centers for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia

Correspondence to: Jeannette Guarner, MD, Infectious Disease Pathology Activity, Centers for Disease Control and Prevention, Mailstop G32, 1600 Clifton Rd. NE, Atlanta, GA 30333. E-mail: jguarner{at}cdc.gov

From October to November 2001, the inhalational and cutaneous anthrax cases that occurred in the U.S. underscored the importance of recognizing the clinical and pathological features of infectious agents that can be used in acts of terrorism. Early confirmation of bioterrorist acts can only be performed by making organism-specific diagnosis of cases with clinical and pathologic syndromes that could be caused by possible bioterrorism weapons. Recognition and diagnosis of these cases is central to establish adequate responses. This review will examine the events that occurred during the anthrax bioterrorist attack with specific emphasis on the role of pathology and immunohistochemistry and will describe the histopathologic features of category A bioterrorism agents (anthrax, plague, tularemia, botulism, smallpox, and viral hemorrhagic fevers). (J Histochem Cytochem 54:–, 2006)

Key Words: bioterrorism • diagnosis • pathology

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