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Bioterrorism, Protective Measures

Bioterrorism, Protective Measures

K. LEE LERNER

Bioterrorism is the deliberate use of microorganisms or the poisonous compounds that can be produced by some microbes as weapons. Bioterrorism can be a well-organized government sanctioned weapons development program, or can involve a small group of people dedicated to their particular cause.

In the past, the weapons employed by nations were more easily recognizable and defendable. For example, surveillance allows missile silos to be detected, and counter-strategies put in place to deal with the launch of the missiles. Microorganisms, however, by virtue of their small size can be readily hidden from detection. A vial of anthrax sporessmall enough to conceal in a pocketcan be released into the ventilation system of a building.

The ability to protect against the use of biological weapons is becoming recognized as one of the paramount security issues facing nations such as the United States.

The need for protective measures against bioterrorism was dramatically evident in the aftermath of the September 11, 2001 terrorist attacks on the United States, when a lethal form of the anthrax bacterium that could be inhaled was mailed to U.S. government leaders, media representatives, and citizens. The form that readiness and response strategies should take is the subject of much public debate.

A range of protective options exist. These include the mass production and stockpiling of antibiotics (i.e., ciprofloxacin, which is normally effective against the bacterial agent of anthrax) and the resumption of offensive biological weapons programs by countries such as the United States (where offensive research was halted in 1968). However, no single solution will provide protection against the many potential biological weapons. Indeed, an argument has been made that a targeted response (e.g., broadly inoculating the public against the virus causing smallpox) might actually lower overall preparedness by diverting personnel and funding from fundamental research programs that could help spawn a variety of protective measures.

The various protective measures to bioterrorism can be divided into three general categories. These are strategic, tactical, and personal measures.

Strategic deterrence can involve international cooperation. For example, late in 2001, the United States and NATO (North Atlantic Treaty Organization) allies reaffirmed treaty commitments that the use weapons of mass destruction (i.e., biological, chemical, or nuclear weapons) against any member state would represent an attack against all NATO members. As of June 2002, this deterrence was pointed at statesin particular Iraqthat have programs to develop or use biological weapons, or which provide aid to bioterrorists.

Tactical measures involve the use of devices or weapons to detect or eliminate potential biological weapons. The United States has a variety of tactical non-nuclear options, which include precision-guided conventional thermal fuel-air bombs. In the 1990s military campaigns in the Gulf region, for example, these bombs were used to destroy facilities that were suspected of being factories for the production of biological warfare agents and weaponry.

Terrorist operations are enigmatic and elusive. As a result, these large-scale military responses offer protection against only the largest, identifiable, and targetable enemies. Such responses are inadequate when the hostility is due a small number of people operating in a clandestine way in other countries, or even citizens targeting their own country. For example, according to expert testimony before the Congress, for less than 10,000 U.S. dollars, a laboratory capable of producing spores of the anthrax bacterium could be built in the basement of a typical house. Surveillance of every structure in a country is beyond the scope of established security agencies and, in a democratic country, would severely curtail individual liberties.

Reestablishing offensive weapons programs is a contentious issue. An argument has been made that an offensive program would further the understanding of potential biological agents and weapons delivery mechanisms. However, many scientists and physicians argue instead that an offensive program is unneeded and could possibly be detrimental to the development of effective protective measures, because of the diversion of funding from less visible but vital preventative research. Resumption of an offensive bioweapons programs in the United States would violate the Biological Weapons Convention to which the United States is a signatory.

Rather than a polarized offensive-versus-preventative national policy, scientific bodies in the United States that include the National Institutes of Health and the Centers for Disease Control and Prevention (CDC) advocate a balanced and flexible scientific and medical response to the need to develop protective measures against the variety of disease causing pathogens in the arsenal of the bioterrorist.

Preparedness programs designed to allow a rapid response to bioterrorism also accompany the increased research. One example is the National Pharmaceutical Stockpile Program (NPS). The NPS stockpile of antibiotics, vaccines, and other medical treatment countermeasures is can be rapidly deployed to the site of a domestic attack. For example, in the aftermath of the deliberate release of Bacillus anthracis (the bacteria that causes anthrax) during the 2001 terrorist attacks, the United States government and some state agencies were able to quickly provide the antibiotic ciprofloxacin (Cipro) to those potentially exposed to the bacterium.

Following these bioterrorist attacks, increase funding for the NPS was authorized. The additional funds will help train medical personnel in the early identification and treatment of disease caused by the most likely pathogens.

Such steps are commendable, but will not provide comprehensive and effective protection to biological terrorism. Indeed, such protection may not be possible.

Advocates of increased research capabilities argue that laboratory and hospital facilities must be increased and modernized to provide maximum scientific flexibility in the identification and response to biogenic threats. The CDC has already established a bioterrorism response program that includes increased testing and treatment capacity. The plan also envisions an enhanced ability to recognize and respond to the illness patterns that are characteristic of the deliberate release of an infectious agent.

An informed and watchful public is a key element in early detection of biological pathogens. Knowing this, the CDC web site contains a list of potential biological threats. As of July 2002, approximately 36 microbes had been identified (e.g., Ebola virus variants, plague bacterium, etc.) as potential bioterrorist weapons.

Other protective and emergency response measures include the development of the CDC Rapid Response and Advanced Technology laboratory, a Health Alert Network (HAN), National Electronic Data Surveillance System (NEDSS), and Epidemic Information Exchange (Epi-X). These responses are designed to coordinate information exchange to enhance the early detection and identification of biological weapons.

The United States Department of Health and Human Services 1999 Bioterrorism Initiative committed funds to initiate or reinforce some of these protective measures. Following the September 11, 2001 terrorist attacks on the United States, the U.S. Congress more than doubled the previous funding for bioterrorism research. Soon thereafter, the Bioterrorism Preparedness and Response Program (BPRP) was created. The BPRP seeks to increase the number and capacity of laboratories that are capable of identifying pathogens and developing countermeasures to their use.

An essential component of a preventative response including effective therapeutic treatments is basic research into the biology and disease mechanisms of the disease causing microorganisms. In response to terrorist attacks, in February 2002, the U.S. National Institute of Allergy and Infectious Diseases (NIAID) undertook a review of current research efforts. The panel of experts convened for this task hopes to recommend research thrusts that will more effectively anticipate and counter potential terrorist threats. An immediate outcome of the panel's deliberations was an increased emphasis on basic research involving smallpox, anthrax, botulism, plague, tularemia, and viral hemorrhagic fevers.

In addition to medical protective measures, a terrorist biological weapon attack targeted at humans would, at a minimum, overburden medical infrastructure. Medical personnel and supplies would be in short supply. As well, the costs of responding to attacks would cause economic havoc. Alternatively, a biological weapon that spared humans but targeted domestic animals or crops could cause famine and economic ruin.

On a local level, cities and communities are being encouraged to develop specific response procedures in the event of bioterrorism. Most hospitals are now required to have response plans in place as part of their accreditation requirements.

Another aspect of prevention focuses on the drinking water supply of communities. Many microorganisms or their poisons readily dissolve in water, and so can be spread to a population virtually undetected. As well, water supplies and distribution systems have bee designed for efficiency of water disinfection and deliver, not for security. Because of this, many communities have placed extra security on water supply and treatment facilities. The U.S. Environmental Protection Agency (EPA) has increased monitoring and working with local water suppliers to develop emergency response plans.

It is beyond the scope of this article to discuss specific personal protective measures. Indeed, given the complexities and ever-changing threat, it would not be prudent to offer such specific medical advice. However, a number of general issues and measures can be discussed. For example, military surplus gas masks provide only the illusion of protection. They offer no real protection against biological agents, and should not be bought for that purpose. Personnel stockpiling of antibiotics is unwise. The potency of antibiotics such as Cipro declines with time. Moreover, the inappropriate use of antibiotics actually can lead to the development of bacterial resistance and a consequential lowering of antibiotic effectiveness.

On the other hand, a few days supply of food and water and the identification of rooms in homes and offices that can be temporarily sealed with duct tape to reduce outside air infiltration is a wise precaution.

More specific response plans and protective measure are often based upon existing assessments of the danger posed by specific diseases and the organisms that produce the disease. For example, Anthrax (Bacillus anthracis ), Botulism (Clostridium botulinum toxin), Plague (Yersinia pestis, Smallpox (Variola major, Tularemia (Francisella tularensis, viral hemorrhagic fevers (e.g., Ebola, Marburg), and arenaviruses (e.g., Lassa) are considered high-risk high-priority. These agents do share a common trait of being easily spread from person to person. And, they all can kill many of those who are infected. But, the natures of the diseases they cause are very different. A response that is effective against one microorganism may well be useless against another.

The protective measures that are in place against smallpox and anthrax remain controversial. Vaccines against both diseases are available. However, both vaccines carry the risk of serious side effects. In the absence of a confirmed case of smallpox, the CDC's position is that the risks of resuming general smallpox vaccination out-weigh the potential benefits. Vaccine is available for use in a bioterrorist emergency, when the benefits of mass vaccination could well outweigh the risks of harm due to the vaccine. Moreover, vaccines delivered and injected during the incubation period for smallpox (approximately 12 days) convey at least some protection from the ravages of the disease.

Also controversial remains the safety and effectiveness of an anthrax vaccine used primarily by military personnel.

BOOKS:

Henderson, D.A., and T.V. Inglesby. Bioterrorism: Guidelines for Medical and Public Health Management. Chicago: American Medical Association, 2002.

Inglesby, Thomas V. "Bioterrorist Threats: What the Infectious Disease Community Should Know about Anthrax and Plague." Emerging Infections 5 Washington, D.C.: American Society for Microbiology Press, 2001.

ELECTRONIC:

World Health Organization. "Strengthening Global Preparedness for Defense against Infectious Disease Threats." Statement to the United States Senate Committee on Foreign Relations Hearing on The Threat of Bioterrorism and the Spread of Infectious Diseases. 5 September 2001. <http://www.who.int/emc/pdfs/Senate_hearing.pdf> (24 November 2002).

SEE ALSO

Anthrax, Terrorist Use as a Biological Weapon
Biological Warfare
USAMRIID (United States Army Medical Research Institute of Infectious Diseases
Vaccines

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LERNER, K. LEE. "Bioterrorism, Protective Measures." Encyclopedia of Espionage, Intelligence, and Security. 2004. Encyclopedia.com. 27 May. 2016 <http://www.encyclopedia.com>.

LERNER, K. LEE. "Bioterrorism, Protective Measures." Encyclopedia of Espionage, Intelligence, and Security. 2004. Encyclopedia.com. (May 27, 2016). http://www.encyclopedia.com/doc/1G2-3403300096.html

LERNER, K. LEE. "Bioterrorism, Protective Measures." Encyclopedia of Espionage, Intelligence, and Security. 2004. Retrieved May 27, 2016 from Encyclopedia.com: http://www.encyclopedia.com/doc/1G2-3403300096.html

Bioterrorism, Protective Measures

Bioterrorism, protective measures

In the aftermath of the September 11, 2001 terrorist attacks on the United States and the subsequent anthrax attacks on U.S. government officials, media representatives, and citizens, the development of measures to protect against biological terrorism became an urgent and contentious issue of public debate. Although the desire to increase readiness and response capabilities to possible nuclear, chemical, and biological attacks is widespread, consensus on which preventative measures to undertake remains elusive.

The evolution of political realities in the last half of the twentieth century and events of 2001 suggest that, within the first half of the twenty-first century, biological weapons will surpass nuclear and chemical weapons as a threat to the citizens of the United States.

Although a range of protective options existsfrom the stockpiling of antibiotics to the full-scale resumption of biological weapons programsno single solution provides comprehensive protection to the complex array of potential biological agents that might be used as terrorist weapons. Many scientists argue, therefore, that focusing on one specific set of protective measures (e.g., broadly inoculating the public against the virus causing smallpox ) might actually lower overall preparedness and that a key protective measure entails upgrading fundamental research capabilities.

The array of protective measures against bioterrorism are divided into strategic, tactical, and personal measures.

Late in 2001, the United States and its NATO (North Atlantic Treaty Organization) allies reaffirmed treaty commitments that stipulate the use of any weapon of mass destruction (i.e., biological, chemical, or nuclear weapons) against any member state would be interpreted as an attack against all treaty partners. As of June 2002, this increased strategic deterrence was directed at Iraq and other states that might seek to develop or use biological weaponsor to harbor or aid terrorists seeking to develop weapons of mass destruction. At the tactical level, the United States possesses a vast arsenal of weapons designed to detect and eliminate potential biological weapons. Among the tactical non-nuclear options is the use of precision-guided conventional thermal fuel-air bombs capable of destroying both biological research facilities and biologic agents.

Because terrorist operations are elusive, these largescale military responses offer protection against only the largest, identifiable, and targetable enemies. They are largely ineffective against small, isolated, and dispersed "cells" of hostile forces, which operate domestically or within the borders of other nations. When laboratories capable of producing low-grade weaponizable anthrax-causing spores can be established in the basement of a typical house for less than $10,000, the limitations of full-scale military operations become apparent.

Many scientists and physicians argue that the most extreme of potential military responses, the formal resumption of biological weapons programseven with a limited goal of enhancing understanding of potential biological agents and weapons delivery mechanismsis unneeded and possibly detrimental to the development of effective protective measures. Not only would such a resumption be a violation of the Biological Weapons Convention to which the United States is a signatory and which prohibits such research, opponents of such a resumption argue any such renewal of research on biological weapons will divert critical resources, obscure needed research, and spark a new global biological arms race.

Most scientific bodies, including the National Institutes of Health, Centers for Disease Control and Prevention, advocate a balanced scientific and medical response to the need to develop protective measures against biological attack. Such plans allow for the maximum flexibility in terms of effective response to a number of disease causing pathogens.

In addition to increased research, preparedness programs are designed to allow a rapid response to the terrorist use of biological weapons. One such program, the National Pharmaceutical Stockpile Program (NPS) provides for a ready supply of antibiotics, vaccines, and other medical treatment countermeasures. The NPS stockpile is designed to be rapidly deployable to target areas. For example, in response to potential exposures to the Bacillus anthracis (the bacteria that causes anthrax) during the 2001 terrorist attacks, the United States government and some state agencies supplied Cipro, the antibiotic treatment of choice, to those potentially exposed to the bacterium. In addition to increasing funding for the NPS, additional funds have already been authorized to increase funding to train medical personnel in the early identification and treatment of disease caused by the most likely pathogens.

Despite this increased commitment to preparedness, medical exerts express near unanimity in doubting whether any series of programs or protocols can adequately provide comprehensive and effective protection to biological terrorism. Nonethless, advocates of increased research capabilities argue that laboratory and hospital facilities must be expanded and improved to provide maximum scientific flexibility in the identification and response to biogenic threats. For example, the Centers for Disease Control and Prevention (CDC), based in Atlanta, Georgia, has established a bioterrorism response program that includes increased testing and treatment capacity. The CDC plan also calls for an increased emphasis on epidemiological detection and surveillance, along with the development of a public heath infrastructure capable of providing accurate information and treatment guidance to both medical professionals and the general public.

Because an informed and watchful public is key element in early detection of biological pathogens, the CDC openly identifies potential biological threats and publishes a list of those biological agents most likely to be used on its web pages. As of July 2002, the CDC identified approximately 36 microbes including Ebola virus variants and plague bacterium, that might be potentially used in a bioterrorist attack

Other protective and emergency response measures include the development of the CDC Rapid Response and Advanced Technology Laboratory, a Health Alert Network (HAN), National Electronic Data Surveillance System (NEDSS), and Epidemic Information Exchange (Epi-X) designed to coordinate information exchange in efforts to enhance early detection and identification of biological weapons.

Following the September 11, 2001 terrorist attacks on the United States, additional funds were quickly allocated to enhance the United States Department of Health and Human Services 1999 Bioterrorism Initiative. One of the key elements of the Bioterrorism Preparedness and Response Program (BPRP) increases the number and capacity of laboratory test facilities designed to identify pathogens and find effective countermeasures. In response to a call from the Bush administration, in December 2001, Congress more than doubled the previous funding for bioterrorism research.

Advances in effective therapeutic treatments are fundamentally dependent upon advances in the basic biology and pathological mechanisms of microorganisms . In response to terrorist attacks, in February 2002, the US National Institute of Allergy and Infectious Diseases (NIAID) established a group of experts to evaluate changes in research in order to effectively anticipate and counter potential terrorist threats. As a result, research into smallpox, anthrax, botulism , plague, tularemia , and viral hemorrhagic fevers is now given greater emphasis.

In addition to medical protective measures, a terrorist biological weapon attack could overburden medical infrastructure (e.g., cause an acute shortage of medical personnel and supplies) and cause economic havoc. It is also possible that an effective biological weapon could have no immediate effect upon humans, but could induce famine in livestock or ruin agricultural production. A number of former agreements between federal and state governments involving response planning will be subsumed by those of the Department of Homeland Security.

On a local level, cities and communities are encouraged to develop specific response procedures in the event of bioterrorism. Most hospitals are now required to have response plans in place as part of their accreditation requirements.

In addition to airborne and surface exposure, biologic agents may be disseminated in water supplies. Many communities have placed extra security on water supply and treatment facilities. The U.S. Environmental Protection Agency (EPA) has increased monitoring and working with local water suppliers to develop emergency response plans.

Although it is beyond the scope of this article to discuss specific personal protective measuresnor given the complexities and ever-changing threat would it be prudent to offer such specific medical advicethere are a number of general issues and measures that can be discussed. For example, the public has been specifically discouraged from buying often antiquated military surplus gas masks, because they can provide a false sense of protection. In addition to issues of potency decay, the hoarding of antibiotics has is also discouraged because inappropriate use can lead to the development of bacterial resistance and a consequential lowering of antibiotic effectiveness.

Generally, the public is urged to make provisions for a few days of food and water and to establish a safe room in homes and offices that can be temporarily sealed with duct tape to reduce outside air infiltration.

More specific response plans and protective measures are often based upon existing assessments of the danger posed by specific diseases and the organisms that produce the disease. For example, anthrax (Bacillus anthracis ), botulism (Clostridium botulinum toxin), plague (Yersinia pestis), smallpox (Variola major), tularemia (Francisella tularensis), and viral hemorrhagic fevers (e.g., Ebola, Marburg), and arenaviruses (e.g., Lassa) are considered high-risk and high-priority. Although these biogenic agents share the common attributes of being easily disseminated or transmitted and all can result in high mortality rates, the disease and their underlying microorganisms are fundamentally different and require different response procedures.

Two specific protective measures, smallpox and anthrax vaccines, remain highly controversial. CDC has adopted a position that, in the absence of a confirmed case of smallpox, the risks of resuming general smallpox vaccination far outweigh the potential benefits. In addition, vaccine is still maintained and could be used in the event of a bioterrorist emergency. CDC has also accelerated production of a smallpox vaccine. Moreover, vaccines delivered and injected during the incubation period for smallpox (approximately 12 days) convey at least some protection from the ravages of the disease.

Also controversial remains the safety and effectiveness of an anthrax vaccine used primarily by military personnel.

See also Anthrax, terrorist use of as a biological weapon; Bacteria and bacterial infection; Biological warfare; Epidemics and pandemics; Vaccine

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"Bioterrorism, Protective Measures." World of Microbiology and Immunology. 2003. Encyclopedia.com. 27 May. 2016 <http://www.encyclopedia.com>.

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Bioterrorism

Bioterrorism

Bioterrorism is the use of a biological weapon against a civilian population. As with any form of terrorism, its purposes include the undermining of morale, creating chaos, or achieving political goals. Biological weapons use microorganisms and toxins to produce disease and death in humans, livestock, and crops.

Biological, chemical, and nuclear weapons can all be used to achieve similar destructive goals, but unlike chemical and nuclear technologies that are expensive to create, biological weapons are relatively inexpensive. They are easy to transport and resist detection by standard security systems. In general, chemical weapons act acutely, causing illness in minutes to hours at the scene of release. For example, the release of sarin gas by the religious sect Aum Shinrikyo in the Tokyo subway in 1995 killed 12 and hospitalized 5,000 people. In contrast, the damage from biological weapons may not become evident until weeks after an attack. If the pathogenic (disease-causing) agent is transmissible, a bioterrorist attack could eventually kill thousands over a much larger area than the initial area of attack.

Bioterrorism can also be enigmatic, destructive, and costly even when targeted at a relatively few number of individuals. Starting in September 2001, bioterrorist attacks with anthrax-causing bacteria distributed through the mail targeted only a few U.S. government leaders, media representatives, and seemingly random private citizens. As of June 2002, these attacks remain unsolved. Regardless, in addition to the tragic deaths of five people, the terrorist attacks cost the United States millions of dollars and caused widespread concern. These attacks also exemplified the fact that bioterrorism can strike at the political and economic infrastructure of a targeted country.

Although the deliberate production and stockpiling of biological weapons is prohibited by the 1972 Biological Weapons Convention (BWC)the United States stopped formal bioweapons programs in 1969unintended byproducts or deliberate misuse of emerging technologies offer potential bioterrorists opportunities to prepare or refine biogenic weapons. Genetic engineering technologies can be used to produce a wide variety of bioweapons, including organisms that produce toxins or that are more weaponizable because they are easier to aerosolize (suspend as droplets in the air). More conventional laboratory technologies can also produce organisms resistant to antibiotics , routine vaccines, and therapeutics. Both technologies can produce organisms that cannot be detected by antibody-based sensor systems.

Among the most serious of potential bioterrorist weapons are those that use smallpox (caused by the Variola virus ), anthrax (caused by Bacillus anthracis ), and plague (caused by Yersinia pestis ). During naturally occurring epidemics throughout the ages, these organisms have killed significant portions of afflicted populations. With the advent of vaccines and antibiotics, few U.S. physicians now have the experience to readily recognize these diseases, any of which could cause catastrophic numbers of deaths.

Although the last case of smallpox was reported in Somalia in 1977, experts suspect that smallpox viruses may be in the biowarfare laboratories of many nations around the world. At present, only two facilitiesone in the United States and one in Russiaare authorized to store the virus. As recently as 1992, United States intelligence agencies learned that Russia had the ability to launch missiles containing weapons-grade smallpox at major cities in the U.S. A number of terrorist organizationsincluding the radical Islamist Al Qaeda terrorist organizationactively seek the acquisition of state-sponsored research into weapons technology and pathogens.

There are many reasons behind the spread of biowarfare technology. Prominent among them are economic incentives; some governments may resort to selling bits of scientific information that can be pieced together by the buyer to create biological weapons. In addition, scientists in politically repressive or unstable countries may be forced to participate in research that eventually ends up in the hands of terrorists.

A biological weapon may ultimately prove more powerful than a conventional weapon because its effects can be farreaching and uncontrollable. In 1979, after an accident involving B. anthracis in the Soviet Union, doctors reported civilians dying of anthrax pneumonia (i.e., inhalation anthrax). Death from anthrax pneumonia is usually swift. The bacilli multiply rapidly and produce a toxin that causes breathing to stop. While antibiotics can combat this bacillus, supplies adequate to meet the treatment needs following an attack on a large urban population would need to be delivered and distributed within 24 to 48 hours of exposure. The National Pharmaceutical Stockpile Program (NPS) is designed to enable such a response to a bioterrorist attack.

Preparing a strategy to defend against these types of organisms, whether in a natural or genetically modified state, is difficult. Some of the strategies include the use of bacterial RNA based on structural templates to identify pathogens; increased abilities for rapid genetic identification of microorganisms ; developing a database of virtual pathogenic molecules; and development of antibacterial molecules that attach to pathogens but do not harm humans or animals. Each of these is an attempt to increaseand make more flexibleidentification capabilities.

Researchers are also working to counter potential attacks using several innovative technological strategies. For example, promising research is being done with biorobots or microchip-mechanized insects, which have computerized artificial systems that mimic biological processes such as neural networks, can test responses to substances of biological or chemical origin. These insects can, in a single operation, process DNA , screen blood samples, scan for disease genes, and monitor genetic cell activity. The robotics program of the Defense Advanced Research Project (DARPA) works to rapidly identify bio-responses to pathogens, and to design effective and rapid treatment methods.

Biosensor technology is the driving force in the development of biochips for detection of biological and chemical contaminants. Bees, beetles, and other insects outfitted with sensors are used to collect real-time information about the presence of toxins or similar threats. Using fiber optics or electrochemical devices, biosensors have detected microorganisms in chemicals and foods, and they offer the promise of rapid identification of biogenic agents following a bioterrorist attack. The early accurate identification of biogenic agents is critical to implementing effective response and treatment protocols.

To combat biological agents, bioindustries are developing a wide range of antibiotics and vaccines. In addition, advances in bioinformatics (i.e., the computerization of information acquired during, for example, genetic screening) also increases flexibility in the development of effective counters to biogenic weapons.

In addition to detecting and neutralizing attempts to weaponize biogenic agents (i.e., attempts to develop bombs or other instruments that could effectively disburse a bacterium or virus), the major problem in developing effective counter strategies to bioterrorist attacks involves the breadth of organisms used in biological warfare . For example, researchers are analyzing many pathogens in an effort to identify common genetic and cellular components. One strategy is to look for common areas or vulnerabilities in specific sites of DNA, RNA, or proteins. Regardless of whether the pathogens evolve naturally or are engineered, the identification of common traits will assist in developing counter measures (i.e., specific vaccines or antibiotics).

See also Anthrax, terrorist use of as a biological weapon; Biological warfare; Contamination, bacterial and viral; Genetic identification of microorganisms; Public health, current issues

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Bioterrorism

Bioterrorism

BRIAN HOYLE

Bioterrorism is the use of a biological weapon against a civilian or military population by a government, organization, or individual. As with any form of terrorism, its purposes include the undermining of morale, creating chaos, or achieving political goals. Biological weapons use microorganisms and toxins to produce disease and death in humans, livestock, and crops.

Bioterrorism is viewed as a serious threat to national security. For example, disaster scenarios created by United States government agencies predict that the release of a few hundred pounds of the spores of Bacillus anthracis (the bacterium that cause the disease called anthrax) upwind of Washington, D.C., could sicken or kill hundreds of thousands to millions of people within twenty-four hours.

Bioterrorism can also be used as a weapon to damage or destroy the economy of the target nation. A report from the Centers for Disease Control and Prevention estimates the costs of dealing with a large-scale anthrax incident is at least $26 billion per 100,000 people. Only a few such incidents could cripple the economy of any nation. Indeed, the few anthrax incidents in the last few months of 2001 cost the United States government hundreds of millions of dollars in treatment, investigation, and other response measures.

Biological, chemical, and nuclear weapons can all be used to achieve similar destructive goals (i.e., massive loss of life). In comparison, biological weapons are inexpensive to make, relative to chemical and nuclear weapons. A sophisticated biological production facility can be set up in a warehouse, or even in a building as small as a house. Biological weapons are relatively easy to transport and resist detection by standard security systems.

In general, chemical weapons act immediately, causing illness in minutes. For example, the release of sarin gas in the Tokyo subway in 1995 by the religious sect Aum Shinrikyo almost immediately killed 12 and hospitalized 5,000 people. In contrast, the illness and death from biological weapons can occur more slowly, with evidence of exposure and illness appearing over time. Thus, a bioterrorist attack may at first be indistinguishable from a natural outbreak of an infectious disease. By the time the deliberate nature of the attack is realized, the health care system may be unable to cope with the large number of victims.

The deliberate production and stockpiling of biological weapons is prohibited by the 1972 Biological Weapons Convention. The United States ceased offensive production of biological weapons in 1969, on orders from then President Richard Nixon. The U.S. stockpiles were destroyed in 19711972. This measure has not stopped

bioterrorists from acquiring the materials and expertize needed to produce biological weapons.

Genetic engineering can produce a wide variety of bioweapons including bacteria or viruses that produce toxins. More conventional laboratory technologies can also produce bacteria that are resistant to antibiotics.

Examples of the most likely to be used bioterrorist weapons include smallpox (caused by the Variola virus), anthrax (caused by Bacillus anthracis ), and plague (caused by Yersinia pestis ).

The last recorded case of smallpox was in Somalia in 1977. As of 2002, only two facilitiesone in the United States and one in Russiaare authorized to store the virus. In spite of international prohibitions, security experts suspect that smallpox viruses may be under development as biological weapons in other laboratories of many nations. As recently as 1992, Russia had the ability to launch missiles containing weapons-grade smallpox. A number of terrorist organizations including Al Qaeda have explored the use of biological weapons.

Bioterrorism may ultimately prove to be more destructive than conventional warfare, because of the mobility of the weapons and their ability to spread infection through an entire population. An epidemic can spread a disease far from the point of origin of the illness.

Preparing a strategy to defend against biological warfare is challenging. Traditional identification of microorganisms such as bacteria and viruses relies on assays that detect growth of the microbes. Newer technologies detect microbes based on sequences of genetic material. The genetic technologies can detect microbes in minutes. As of 2002, however, the genetic technologies are not available to any but the most sophisticated field investigative units.

Researchers are also working to counter bioterrorist attacks using several other new technological strategies. For example, robots equipped with sensors or microchipmechanized insects (with computerized circuitry that can mimic biological processes such as neural networks) are being developed. Bees, beetles, and other insects outfitted with sensors are used to collect real-time information about the presence of toxins or similar threats. These new technologies could be used to examine a suspected biological weapon and spare exposing investigators to potential hazards. The robotics program of the Defense Advanced Research Project (DARPA) works to rapidly identify bio-responses to pathogens, and for designs to effectively and rapidly treat them.

Research is also underway to find genetic similarities between the microbes that could be used by bioterrorists. A vaccine made of a protein that is common to several bacteria could potentially offer protection to the exposure any bacterium in the group, for example.

FURTHER READING:

BOOKS:

Frist, W.H. When Every Moment Counts: What You Need to Know about Bioterrorism from the Senates only Doctor. Lanham, MD: Rowman & Littlefield, 2002.

Henderson, D. A., and T. V. Inglesby. Bioterrorism: Guidelines for Medical and Public Health Management. Chicago: American Medical Association, 2002.

Inglesby, Thomas V. "Bioterrorist Threats: What the Infectious Disease Community Should Know about Anthrax and Plague," in Emerging Infections 5 Washington, D.C.: American Society for Microbiology Press, 2001.

PERIODICALS:

Kaufmann, A.F., M.I. Meltzer, and G.P. Schmid. "The Economic Impact of a Bioterrorist Attack: Are Prevention and Postattack Intervention Program Justifiable?" Emerging Infectious Diseases no. 3 (1997): 8394.

SEE ALSO

Anthrax, Terrorist Use as a Biological Weapon
Anthrax Vaccine
Anthrax Weaponization
Antibiotics
Biocontainment Laboratories
Biological Warfare
Biological Warfare, Advanced Diagnostics
Biological and Toxin Weapons Convention
Biological weapons, Genetic Identification
Bioterrorism, Protective Measures
Chemical and Biological Defense Information Analysis Center (CBIAC)
Chemical and Biological Detection Technologies
Chemical and Biological Incident Response Force, United States
DARPA (Defense Advanced Research Projects Agency)
DNA Recognition Instruments
DNA Sequences, Unique
Mail Sanitization
Pathogen Genomic Sequencing
Pathogen Transmission
Pathogens
Polymerase Chain Reaction (PCR)
Salmonella and Salmonella Food Poisoning
Smallpox Vaccine
Spores
Weapons of Mass Destruction
Weapons of Mass Destruction, Detection
World War I

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HOYLE, BRIAN. "Bioterrorism." Encyclopedia of Espionage, Intelligence, and Security. 2004. Encyclopedia.com. 27 May. 2016 <http://www.encyclopedia.com>.

HOYLE, BRIAN. "Bioterrorism." Encyclopedia of Espionage, Intelligence, and Security. 2004. Encyclopedia.com. (May 27, 2016). http://www.encyclopedia.com/doc/1G2-3403300095.html

HOYLE, BRIAN. "Bioterrorism." Encyclopedia of Espionage, Intelligence, and Security. 2004. Retrieved May 27, 2016 from Encyclopedia.com: http://www.encyclopedia.com/doc/1G2-3403300095.html

Bioterrorism

Bioterrorism

Bioterrorism is the use of a biological weapon against a civilian or military population by a government, organization, or individual. As with any form of terrorism, its purposes include the undermining of morale, creating chaos, or achieving political goals. Biological weapons use microorganisms and toxins to produce disease and death in humans, livestock, and crops.

Bioterrorism is viewed as a serious threat to national security and a range of experts, including forensic investigation teams, would be called on to deal with an incident involving biological weapons. For example, disaster scenarios created by United States government agencies predict that the release of a few hundred pounds of the spores of Bacillus anthracis (the bacterium that cause the disease called anthrax ) upwind of Washington, D.C., could sicken or kill hundreds of thousands to millions of people within 24 hours. Forensic scientists would likely respond by identifying the bacterium, tracing its source, and gathering and analyzing other evidence from the biocrime scene and the victims.

Bioterrorism can also be used as a weapon to damage or destroy the economy of the target nation. A report from the Centers for Disease Control and Prevention (CDC) estimates the cost of dealing with a large-scale anthrax incident is at least $26 billion per 100,000 people. Only a few such incidents would cripple the economy of any nation. Indeed, the few anthrax incidents that occurred following the September 11, 2001, terrorist attacks cost the United States government hundreds of millions of dollars in treatment, investigation, and other response measures.

Biological, chemical, and nuclear weapons can all be used to achieve similar destructive goals (i.e., massive loss of life). Relative to chemical and nuclear weapons, biological weapons are inexpensive to make. A sophisticated biological production facility can be set up in a warehouse or even a small house. Biological weapons are relatively easy to transport and can resist detection by standard security systems.

In general, chemical weapons act immediately, causing illness in minutes. For example, the release of sarin gas in the Tokyo subway in 1995 by the religious sect Aum Shinrikyo almost immediately killed 12 and hospitalized 5,000 people. In contrast, the illness and death from biological weapons can occur more slowly, with evidence of exposure and illness appearing over time. Thus, a bioterrorist attack may at first be indistinguishable from a natural outbreak of an infectious disease. By the time the deliberate nature of the attack is realized, the health care system may be unable to cope with the large number of victims.

The deliberate production and stockpiling of biological weapons is prohibited by the 1972 Biological Weapons Convention. The United States ceased offensive production of biological weapons in 1969, on orders from President Richard Nixon. The U.S. stockpiles were destroyed in 19711972. This measure has not stopped bioterrorists from acquiring the materials and expertise needed to produce biological weapons.

Genetic engineering can produce a wide variety of bioweapons including bacteria or viruses that produce toxins. More conventional laboratory technologies can also produce bacteria that are resistant to antibiotics .

Examples of the bioterrorist weapons most likely to be used include smallpox (caused by the variola virus ), anthrax (caused by Bacillus anthracis ), and plague (caused by Yersinia pestis ).

The last recorded case of smallpox was in Somalia in 1977. Today, only two facilitiesone in the United States and one in Russiaare authorized to store the virus. In spite of international prohibitions, security experts suspect that smallpox viruses may be under development as biological weapons in other laboratories of many nations. As recently as 1992, Russia had the ability to launch missiles containing weapons-grade smallpox. A number of terrorist organizations, including Al Qaeda, have explored the use of biological weapons.

Bioterrorism may ultimately prove to be more destructive than conventional warfare because of the mobility of the weapons and their ability to spread infection through an entire population. An epidemic can spread a disease far from the point of origin of the illness.

Preparing a strategy to defend against biological warfare is challenging. Traditional identification of microorganisms such as bacteria and viruses relies on assays that detect growth of the microbes. Newer technologies detect microbes based on sequences of genetic material. The genetic technologies can detect microbes in minutes. However, these technologies are not available to any but the most sophisticated field investigative units.

Researchers are also working to counter bioterrorist attacks using several other technological strategies. For example, robots equipped with sensors or microchip-mechanized insects (with computerized circuitry that can mimic biological processes such as neural networks) are being refined. Bees, beetles, and other insects outfitted with sensors are used to collect real-time information about the presence of toxins or similar threats. These technologies could be used to examine a suspected biological weapon and spare exposing investigators to potential hazards. The robotics program of the Defense Advanced Research Project (DARPA) works to rapidly identify bio-responses to pathogens , and to effectively and rapidly treat them.

Research is also underway to find genetic similarities between the microbes that could be used by bioterrorists. A vaccine made to act on a protein that is common to several bacteria could potentially offer protection to the exposure any bacterium in the group, for example.

see also Anthrax, investigation of the 2001 murders; Biological warfare, advanced diagnostics; Biological weapons, genetic identification; Chemical Biological Incident Response Force, United States; Pathogen transmission; Pathogens; Sarin gas; September 11, 2001, terrorist attacks (forensic investigations of); Smallpox; Vaccines.

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Bioterrorism

Bioterrorism

BIBLIOGRAPHY

Terrorism is the intentional use or threat to use violence against civilians or civilian targets in order to attain political ends. Bioterrorism uses microorganisms or toxins that are derived from living organisms to produce death or disease in humans, animals, or plants. Animals and plants are of concern because of the economic consequences of terrorism on food production and exports.

Historically, terrorists have relied primarily on conventional weapons such as guns and explosives to further their objectives. While conventional weapons will continue to be the most accessible, biological weapons are becoming increasingly available, and terrorists have turned from low-casualty, high-visibility targets to targets that can result in mass casualties, where biological weapons are an ideal choice. One of the most important advantages of biological weapons is cost. One dollars worth of anthrax can kill as many people as $2,000 worth of conventional explosives.

Biological agents had been used as weapons only twice in the United States. On September 9, 1984, a religious cult, the Rajneeshees, sprayed Salmonella typhimurium on salad bars in The Dales, Oregon, causing 751 cases of food poisoning. No deaths occurred. The second U.S. attack occurred in September 2001, when Bacillus anthracis spores were distributed through the U.S. Postal Service. This attack resulted in twenty-two cases of anthrax infection and five deaths. The production of this weapons-grade anthrax required a high degree of scientific knowledge and sophisticated equipment. Approximately two grams of the anthrax spores, if aerosolized effectively, could kill tens of thousands of people. Although the 1995 subway attack in Tokyo by the religious extremist group Aum Shinrikyo used a chemical agent, Aum had previously attempted to use anthrax and botulinum toxin.

Terrorists have access to hundreds of potential biological agents to use as weapons. These weapons can be in liquid or powder form, and they can be dispersed successfully as an aerosol if particle sizes are small enough to enter the lungs. The particles can be aerosolized from a stationary location or from a moving source either outdoors or indoors. Furthermore, many biological agents can be delivered in food or water.

The North Atlantic Treaty Organization (NATO) has identified thirty-one potential agents that bioterrorists can use. The United States Army Medical Research Institute of Infectious Diseases (USAMRIID), has reduced this list to six primary agents: anthrax, smallpox, plague, tularemia, botulinum toxin, and agents of viral hemor-rhagic fever. Many of these agents cause diseases that present-day physicians have never seen, decreasing the likelihood that they can be rapidly diagnosed.

The United States, United Kingdom, and other countries have developed national response plans to deal with natural disasters and acts of terrorism, including bioterrorism. These plans will be important for mounting a coordinated response to a bioterrorist attack. Equally important are plans to respond to a global outbreak of an infectious disease because similar response mechanisms will be used for bioterrorism. Both the World Health Organization and the United States released plans in 2005 for responding to a pandemic of influenza. Other countries are developing similar plans, and these plans will be important not only for a naturally occurring infectious disease but also for a bioterrorist attack.

An effective response to an attack will also require modifying existing laws so that governments can maximize their response efforts. Governors must be able to suspend provisions that regulate how state agencies do business in order for them to rapidly respond to public health emergencies. Public health authorities must be able to close and order the decontamination of buildings and destroy or safely dispose of any material or human remains that have been contaminated. They must also be able to take every available measure to prevent the transmission of infectious disease, including the use of isolation and quarantine, and to ensure that all cases of contagious disease are properly controlled and treated. Laws will also need to be modified to allow for the rapid purchase of pharmaceutical agents and the rationing of scare supplies. Public health authorities must be able to provide temporary licenses to out-of-state health care providers and modify liability laws to protect state officials and health care providers during a declared emergency.

Although extreme measures are called for during an emergency such as a bioterrorist attack, civil liberties must be protected. Gross negligence or willful misconduct should not be exempt from liability. Provisions of the law must be in place for rescinding the emergency orders when health conditions that caused the emergency no longer pose a high probability of a large number of deaths. Lawyers have developed a model emergency health powers act that can be used to strengthen governments ability to respond to bioterrorism and at the same time protect civil liberties.

SEE ALSO Terrorism

BIBLIOGRAPHY

Alibek, K., and S. Handelman. 1999. Biohazard. New York: Random House.

Diamond, Jared M. 1997. Guns, Germs, and Steel: The Fates of Human Societies. New York: Norton.

Gostin, Lawrence O., J. W. Sapsin, S. P. Teret, et al. 2002. The Model State Emergency Health Powers Act: Planning for and Response to Bioterrorism and Naturally Occurring Infectious Diseases. Journal of the American Medical Association 288 (5): 622628.

Miller, J., S. Engelberg, and W. Broad. 2001. Germs: Biological Weapons and Americas Secret War. New York: Simon and Schuster.

Tucker, J. B., ed. 2000. Toxic Terror: Assessing the Terrorist Use of Chemical and Biological Weapons. Cambridge, MA: MIT Press.

R. Gregory Evans

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Bioterrorism

BIOTERRORISM

BIOTERRORISM, the deliberate, private use of biological agents to harm and frighten the people of a state or society, is related to the military use of biological, chemical, and nuclear weapons. Formally the use of such weapons by one state to threaten or attack another state is warfare, although such warfare may violate the laws of war, and any use of such weapons by private individuals is terrorism.

The use of biological weapons for terror is ancient. Assyrian politicians (c. 650 b.c.) dumped fungus from rye into their opponents' wells, giving them fatal ergot poisoning. Armies besieging a town relied on increased disease among the defending populace and threw dead animals into water supplies to encourage it. Fourteenth-century Tatars spread bubonic plague by catapulting diseased corpses into towns.

With the advent of the germ theory of disease, greater knowledge of microbiology, and military bioengineering, the potential devastation due to biological weapons grew exponentially. In 1876, the German biologist Robert Koch first proved that anthrax is caused by bacteria. In World War I (1914–1918), biological weapons developed by the United States and Germany were perhaps used to contaminate animal fodder, and the Germans used Burkholderia mallei to cause glanders in enemy support animals. During World War II renewed concern over "germ warfare" fueled both sides' research regarding biological weapons, but there is no record of their being used. The height of the development of "weaponized" biological agents was the Cold War (1946–1991), in which both the United States and the Soviet Union created arsenals of biological agents for use both in battle and against civilian populations. This research led to propagandist charges of using such weapons; during the Korean War (1950–1953), North Korea accused the United States of dropping bombs containing diseased flies. Since the 1975 ratification of the Biological Weapons Convention, the United States, Russia, and most states have publicly claimed that they have destroyed their stockpiles and now research biological warfare only to defend against it. Even so, during the Persian Gulf War of 1991, Iraq equipped, but did not fire, rocket warheads containing anthrax.

The danger of the use of biological weapons by terrorists has grown as knowledge of such weapons and the military technology for them has become more widely available following the end of the Cold War. Acts of bioterrorism have increased in frequency and severity since then. In 1984, the pseudo-Buddhist Rajneeshee cult distributed salmonella in restaurants and a grocery store in The Dalles, Oregon, attempting to poison civic leaders to gain control of local government; 751 people developed gastroenteritis. Aum Shinrikyo, a Japanese cult, killed twelve people and injured thousands in the Tokyo subway through a sarin gas attack in 1995 and has made further, but unsuccessful, attempts to release airborne biological agents in the subways.

In 2001, letters containing anthrax spores were mailed to television news anchor Tom Brokaw, U.S. Senator Tom Daschle, and others, leading to the deaths of five people and the hospitalization of at least twelve others, although the targeted individuals were unhurt. The attacks coincided with the attacks by the Islamic terrorist group Al Qaeda on New York City and Washington, D.C., although at this writing their perpetrator remains unknown.

BIBLIOGRAPHY

Falkenrath, Richard A., Robert D. Newman, and Bradley A. Thayer. America's Achilles' Heel: Nuclear, Biological, and Chemical Terrorism and Covert Attack. Cambridge, Mass.: MIT Press, 1998.

Laqueur, Walter. The New Terrorism: Fanaticism and the Arms of Mass Destruction. New York: Oxford University Press, 1999.

Miller, Judith, Stephen Engelberg, and William J. Broad. Germs: Biological Weapons and America's Secret War. New York: Simon and Schuster, 2001.

Zilinskas, Raymond A. "Rethinking Bioterrorism." Current History 100 (2001): 438–443.

Stephen M.Sheppard

See alsoChemical and Biological Warfare ; Terrorism .

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Bioterrorism

Bioterrorism

What Is Bioterrorism?

The History of Bioterrorism

How Can Biological Agents Be Spread?

What Are Potential Biological Agents?

What Can We Do to Protect Ourselves?

Resources

Bioterrorism is the intentional use of harmful biological, or living, organisms or their toxic products to cause injury or death to people or animals.

KEYWORDS

for searching the Internet and other reference sources

Anthrax

Biological agent

Biological warfare

Bioweapon

Botulism

Plague

Smallpox

Tularemia

Vaccination

What Is Bioterrorism?

Also known as biological warfare, bioterrorism is a form of warfare that uses specific microorganisms*, such as harmful bacteria and viruses, to cause illness or death deliberately in people or animals. When organisms are used in this way, they become weapons.

*microorganisms
are tiny organisms that can be seen only using a microscope. Types of microorganisms include fungi, bacteria, and viruses.

The History of Bioterrorism

The use of microorganisms to spread disease intentionally is not new to the twenty-first century. In 1346, it is believed that the Tartar army tried to capture the port city of Caffa on the Black Sea in the Crimea by catapulting bodies of plague (PLAYG) victims over the city walls. A plague epidemic* ensued, and Caffa surrendered. During the French and Indian Wars in the eighteenth century in North America, the British were rumored to have given blankets contaminated with smallpox to Native Americans, leading to an epidemic of the disease.

*epidemic
(eh-pih-DEH-mik) is an outbreak of disease, especially infectious disease, in which the number of cases suddenly becomes far greater than usual. Usually epidemics are outbreaks of diseases in specific regions, whereas worldwide epidemics are called pandemics.

The Tartars and the British troops did not know that certain microorganisms cause disease. They knew only that disease was rumored to have spread from dead bodies or, in the case of smallpox, even from the blankets that touched victims. People were not aware that microorganisms are at the root of infectious disease until the latter part of the nineteenth century, when scientists began to understand the connection. In 1876, the German scientist Robert Koch had proved that anthrax (AN-thraks) bacteria cause anthrax. After World War II the United States and other nations experimented with harmful biological organisms and various methods of transmitting them. In 1972 the Biological Weapons Convention treaty was signed by more than 100 countries around the world, including the United States and the Soviet Union, to stop research and production of biological organisms as weapons of war.

It is likely that some countries in the world todayespecially those harboring or supporting known terrorist groupscontinue to manufacture and store stockpiles of dangerous microorganisms, such as those that cause anthrax. The use of bioterrorism to wage warfare is favored among terrorists or fringe groups because it requires few resources compared with traditional warfare and can potentially harm large numbers of people.

How Can Biological Agents Be Spread?

Deadly microorganisms (also known as biological agents or bioweapons) can be spread purposely through air or food and water supplies or by intentionally infecting someone with a highly contagious agent and letting that person circulate in a community, starting a massive wave of disease. But the handling and release of many of these organisms are dangerous and could be deadly for potential terrorists trying to use them.

Some organisms can be aerosolized (AIR-o-suh-lized), meaning that they are processed into the tiniest of particles, in a wet or dry form, that can be sprayed or released into the air so that large numbers of people can inhale them. Aerosolized organisms can be dispersed by aerosol containers, small crop-dusting planes, ventilation systems, or contamination of an object that can carry disease throughout a region, like the anthrax-tainted letters received by various government and media employees in the United States in late 2001.

Some harmful biological organisms become weakened, however, as they spread into water or food supplies, making them less likely to cause significant harm to anyone who comes into contact with them. For example, a person would have to inhale thousands of anthrax spores* to become sick. A terrorist group trying to use anthrax as a bioweapon would have to use a highly concentrated form to be able to harm large numbers of people via contaminated packages or envelopes.

*spores
are a temporarily inactive form of a germ enclosed in a protective shell.

What Are Potential Biological Agents?

The U.S. Centers for Disease Control and Prevention (CDC) separates biological organisms into categories according to their virulence (VEER-uh-lents), or ability to cause disease. The most virulent biological diseases are also the most likely to be used by terrorists. These diseases are anthrax, smallpox, plague, botulism (BOH-chu-lih-zum), and tularemia (too-lah-REE-me-uh).

Anthrax

Anthrax is caused by the bacterium Bacillus anthracis. The bacteria can form spores, which have a hard coating that allows them to survive in harsh environments. The spores are found naturally in soil and can infect grazing animals, most often livestock such as cattle, sheep, or horses. The disease is not contagious from person to person, and natural human infection is rare.

There are three types of anthrax, distinguished by the three different ways in which a person becomes infected: cutaneous (kyoo-TAY-nee-us) anthrax, which infects the skin; inhalation (in-huh-LAY-shun) anthrax, which results from breathing in large numbers of concentrated spores; and gastrointestinal* (gas-tro-in-TES-tih-nuhl) anthrax, which is caused by ingesting spores. Cutaneous anthrax causes brownish-black ulcers, or sores, that turn into scabs on the skin. Symptoms of inhalation anthrax include rapid onset of fever, chills, headache, nausea, and vomiting, with victims quickly experiencing difficulty in breathing. Gastrointestinal anthrax is very rare and causes severe abdominal* pain, diarrhea (dye-uh-REE-uh), and hemorrhaging* from the gastrointestinal tract.

*gastrointestinal
means having to do with the organs of the digestive system, the system that processes food. It includes the mouth, esophagus, stomach, intestines, colon, and rectum and other organs involved in digestion, including the liver and pancreas.
*abdominal
(ab-DAH-mih-nul) refers to the area of the body below the ribs and above the hips that contains the stomach, intestines, and other organs.
*hemorrhaging
(HEM-rij-ing) describes a condition in which uncontrolled or abnormal bleeding occurs.

All forms of anthrax can be treated with antibiotics if they are diagnosed early, but the inhalation and gastrointestinal types of anthrax are extremely deadly if left untreated. Even with treatment, patients with inhalation or gastrointestinal anthrax can die from the disease. There is an anthrax vaccine*, but it is given only to people in the military and people such as veterinarians who routinely handle livestock and are therefore more likely to come into contact with the natural form of the disease.

*vaccine
(vak-SEEN) is a preparation of killed or weakened germs, or a part of a germ or product it produces, given to prevent or lessen the severity of the disease that can result if a person is exposed to the germ itself. Use of vaccines for this purpose is called immunization.

Smallpox

Smallpox is a deadly viral infection that is caused by the variola virus and is found only in humans. In the twentieth century smallpox claimed millions of lives, but in 1980 the World Health Organization (WHO) declared the disease to have been eradicated (eliminated) from the human population following an aggressive worldwide vaccination (vak-sih-NAY-shun) program. Routine vaccination against smallpox in the United States ended in 1972, and the last known natural case of smallpox was in 1977 in Somalia in Africa. Today there are two official facilities that store samples of the virus: the CDC in Atlanta, Georgia, and the Russian State Research Center of Virology and Biotechnology in Koltsovo.

Smallpox is the most contagious disease known and is transmitted through direct contact with the lesions* of an infected person, by inhaling infected droplets of moisture released into the air by coughing patients, and even by handling contaminated clothing that contains fluid from smallpox sores. The symptoms of smallpox are high fever, headache, backache, vomiting, and a painful rash of lesions that covers the face, arms, and body and often leaves scars. The disease is fatal in up to 30 percent of cases, and at this time there is no known medication that can cure smallpox. Vaccination given within 4 days of exposure to the virus sometimes can prevent smallpox or lessen its symptoms, including the rash.

*lesions
(LEE-zhuns) is a general term referring to sores or damaged or irregular areas of tissue.

The CDC keeps an emergency supply of smallpox vaccine in the event that bioterrorism attacks with smallpox occur in the United States. In 2002, some vaccine-making companies received approval from the CDC to make an additional supply of the vaccine, should it be needed on a more widespread basis.

In order to protect U.S. citizens against the threat of a bioterrorism attack, President George W. Bush announced in late 2002 that some members of the U.S. military will be vaccinated against smallpox and he called for health care workers to volunteer to receive the vaccine.

Plague

Plague, caused by the bacterium Yersinia pestis (yer-SIN-e-uh PES-tis), has been around for centuries. It can take three forms: bubonic (byoo-BAH-nik), septicemic (sep-tih-SEE-mik), and pneumonic (nu-MOH-nik). Bubonic plague, the most common form, involves the bodys lymph nodes*; septicemic plague enters the bloodstream, causing internal bleeding and shock*; and pneumonic plague infects the respiratory tract*. The last form is potentially important in biological warfare because Yersinia pestis bacteria can remain alive in the air for up to an hour, making aerosolized transmission possible.

*lymph
(LIMF) nodes are small, bean-shaped masses of tissue that contain immune system cells that fight harmful microorganisms. Lymph nodes may swell during infections.
*shock
is a serious condition in which blood pressure is very low and not enough blood flows to the bodys organs and tissues. Untreated, shock may result in death.
*respiratory tract
includes the nose, mouth, throat, and lungs. It is the pathway through which air and gases are transported down into the lungs and back out of the body.

Yersinia pestis is found in rats and other rodents in all parts of the world, including the United States. Plague can spread from infected rats to humans by direct bites or from fleas. The pneumonic form of plague is the only kind that is contagious among humans; transmission takes place by being in close contact with someone who is coughing or sneezing. Symptoms of the plague include fever, chills, headache, abdominal pain, painful and swollen lymph nodes (called buboes, BYOO-boze), chest pain, coughing, bloody sputum*, and septic shock*. There is no vaccine available in the United States, but antibiotics can treat the disease successfully if it is diagnosed early.

*sputum
(SPYOO-tum) is a substance that contains mucus and other matter coughed out from the lungs, bronchi, and trachea.
*septic shock
is shock due to overwhelming infection and is characterized by decreased blood pressure, internal bleeding, heart failure, and, in some cases, death.

Botulism

Botulism is caused by the toxin* produced by the bacterium Clostridium botulinum. The bacteria can be inhaled or swallowed, or they can enter the body through a wound, but the disease is not contagious from person to person. The toxin produced by the bacteria affects neurotransmitters* in the body, causing nerve damage and temporary paralysis*, including the muscles for speaking, swallowing, and breathing. Botulism can lead to respiratory failure* and even death. The bacterium and its toxin could be used to produce bioweapons. An antitoxin* against the Clostridium botulinum toxin is available from the CDC, but there is currently no vaccine available.

*toxin
is a poison that harms the body.
*neurotransmitters
(nur-o-trans-MIH-terz) are chemical substances that transmit nerve impulses, or messages, throughout the brain and nervous system and are involved in the control of thought, movement, and other body functions.
*paralysis
(pah-RAH-luh-sis) is the loss or impairment of the ability to move some part of the body.
*respiratory failure
is a condition in which breathing and oxygen delivery to the body are dangerously altered. This may result from infection, nerve or muscle damage, poisoning, or other causes.
*antitoxin
(an-tih-TOK-sin) counteracts the effects of toxins, or poisons, on the body. It is produced to act against specific toxins, like those made by the bacteria that cause botulism or diphtheria.

Tularemia

Tularemia is caused by the bacterium Francisella tularensis and is highly infectious. It occurs naturally in mice, rabbits, squirrels, and other small mammals. The disease is not contagious among humans, and human infection is rare. Tularemia can be transmitted through contact with infected animals or contaminated water or soil. The disease is potentially dangerous as a biological weapon, because even small numbers (less than 10 to 50) of the aerosolized bacteria can cause serious disease, such as life-threatening pneumonia*. Symptoms include fever, chills, headache, cough, and extreme tiredness. Patients also may have painful ulcers on the skin; swollen, painful eyes; and abdominal pain. Early treatment with antibiotics may prevent or limit the severity of the disease.

*pneumonia
(nu-MO-nyah) is inflammation of the lung.

What Can We Do to Protect Ourselves?

Following the terrorist incidents and anthrax scare of fall 2001, the U.S. government proposed that billions of dollars be channeled into improving national resources that provide protection against and treatment of the effects of bioweapons. The Office of Homeland Security was formed in late 2001 to oversee the governments preparation for and defense against future acts or threats of bioterrorism that might occur in the United States. The government has authorized an increase in federal stockpiles of antibiotics to treat anthrax, plague, tularemia, and other potential bioweapons, as well as the production of additional supplies of smallpox vaccine. Research continues in the development of better medical treatment and the creation of vaccines for protection against biological agents. Medical professionals and emergency response teams are being trained to diagnose the diseases and respond quickly to the epidemics that could result from bioterrorism. Experts advise that people not stockpile antibiotics out of fear of possible biological warfare, because they could end up using the medicine incorrectly or in the wrong situation. Stockpiling also can lead to a shortage of certain antibiotics and make them unavailable to people who truly need them to treat other diseases.

See also

Anthrax

Botulism

Plague

Smallpox

Tularemia

Zoonoses

Resources

Organizations

Center for Civilian Biodefense Strategies, Johns Hopkins University, 111 Market Place, Suite 830, Baltimore, MD 21202. The Center for Civilian Biodefense Strategies carries information about possible bioweapons and posts news updates on the preparedness and response plans of public health agencies and the work of the Department of Homeland Security.

Telephone 410-223-1667 http://www.hopkins-biodefense.org

U.S. Centers for Disease Control and Prevention (CDC), 1600 Clifton Road, Atlanta, GA 30333. The CDCs website carries information about bioterrorism and fact sheets about various biological agents and threats, including anthrax, smallpox, plague, botulism, and tularemia.

Telephone 800-311-3435 http://www.cdc.gov

World Health Organization (WHO), Avenue Appia 20, 1211 Geneva 27, Switzerland. WHO tracks disease outbreaks and emergencies around the world and posts information at its website about potential biological weapons.

Telephone 011-41-22-791-2111 http://www.who.int

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