Anthrax, Smallpox, Plague: Reborn as Bioweapons?

By Barry James
International Herald Tribune

October 12, 2001

The threat of anthrax, an ancient scourge described in the Bible, again
hangs over mankind. And one of history's great medical advances—the
defeat of smallpox—could be undone if the worst of the dark fears
stirred up by the terrorist attacks on New York and Washington come to
pass.

Also lurking in the background is another of the human
race's great enemies: bubonic plague. It was probably the Black Death
that killed a third of Europe's population in the Middle Ages.

Anthrax, smallpox, and plague are three of the biological agents that experts fear most, should terrorists seek to carry out an even deadlier attack, because these diseases can be spread so quickly through a population.

While there are significant practical difficulties in mounting an attack using any of them, terrorists may already have the capability to do so. The CIA warned earlier this year that terrorist groups were actively searching the Internet for information on biological weapons, as well as chemical and nuclear ones. And the terrorist suspect Osama bin Laden said in 1998 that it was a "religious duty" to acquire unconventional weapons.

"I'm not trying to be alarmist," said Andrew Card, the White House chief of staff, "but we know these terrorist organizations have probably found the means to use biological and chemical weapons."

Little Protection

The United States and some other governments have intensified programs for reacting to a biological weapons attack. But the sad truth for people feeling newly threatened is that preparation is not much use.

Although there has been a panic rush on masks and antibiotics in the United States, "there is presently little that individuals can do in advance to protect themselves from a bioterrorist attack," according to the U.S. Center for Civilian Biodefense Studies.

Fear of biological terrorism has jumped with the discovery of anthrax spores in the co-worker of a man who died of the disease in South Florida last week. Concern also rose with the revelation that one of the suspects in the Sept. 11 attacks on the World Trade Center and Pentagon had asked earlier in Florida about renting a crop duster plane.

Some experts say a possible method of causing an epidemic of pulmonary anthrax, which is almost universally fatal, would be to launch disease-causing spores into the air upwind of a population center.

Before Sept. 11, the sheer revulsion against biological weapons was widely seen as the best guarantee that they would not be used. After all, the theory went, terrorists wanted people alive and watching, not dead.

But Bruce Hoffman, a terrorism researcher at St. Andrews University in Scotland, has described the new generation of terrorists as "a nihilistic, apocalyptic, angry bunch," more willing than in the past to sacrifice themselves to achieve mass slaughter.

In fact, biological weapons have already been used many times in history. It was common in siege warfare to hurl the bodies of plague victims over city walls to infect the population. The Japanese used anthrax against the Chinese in the 1930s, and the Soviets are believed to have infected German troops at Stalingrad with tularemia, a pathogenic bacteria that swept through both sides and killed about 100,000. In 1984, an Oregon cult led by Bhagwan Shri Rajneesh made hundreds of people sick by spreading salmonella germs.

Any competent biologist using the same kind of equipment used to manufacture beer, yogurt, or pharmaceuticals can just as easily produce large quantities of slurry containing anthrax in a matter of days. But finding the deadliest strain, which causes fever, shock, and pneumonia and is almost invariably fatal, is not simple. Nor, the thinking goes, is it easy to turn the disease into an aerosol form that can penetrate deep into the lungs.

The Japanese Aum Shinriko sect scattered anthrax on several occasions and produced no effects other than complaints about bad smells. Only after this failure did the sect go on to use nerve gas in a terrorist attack in 1995 in a Tokyo subway.

Growing Concern

Worry has grown because of improved technology and because there are plenty of biologists from the biowarfare program of the old Soviet Union and elsewhere who know how to make concoctions even deadlier than those contained in the "cookbooks" that circulate among survivalists in the United States.

"Terrorist interest in chemical and biological weapons is not surprising given the relative ease with which some of these weapons can be produced in simple laboratories," the CIA says.

Last weekend in Ferney-Voltaire, France, the council of the World Medical Association, which represents about 8 million doctors, warned that any release of organisms causing smallpox, plague, anthrax, and other diseases "could prove catastrophic in terms of the resulting illnesses and deaths, compounded by the panic such outbreaks would generate."

The group warned that there was growing potential for the production of new microbial agents as expertise in biotechnology increases and methods for genetic manipulation of organisms becomes simpler.

"The consequences of a successful biological attack, especially if the infection were readily communicable, could far exceed those of a chemical or even a nuclear event," the medical council said. "Given the ease of travel and increasing globalization, an outbreak anywhere in the world could be a threat to all nations."

Delon Human, secretary-general of the World Medical Association, said a verification protocol was urgently needed to empower UN agencies to enter laboratories where they suspected that biological and toxin weapons were being produced.

The United States blocked such a protocol this year, in part to protect the U.S. pharmaceutical industry, said Timothy Flaherty, chairman of the American Medical Association. "I am sure this will be relooked at now," he said.

Chemical agents that asphyxiate, blister, blind, and madden their victims are bad enough. But furthermore, their effect would be localized, unlike that of biological weapons.

Biological weapons "are the easiest to acquire," according to the former head of Britain's chemical and biological defense establishment, Graham Pearson. "They have the weakest international prohibition regime, and yet their effects can be comparable to those of nuclear weapons."

Little Warning

An infectious disease such as smallpox would spread wildly before most people realized the threat existed. Worse, biologists have experimented with cocktails of diseases, known as chimeras, and microbes capable of resisting all antibiotics.

The threat of biological terrorism could compound a naturally occurring problem. More than 30 new infectious diseases—many resistant to drug treatment—have emerged in the past quarter of a century. David Heymann, the World Health Organization's executive director for communicable diseases, said that "an outbreak anywhere in the world must now be considered a threat anywhere else."

The World Health Organization is calling for increased vigilance and a strengthening of public health structures. According to the Centers for Disease Control in Atlanta the "early detection of and response to biological or chemical terrorism are crucial."

That means training hundreds of thousands of workers on emergency response teams and in hospital casualty departments about biological agents and their symptoms and treatments. Quick collating of reports of suspicious outbreaks at the national and international level is also crucial.

"I don't think we should be panicking," Flaherty said, "but I do think we should be upgrading public health facilities so that we can have as good a detection system as possible."

The U.S. secretary of health, Tommy Thompson, said he was starting a program to train doctors and laboratories in detection of anthrax, smallpox, and other agents "and make sure we are doing today what this country once thought it could put off until tomorrow." France last week revealed a plan called Biotox, which includes tighter control of water supplies and tough security around pharmaceutical plants and the country's big containment laboratory at Lyon.

Anthrax, which is believed to be the cause of the animal and human plagues in the fifth Book of Exodus, is considered the most likely terrorist bioweapon.

Anthrax spores are hardy survivors. It took more than 40 years to clean up a Scottish island after scientists used it for experiments in 1942. Anthrax is an animal disease, and the spores can still be found along the cattle drive trail across the continental United States. The one saving grace of pulmonary anthrax is that it cannot easily, if at all, be passed from person to person.

Smallpox, a viral disease, is a different matter. Smallpox was the first major infectious disease to be declared eradicated, 21 years ago. Since then people have not been routinely vaccinated, meaning there is little protection against it. The United States has some 15 million doses of vaccine in store and is hurrying up a program to produce an additional 40 million doses.

The United States and the Soviet Union held onto the virus in the event they might need to create a vaccine, but in the early 1990s it was reported that the virus had been moved from the main research facility in Siberia and used to produce weapons. There are fears that Iraq and North Korea have obtained the virus or that Russian scientists might have sold it to terrorist groups.

Bubonic plague also has recognized biowarfare potential. When an outbreak occurred at Surat in India in 1994, half a million people fled the city in panic—suggesting the hysteria that might follow any report of a bioterrorism attack.

(c) 2001 International Herald Tribune