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Abstract
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Terrorist attacks fall under a unique category within the disaster medicine (DM) spectrum. Unlike accidental man-made disasters where there is an inherent pre-disaster objective to reduce risk and mitigate potential hazards, terrorist events have the aim of intentionally inflicting maximum casualties and disrupting the day to day functioning of society.
Bioterrorism in particular, has been an attractive methodology by terrorists as certain naturally occurring biological agents are relatively easy and inexpensive to obtain, can be easily disseminated, and can cause widespread fear and panic. The development of Counter Terrorism Medicine (CTM) as a subspecialty of Disaster Medicine, and the recent non-terrorism related deaths as a result of bongkrekic acid (BKA) poisoning after consuming homemade corn noodles, reignited the dialogue on the potential adaptation of naturally occurring biological agents into a bioterrorism tool, and highlights the subsequent terrorism risk mitigation strategies required for this potential attack modality (Court et al., 2020).
BKA is a little known toxin produced in fermented coconut or corn contaminated by the bacterium Burkholderia gladioli pathovar cocovenanans. BKA is odourless and tasteless and affected food products can have a normal appearance, smell and taste. Outbreaks of BKA poisoning affecting thousands were documented since the mid '70s in Indonesia where fermented food products made out of coconut residues are popular local dishes. In 2015, the first outbreak of BKA outside of Asia was documented in Mozambique, which led to 230 poisonings and 75 deaths...
Language: en |