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KESHOB kUMER GHOSH-2016000300001
Bioterrorism
OVERVIEW
pg. 1
BIOTERRORISM
Bioterrorism. It is a biological warfare where biological agents (there are three
basic groups of agents include bacteria, virus and toxin) are used as weapons. From
my viewpoint, it is the most abhorrent concept to fight with enemies. As we already
familiar with the word “terrorism” which is a present decades fact. But Bioterrorism
is not a new concern for us it started from ancient times.
The center for disease control and prevention (CDC) defines Bioterrorism as “the
intentional release of viruses, Bacteria or other germs that can sicken or kill
people, livestock or crops”. This can be achieved in a number of ways, such as: via
aerosol sprays; in explosive devices; via food or water; or absorbed or injected into
the skin. (Newman, 2018)
An early example take us back more than two and half millennia. Assyrians
infected their enemy’s wells with a rye ergot fungus which contains chemical
related to LSD. Consuming the tainted water produced a confused mental state,
hallucinations and in some cases death.
In the 1300s, Tartar warriors besieged the Crimean city of kaffa. During the
siege, many tartars died at the hands of plague and their lifeless, infected bodies
were hurled over the city walls. (S.Ridel, 2004)
Terrorism "unlawful use of force and violence against persons or property
to intimidate or coerce a government, the civilian population, or any
segment thereof, in furtherance of political or social objectives."
According to U.s Govt.
There are so many bioterror attack which will be discussed later
pg. 2
BIOTERRORISM
Classification of bioterror agent: The U.S center for disease
control and prevention (CDC) has developed a classification system for biological
terror agents depend on the, how easily they can be spread and the severity of
illness or death. (ready.gov, n.d.)
According to CDC biological terror agents are divided into 3 categories. Category
A, category B and category. Each category has some characteristics that make the
agents classified.
Category A: It includes high priority organisms that pose a risk to national
security because they can be easily disseminated from person to person. Result in
high mortality rates and cause public panic and social disruption.
Category B: It include second highest priority agents that are moderately easy
to disseminate. Result in moderate morbidity rates and low mortality rates.
Category C: Third highest priority agents include emerging pathogens that
could be engineered for mass dissemination in the future because of availability,
ease of production and dissemination. It has high morbidity and mortality rates.
Ideal bioterror weapon: Bioterror agents would be contagious, virulent,
robust, difficult to detect, drug resistant, user controllable. No natural agent meets
all of these criteria. Thus, sooner or later, terrorists may decide to devise novel
weapons using the techniques of synthetic biology to enhance or replace the
characteristics of pre-existing organisms or toxins.
pg. 3
BIOTERRORISM
Categorical presentation of Bioterror agents
Arenaviruses
 Lassa (Lassa fever)
 Junín (Argentine hemorrhagic fever)
Coxiella burnetti (Q fever) Brucella species (brucellosis)
Burkholderia mallei (glanders) alpha viruses
Venezuelan encephalomyelitis eastern and western equine
encephalomyelitis
Equine encephalomyelitis Epsilon toxin of Clostridium
perfringens
Staphylococcus enterotoxin B
Nipha virus Hanta virus
HIV SARS
variola major (smallpox) Bacillus anthracis (anthrax)
Yersinia pestis (plague) Clostridium botulinum toxin (botulism)
Francisella tularensis (tularaemia) Filoviruses
 Ebola hemorrhagic fever
 Marburg hemorrhagic fever
Category B
CategoryA
Category C
pg. 4
BIOTERRORISM
Methods of delivering biological agents: Delivery methods
contributed significantly in the mass destructive potential of a weapon there by
making it a WMD (weapon of mass destruction). The mass destructive capability of
a weapon was dependent on the means used to deliver the weapon at the target. Once
the agent was released on target, the deliberate outbreak of disease would follow the
same pathway of infection as in the case of a natural disease. (htt15)
There are several method for disseminating biological agents. These way are related
to our daily life that’s why it’s easy to disseminate the agents among the peoples. It
includes Food/water, Air handling systems, Aircraft sprayers, Human vector,
Animal vector, Hand sprayers, and vehicle sprayers. Some of the paths that had been
identified for infecting animate targets from several bioterrorism attacks included:
inhalation, ingestion, or percutaneous inoculation.
Planning & response: It involves the development of biological
identification system. Recently in the U.S.A most biological defense strategies have
geared to protecting soldiers on the battlefield rather than ordinary people in the
cities. (wikipedia, n.d.)
pg. 5
BIOTERRORISM
Preparedness: The word preparedness means readiness for something here it
refers, the readiness for bioterrorism attack. Biological agents are relatively easy to
obtain by terrorist and becoming more threating in the U.S laboratories are working
on advanced detection system to provide early warning at risk and to facilitate
prompt treatment.
Aspect of protection against Bioterrorism in the U.S.A includes: It include
several protection from bioterrorism attack in the USA. Basically there are many
organizations (governmental and nongovernmental) those work together to protect
their country from bioterror attack. This are not a onetime approach. They always
analysis the environmental data and prepare their team as well as their country’s
people to protect them from attack. Several aspects are discussed below about
protection from bioterrorism attack-
Detection and resilience strategies in combating Bioterrorism - It occurs
primarily through the efforts of the office of health affairs, whose role is to prepare
for an emergency situation that impacts the health of the American populace. First
there is an OHA’s Bio watch programme in which collection devices are
disseminated to thirty high risk areas throughout the country to detect the presence
of aerosolized biological agents before symptoms present in patients.
Implementation of the Gen-3 automated detection system - This advancement is
significant simply because it enables action to be taken in four to six hours due to its
automatic response system, whereas the previous system required aerosol detectors
to be manually transported to laboratories.
pg. 6
BIOTERRORISM
Enhancing the technological capabilities of first responders - It is accomplished
through numerous strategies. The first of these strategies was developed by the
Science and Technology Directorate (S&T) of DHS to ensure that the danger of
suspicious powders could be effectively assessed, (as many dangerous biological
agents such as anthrax exist as a white powder). By testing the accuracy and
specificity of commercially available systems used by first responders, the hope is
that all biologically harmful powders can be rendered ineffective.
Enhanced equipment for first responders - One recent advancement is the
commercialization of a new form of Tyvex™ armor which protects first responders
and patients from chemical and biological contaminants. There has also been a new
generation of Self-Contained Breathing Apparatuses (SCBA) which has been
recently made more robust against bioterrorism agents.
Excelsior challenge - In the second week of September 2016, the state of New York
held a large emergency response training exercise called the Excelsior Challenge,
with over 100 emergency responders participating.
Project Bioshield - The accrual of vaccines and treatments for potential biological
threats, also known as medical countermeasures has been an important aspect in
preparing for a potential bioterrorist attack; this took the form of a program
beginning in 2004, referred to as Project BioShield.
pg. 7
BIOTERRORISM
Biosurveillance: In 1999, the University of Pittsburgh’s for biomedical
informatics deployed the first automated Bioterrorism detection system called
RODS (Real time outbreak disease surveillance). RODS are designed to collect data
form sources including clinical data, laboratory data and data form over the counter
drug sales.
CDC guideline for peoples: Sometimes it’s quite difficult to reach people
for some circumstances as well as it’s not possible to serve all people at a time for
government. That’s why peoples has some responsibility and duty before, during
and after biological attack. CDC (centers for disease control and prevention)
explained the duty and responsibility of peoples by following. (htt16)
Before a biological threat: A biological attack may or may not be immediately
obvious. In most cases local health care workers will report a pattern of unusual
illness or there will be a wave of sick people seeking emergency medical attention.
The public would be altered through an emergency radio or Tv broadcast, or some
other signal used in your community, such as a telephone call or a home visit form
an emergency response worker. The following are things that can do to protect
peoples from the effect of biological threat like Build an emergency supply kit; Make
a family emergency plan; Check with doctor to ensure all required or suggested
immunizations are up to date; considering installing a High-Efficiency particulate
Air filter.
All activities those are discussed in the planning and response section
are preformed form government site for safety of their peoples.
pg. 8
BIOTERRORISM
During a biological threat: The first evidence of an attack may observed when
symptoms of the disease caused by exposure to an agent. In the event of a biological
attack, public health officials may not immediately be to provide information on
what people should do. It will take time to determine exactly what illness is, how it
should be treated, and who is in danger. Follow these guidelines during a biological
threat like watch TV, listen to the radio, or check the internet for official news and
information including assigns and symptoms of the disease areas in danger, if
medication or vaccination are being distributed and where people should seek
medical attention if they become ill; depending on the situation, wear a face mask to
reduce inhaling or spreading germs; follow instruction of doctor and other public
health officials; if the disease is contagious expect to receive medical evaluation and
treatment; do not share food or utensils.
After a biological threat: Pay close attention to all official warning and
instruction on how to proceed. The delivery of medical services for a biological
event may be handled different to respond to increase demand. Pay close attention
to all official warnings and instruction on how to proceed.
Conclusion: Bioterrorism remains a legitimate threat both from domestic and
international terrorist groups. From a public health perspective, timely surveillance,
awareness of syndromes resulting from bioterrorism, epidemiologic investigation
capacity, laboratory diagnostic capacity and the ability to rapidly communicate
critical information on a need to know basis to manage public communication
through the media are vital. Ensuring adequate supply of drugs, laboratory reagents,
antitoxins and vaccines is essential.
pg. 9
BIOTERRORISM
List of bioterrorism attack during the past2000 years
Time Event
1155 Emperor Barbarossa poison water well with human bodies in
Tortora, Italy.
1495 Spanish mix wine with blood of leprosy patient to sell their
French foes in Naples, Italy.
1710 Russian troops catapult human bodies of plague victim into
Swedish cities.
1763 British distribute blankets from small pox patients to Native
American,
World
War I
German and French agents use ganders and anthrax.
World
War II
Japan uses plague, anthrax and other disease.
1980-
1988
Iraq uses mustard gas, sarin and tabun against Iran and ethnic
groups inside Iraq during the person gulf war.
Cases associated with Biological agents
Anthrax: Experts believe that today, the most likely organism to be used in a
bioterrorism attack would be Bacillus anthracis, the bacteria that causes anthrax. It
is widely found in nature, easily produced in the laboratory, and survives for a long
time in the environment. Also, it is versatile and can be released in powders, sprays,
water, or food. Anthrax has been used before. In 2001, anthrax spores were sent
through the United States postal system. In all, 22 people contracted anthrax, five of
whom died. And, the guilty party was never caught.
pg. 10
BIOTERRORISM
Small pox: Another potential agent of bioterrorism is smallpox, which, unlike
anthrax, can spread from person to person. Smallpox is no longer a disease of
concern in the natural world, because concerted vaccination efforts stamped it out
and the last naturally spread case occurred in 1977. However, if someone were to
gain access to the smallpox virus (it is still kept in two laboratories — one in the
U.S. and one in Russia), it could be an effective weapon, spreading quickly and
easily between people.
Plague: I have already mentioned the Tartars' use of the plague, Yersinia pestis,
hundreds of years ago, but some believe that it could be used in the modern world,
too. Y. pestis is passed to humans through the bite of a flea that has fed on infected
rodents. Once a human is infected, the resulting disease can either develop into
bubonic plague, which is difficult to transmit among humans and fairly easy to treat
with antibiotics, or if the infection spreads to the lungs it becomes pneumonic
plague, which develops rapidly and does not respond well to antibiotics.
Tularemia: Some consider tularemia, an infection caused by the Francisella
tularensis bacterium, as a potential bioweapon. It causes fever, ulcerations, swelling
of lymph glands, and, sometimes, pneumonia. The bacterium can cause infection by
entering through breaks in the skin or by being breathed into the lungs. It is
particularly infectious, and only a very small number of organisms (as few as 10)
need to enter the body to set off a serious bout of tularemia. Studied by the Japanese
during World War II and stockpiled by the U.S. in the 1960s, F. tularensis is hardy,
capable of withstanding low temperatures in water, hay, decaying carcasses, and
moist soil for many weeks.
pg. 11
BIOTERRORISM
References
(n.d.). Retrieved from https://www.ready.gov/Bioterrorism
(n.d.). Retrieved from
http://shodhganga.inflibnet.ac.in/bitstream/10603/29372/8/08_chapter%203.
pdf
(n.d.). Retrieved from
https://www.cdc.gov/healthcommunication/toolstemplates/entertainmented/t
ips/Bioterrorism.html
Newman, T. (2018, February 28). MedicalNewsToday. Retrieved from
www.google.com: https://www.medicalnewstoday.com/articles/321030.php
ready.gov. (n.d.). Retrieved from https://www.ready.gov/Bioterrorism
S.Ridel. (2004). Biological warfare and Bioterrorism: Historical overview. NCBI-
NIH, 1.
wikipedia. (n.d.). Retrieved from https://en.wikipedia.org/wiki/Bioterrorism
pg. 12
BIOTERRORISM

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Bio terrorism

  • 2. pg. 1 BIOTERRORISM Bioterrorism. It is a biological warfare where biological agents (there are three basic groups of agents include bacteria, virus and toxin) are used as weapons. From my viewpoint, it is the most abhorrent concept to fight with enemies. As we already familiar with the word “terrorism” which is a present decades fact. But Bioterrorism is not a new concern for us it started from ancient times. The center for disease control and prevention (CDC) defines Bioterrorism as “the intentional release of viruses, Bacteria or other germs that can sicken or kill people, livestock or crops”. This can be achieved in a number of ways, such as: via aerosol sprays; in explosive devices; via food or water; or absorbed or injected into the skin. (Newman, 2018) An early example take us back more than two and half millennia. Assyrians infected their enemy’s wells with a rye ergot fungus which contains chemical related to LSD. Consuming the tainted water produced a confused mental state, hallucinations and in some cases death. In the 1300s, Tartar warriors besieged the Crimean city of kaffa. During the siege, many tartars died at the hands of plague and their lifeless, infected bodies were hurled over the city walls. (S.Ridel, 2004) Terrorism "unlawful use of force and violence against persons or property to intimidate or coerce a government, the civilian population, or any segment thereof, in furtherance of political or social objectives." According to U.s Govt. There are so many bioterror attack which will be discussed later
  • 3. pg. 2 BIOTERRORISM Classification of bioterror agent: The U.S center for disease control and prevention (CDC) has developed a classification system for biological terror agents depend on the, how easily they can be spread and the severity of illness or death. (ready.gov, n.d.) According to CDC biological terror agents are divided into 3 categories. Category A, category B and category. Each category has some characteristics that make the agents classified. Category A: It includes high priority organisms that pose a risk to national security because they can be easily disseminated from person to person. Result in high mortality rates and cause public panic and social disruption. Category B: It include second highest priority agents that are moderately easy to disseminate. Result in moderate morbidity rates and low mortality rates. Category C: Third highest priority agents include emerging pathogens that could be engineered for mass dissemination in the future because of availability, ease of production and dissemination. It has high morbidity and mortality rates. Ideal bioterror weapon: Bioterror agents would be contagious, virulent, robust, difficult to detect, drug resistant, user controllable. No natural agent meets all of these criteria. Thus, sooner or later, terrorists may decide to devise novel weapons using the techniques of synthetic biology to enhance or replace the characteristics of pre-existing organisms or toxins.
  • 4. pg. 3 BIOTERRORISM Categorical presentation of Bioterror agents Arenaviruses  Lassa (Lassa fever)  Junín (Argentine hemorrhagic fever) Coxiella burnetti (Q fever) Brucella species (brucellosis) Burkholderia mallei (glanders) alpha viruses Venezuelan encephalomyelitis eastern and western equine encephalomyelitis Equine encephalomyelitis Epsilon toxin of Clostridium perfringens Staphylococcus enterotoxin B Nipha virus Hanta virus HIV SARS variola major (smallpox) Bacillus anthracis (anthrax) Yersinia pestis (plague) Clostridium botulinum toxin (botulism) Francisella tularensis (tularaemia) Filoviruses  Ebola hemorrhagic fever  Marburg hemorrhagic fever Category B CategoryA Category C
  • 5. pg. 4 BIOTERRORISM Methods of delivering biological agents: Delivery methods contributed significantly in the mass destructive potential of a weapon there by making it a WMD (weapon of mass destruction). The mass destructive capability of a weapon was dependent on the means used to deliver the weapon at the target. Once the agent was released on target, the deliberate outbreak of disease would follow the same pathway of infection as in the case of a natural disease. (htt15) There are several method for disseminating biological agents. These way are related to our daily life that’s why it’s easy to disseminate the agents among the peoples. It includes Food/water, Air handling systems, Aircraft sprayers, Human vector, Animal vector, Hand sprayers, and vehicle sprayers. Some of the paths that had been identified for infecting animate targets from several bioterrorism attacks included: inhalation, ingestion, or percutaneous inoculation. Planning & response: It involves the development of biological identification system. Recently in the U.S.A most biological defense strategies have geared to protecting soldiers on the battlefield rather than ordinary people in the cities. (wikipedia, n.d.)
  • 6. pg. 5 BIOTERRORISM Preparedness: The word preparedness means readiness for something here it refers, the readiness for bioterrorism attack. Biological agents are relatively easy to obtain by terrorist and becoming more threating in the U.S laboratories are working on advanced detection system to provide early warning at risk and to facilitate prompt treatment. Aspect of protection against Bioterrorism in the U.S.A includes: It include several protection from bioterrorism attack in the USA. Basically there are many organizations (governmental and nongovernmental) those work together to protect their country from bioterror attack. This are not a onetime approach. They always analysis the environmental data and prepare their team as well as their country’s people to protect them from attack. Several aspects are discussed below about protection from bioterrorism attack- Detection and resilience strategies in combating Bioterrorism - It occurs primarily through the efforts of the office of health affairs, whose role is to prepare for an emergency situation that impacts the health of the American populace. First there is an OHA’s Bio watch programme in which collection devices are disseminated to thirty high risk areas throughout the country to detect the presence of aerosolized biological agents before symptoms present in patients. Implementation of the Gen-3 automated detection system - This advancement is significant simply because it enables action to be taken in four to six hours due to its automatic response system, whereas the previous system required aerosol detectors to be manually transported to laboratories.
  • 7. pg. 6 BIOTERRORISM Enhancing the technological capabilities of first responders - It is accomplished through numerous strategies. The first of these strategies was developed by the Science and Technology Directorate (S&T) of DHS to ensure that the danger of suspicious powders could be effectively assessed, (as many dangerous biological agents such as anthrax exist as a white powder). By testing the accuracy and specificity of commercially available systems used by first responders, the hope is that all biologically harmful powders can be rendered ineffective. Enhanced equipment for first responders - One recent advancement is the commercialization of a new form of Tyvex™ armor which protects first responders and patients from chemical and biological contaminants. There has also been a new generation of Self-Contained Breathing Apparatuses (SCBA) which has been recently made more robust against bioterrorism agents. Excelsior challenge - In the second week of September 2016, the state of New York held a large emergency response training exercise called the Excelsior Challenge, with over 100 emergency responders participating. Project Bioshield - The accrual of vaccines and treatments for potential biological threats, also known as medical countermeasures has been an important aspect in preparing for a potential bioterrorist attack; this took the form of a program beginning in 2004, referred to as Project BioShield.
  • 8. pg. 7 BIOTERRORISM Biosurveillance: In 1999, the University of Pittsburgh’s for biomedical informatics deployed the first automated Bioterrorism detection system called RODS (Real time outbreak disease surveillance). RODS are designed to collect data form sources including clinical data, laboratory data and data form over the counter drug sales. CDC guideline for peoples: Sometimes it’s quite difficult to reach people for some circumstances as well as it’s not possible to serve all people at a time for government. That’s why peoples has some responsibility and duty before, during and after biological attack. CDC (centers for disease control and prevention) explained the duty and responsibility of peoples by following. (htt16) Before a biological threat: A biological attack may or may not be immediately obvious. In most cases local health care workers will report a pattern of unusual illness or there will be a wave of sick people seeking emergency medical attention. The public would be altered through an emergency radio or Tv broadcast, or some other signal used in your community, such as a telephone call or a home visit form an emergency response worker. The following are things that can do to protect peoples from the effect of biological threat like Build an emergency supply kit; Make a family emergency plan; Check with doctor to ensure all required or suggested immunizations are up to date; considering installing a High-Efficiency particulate Air filter. All activities those are discussed in the planning and response section are preformed form government site for safety of their peoples.
  • 9. pg. 8 BIOTERRORISM During a biological threat: The first evidence of an attack may observed when symptoms of the disease caused by exposure to an agent. In the event of a biological attack, public health officials may not immediately be to provide information on what people should do. It will take time to determine exactly what illness is, how it should be treated, and who is in danger. Follow these guidelines during a biological threat like watch TV, listen to the radio, or check the internet for official news and information including assigns and symptoms of the disease areas in danger, if medication or vaccination are being distributed and where people should seek medical attention if they become ill; depending on the situation, wear a face mask to reduce inhaling or spreading germs; follow instruction of doctor and other public health officials; if the disease is contagious expect to receive medical evaluation and treatment; do not share food or utensils. After a biological threat: Pay close attention to all official warning and instruction on how to proceed. The delivery of medical services for a biological event may be handled different to respond to increase demand. Pay close attention to all official warnings and instruction on how to proceed. Conclusion: Bioterrorism remains a legitimate threat both from domestic and international terrorist groups. From a public health perspective, timely surveillance, awareness of syndromes resulting from bioterrorism, epidemiologic investigation capacity, laboratory diagnostic capacity and the ability to rapidly communicate critical information on a need to know basis to manage public communication through the media are vital. Ensuring adequate supply of drugs, laboratory reagents, antitoxins and vaccines is essential.
  • 10. pg. 9 BIOTERRORISM List of bioterrorism attack during the past2000 years Time Event 1155 Emperor Barbarossa poison water well with human bodies in Tortora, Italy. 1495 Spanish mix wine with blood of leprosy patient to sell their French foes in Naples, Italy. 1710 Russian troops catapult human bodies of plague victim into Swedish cities. 1763 British distribute blankets from small pox patients to Native American, World War I German and French agents use ganders and anthrax. World War II Japan uses plague, anthrax and other disease. 1980- 1988 Iraq uses mustard gas, sarin and tabun against Iran and ethnic groups inside Iraq during the person gulf war. Cases associated with Biological agents Anthrax: Experts believe that today, the most likely organism to be used in a bioterrorism attack would be Bacillus anthracis, the bacteria that causes anthrax. It is widely found in nature, easily produced in the laboratory, and survives for a long time in the environment. Also, it is versatile and can be released in powders, sprays, water, or food. Anthrax has been used before. In 2001, anthrax spores were sent through the United States postal system. In all, 22 people contracted anthrax, five of whom died. And, the guilty party was never caught.
  • 11. pg. 10 BIOTERRORISM Small pox: Another potential agent of bioterrorism is smallpox, which, unlike anthrax, can spread from person to person. Smallpox is no longer a disease of concern in the natural world, because concerted vaccination efforts stamped it out and the last naturally spread case occurred in 1977. However, if someone were to gain access to the smallpox virus (it is still kept in two laboratories — one in the U.S. and one in Russia), it could be an effective weapon, spreading quickly and easily between people. Plague: I have already mentioned the Tartars' use of the plague, Yersinia pestis, hundreds of years ago, but some believe that it could be used in the modern world, too. Y. pestis is passed to humans through the bite of a flea that has fed on infected rodents. Once a human is infected, the resulting disease can either develop into bubonic plague, which is difficult to transmit among humans and fairly easy to treat with antibiotics, or if the infection spreads to the lungs it becomes pneumonic plague, which develops rapidly and does not respond well to antibiotics. Tularemia: Some consider tularemia, an infection caused by the Francisella tularensis bacterium, as a potential bioweapon. It causes fever, ulcerations, swelling of lymph glands, and, sometimes, pneumonia. The bacterium can cause infection by entering through breaks in the skin or by being breathed into the lungs. It is particularly infectious, and only a very small number of organisms (as few as 10) need to enter the body to set off a serious bout of tularemia. Studied by the Japanese during World War II and stockpiled by the U.S. in the 1960s, F. tularensis is hardy, capable of withstanding low temperatures in water, hay, decaying carcasses, and moist soil for many weeks.
  • 12. pg. 11 BIOTERRORISM References (n.d.). Retrieved from https://www.ready.gov/Bioterrorism (n.d.). Retrieved from http://shodhganga.inflibnet.ac.in/bitstream/10603/29372/8/08_chapter%203. pdf (n.d.). Retrieved from https://www.cdc.gov/healthcommunication/toolstemplates/entertainmented/t ips/Bioterrorism.html Newman, T. (2018, February 28). MedicalNewsToday. Retrieved from www.google.com: https://www.medicalnewstoday.com/articles/321030.php ready.gov. (n.d.). Retrieved from https://www.ready.gov/Bioterrorism S.Ridel. (2004). Biological warfare and Bioterrorism: Historical overview. NCBI- NIH, 1. wikipedia. (n.d.). Retrieved from https://en.wikipedia.org/wiki/Bioterrorism