In summary, this chapter has described the four major biothreat toxins, botu-linum neurotoxin ricin, staphylococcal enterotoxin B, and Clostridia perfrin-gens epsilon toxin. The common forensic threat for these threat agents is that the first indication of a bioterror event is likely to be the appearance of intoxicated patients at local hospitals. Rapid appreciation that a biothreat event has occurred is dependent on astute clinicians and a reporting system that can recognize the clustering of cases with a common clinical presentation consistent with intoxication. It is important to recognize that the toxins are all proteins composed of amino acid building blocks. As such, they have a number of forensic features that distinguish them from viral or bacterial threat agents. First, they are not contagious, as the threat agent is not a living organism. For the same reason, these agents cannot be routinely cultured from either patients or the environment after exposure, making forensic detection more difficult. Since proteins are composed of amino acids and not nucleic acid, it is also not possible to amplify and detect the presence of toxins using PCR, or by any type of classic DNA hybridization technology. Rather, detection typically relies on the use of antibodies and serologic testing. Environmental and patient sampling followed by serologic testing is likely to provide the greatest amount of forensic information.
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