17 Apr 2003
Source: Washington Times, April 17, 2003
By Christian Toto, THE WASHINGTON TIMES
The nation has read all the headlines about bio-terrorism and watched the terrorist threat level jump from yellow to orange and drop back again.
Much of what might happen in the future will be out of our control, but experts in bio-terrorism say we can take several key steps to prepare for a stateside bio-terror assault.
Bio-terrorism refers to the release of potentially deadly chemicals, bacteria or other toxins in the air, food or water supply. Tiny amounts of anthrax or smallpox, two of the better-known agents, could kill hundreds, if not more, and cause considerable panic.
Chemical weapons such as mustard gas are instantly detectable because of their fast-acting nature and can inspire panic in the populace.
Other weapons are far less obvious initially. It may take several days, if not weeks, for people to show symptoms from exposure to smallpox.
Nerve agents, man-made poisons such as sarin and VX, typically are odorless and tasteless.
Keith Holtermann, associate dean of George Washington University's School of Medicine and Health Sciences, says the stealthy nature of some bio-weapons makes them uniquely dangerous.
The 1995 sarin attack that killed 11 in a Tokyo subway "was an in-your-face event; we know it occurred," Mr. Holtermann says. Biological attacks from, say, smallpox, would make themselves known in a different fashion.
"In a biological type of event ... we may have a couple of days or so of lag time," he says. That delay, combined with the mobile nature of American society, could spread disease far and wide before anyone realized an attack had happened.
Getting the word out
Government and health groups have been working for months on ways to educate the public on bio-terrorism.
Monica Schoch-Spana, senior fellow with the Center for Civilian Biodefense Strategies at Johns Hopkins University in Baltimore, says the medical community created a priority list of potential bio-weapons in the weeks following September 11.
Researchers identified 30 to 40 agents with some historical significance as potential weapons. They decided to focus their work on six agents that posed the greatest risk to the populace for their deadly nature and ease in dissemination.
These "Class A" agents are anthrax, smallpox, botulism, plague, tularemia and viral hemorrhagic fevers, a group that includes the ebola virus.
"They used those pathogens [as the basis] for building a response system," Ms. Schoch-Spana says.
She says the medical community didn't release information to the public on various bio-terror weapons until several weeks after the attacks.
"All of us ... were caught unaware by 9/11 and had to go into reactive mode," she says. The health community in particular wasn't used to dealing with instant threats like police departments routinely do.
"In the medical and public health communities," she continues, "there's a strong emphasis on being accurate on the scientific details and also to be careful not to foment fear where there's no cause to. You find a reticence to speak in black-and-white terms."
Her center created a "frequently asked questions" link on its Web site (www.hopkins-biodefense.org).
The public, too, has to come to terms with a new way of thinking regarding possible attacks.
"The answer for dealing with bio-terrorism doesn't come individually packaged," Ms. Schoch-Spana says. "We have to change our thinking to realize it's about collective protection, not individual families being prepared."
People would be well-advised to create an emergency kit to help them in case the worst should happen. J.B. Hanson, deputy director of public relations with the Maryland Department of Health and Mental Hygiene, says a practical "grab and go" kit should take all family members into consideration, even pets.
That first-aid-style kit can include traditional medicines such as aspirin as well as specific medications for family members, such as pills for diabetics. Part of the preparation must include plenty of water that can be used for drinking, cleaning, cooking and keeping pets in good health.
"Animals drink more water than people do," Mr. Hanson says.
Other crucial items include fresh batteries, about four days' worth of nonperishable foods and a small tool kit to deal with any unexpected contingencies.
Extra clothing can be important should a family member's clothes be exposed to a toxin. In that case, the person should immediately strip down and place the clothing in a sealable plastic bag. A quick soap-and-water shower should follow, which can cut down on chemical irritation and transmission to others.
Much has been made about securing gas masks for a measure of protection. Mr. Hanson cautions that this simple step could be deadly.
"You need to know how to operate a gas mask, and you need to know the proper fit," he says. "You can't just order them over the Internet." A person could suffocate if his or her gas mask were used incorrectly, he says.
No matter how well-prepared a family may be for an emergency, plans may collapse without a successful meeting plan. Parents should decide on a contact person outside their hometown whose location can serve as a meeting place, a call center or both. An out-of-state grandparent or aunt could serve such a role, allowing all family members to check in or leave messages at a single phone number.
Mr. Holtermann says parents also should work with their local school districts to make sure their children will be safe in case of an attack.
The schools "need to instill confidence in the parents that they have an action plan," he says.
Should a biological attack occur, experts say it would be nearly impossible to prepare because such an assault would be quiet and give no detectable warning signs. Should a chemical attack happen, the public should stay indoors, shut off all ventilation systems, close all doors and wait until an "all clear" signal is given via the media.
Prevention and preparation
While people mull the best way to deal with a crisis, government officials are working on ways to prevent and prepare for the worst.
At last week's 28th annual American Association for the Advancement of Science Colloquium on Science and Technology Policy, held in the District, researchers and public officials spoke to scientists about work being done to prevent and prepare for future atrocities.
Dr. John Killen, assistant director for biodefense research at the National Institute of Allergy and Infectious Diseases at the National Institutes of Health, says progress is being made to prepare the public for a bio-terrorist attack.
Nearly $6 billion is allotted in NIH's 2004 budget for bio-terror, a dramatic increase from the $40 million to $50 million set aside for the same cause in 2000.
"This is all-new money coming to NIH and the Institute of Allergy and Infectious Diseases," Dr. Killen says. Part of that funding will go to creating "next generation" vaccines that don't have the significant side effects that existing vaccines such as the one for smallpox have.
Meanwhile, researchers have found that the drug Cidofovir, normally used for HIV patients, helps reduce the side effects from the smallpox vaccine. Dr. Killen also says Harvard researchers are working on antibodies that help inhibit smallpox growth in mice.
Another looming breakthrough involves a diagnostic tool that would screen people for various biotoxins in their systems before telltale symptoms emerge.
"That's the kind of technology we're on the verge of having available," Dr. Killen says.
Complicating matters is that the current medical health system already is under considerable stress from a lack of resources and constant demand, so a bio-terror attack would have severe ramifications, Mr. Holtermann says.
Still, there is only so much that can be done to prevent or prepare for an unconventional attack.
"So much of this ... we're learning as we go along," Mr. Holtermann says. The information we have right now "is not much. But it's the only way we can empower us as individuals."