BIOLOGICAL WARFARE:
Biological agents are probably the oldest of the nuclear/biological/chemical weapons of mass destruction and have been used for over 2,500 years. They are more calamitous than chemical weapons.
Inhalation of the offending organism is the primary route of transmission. Biological weapons are usually dispersed as an aerosol and may be disseminated from a point source such as industrial sprayers, from moving sources such as airplanes or boats, or from military weapons such as bombs or missile warheads. Humans are not the only potential targets of biological warfare. These agents may also be used to destroy crops and farm animals.
From fifteen to twenty countries are thought to possess biological weapons, including Iran and North Korea. Russia has had an extensive and sophisticated biological weapons program for many years.
The ideal biological weapon can be delivered as an aerosol and maintains its viability and infectivity once dispersed in the environment. It has a high disease-to-infection ratio and has a vaccine or other method available to protect the attacker.
The purpose of a biological weapon is to cause widespread illness and death. The ideal agent will create large numbers of casualties, severe psychological stress on the population, extensive need for medical services overwhelming doctors and hospitals, and the need for individual and collective quarantine and protection of medical personnel. In an article published in the prestigious journal Science, Dr. D. A. Henderson informed us that of the thousands of biological agents that could be used as weapons, only a few make near-perfect weapons with high infectivity, ease of production, ability for aerosolization, high death/disability rates, human-to-human spread, and other factors. Experts have determined that the two biological weapons most likely to be used by bioterrorists are smallpox (a virus) and anthrax (a bacterium). Other biological agents under consideration include bacterial agents like bubonic plague and tularemia, viral agents like Ebola and VEE, and the toxins botulism, ricin, and SEB (Staphylococcal enterotoxin B).
Smallpox
Smallpox vaccine was developed by Edward Jenner in 1796. Smallpox is again a serious threat because vaccinations against the disease stopped more than twenty years ago, and very few people still have immunity. The virus can survive for twenty-four hours or more in aerosol form and is highly infectious even in small amounts. There is no effective treatment. Since smallpox is a virus, antibiotics are of no use. A second wave of cases, occurring about fourteen days after the first wave, is almost inevitable. This second wave will decimate the population of doctors, nurses, and other medical personnel who will have come in contact with the first wave.
If adversaries of the United States are considering using smallpox as a weapon against its people, it will not be the first occurrence of its kind. Smallpox was widespread at the beginning of the American Revolution. There are indications that the British had purposefully sent infected blankets into American Indian camps during Pontiac’s War (1763). Epidemics occurred among the tribes, killing more than half the population. American soldiers besieging Boston and Quebec in 1775 were convinced of the same sort of British treachery.
In 1777, Major Robert Donkin, a British officer during the American Revolution, published a book titled Military Collections and Remarks (published by Hugh Gaine, New York City). On page 190, there is a footnote, which is deleted in many copies because of its inflammatory nature but is still present in a copy obtained by the Clements Library at the University of Michigan. The footnote reads: “Dip arrows in matter of small pox, and twang them at the American rebels, in order to inoculate them; This would sooner disband these stubborn, ignorant, enthusiastic savages, than any other compulsive measures. Such is their dread and fear of that disorder!”
Smallpox is a deadly disease. The usual mortality rate for a person without prior immunization stands at 30 percent. In some epidemics, however, it has been as high as 50 percent. Smallpox is thought to have killed more human beings than any other infectious disease. It is known to have occurred among the early Egyptians and killed at least 300 million people during the twentieth century.
Smallpox has an incubation period of ten days. The first symptoms are fever, backache, and vomiting. Small red spots then appear all over the body, though more densely on the face and extremities, and the patient gets a characteristic worried look. The spots then turn into painful blisters (pustules) with a dimple in the center. The pustules become larger and fill with virus-containing fluid. The pustules then become hard, about the size of peas, giving the skin the appearance of a cobblestone street. If the patient lives, the pustules leave scars for the remainder of the patient’s life.
In 1980, the Soviet government began a successful program to create an even more virulent strain of the smallpox virus and to weaponize it so it could be released on an enemy using bombs and missiles. There is concern that the weaponized virus has been passed on to other countries.
Smallpox spreads from person to person by droplets or aerosol expelled from the nose or mouth of infected persons. Contaminated bed linens or clothes can also spread the virus. Smallpox patients are most infectious from the onset of the rash through the next seven to ten days.
The previously mentioned Dr. Henderson is the man credited with ridding the world of smallpox. Due to the efforts of a team led by him, smallpox was eradicated from the world in 1979. It is a fascinating story:
Although most of the people of Yugoslavia had been vaccinated and the last case of smallpox had occurred in 1930, a case of smallpox was discovered in 1972. On February 15th of that year, a thirty-eight-year-old Muslim clergyman returned to his hometown in Kosovo from a pilgrimage to Mecca. The next morning he awoke feeling achy. He shivered for a day or two, then developed a red rash. The clergyman’s family and friends came to visit him. Unknowingly, he was breathing smallpox virus into the air, attached to droplets of saliva. The visitors inhaled the infected droplets and became infected.
Several weeks later on March 3, 1972, one of the visitors, a thirty-year-old male schoolteacher, developed fever. Two days later, he developed dark spots on his skin, which turned into blackened, mottled splashes; the local doctors did not recognize the condition as hemorrhagic smallpox. He developed bleeding in the sclera of each eye. On March 10, 1972, he suffered massive hemorrhages in the intestines and expelled quarts of blood along with the sloughed intestinal and rectal mucosa; he died from exsanguination. The doctors, nurses, and some of the patients at the hospital who cared for him became infected.
Meanwhile, the clergyman infected twenty-seven people at the hospital alone, and thirty-eight people in all. Eight of them died.
A World Health Organization team, led by Dr. Henderson, rushed in to contain the epidemic. The Yugoslavian Army was mobilized, villages were closed, roadblocks were erected, and ten thousand people were quarantined by the Yugoslav military. The country’s borders were closed. A massive campaign was instituted to revaccinate every person in Yugoslavia. Eighteen million doses of vaccine were given in ten days. The epidemic was contained, and smallpox was finally eradicated from the human population.
The release of a highly virulent weapon-grade smallpox virus into the population would constitute a global emergency. The disease would spread in logarithmic fashion, with each diseased person infecting an average of twenty people. As a result, within ten to fourteen days of the first occurrence, the infection would spread from 1 to 20, then to 400, then to 8,000, then to 160,000, and so on. Millions, perhaps billions, would die from the disease.
A genetically manipulated, highly virulent, highly transmissible strain of smallpox is the ideal weapon for a country or a religious or politically inspired group to use to eliminate their adversaries, nonbelievers, or opponents. After vaccinating all their followers and then releasing the virus into the general population, they would be the only major surviving group.
The main defense against contracting the disease, if it is released into the population, is quarantine—complete isolation from that population until the epidemic has run its course.
Anthrax
Anthrax is an infectious disease that occurs naturally in cows, sheep, goats, camels, and other animals. It can also occur in humans by handling products from infected animals, inhaling anthrax spores from contaminated animal products, or by eating undercooked meat from infected animals. Anthrax has also been referred to as “woolsorters’ disease.” It is caused by the spore-forming bacterium Bacillus anthracis. Anthrax spores can live in the soil for many years.
The disease can occur in three forms: infection of the skin, the lungs, or the intestines. Symptoms usually occur within seven days following exposure. However, with inhalation, anthrax symptoms can take up to forty-two days to appear. Antibiotics are used to treat all three types of anthrax. Early identification and treatment are important. Before symptoms appear, anthrax can be prevented after exposure with antibiotics plus anthrax vaccine. After symptoms occur, treatment is a sixty-day course of antibiotics. Treatment is not always effective, and patients may die regardless of the medication.
With skin infection, the spore enters a cut or abrasion; it is usually contracted in handling of contaminated wool, hides, hair, or leather of infected animals. The infection starts as a small sore that looks like an insect bite, but it soon becomes blisterlike and then a painless ulcer about an inch in diameter with a characteristic black center. About 20 percent of patients with cutaneous anthrax die if untreated.
With lung infection, the initial symptoms are sore throat, mild fever, and muscle aches. After several days, the symptoms progress to severe breathing problems and shock. Inhaled anthrax is usually fatal, even with aggressive antibiotic and supportive therapy. Inhalation is the route most likely to be used by an aggressor nation or terrorist group. The spores can be disseminated from a spraying device either on the ground or from the air.
Intestinal infection usually occurs due to consumption of contaminated meat. It causes acute inflammation of the intestinal tract. Initial symptoms include nausea, loss of appetite, vomiting, and fever; these are followed by abdominal pain, vomiting of blood, and severe and sometimes bloody diarrhea. Patients may complain of sore throat and difficulty in swallowing. Swelling of the neck and regional lymph glands may occur. Depending on the virulence of the anthrax strain and other factors, 25 percent to 60 percent of patients with intestinal anthrax die.
Anthrax was used as a biological weapon in the United States in 2001. Anthrax spores were deliberately spread through the postal system by a scientist who worked at the government’s biodefense labs. He sent letters containing anthrax spores to various governmental employees and others. Twenty-two cases of anthrax infection resulted from the mailings, eleven of which were cutaneous anthrax and eleven inhalation anthrax. Five of the inhalation anthrax cases died from the disease.
Government agencies are working diligently to prepare not just for anthrax but for all kinds of possible bioweapon attacks. Plans and procedures are in place to respond to an attack. Emergency response teams have been trained and equipped to help state and local governments control infection, obtain samples, and perform laboratory tests. These agencies have developed programs to educate health care providers, the media, and the general public regarding potential attacks. The Centers for Disease Control (CDC) works closely with health departments, veterinarians, and laboratories in surveillance efforts; it also works with hospitals, laboratories, and emergency response teams to make sure they are equipped to handle bioweapon at
