- CRYSTAL CITY, Va. - A lone terrorist creates a designer microbe deadly enough
to annihilate most of Manhattan. After it's unleashed into the air, the
virus will jump, silently, from person to person, infecting millions of
unknowing victims. Air travelers will spread the microbe across the nation
- and thousands will die within weeks. It hasn't happened yet, but it could,
public-health experts said here Tuesday - and more importantly, America
is woefully unprepared for such an attack.
- The compelling tale is indeed fiction,
but presents a potentially very real scenario, said U.S. Health and Human
Services Secretary Donna Shalala, who gave the keynote address here Monday
at the start of a groundbreaking meeting on bioterrorism.
- More importantly, novels such as Richard
Preston's "The Cobra Event" raise a logical question that has
not been adequately answered: "How do we successfully contain and
combat the emerging threat [of bioterrorism]?" Shalala asked the audience
of political leaders, physicians, scientists and intelligence experts gathered
to talk about what to do should an assault be launched on civilians in
the United States.
- While experts here stressed that the
risk of a biological attack is extremely small - you're much more likely
to be hit by a car, for example - they said the United States is woefully
unprepared should an attack occur.
- Bioterrorism presents unique challenges,
they added. The effects of chemical warfare are often obvious immediately
after an attack, allowing public-health officials time to mobilize and
clean up the area within hours or days.
- But a biological attack might not be
evident until weeks after the initial infection. And by then, the silent
microbes could have spread to thousands, killing most in their wake.
- "Release of smallpox into the general
population would be one of the most serious threats to mankind," said
Dr. D.A. Henderson, director of the new Johns Hopkins Center for Civilian
Biodefense Studies, which sponsored the meeting. "Unfortunately today,
that is a very real scenario."
- Diary of an anthrax attack
- While there are any number of organisms
that bioterrorists could use as weapons, smallpox and anthrax are the big
two that are capable of causing disease and death sufficient to cripple
a city, even a country, experts here said.
- And if you thought smallpox was eradicated,
think again, they said. Yes, the World Health Assembly announced in 1980
that smallpox had been obliterated and recommended that all countries cease
vaccination. But that same year, the Soviet government embarked on an ambitious
program to grow smallpox in large quantities and adapt it for use in bombs
and intercontinental ballistic missiles.
- "We now know unequivocally that
the former Soviet Union continued to produce biowarfare agents even in
the face of the 1970s ban on such weapons," said Dr. Christopher Davis,
director of the ORAQ Consultancy Group in Marlborough, U.K. "The questions
now are, What happened to the seed stocks? What about the planning documents?
- Russia still maintains a research program
that is thought to be producing more virulent and contagious strains, he
added. "It's difficult to say what they are capable of, but it must
- On Wednesday, attendees at the meeting
hope to develop recommendations for a response plan. The first step toward
planning for an attack is education - to be aware that an act of bioterrorism
is a real possibility, Shalala said.
- In addition, the government is spending
more than $150 million this fiscal year to fund its "Anti-Bioterrorism
Initiative," which is designed to increase medical response and build
a stockpile of treatments, she said.
- WEAPONS OF CHOICE
- Some of the reasons bioterrorists prefer
smallpox are its high fatality rates - it kills some 30 percent of its
victims - and its long incubation periods - up to 14 days. While the victims
do not experience symptoms during these two weeks, they can infect others.
- About two weeks after infection, a victim
may develop high fever, malaise, headache and backache. A rash then develops,
spreading all over the body.
- There is no treatment and it is easily
spread from person to person, Henderson said. And since no one in the United
States has been vaccinated during the past 25 years, even those immunized
before that time are unlikely to still be protected.
- Unlike smallpox, anthrax is not spread
from person to person. But it is just as deadly: Given appropriate weather
and wind conditions, 50 kilograms of anthrax released from an aircraft
along a 2 kilometer line could create a lethal cloud of anthrax spores
that would extend beyond 20 kilometers downwind.
- The aerosol cloud would be colorless,
odorless and invisible. And given the small size of the spores, they are
as likely to infect people indoors as those on the street.
- An analysis by the Office of Technology
Assessment of the U.S. Congress estimated that 130,000 to 3 million deaths
could occur following the release of 100 kilograms of aerosolized anthrax
over Washington D.C., making such an attack as lethal as a hydrogen bomb.
- Again, a long incubation period is a
potential problem. Exposure to an aerosol of anthrax spores could cause
symptoms as soon as two days after exposure. However, illness could also
develop as late as eight weeks later - in Svedlovsk, one case developed
46 days after Further, early symptoms of anthrax resemble a flu and are
therefore often misdiagnosed. Untreated, 90 percent of people die, most
within one to three days. Antibiotics can significantly reduce the risk
of death, but only if given within the first few days of symptoms.