Biological Warfare

No Master Plan for Dealing with the Impact of Biological Weapons


Terror in the Air
by Laurie Garrett

Source: The Star
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February 25, 2001

It's getting easier to mass-produce deadly biological weapons; at the same time, supplies of vaccines to counter such killer viruses

As the 21st century gets under way, the following nations possess biological weapons: Iraq, Iran, Syria, Libya, China, North Korea, Russia, Israel and Taiwan. It's possible that Sudan, India, Pakistan and Kazakhstan also have them.

The list cuts across lines of ideology, politics and geography. In addition, according to intelligence sources in Europe and the United States, militant political groups around the globe are now developing or seeking to purchase biological weapons for terrorist use.

Meanwhile, the sophistication of biological weaponry has improved by leaps and bounds.

Until 1985, all of the world's biological-weapons makers were stuck with the same list of pathogens and toxins that could kill thousands of enemies and be delivered with missiles or large-scale aerosol systems. Each nation knew the list and stocked antidotes and vaccines. It was a standoff.

But biology in the last decade has been what physics was in the 1940s and 1950s: a field of exponential discovery. What seemed impossible in 1980 was accomplished by 1990 and, by 2000, had become ho-hum fodder for high school biology classes.

By the late 1990s, a massive pool of bioengineers had emerged, equipped with genetic blueprints to guide their efforts. Determining the genetic sequence of a virus, such as Ebola, was no longer much of a feat. In 1998, scientists at the Frederick Cancer Research Centre in Maryland determined, at the genetic level, exactly how anthrax kills human cells.

Just last week, a science conference in San Francisco was told that researchers are close to producing artificial viruses, a development that could be misused in the wrong hands.

`If smallpox is totally destroyed, someone could make smallpox again'
- Clyde Hutchinson, microbiologist

``If smallpox is totally destroyed, someone could make smallpox again,'' American microbiologist Clyde Hutchinson told the conference.

Jonathan Moreno, a biotechnology ethicist, said artificial viruses could lead to frightening new weapons.

``It obviously goes directly to the question of biological (warfare) agents,'' he said.

In response to such advances, Western nations are hardening their military defences against biological warfare as they vaccinate troops, stockpile antitoxins, store appropriate antibiotics, purchase protective suits and masks, practise war-game drills involving biological weapons and support research on potential microbe-detecting devices.

But no one has a master plan for dealing with the collateral impact of biological weapons on civilians located around the combat zone - or the deliberate impact of bioterrorist damage inflicted on an unsuspecting community.

Were a terrorist to disperse the smallpox virus, for example, populations that were once universally vaccinated would now be horribly vulnerable.

Today, the U.S. government stows only about 15.4 million doses of the smallpox vaccine - enough for less than 7 per cent of the American population.

The World Health Organization (WHO) keeps another 500,000 doses in the Netherlands, and other national stockpiles total about 60 million more doses of varying quality and potency.

(In Ontario, a spokesperson for the provincial health ministry says the government has no stockpiles of smallpox vaccine.)

If the smallpox virus were released today, the majority of the world's population would be defenceless. Given the virus' 30 per cent kill rate, nearly 2 billion people could die.

The picture worsened in 1999, when scientists discovered that the U.S. samples of the smallpox vaccine had severely deteriorated.

Originally made in the 1970s by the Wyeth pharmaceutical company, the samples were stored at the Centres for Disease Control and Prevention (CDC) in Atlanta in the form of freeze-dried crystals parcelled out in 100-dose quantities inside vacuum-sealed glass tubes. The tubes were further sealed with rubber stoppers secured by metal clamps.

To their dismay, CDC investigators discovered condensation in many of the glass tubes, indicating that the rubber stoppers had decayed and vacuum pressure had been lost. Such vaccine supplies can no longer be considered safe for human use.

The rest of the world's vaccine reserves have not undergone similar scrutiny, but experts don't have much confidence in those, either.

Furthermore, the world's supplies of bifurcated needles - uniquely designed for scratch-administering the smallpox vaccine on human skin - have been depleted and companies are no longer interested in manufacturing such specialized devices.

The world is thus completely vulnerable to a smallpox attack.

The last time a mass emergency vaccination took place in the United States was 1947, when a traveller from Mexico spread smallpox to New York City. Vaccines were then readily available and 6.35 million New Yorkers were immunized in less than four weeks.

In 1961, a similar vaccination campaign was administered following a smallpox outbreak in England: 5.5 million people were immunized in a month's time. A decade later, smallpox cases in Yugoslavia prompted the rapid vaccination of 20 million people.

Were a smallpox crisis to emerge today, none of these efforts could be repeated.

Even if large stockpiles of the smallpox vaccine could be collected immediately, they would be of limited value for two reasons: Victims would develop recognizable symptoms only several days after infection, by which time thousands - even millions - of people would have been exposed; and people would develop sufficient antibodies to stave off infection only several days or weeks after vaccination.

For other diseases preventable by vaccine, such as anthrax, the lag time between inoculation and the development of powerful antibodies could be far longer - up to a year, even with boosters.

And, of course, immunization efforts would be useless against vaccine-resistant pathogens, such as those created by scientists in the former Soviet Union working on anthrax weapons.

Furthermore, a determined bioterrorist could simply try a succession of microbial weapons - or use a cocktail at the outset - defying even the best-organized vaccination programs.

The cost of a delayed response to an anthrax attack would be staggering, explains CDC economist Martin Meltzer.

In a city of 100,000 people, Meltzer says, the number of deaths would be 5,000 if a vaccination program began on the day after an attack, ``versus 35,000 on day six.''

Cities large and small, then, should start stockpiling relevant antibiotics, vaccines and general medical supplies.

But even if cities were well-equipped for a bioterrorist attack, they still would have a difficult time recognizing that such an attack had occurred.

Local authorities ``probably aren't going to be able to recognize it has happened . . . until the incubation period is over,'' says Clark Staten, executive director of the Emergency Response and Research Institute in Chicago.

``And by then, you've got it spread over a wide area. And it may take longer to recognize there's a pattern going on.''

Once an outbreak is recognized, an epidemiologist would be dispatched to identify the cause. If the pathogen were fairly common, like Clostridium botulinum (the bacterium that causes botulism, a potentially fatal food poisoning), local hospital laboratories could probably identify the culprit quickly.

But if the microbes were rare, like those that cause anthrax, Q fever, Ebola, smallpox or the plague, local facilities would probably be unable to diagnose the problem.

With precious time passing, people dying and disease possibly spreading, local officials would then have to await word from the diagnostic labs at the CDC.

If the suspected pathogen were highly deadly, like the smallpox virus, the analysis would be handled in the CDC's Special Pathogens laboratory, which is normally staffed by fewer than a dozen highly specialized scientists. And during a crisis, it would be difficult to find qualified supplementary staff to scale up operations.

During the 1995 Ebola outbreak in Zaire, for example, the lab was staffed by a mere six scientists who toiled around the clock trying to identify the presence of the lethal virus in some 30,000 tissue, blood, plant, insect and animal samples.

In the case of a bioterrorist attack, valuable time - and lives - might be lost during such an arduous process.

In a large urban centre, the true costs of a bioterrorist attack might be the consequences of panic, such as a stock market collapse in New York or a commodities market crash in Chicago.

Handfuls of Internet-hooked extremists, right-wing militia members, psychologically unbalanced belligerents and postmodern Fascists are well-versed in the fine points of bioterrorism.

Recipes for producing botulinum and anthrax are posted on the Web. Books describing biological-warfare assassination techniques are readily available. Some private militia groups in the U.S. train to use biological weapons.

Indeed, law-enforcement leaders claim that American religious cults and militant political groups are likely to engage in biological terrorism.

After all, they argue, the first bioterrorist attack in the U.S. was carried out by members of an Oregon-based religious cult led by Bagwan Shree Rajneesh.

The cult members, hoping to disrupt an upcoming county election, contaminated local salad bars with salmonella, infecting hundreds of Oregonians.

Perhaps it is the tone of some militants' rhetoric that sparks the most concern.

In The Poisoner's Handbook, for example, Maxwell Hutchkinson suggests that readers poison or kill Internal Revenue Service workers by filling out phony tax-return forms and lacing them with a mixture of ricin (a poisonous protein) and dimethylsulfoxide (DMSO) - a concoction Hutchkinson claims is 100-per-cent lethal.

``The purpose of all this is to disrupt the operations'' of the IRS, Hutchkinson writes. ``If done on a large-enough scale, it would serve two purposes - it would make it more difficult for the IRS to operate efficiently, thus helping tax cheats and tax protesters. It might also awaken the politicians to the depth of resentment felt by the taxpaying public.''

Fortunately, Hutchkinson is a lousy chemist: Only simple chemicals - not proteins such as ricin - can dissolve in DMSO.

But the depth of his antagonism is unmistakable. He suggests that readers kill Catholics by soaking their victims' rosary beads in phytotoxin abrin, a toxin derived from a rare bean.

He writes that botulinum is ``fun and easy to make'' and he urges survivalists around the world to hone their skills, readying themselves for biological warfare in the coming Armageddon.

In response to such threats, the U.S. Congress has passed a number of laws aimed at making it harder for anyone - domestic or foreign - to attack the U.S. with biological weapons.

In 1989, Congress passed the Biological Weapons Act, outlawing the possession, trade, sale or manufacture of a biological substance ``for use as a weapon.''

In 1991, it enacted an embargo, soon enforced against Iraq, barring U.S. companies from trading with countries believed to be developing biological weapons.

After the 1995 Oklahoma City bombing, Congress passed the Anti-Terrorism Act of 1996, allowing federal authorities to arrest anyone who even ``threatens'' to develop or use biological weapons.

And the following year, by order of Congress, the CDC named 24 infectious organisms and 12 toxins as ``restricted agents,'' the use or possession of which requires a federal permit.

Although these measures provide legal instruments for federal law-enforcement officials, it is impossible to judge how effectively they have, or have not, deterred biological terrorism.

The administration of former president Bill Clinton hoped to stave off the worst threats by training the National Guard and local hazardous-material defence teams to rapidly respond to bioterrorist attacks.

But the teams, comprising elite local police squads and fire department personnel, handled chemical and biological threats as if they were roughly synonymous - a fatal mistake, according to biologists.

Having been trained in techniques for limiting the spread of lethal chemicals, the defence teams assumed that a visible source of contamination could be identified, that exposed individuals could be isolated and that a toxin could be swiftly cleared out of the environment with water or neutralizing chemicals.

None of these assumptions holds true for lethal microbes, biologists point out, because their long incubation periods in potentially contagious human beings render it nearly impossible to identify and contain a source.

Furthermore, ``washing'' an area contaminated with pathogens might only spread them.

Even the simplest technological defence against biological weapons has proven to be too much for department of defence contractors.

Last spring, Pentagon officials revealed that the protective suits U.S. troops had relied on during the Persian Gulf War (and that still form the basis of soldiers' defence against deadly microbes) were defective.

At least 5 per cent of the 900,000 suits the Pentagon had purchased during the 1990s were useless and the reliability of the entire inventory was suspect.

It seems unlikely, then, that a technological quick fix will soon be found. The three immediate U.S. responses to bioterrorism - military defence, hazardous-material defence teams and high-technology sensors - appear to be seriously flawed.

Published by Foreign Affairs Magazine. Adapted from Laurie Garrett's book Betrayal Of Trust: The Collapse Of Global Public Health.

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