The Role of Bioforensics in Medical Bio-Reconnaissance

  • Lothar Zöller
  • Gelimer H. Genzel
Conference paper
Part of the NATO Science for Peace and Security Series A: Chemistry and Biology book series (NAPSA)


Since the 1990s, a broad spectrum of regional conflicts and crises have evolved that have been accompanied by a growing threat of international terrorism. How vulnerable our modern societies would be towards a covert biological attack became evident in the 2001 anthrax letters attack in the United States. Biothreats are currently associated with asymmetric warfare scenarios and non-state actors rather than with state-driven biowarfare facilities. Against this backdrop, NATO has to consider biological warfare and bioterrorism as a serious threat to its forces. In bioterroristic scenarios the deliberate release of a biological agent will most probably remain undetected until a cluster of cases will suggest an unusual outbreak of disease. In military settings it is primarily the responsibility of the Medical Services to recognize the outbreak and to launch an appropriate outbreak investigation. Major goals of a medical bio-reconnaissance mission are to rapidly identify the causative agent of the outbreak and to differentiate between natural and deliberate outbreaks. In contrast to the investigation of overt natural outbreaks, forensic aspects have to be considered and appropriate procedures have to be implemented quite from the beginning when unusual outbreaks are to be investigated. If a biothreat agent is detected, it may be necessary to enter further genetic analysis in order to differentiate between natural and intentional outbreaks and to trace back the origin of the agent. Microbial forensics is mainly concerned with taking molecular fingerprints of biothreat agents by means of molecular typing techniques enabling the investigator to identify and trace back a particular strain by comparing it with the fingerprints stored in a typing database. The bioforensic approach may well be capable of elucidating the source of an outbreak as has been evidenced in the Amerithrax case in 2001. In order to detect molecular differences of microbial strains, a number of sophisticated typing techniques are currently employed, the most recent of which is whole genome sequencing, which has even entered the field laboratories by means of portable next generation sequencing devices like the MinION™.


  1. 1.
    Read TD, Salzberg SL, Pop M, Shumway M, Umayam L, Jiang L, Holtzapple E, Busch JD, Smith KL, Schupp JM, Solomon D, Keim P, Fraser CM (2002) Comparative genome sequencing for discovery of novel polymorphisms in Bacillus anthracis. Science 296:2028–2033CrossRefPubMedGoogle Scholar
  2. 2.
    Van Ert MN, Easterday WR, Simonson TS, U’Ren JM, Pearson T, Kenefic LJ, Busch JD, Huynh LY, Dukerich M, Trim CB, Beaudry J, Welty-Bernard A, Read T, Fraser CM, Ravel J, Keim P (2007) Strain-specific single-nucleotide polymorphism assays for the Bacillus anthracis Ames strain. J Clin Microbiol 45:47–53CrossRefPubMedPubMedCentralGoogle Scholar
  3. 3.
    Budowle B, Schutzer SE, Roger G, Breeze RG, Keim P, Stephen A, Morse SA (eds) (2010) Microbial forensics. Elsevier, AmsterdamGoogle Scholar
  4. 4.
    NATO DTP Lexicon (2017) Accessed 23 Sept 2017
  5. 5.
    Grundmann O (2014) The current state of bioterrorist attack surveillance and preparedness in the US. Risk Manag Healthc Policy 7:177–187CrossRefPubMedPubMedCentralGoogle Scholar
  6. 6.
    Holtherm HU (2012) Development of a multinational Deployment Health Surveillance Capability (DHSC) for NATO. Wehrmedizinische Monatsschrift 11–12Google Scholar
  7. 7.
    Grunow R, Finke EJ (2002) A procedure for differentiating between the intentional release of biological warfare agents and natural outbreaks of disease: its use in analyzing the tularemia outbreak in Kosovo in 1999 and 2000. Clin Microbiol Infect 8:510–521CrossRefPubMedGoogle Scholar
  8. 8.
    Dembek ZF, Kortepeter MG, Pavlin JA (2007) Discernment between deliberate and natural infectious disease outbreaks. Epidemiol Infect 135:353–371CrossRefPubMedGoogle Scholar
  9. 9.
    Wölfel R, Stoecker K, Fleischmann E, Gramsamer B, Wagner M, Molkenthin P, Di Caro A, Günther S, Ibrahim S, Genzel GH, Ozin-Hofsäss AJ, Formenty P, Zöller L (2015) Mobile diagnostics in outbreak response, not only for Ebola: a blueprint for a modular and robust field laboratory. Euro Surveill 20(44)Google Scholar
  10. 10.
    AEP-66 NATO Standard (2012) NATO handbook for Sampling and Identification of Biological, Chemical and Radiological Agents (SIBCRA) Edition 1, Version 1Google Scholar
  11. 11.
    Budowle B, Johnson MD, Fraser CM, Leighton TJ, Murch RS, Chakraborty R (2005) Genetic analysis and attribution of microbial forensics evidence. Crit Rev Microbiol 31(4):233–254CrossRefPubMedGoogle Scholar
  12. 12.
    Gilchrist CA, Turner SD, Riley MF, Petri WA Jr, Hewlett EL (2015) Whole-genome sequencing in outbreak analysis. Clin Microbiol Rev 28(3):541–563CrossRefPubMedPubMedCentralGoogle Scholar
  13. 13.
    Antwerpen MH, Sahl JW, Birdsell D et al (2017) Unexpected relations of historical Anthrax strain. MBio. 2017 Apr 25;8(2). pii: e00440-17Google Scholar
  14. 14.
    Walter MC, Zwirglmaier K, Vette P, Holowachuk SA, Stoecker K, Genzel GH, Antwerpen MH (2017) MinION as part of a biomedical rapidly deployable laboratory. J Biotechnol 250:16–22CrossRefPubMedGoogle Scholar
  15. 15.
    Hanczaruk M, Reischl U, Holzmann T, Frangoulidis D, Wagner DM, Keim PS, Antwerpen MH, Meyer H, Grass G (2014) Injectional anthrax in heroin users, Europe, 2000–2012. Emerg Infect Dis 2:322–323CrossRefGoogle Scholar
  16. 16.
    Cliff JB, Kreuzer HW, Ehrhardt CJ, Wunschel DS (eds) (2012) Chemical and physical signatures for microbial forensics. Springer Book, Infectious Disease Series. Humana Press, New YorkGoogle Scholar

Copyright information

© Springer Science+Business Media B.V., part of Springer Nature 2018

Authors and Affiliations

  1. 1.Bundeswehr Institute of Microbiology (BwIM)MunichGermany

Personalised recommendations