What type of bioterrorism did americans face

How do they work? And are we really at risk? In this Spotlight, we survey their history and potential future. This can include bacteria, viruses, or fungi. These agents are used to incapacitate or kill humans, animals, or plants as part of a war effort. In effect, biological warfare is using non-human life to disrupt — or end — human life.

Because living organisms can be unpredictable and incredibly resilient, biological weapons are difficult to control, potentially devastating on a global scale, and prohibited globally under numerous treaties. The history of biological warfare is a long one, which makes sense; its deployment can be a lo-fi affair, so there is no need for electrical components, nuclear fusion, or rocket grade titanium, for instance. Consuming the tainted water produced a confused mental state, hallucinations, and, in some cases, death.

In the s, Tartar Mongol warriors besieged the Crimean city of Kaffa. During the siege, many Tartars died at the hands of plague, and their lifeless, infected bodies were hurled over the city walls. Some researchers believe that this tactic may have been responsible for the spread of Black Death plague into Europe. If so, this early use of biological warfare caused the eventual deaths of around 25 million Europeans.

In an attempt to spread the disease to the locals, the Brits presented blankets from a smallpox hospital as gifts. Although we now know that this would be a relatively ineffective way to transmit smallpox, the intent was there. During World War II, many of the parties involved looked into biological warfare with great interest. The Allies built facilities capable of mass producing anthrax spores, brucellosis, and botulism toxins.

Thankfully, the war ended before they were used. It was the Japanese who made the most use of biological weapons during World War II, as among other terrifyingly indiscriminate attacks, the Japanese Army Air Force dropped ceramic bombs full of fleas carrying the bubonic plague on Ningbo, China. The following quote comes from a paper on the history of biological warfare. Friedrich Frischknecht, professor of integrative parasitology, Heidelberg University, Germany.

This can be achieved in a number of ways, such as: via aerosol sprays; in explosive devices; via food or water; or absorbed or injected into skin.

Because some pathogens are less robust than others, the type of pathogen used will define how it can be deployed. Utilizing such weapons holds a certain appeal to terrorists; they have the potential to cause great harm, of course, but they are also fairly cheap to produce when compared with missiles or other more hi-tech equipment.

Biological weapons can be difficult to control or predict in a battlefield situation, since there is a substantial risk that troops on both sides will be affected. In , powdered anthrax spores were deliberately put into letters that were mailed through the U.

Twenty-two people, including 12 mail handlers, got anthrax, and five of these 22 people died. An anthrax attack could take many forms. For example, it could be placed in letters and mailed, as was done in , or it could be put into food or water. Anthrax also could be released into the air from a truck, building, or plane. It only takes a small amount of anthrax to infect a large number of people. If anthrax spores were released into the air, people could breathe them in and get sick with anthrax.

Inhalation anthrax is the most serious form and can kill quickly if not treated immediately. If the attack were not detected by one of the monitoring systems in place in the United States, it might go unnoticed until doctors begin to see unusual patterns of illness among sick people showing up at emergency rooms. A subset of select agents and toxins have been designated as Tier 1 because these biological agents and toxins present the greatest risk of deliberate misuse with significant potential for mass casualties or devastating effect to the economy, critical infrastructure, or public confidence, and pose a severe threat to public health and safety.

Bacillus anthracis is a Tier 1 agent. The possession, use, or transfer of B. This video describes anthrax and its history as a biological weapon.

Infectious disease agents from specific origins exhibit unique molecular fingerprints that are all but impossible to erase Jackson et al. These fingerprints are inherent to many, if not all, bioweapons agents on the A-List, including bacteria and viruses against humans and animals.

It is therefore feasible to sequence the genes of such agents, organize that information in large databases, and use this molecular information to strengthen future BWC agreements and homeland security efforts. The elements of the plan are as follows. Optimally, there would be two such facilities. The first would be domestically based, used to enhance homeland security, and serve as a model to states that are parties to the BWC.

The second would be internationally based and offer improved verification and compliance capabilities to future BWC agreements. These two facilities could generate complementary and corroborative information. A dedicated high-throughput laboratory against bioweapons agents would offer several important capabilities. First, it would enable exhaustive molecular fingerprinting and taxonomic positioning for a broad spectrum of known threat agents. Second, it would perform such analyses in a consistent and chain-of-custody manner.

Third, it would produce high-resolution information within hours to days after sample receipt. The international facility could operate with capabilities and compartments established by future BWC agreements.

Such arrangements would enable the United States to maintain its own molecular forensics and database capability yet share powerful testing methods and technologies with states that are parties to the BWC. In , the Australia Group identified nearly bacteria, viruses, fungi, and toxins against people, animals, and plants with potentials for weaponization. To date, however, only about 20 infectious agents have been used to produce biological weapons. All the necessary technologies are available to build and operate a highthroughput molecular forensics laboratory and database system against bioweapons agents Layne et al.

The first are portable devices offering relatively simple and rapid tests. The second are high-throughput automation and robotic systems offering highly definitive tests. These larger systems must be housed in a semitractor trailer or suitable building, where samples must be brought to them. As outlined below, the optimal system would integrate both designs. The tests are based on polymerase chain reaction PCR methods and utilize tailored molecular primers against specific biothreat agents, such as B.

A larger set of primers is capable of screening for a larger list of biothreat agents. Such portable devices are able to detect very small traces of organisms but cannot actually sequence their genes. They often incorporate a personal computer to control and monitor tests, an Internet link to enable real-time data acquisition, and a global positioning device to automatically track locations.

With such technologies, a trained individual can screen about two dozen samples per hour. To increase testing capacity, multiple devices can be deployed. More definitive molecular forensics tests require more steps. A large assortment of automated and robotic equipment is available for this kind of work.

Such industrial-scale technologies e. From a design standpoint, the various plug-and-work modules would be integrated into a flexible working system that could be upgraded with the latest commercial technologies. Incoming samples would follow an orderly flow, with different massanalysis lines focusing on different biothreat agents. Because of automation and miniaturization, the entire facility which permits the growing, extracting, sequencing, and archiving of samples would fit into a surprisingly compact space that contains biohazardous materials and safeguards workers.

More sequence information is always better for molecular forensics, yet there are tradeoffs between laboratory productivity and definitive identifications. In comparison, the human genome is composed of about 4,,, bases. Current technologies would enable a highthroughput molecular forensics laboratory to sequencing about 10,, bases per day. This would correspond roughly to fingerprinting and positioning about viruses or 50 bacteria per day.

Such procedures could be completed within hours or days after receiving samples. A surge capacity of 10, samples per day would be feasible with current technologies. At such rates, however, the limiting factors would be sample collection and transportation rather than rapid testing. The high-throughput molecular forensics laboratory would generate a sizeable database within a few years.

In addition to cataloguing molecular fingerprints, the laboratory would also be able to analyze the taxonomic position and natural genetic history of threat agents genealogies. In reach-back and attribution scenarios, genealogies could prove to be more powerful than fingerprints alone. The most recent generation of teraflop computers, which can achieve speeds of 30 x 10 12 calculations per second, would be well suited to analyze the threat agent database. Domestically, the goal would be to support decisionmaking processes and offer surge capacity for public health, emergency medical, agricultural, and law enforcement efforts.

Internationally, the goal would be to support United States national security and intelligence operations as well as future BWC agreements. The toolbox for such undertakings includes currently available tracking, mapping, and modeling technologies. The United States has mature policies to deter nuclear attacks, set forth as mutual assured destruction MAD. It also has established policies to deter conventional attacks, set forth by the ability to fight on one or two major fronts and several minor fronts at once.

But the United States has few well-developed policies to deter biological attacks. A high-throughput molecular forensics laboratory and database facility would help to fill this gap by enabling a new policy of virtually assured detection and response VADAR regarding biological attacks.

The framework is as follows. The collapse of the system of two opposing superpowers has led to an uncertain world order characterized by one global ultrapower, a majority of responsible governments, several rogue states, multiple religious fringe groups, and some shadowy international syndicates that are forming new networks and posing new challenges to global security.

Today, at least 17 countries are known to be developing or producing bioweapons and the list may be expanding. The scale of global trade also poses a major challenge. For example, more than 14, loaded foot marine containers enter the United States each day Flynn, Containers routinely travel through the country before reaching a port of entry and the system tracking their intended course and location is rudimentary.

Furthermore, few containers undergo any form of inspection and, even when this occurs, specialized inspection technologies are rarely used. Current methods of disease control, which rely on veterinarians inspecting animals for signs of infection, collecting mucosal and blood samples, and analyzing them with manual laboratories, have cycle times of three to five days.

Foot-and-mouth disease can spread from one location to another, however, in far less time. Consequently, the current system with manual laboratories cannot support science-based decisions on quarantine zones, animal destruction, and resource allocation.

At the heart of the problem is a lack of rapid, accurate, and complete information on which to make dependable decisions. A quantum leap in threat agent surveillance and data analysis is needed. In a bioattack on the United States, as few as 50 sickened people in one major city could stretch public health, emergency medical, and law enforcement services beyond local capabilities. Larger attacks involving major metropolitan areas would be overwhelming and require the delivery of tons of antibiotics to exposed persons within days, challenging national capabilities.

A coherent program that strengthens homeland security thus requires sizeable laboratory and informatic resources that can be organized in terms of four overall phases. First, in preventing attacks, the United States would rely on the ability to fingerprint and catalogue bioweapons agents with high-throughput technologies. An extensive database of molecular fingerprints and associated origins would offer a new means of rapid attribution and therefore deterrence.

It would put rogue states, religious fringe groups, and international syndicates on notice that there is little chance to evade blame for bioattacks.

Second, in the unfortunate event of an attack, public health laboratories would be overwhelmed simply because there would be too many samples to analyze quickly. Manual laboratories would be unable to answer even the simplest questions: Is the agent present? How many different infectious agents were. How do they differ? What are the best initial therapies to treat those afflicted and exposed? Information from high-throughput laboratories would reduce confusion and save lives by offering rapid testing in acute situations.

Third, in the aftermath of an attack, public health, agricultural, and law enforcement officials would need accurate answers to another set of questions. What are the geographic boundaries of each infectious agent? What are their stabilities? What are the effects on animals and plants? Information from highthroughput laboratory and mapping systems would speed the recovery process by offering testing for cleanup and investigatory operations.

Fourth, in response to the attack, law enforcement officials must collect evidence in accordance with chain of custody procedures. Intelligence agencies and military services must make accurate attributions and take swift actions to protect national security. Information from high-throughput laboratories and their associated databases could prevent further attacks by rapidly pinpointing suspected sources.

The relatively small anthrax attacks in a few American cities flooded the bioterrorism response network. Thousands of samples were sent to a patchwork of state and federal laboratories which, at best, were equipped to handle about samples per day Kahn et al. Even with many laboratories working around-the-clock, they could not keep pace with emergency testing demands.

Strengthening homeland security against bioterrorism needs enhanced public health and emergency medical preparedness at home and expanded human intelligence capabilities abroad. Moving beyond the BWC Protocol stalemate requires reliable disclosure of dual use facilities, timely inspection of suspicious programs, and systematic testing for certain i.

The common element among such undertakings is rapid, complete, and reliable information on which to make assessments and decisions. A high-throughput molecular forensics laboratory and database facility would cost several hundred million dollars to build and operate over the first five years. Since the needed technologies already are available, it could be operational within two years.

Such a facility could be operated under the newly created Homeland Security Council. The mission of this new national medical forensics and intelligence support laboratory would be to complement and cooperate with existing government agencies such as health, agriculture, emergency management, justice, defense, intelligence, and the national laboratories.

It would support public health, law enforcement, and homeland security programs without usurping their long-established missions. It would provide needed surge capacity in the acute and cleanup phases of terrorist bioattacks. It would also have mechanisms to support certain scientific and technical research.

In building the first molecular forensic laboratory against bioweapons agents, the overall testing methods and high-throughput capabilities would be shared with the scientific community. The design of certain molecular primers against specific biothreat agents and resulting fingerprint and genealogies, however, would be available to the national and homeland security communities only.

Such open architectures would facilitate the development a second internationally-based laboratory that parallels the initial design. In the aftermath of the terrorist attacks on the World Trade Center and Pentagon and organized anthrax attacks in several American cities, there has been renewed debate on the risks of further biological attacks. At present, the risk remains unclear. Yet it is clear that terrorist attacks have become more spectacular and lethal and have now reached our homeland soil.

The question is: When will the shift to more devastating forms of bioterrorism take place? The United States now has the opportunity to organize effective prevention, deterrence, and response measures.

The United States must also act on domestic and international fronts. Is it an improvement over existing methods and policies? Is it possible to circumvent? But with secret offensive bioweapons programs possibly assisting organized terrorism, can we afford to wait?

Technology could help public health enormously; but to help focus the development of technology for public health as well as for the FBI and other law enforcement agencies who cope with forensic issues that resemble the diagnostic ones faced by public health , the public health community needs to articulate its technology needs.

Once these needs are defined, then the science and technology communities, including funding organizations such as DARPA , can begin to define the science and technology programs required to develop the desired capability.

In this way, bridges can be built between public health and the technical community. Indeed, agencies like DARPA are very good at assembling the kind of interdisciplinary scientific and technical efforts—involving academia, industry, and government laboratories—that are required to develop new capabilities.

Suppose, for example, the case could be made for a routine molecular. This statement reflects the professional view of the author and should not be construed as an official position of the Defense Advanced Research Projects Agency. A research and development effort might then be mounted to develop this new diagnostic capability by assembling researchers from the appropriate technical and user communities—e.

The challenge would be enormous but the magnitude of the development effort will be a strong function of how strongly the case had been made for doing it in the first place. Genomics-based technologies, for example, have great potential for improving public health. Fulfillment of this potential would be accelerated if the public health community participated in developing a vision of how the application of genomics information could enhance health care.

Such a vision might serve to rally the nation to develop technological capabilities that enhance our ability to cope with many of the bioterrorism response and preparedness issues that have been identified in our discussions.

During World War II, for example, it was recognized that radar had tremendous potential for identifying U boats. The proof of principle had been done, but the technology still needed to be developed. A vision of what radar might be capable of doing for the military led to the initiation of the radar program at MIT from which great science and technology emerged including the foundations of the microelectronics industry. Finally, it is very difficult to bound all of the bioterrorism response capabilities that have been discussed during this workshop.

There are simply too many imaginable bioterrorist scenarios multiple agents and multiple ways to create mischief with them. We do not have sufficient resources to address an unbounded set of problems. So we must try in some rational way to bound bioterrorism and define the set of bioterrorism issues that need to be addressed.

We must focus and develop a big vision that the country can respond to. For example, why not identify as a national goal the removal of infectious disease as a public health threat? This does not mean that we need to define how to eliminate infectious disease. But by crisply stating the problem and offering a prize to the one who solved it, some fantastic science and technology emerged.

Could we not rally the country behind a campaign to eliminate the infectious disease threat? Update: West Nile-like viral encephalitis — New York, Mortality and Morbidity Weekly Record — Jarroff L. Of mosquitoes, dead birds and epidemics. Time 15 — Miller JR, Mikol Y. Surveillance for diarrheal disease in New York City. Journal of Urban Health — Surveillance data for waterborne illness detection: an assessment following a massive waterborne outbreak of Cryptosporidium infection.

Epidemiology and Infection — Pharmaceutical sales a method of disease surveillance. Journal of Environmental Health — Using nurse hot line calls for disease surveillance. Emerging Infectious Diseases Apr—Jun;4 2 — Vet Pathol — Thacker SB. Historical development.

Principles and Practice of Public Health Surveillance. Public health surveillance in the United States. Epidemiology Review — Flynn SE. Beyond Border Control. Foreign Affairs 57— PCR analysis of tissue samples from the Sverdlovsk anthrax victims: The presence of multiple Bacillus anthracis strains in different victims. Public health preparedness for biological terrorism in the USA. Lancet — Multiple-locus variable-number tandem repeat analysis reveals genetic relationships within Bacillus anthracis.

Journal of Bacteriology — Washington, D. From the discussions, it became clear that of utmost urgency is the need to cast the issue of a response in an appropriate framework in order to attract the attention of Congress and the public in order to garner sufficient and sustainable support for such initiatives. No matter how the issue is cast, numerous workshop participants agreed that there are many gaps in the public health infrastructure and countermeasure capabilities that must be prioritized and addressed in order to assure a rapid and effective response to another bioterrorist attack.

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Get This Book. Visit NAP. Looking for other ways to read this? No thanks. Page Share Cite. Detection and Diagnosis. Expectations for a Health Indicator Surveillance System. Specific Needs for Bioterrorism Surveillance. Needs for Animal and Plant Surveillance. Key Issues for Developing a Surveillance System. The following questions addressed the usefulness of health surveillance data. Improvement in Active Patient Data Collection.

Syndrome-based reporting from a pre-determined list of signs and symptoms; Touch screen or personal digital assistant PDA -based electronic data reporting, collection, and submission; Graphical presentation of data based on GIS and temporal information; Automatic alerts to public health officials of specific signs and symptoms e.

The Need for a System of Systems. TABLE Selected infectious disease outbreaks characterized by delayed recognition, characterization, or response Disease Outbreak Characteristics Influenza Worldwide, — 3,4 pp— Rapid spread over large geographic area Overwhelms health care system Overwhelms essential services e. Some of the current large computational modeling and simulation efforts in other scientific fields include: The Department of Transportation, in collaboration with the Department of Energy, is using agent-based modeling to model automobile traffic flows in major cities.

Examples of current enabling procedures and technologies There are some reasonably good collectors available that can sample large volumes of air over short periods of time by concentrating and impacting air content onto either a water filter or solid substrate; the collected material is then introduced into a detection scheme.

How can we better control access to potential biothreat agents? Thus, the law contains no provision for exemptions under any circumstances While prohibiting the possession of select agents for purposes that are not for bona fide research and other beneficial purposes, the USA Patriot act does not impose registration requirements for the possession of select agents for legitimate purposes ASM has supported such registration since Homeland Security and the Biological Weapons Convention.

Molecular Forensics. Available Technologies. Login or Register to save! Stay Connected! Disease Outbreak Characteristics.

Influenza Worldwide, — 3,4 pp— Rapid spread over large geographic area Overwhelms health care system Overwhelms essential services e.

Common-source Exposed population disperses from point of exposure throughout the state of Pennsylvania Unknown agent Rapid spread and demise Mimics a biological terrorist attack. Affects small population spread over a large geographic area Cultural concerns Zoonotic.

Salmonellosis Oregon, , US, 7. Bioterrorism attack that mimics naturallyoccurring outbreak Unrecognized as bioterrorism at time Community-wide outbreak Common agent. Zoonotic birds are first victims Initial diagnosis wrong Limited geographic area affected humans Specific population group affected elderly humans New agent to New York City Suspicion of bioterrorism. Data Source. Cons and Confounders. Reflects incidence of disease in general population. Nonspecific- May be difficult to document definitive information.

Reflects symptomatology most broadly. May not be ordered for all most patients. Problems with timeliness and accuracy Not broadly representative.