Biological hazards (biohazards) have long been recognized as a potential threat to the U.S. Department of Defense (DoD) and could originate from naturally occurring, accidental, and deliberate sources.1 The Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) pandemic illustrated how a biological incident (bioincident) caused by an emerging infectious disease (EID) could impact the Joint Force. The risk of future pandemics from novel EIDs continues to increase due to multiple factors. In addition, while advancements in fields including biotechnology, nanotechnology, and artificial intelligence have the potential to revolutionize medicine, there is also the potential for misuse by adversaries.2  In response to this unprecedented biothreat environment, the U.S Government and the DoD have taken significant steps to assess and bolster biological defense (biodefense), that are outlined in the following documents:

This guideline is designed to align with the objectives from the above documents. This CPG also aligns with DoD Medical Readiness Training policy DoD Instruction (DoDI) 1322.24, because it augments existing training material for triage, treatment, and management of patients exposed to biological agents.4  

This document is intended to be a general framework for military clinical personnel which consolidates and links to more detailed resources. Other referenced resources focus heavily on specific biothreats, and a vital goal of this guideline is to focus on augmenting clinical reasoning. An all-hazards clinical approach to biodefense would effectively capture all biothreats in an agnostic manner and would not require the traditional split into endemic and biowarfare agents. For that reason, this CPG is structured with the general all-hazards clinical approach with more detailed appendices for those interested in a particular area. Because Combatant Commands (CCMDs) greatly differ in climate, terrain, and resources, the JTS CPGs are not representative of a specific CCMD or contingency. Services, unit organizations, and other relevant stakeholders should tailor the concepts herein to unit missions, deployed settings, and unique situations. While doctrine is referenced in this document, this CPG is not DoD or Service doctrine and should not be misconstrued as such. This CPG will be updated as rapidly as possible as new threats emerge, or as new information on medical countermeasures (MCMs) are developed.  Figure 1 below serves as a quick guide to this CPG with hyperlinks to key topics, tables, and figures.