Diseases Can Be Weapons of Terror

Soldiers lose their lives on the battlefield, and car bombs continue to wreak havoc, but a more insidious threat looms for civilian populations: a bioterrorist attack.

Bioterrorism, put simply, is an act of terror or violence that involves the use of a biological agent. The United States got a taste of such an attack in 2001 when mail tainted by anthrax sickened 11 people and killed five.

Monica Schoch-Spana, Ph.D., a former senior fellow at the Center for Civilian Biodefense Strategies at Johns Hopkins University, says that NATO and the Centers for Disease Control and Prevention (CDC) have identified about 30 to 40 agents that could be used as weapons, or "weaponized," in military jargon.

Six of those are the ones that most concern CDC and world health officials. They are smallpox, anthrax, botulinum toxin, tularemia, plague and viral hemorrhagic fevers. But just how would they be used as weapons?

"People need to understand there's a wide range of scenarios," Schoch-Spana says. "They range from hoaxes to smaller attacks to highly disruptive attacks with deaths and multiple cases, which is what we saw in the anthrax attacks. On the far end is a large-scale outbreak with aerosol release of some pathogen with mass fatalities. There's a wide range from mere threat to wholesale pandemic, which is an outbreak that has gone global."

Just as there are multiple scenarios, so, too, are there multiple questions about how best to protect the population.

"Americans need to face the frank reality that answers to bioterrorism don't come individually packaged," Schoch-Spana says. "Our greatest protection is a robust public health system and a trained clinician base."

After all, medical and public health practitioners face infectious disease on a regular basis.

"Duct tape, plastic sheeting and gas masks don't provide protection," Schoch-Spana notes.

The problem is that a bioterrorist attack will be covert. "There is no warning, and the targeted population won't know it's happened until people get sick."

Nor is stockpiling antibiotics an easy solution.

"An antibiotic has to match the disease to be effective," Schoch-Spana says. "Antibiotics don't help against smallpox. And antibiotics, despite their widespread use, are very potent medicines. There are shelf-life issues, and there are dosage issues. God forbid we should have a parent who thinks they're protecting their child and gives a dangerous dose."

So what can people do?

"In the middle of an outbreak - and a lot will depend on what the agent is - listen to what public authorities are saying, and touch base with your personal physician," Schoch-Spana says.

Another step to take now is to learn about the top agents, what they are and how they're spread. Anthrax, for example isn't contagious; it can't be spread person to person. In contrast, pneumonic plague and smallpox can pass from person to person. The good news, however, is that in many cases, basic barrier precautions and infection control methods can inhibit spread.

Families need to plan, too, as they would for any crisis, to know where family members are and to devise a way to let them know that family members are safe.

What should you have on hand?

"If one is looking to do this," Schoch-Spana says, "You should have three days supply of non-perishable food and water. These are also useful if the water main breaks or the lights go out, and they don't require a lot of economic investment."

By the way, that bottled water is more for an interruption in supply, not because the water itself might become tainted. Schoch-Spana says, "it would take such vast amounts of chemical or biological agents to contaminate our water supply, most of which is actually for industrial use, that it would be hard for a terrorist to do."

"One would hope someone dumping tons and tons of something in the water would be noticed," she says, "and our water processing plants are in the business of killing things that can contaminate water."

As in any disaster, natural or otherwise, it's important to hook up with neighbors, co-workers and schools. It is especially important for schools to plan how they will respond.

"People really do come together to act collectively with a problem," Schoch-Spana says.

Because bioterrorism will require collective, not individual, solutions, people should express concerns to their leaders and deal with elected officials.

Presently, people are justifiably nervous and concerned about a possible biological attack. But this modern problem isn't going to diminish.

"Right now, there's a peak in people's interest and concern," Schoch-Spana says. "But it's not just the immediate threat. We're in an age of big advances in biology right now. We're not thinking just of immediate problems, but also how we can control the malicious use of advances. This is a problem that's not going to go away; it's something we'll be grappling with in the future."

Part two: an in-depth look at six possible bioterrorism agents.

External Source U. S. Department of Homeland Security

This article was reviewed and updated June 2007.

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