Epidemiology of Pathogens Listed as Potential Bioterrorism Agents, the Netherlands, 2009-2019

We provide incidences (cases/10 million persons) in the Netherlands during 2009-2019 for pathogens listed as potential bioterrorism agents. We included pathogens from the highest categories of the Euro-pean Medicines Agency or the US Centers for Disease Control and Prevention. Notifiable diseases and re-cently published data were used to calculate the aver-age annual incidence. Coxiella burnetii had the high-est incidence because of a Q fever epidemic during 2007-2010. Incidence then decreased to 10.8 cases/. Pathogens with an incidence >1 were Brucella spp. (2.5 cases), Francisella tularensis (1.3 cases), and Burkholderia pseudomallei (1.1 cases). Pathogens with an incidence <1 were hemorrhagic fever viruses (0.3 cases), Clostridium botulinum (0.2 cases), and Bacillus anthracis (0.1 cases). Variola major and Yer-sinia pestis were absent. The generally low incidences make it unlikely that ill-meaning persons can isolate these pathogens from natural sources in the Nether-lands. However, the pathogens are stored in laborato-ries, underscoring the need for biosecurity measures.

Automated summary

We provided the incidences of potential bioterrorism agents in the Netherlands from 2009 to 2019. The highest category pathogens from the European Medicines Agency or the US Centers for Disease Control and Prevention were included. The average annual incidence was calculated using notifiable diseases and recently published data. Coxiella burnetii had the highest incidence due to a Q fever epidemic, but the incidence decreased to 10.8 cases. Pathogens with an incidence >1 included Brucella spp. (2.5 cases), Francisella tularensis (1.3 cases), and Burkholderia pseudomallei (1.1 cases). Pathogens with an incidence <1 were hemorrhagic fever viruses (0.3 cases), Clostridium botulinum (0.2 cases), and Bacillus anthracis (0.1 cases). Variola major and Yersinia pestis were not present. The generally low incidences make it unlikely for ill-meaning persons to isolate these pathogens from natural sources in the Netherlands. However, the presence of these pathogens in laboratories underscores the need for biosecurity measures.