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Because biological incidents can cross jurisdictional boundaries and have cascading effects, coordinated response and recovery efforts will include organizations at all levels of government, the private sector, non-governmental organizations (NGOs), and, potentially, international partners. Planning for a biological incident requires considerations beyond a general, all-hazards approach to preparedness; this document focuses on strategic issues and critical considerations that are specific to infectious diseases and biological incidents.


The purpose of this document is to identify key areas where appropriate planning among key partners and stakeholders can significantly enhance the response to and recovery from a biological incident. It serves as a comprehensive update of the April 2017 Key Planning Factors and Considerations for Response to a Biological Incident and now includes planning considerations for recovery, issues related to household pets and service animals, non-pharmaceutical interventions (NPIs), medical countermeasures (MCMs), and public fear during a biological incident.

Although they may vary based on the size, scope, and complexity of a particular incident, the overall challenges posed by a biological incident and corresponding menu of response and recovery measures to be considered will be similar regardless of agent or disease vector. These include consideration of the pathogen causing disease, potential intentionality of the incident, availability of specialized MCMs, long-term contamination, etc. For this reason, the document does not describe planning approaches to specific biological incident scenarios (e.g., template plans for various individual pathogens). Rather, it provides key planning factors (KPFs) and considerations applicable across a range of potential biological incident types.


The scope of this document is planning for biological incidents in state, local, tribal, and territorial (SLTT) jurisdictions throughout the United States (U.S.). While most international issues are beyond the scope of this document and are addressed principally at the federal level, some considerations are included here as they may relate to SLTT biological incident response and recovery. Readers are directed to the Biological Incident Annex to the Response and Recovery Federal Interagency Operational Plans (BIA; FIOP) for additional information on the United States government’s (USG’s) international engagement during a biological incident.

Foodborne and agricultural incidents are also beyond the scope of this document, and readers are directed to the National Food and Agriculture Incident Annex to the Response and Recovery Federal Interagency Operations Plans (FAIA; FIOP) for additional information.


This document supports education, awareness, and guidance for the development of effective biological incident plans at the SLTT and regional levels. The intended audience is SLTT emergency management planners.

Organization of Document

This document is organized into seven sections:

  • Crosscutting Considerations: Provides background on biological incidents, past examples, common characteristics across all types of pathogens, planning considerations, and relevant authorities and legislation.
  • KPF 1: Detect and Characterize the Threat- Offers an overview of biological incident detection, incident characterization, initial response, and considerations for criminal investigations.
  • KPF 2: Communicate with External Partners and the Public- Identifies effective communication strategies to provide public information and to collaborate with partners for a coordinated response and recovery effort.
  • KPF 3: Control the Spread of Disease- Describes types of NPIs, access to MCMs, environmental containment, source reduction, and decontamination during biological incidents.
  • KPF 4: Augment Provision of Mass Care and Human Services to the Affected Population- Explains mass care considerations for shelter-in-place or restricted movement scenarios and for evacuation scenarios. Additional information on mental health, public fear, and household pets and service animals is also included.
  • KPF 5: Augment Provision of Health and Medical Services to the Affected Population- Details medical care considerations, healthcare resilience, and fatality management.
  • KPF 6: Augment Essential Services to Achieve Recovery Outcomes- Reviews recovery planning, indicators, and priorities for a biological incident including considerations for long-term recovery. Supporting the affected community through Recovery Support Functions (RSFs) is also discussed.

These KPFs are augmented by Planning, Decision-Support, and Modeling Resources for Biological Incidents and various appendices, which provide additional reference materials that will be useful when developing plans and implementing the actions recommended throughout the document.