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Antidote to Terrorism: Preparedness

Public Health Experts Plan for the Unthinkable

Where's There's Ill Will, There's a Way continued...

In 1995, the fringe Japanese group Aum Shinrikyo spread the deadly nerve gas sarin in the Tokyo subway system, causing 12 deaths and more than 5,500 injuries.

"The scenarios are numerous. That is the problem," notes Jennifer Leaning, MD, professor of international health at the Harvard School of Public Health in Boston, one of 19 academic institutions funded by the CDC to develop public health strategies for coping with bioterrorism.

In a written reply to questions from WebMD, Leaning noted, "there are many pathways [for terrorist acts] -- think air and water.  Then think of all the networked systems we live in -- the mail system was just one.  The possible ingenuity a terrorist might employ, of relying on a system that already disseminates things, is what troubles many of us."

Leaning contends that it is "virtually impossible" to fully protect food and water supplies in a country as large and complex as the United States.

Easier Said Than Done

It is somewhat reassuring to know, say public health experts, that most biological agents are difficult to convert into weapons that can do large-scale damage, and they usually require special laboratory techniques and equipment to make them into a form that is easy to spread through the air.

For example: The CDC notes that in the anthrax scare of autumn 2001, only 22 people were infected with either the inhaled or skin (cutaneous) form of anthrax, and there were only five deaths, despite the fact that 85 million pieces of mail passed through the processing centers in New Jersey and the District of Columbia through which the contaminated envelopes also traveled.

As the HHS official told WebMD, it would take massive quantities of biological agents to even begin to contaminate a large municipal reservoir, because the toxin would otherwise be highly diluted and therefore very weak. Even then, the disease-causing agents would probably be killed by chlorination or filtered out of the water through the normal treatment process.

Similarly, the HHS expert said, poisoning of the food supply would have to occur fairly high up in the chain of production, such as a processing plant, for an intended biological weapon to have a large-scale impact.

And even such highly contagious and deadly agents as smallpox, while terrifying, can be contained if doctors remain vigilant for signs of infection and public health measures such as quarantine and vaccination are set into motion at the first sign of trouble, infectious disease experts say.

Be Prepared

The Department of Homeland Security recently issued terrorism-preparedness guidelines that mirror natural disaster-readiness guidelines. The agency recommends that citizens have adequate supplies of food and water, battery-operated flashlights and radios, but also duct tape and plastic sheeting for sealing off windows and doors and presumably sealing out infectious agents or chemical contaminants.

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