How to Recognize Category C Bioterrorism Agents

Two Parts:Recognizing Category C Priority Pathogens and SymptomsProtecting Yourself from Bioterrorism

According to the CDC, category C bioterrorism agents are the "third highest priority agents, [including] emerging pathogens that could be engineered for mass dissemination in the future because of availability, ease of production and dissemination, and potential for high morbidity and mortality rates and major health impact." Category C agents don't have the name recognition of more famous bioterrorism agents like Anthrax, but can still be deadly in the wrong hands, so it's important to educate yourself about these agents.

Part 1
Recognizing Category C Priority Pathogens and Symptoms

Official listings of Category C agents are often in a state of flux - because these agents are defined in part by the future likelihood that they can be weaponized, the listings can change as new information about these agents is uncovered. That being said, the National Institute of Allergy and Infectious Disease (NIAID) provides a comprehensive list of the current priority category C agents. See below:

Priority Category C Bioterrorism Agents and Symptoms. [1]
Agent Symptoms
Influenza Fever, nausea, coughing, congestion, aches, general malaise.
Yellow Fever Initial flu-like symptoms (headache, fever, aches, nausea, etc.). About 15% of cases eventually develop into severe form of disease after brief remission and exhibit jaundice, high fever, liver damage, organ failure.
Rabies Initial flu-like symptoms followed by progressive anxiety, confusion, dementia, agitation, hallucination, difficulty swallowing, and fear of water.
Prion diseases Progressive brain damage, dementia, confusion, and loss of neurological function following long incubation period.[2]
Chikungunya virus Fever, rash, vomiting, headache, and/or severe muscle and joint pain.
Tickborne hemorrhagic fever viruses Initial flu-like symptoms with fever, followed by rash, red eyes, chest pain, difficulty breathing and swallowing, and bleeding (internal and external).
Tickborne encephalitis viruses Initial flu-like symptoms, then a brief period of no symptoms, followed by a second stage with neurological symptoms (headache, paralysis, and sometimes confusion or seizure) with high fever
SARS Flu-like symptoms w/ high fever
Coccidioides immitis and Coccidioides posadasii Flu-like symptoms w/ fever, rash, muscle pain, and joint pain
Hantaviruses Fatigue, fever, muscle pain, respiratory problems[3]
Rickettsias Fever, headache, nausea, abdominal pain, muscle pain. Some cases also exhibit a rash.

Additionally, strains of many other commonly-known diseases can receive Category C classification if they exhibit antimicrobial resistance - that is, if they're difficult to kill with current medicines. For instance, gonorrhea and Hepatitis B can fall under Category C classification if they exhibit antimicrobial resistance.[4]

Part 2
Protecting Yourself from Bioterrorism

  1. Image titled Recognize Category C Bioterrorism Agents Step 1
    Beware of common dispersal methods for bioterrorism agents. One of the biggest challenges that would-be bio-terrorists face is finding a way to administer their biological agents in ways that preserve the lethality of the agents themselves. Many dangerous microbes are difficult to grow and cultivate, while still others are fragile and die when exposed to air or light. Know the most common delivery methods for bioterrorism agents (listed below[5]) so that, in the event of an attack, you will be better prepared to protect yourself.
    • Food and water contamination: Certain bioterrorism agents can persist in food and water, especially if consumed unheated. Thoroughly cooking food and boiling water can help kill these pathogens.
    • Animal transmission: Some animals, especially pests like mosquitoes and ticks, can be vectors for deadly diseases. Keeping pest-control agents (insecticides, etc.) is a smart choice to protect against this dispersal method.
    • Person-to-person transmission: Diseases like smallpox spread extremely contagiously simply from person-to-person contact. In these cases, physically staying away from infected people (via quarantine, for instance) is the best move.
    • Aerosol transmission: In perhaps the most dangerous method of transmission, a few bioterrorism agents (like anthrax) can be converted to a fine mist and spread through the air, where they can drift for miles and cause infection upon inhalation. In this case, closing windows and doors and using a proper gas mask can help prevent infection.
  2. Image titled Recognize Category C Bioterrorism Agents Step 2
    Keep up-to-date on emerging pathogen threats. Category C contains many emerging pathogens - that is, infectious diseases that have recently had an increased incidence in humans or otherwise are poised for such an increase.[6] Keeping up-to-speed on the status of these types of diseases worldwide can allow you to be aware of likely bioterrorism agents before they're used.
    • Luckily, the website of the CDC's National Center for Emerging and Zoonotic Infectious Diseases (NCEZID) provides up-to-date information on the status of emerging diseases across the globe.[7]
    • The CDC also provides a report called the Morbidity and Mortality Weekly Report (MMWR), an excellent source for monitoring emerging disease outbreaks.[8]
  3. Image titled Recognize Category C Bioterrorism Agents Step 3
    Research bio-weapons. Understanding the history of bio-weapon development is useful for understanding the current threat. Agents that have been mass produced or engineered in the past are more likely to surface in the future, even if these stock piles have been destroyed. Dissemination of biological agents is a complex, sophisticated process, so, by researching historical accounts of the usage of such agents, the dangers and limitations of Category C agents can become more apparent.
    • Great reading resources include; "The Anthrax Letters” by Dr. Leonard A. Cole, “Rising Plague: The Global Threat from Deadly Bacteria and Our Dwindling Arsenal to Fight Them” by Brad Spellberg, “Bioterrorism and Infectious Agents: A New Dilemma for the 21st Century” edited by Ken Alibek, and “Biohazard” by Ken Alibek.
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    Report suspicious activities to the authorities. If you believe you may have information about a biological attack, even if it's far-fetched, it's better to be safe than sorry. Suspicious activity, especially around hospitals, medical waste facilities, and similar places should be reported to the authorities immediately. Odd or suspicious letters and packages should be turned over to the police without being opened. Be vigilant for other threats - if you're able to quickly report a bioterrorism attack, you may save many lives.
  5. Image titled Recognize Category C Bioterrorism Agents Step 4Bullet1
    Stockpile supplies. In the event of a biological attack, it may be impossible to leave the house for some time. Thus, it's important that your family has what it needs to survive without help from the outside world. There are many resources for emergency planning which you may want to consult, as the necessary supplies and procedures are generally the same regardless of the emergency. Here are just a few things you may want to have:
    • Sealed, non-perishable food
    • Sealed, purified water
    • A secure quarantine area (for instance, a specific part of your house)
    • HEPA Air filters (for aerosol attacks)
    • Flashlights and batteries
    • Radio
    • Toiletries
    • Soap
    • Access to a toilet or latrine
    • Over-the-counter medicine
  6. Image titled Recognize Category C Bioterrorism Agents Step 4
    Protect yourself in the event of an attack. If you experience a bioterrorism attack, do everything you can to protect yourself and your loved ones from possible exposure. The key here is prevention - being ready for an attack well in advance is the best way to be able to survive. Have a plan to quickly gather your loved ones in a quarantined area (like your house) where you'll have access to supplies, like gas masks, hazard suits, and a radio or television (so that you'll be able to know when the threat passes).
    • Practice your quarantine plan like you would with a fire drill. Everyone in your family should know exactly where to go and what to do in the event of a biological attack. If the real thing ever occurs, every second may count.


  • Great resources include;"America's Forgotten Pandemic: The Influenza of 1918" by Alfred W. Crosby,This book provides an eye opening account of the effect of a pandemic on daily life.“Emergency Preparation: 100 Tips for Practical Family Preparedness Using A Realistic Approach for Better Planning” by Major Stroud

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