...occurring infections with most of the designated bioterrorism agents are rarely seen in the U.S. today. Because of this, many clinicians are unfamiliar with the associated clinical syndromes and ...may not initially recognize when an illness stems from exposure to one of these agents, much less from intentional release in a bioterrorism attack (6). Distinguishing the microbial etiology of each syndrome can be challenging; whether intentionally released for bioterrorism or naturally occurring, different infectious agents can cause indistinguishably similar clinical signs and symptoms. ...it may not be obvious to clinicians, at least early in a bioterrorism attack, that a cardiovascular syndrome is due to biological warfare, especially if the biological agent does not grow or grows slowly in the culture media routinely used by clinical laboratories to detect naturally occurring pathogens.
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