Distinguishing Natural Disease vs Bioterrorism

The most likely sentinel events of an intentional Y. pestis release are considered to be:

• An announced, threat deemed to be credible by law enforcement.
• An observed suspicious or obvious credible threat event.
• Detection of the plague bacterium in the environment.
• Identification of animal cases in an unusual setting or unusual conditions.
• Identification of more than one primary pneumonic cases within a similar area or time.