Doctors Will Be First To
Recognize BioTerrorism Attack
By Lauran Neergaard
Associated Press
ARLINGTON, Va. (AP) - It will fall to doctors - not the military or police - to recognize when bioterrorists have struck and to react in time to stop thousands of Americans from getting sick or dying, experts told the first medical conference on the danger Tuesday.
Imagine a truck driving by a football stadium during a fall game. It sprays a mist that drifts over the stadium. Nobody notices.
Two days later, hundreds show up with sniffles and fevers that doctors believe is the flu. But five days later 300 people are dead before a local scientist solves the mystery: It's not flu, it's anthrax.
Johns Hopkins University used that fictional scenario to tell doctors that the danger is real -- and the nation isn't yet ready to handle it.
``To remain unprepared is to invite disaster,'' said Hopkins' Dr. D.A. Henderson, who led the world's eradication of smallpox and now is mobilizing health workers and the government against bioterrorism.
Policy-makers know how to respond to bombs, but have ``an almost total lack of understanding of the implications of epidemic disease'' that bioterrorism would cause, Henderson said.
The average American is far more likely to die in a car crash than ever face a bioterrorist attack, other experts reassured the conference. But the threat is real, so the government is starting to prepare doctors and hospitals.
``We must not be afraid, but we must be aware,'' said Health and Human Services Secretary Donna Shalala, whose office is spending $158 million this year, and has asked Congress for $230 million next year, to prepare.
Currently, there is no national stockpile of treatment or vaccines. And doctors must be educated how to spot unusual symptoms and then what to do. They may not know, for example, that anthrax can't be spread person-to-person but that smallpox is highly contagious.
A huge attack like the Hopkins' anthrax scenario is unlikely, but possible, said Col. Gerald Parker, the U.S. Army's chief of infectious disease. The worst agents would be anthrax and smallpox, which are highly deadly and can be manipulated into weapons that victims inhale.
A more likely scenario is small attacks, said former National Security Council member Jessica Stern. Americans already have experienced one: In 1985, a religious cult poisoned Oregon salad bars with salmonella, making 750 people sick.
Germs are the ultimate sneak attack. Leave a germ-tainted package in a subway, and the terrorist is long gone before anyone knows there's a problem.
Publicly, the most feared germ weapons program has been Iraq's.
But the Japanese cult that released the nerve gas sarin in a Tokyo subway in 1995 attempted bioterrorism first, said terrorism expert Kyle Olson of Research Planning Inc.
Four times before the nerve gas attack, the cult attempted to spray botulism toxin and anthrax around Japanese government buildings, he said. Although there were some reports of pet deaths, the attempts apparently failed to sicken any people, for unknown reasons, Olson said.
And nobody knows what has happened to the former Soviet Union's vast stockpiles of weaponized germs, including smallpox, said Christopher Davis of ORAQ Consultancy, who investigated Soviet bioweapons for Britain.
But terrorists don't have to dispense germs to cause terror, Stern said, pointing to a spate of anthrax hoaxes starting last year that have so far affected more than 5,000 Americans.
A typical case: An abortion clinic opens a letter mixed with powder that says, ``You have just been exposed to anthrax.'' The local fire department makes everyone in the clinic take a decontamination shower, and the hospital doles out antibiotics, which can prevent anthrax if taken soon after exposure.
All the threats so far have been hoaxes, but investigating can cost up to $100,000 and repeated false alarms mean some cities don't take the threats seriously anymore, Olson said.
``It's the 'cry wolf syndrome,''' he said. ``The danger, obviously, is we're going to miss something.''
If local doctors spot unusual symptoms, alerting the Centers for Disease Control and Prevention quickly could help health officials mobilize drugs to stop an epidemic. Antibiotics can prevent anthrax if people take them soon enough after exposure, for instance.
But more research is needed, Henderson said. Smallpox vaccination hasn't been given anywhere in the world for years; there are only enough vaccination doses left for 6 million people and no factory left to make more.