Responding to Biological Attacks

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How dangerous could biological terrorism be?

The anthrax-laced letters mailed in the fall of 2001 infected twenty-three people and killed five—a toll that only hinted at the damage bioterrorism could cause. In a 2001 government exercise called Dark Winter, a simulated “worst-case” terrorist attack with smallpox virus—a germ more worrisome than the anthrax bacterium because it’s contagious—was projected to cause some 300,000 smallpox cases within three weeks, about one in three of which would be fatal. Plague, anthrax, and other diseases could also be major killers.

Have terrorists experimented with biological weapons before?

Yes. CIA Director George Tenet has testified that documents found in Afghanistan showed that the al-Qaeda terrorist network was pursuing sophisticated biological weapons research in Afghanistan. Aum Shinrikyo, a doomsday cult in Japan, had an ambitious biological weapons program and released anthrax spores and botulinum toxin in Tokyo on several occasions, but none of the attacks inflicted any known casualties. Iraq, the Soviet Union, and other countries experimented extensively with anthrax bacteria and other germs as recently as the 1990s. (The United States abandoned its offensive biowarfare program in 1969 and destroyed its biological arsenal in the early 1970s.)

How is the U.S. government responding to the threat of bioterrorism?

Through a wide variety of measures including:

• The Department of Health and Human Services has established a new Office of Public Health Preparedness to address bioterrorist threats.
• In July 2002, Dr. Julie Gerberding, an infectious diseases expert noted for her work combating anthrax and bioterrorism, was named director of the Centers for Disease Control and Prevention (CDC).
• In December 2002, the Bush administration announced plans to start inoculating some ten million health-care, emergency, law-enforcement, and military personnel against smallpox before making the vaccine available to the general public on a voluntary basis in 2004.
• In January 2003, the Bush administration created a system designed to detect the release of deadly germs like anthrax and smallpox within twenty-four hours by adapting many of the Environmental Protection Agency’s 3,000 air-quality monitoring stations nationwide.

Funding to combat bioterrorism, which was increasing even before September 11 and the 2001 anthrax letters, has shot up in their wake. A June 2002 bioterrorism law provided $4.6 billion for stockpiling medicines and vaccines, enhancing inspections of the nation’s food supply, increasing water-system security, and improving hospital preparedness. In President Bush’s January 2003 State of the Union address, he proposed spending $6 billion more for research and production of vaccines and other treatments against agents like anthrax, botulinum toxin, Ebola, and plague.

Will the increased spending help?

It should, experts say. The threat from bioterrorism is serious, but quick and effective public health and medical responses could save many lives. Preparedness has improved significantly in recent months, and public health authorities are on alert. Nevertheless, state and local governments are inadequately prepared to cope with a major bioterrorist attack. The new spending is earmarked for scientific research, public health initiatives, vaccine and drug stockpiles, hospital preparedness, and disease surveillance and response systems at the federal, state, and local levels. Down the road, the planned expenditures should also produce indirect benefits for public health in general, experts say.

What diseases are authorities most worried about?

The “Category A” list of biological threat agents—as classified by the CDC—includes the germs that cause anthrax, botulism, plague, smallpox, tularemia, and hemorrhagic fever viruses such as Ebola. These infectious diseases cause potentially high death rates, could trigger public panic, and require special action to cure and contain. A few are contagious (smallpox, plague, and Ebola). More than a dozen other types of biological disease threats are classified by the CDC as generally less dangerous but still capable of killing many victims.

How would health authorities discover that a biological attack was underway?

Bioterrorism can be hard to detect, experts say. Environmental monitoring might be able to pick up signs of an airborne release of germs, assuming authorities knew where to look. But an attack could go unnoticed until victims feel sick and visit hospitals. A 1984 outbreak of food poisoning in a small Oregon town that sickened 751 people was initially believed to be a natural outbreak; only a year later did authorities realize that a religious cult called the Rajneeshees had deliberately contaminated salad bars with salmonella bacteria.