Bioterrorism Risk Is Real, but Safeguards Are Falling Into Place

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Jan. 10, 2000 (Atlanta) -- The worst Y2K bug may have nothing to do with computers at all. Instead, it may be a real "bug," a micro-organism used by terrorists to wreak widespread damage. Whether it's anthrax or smallpox or some other lethal organism, in the wrong hands, it could be used to cause a major public health disaster.

That's all true. But is it likely? And does the real danger lie not in the threat itself, but in the rhetoric surrounding it?

In a recent editorial in the American Journal of Infection Control (AJIC), Michael T. Osterholm, PhD, MPH, and CEO of the Infection Control Advisory Network, wrote "I firmly believe that it is not a matter of 'if' a bioterrorism event will occur in the United States, but rather 'when, where, and how large?'"

Leonard A. Cole, PhD, author of the book The Eleventh Plague: The Politics of Biological and Chemical Warfare, wrote in the same issue of AJIC of the risks associated with "hyperbole" on the subject, calling for "rhetorical restraint." He links the spate of anthrax hoaxes over the last two years to government and media attention given to the subject of bioterrorism.

The threat of biological weapons in the Gulf War, and the chemical terrorism used by the Japanese cult Aum Shinrikyo, which released sarin nerve gas into a Tokyo subway in 1995, combined to raise concerns among many people over whether such threats could affect the United States.

Congress took notice, and federal coffers opened. Last year, hundreds of millions of dollars were allocated to prepare for the possibility of bioterrorism. The CDC set up a bioterrorism preparedness and response program.

Scott Lillibridge, MD, the director of the program for the CDC, tells WebMD that the agency is not "predicting threats," but working to "shore up public health vulnerabilities." He says that in the program's first year, the CDC worked to develop a national stockpile of critical medications, vaccines, and antitoxins.

"Two-thirds of the money went out to enhance state and local capacities in areas related to surveillance, laboratory [detection], and general public health preparedness," Lillibridge says. That preparedness will have "dual-use capacities." he says, when the program meets its goals in about three to five years.


"The threats that such preparedness can be directed against certainly include bioterrorism," Lillibridge tells WebMD, "but they would also include any emerging infectious disease or any other broad scale public health emergency that threatened the population."

The former chief of the CDC's surveillance section and current director of the Johns Hopkins Center for Civilian Biodefense Studies, D.A. Henderson, tells WebMD, we still have a "long way to go with the safety nets", but the threat warrants the action.

"I think it's very real, I think there's very little in the way of disagreement that it's before us; it's a reality, it's a real threat. I would say generally, the feeling is that the probability that any of the very serious weapons are going to be used is small, but if they are used the results could be catastrophic. Are we worried? Yes, I think we've got cause to be," Henderson says.

Jonathan Tucker, PhD, is a Robert Wesson Fellow at Stanford University and is writing a book on smallpox. He formerly directed the Chemical and Biological Weapons Nonproliferation Project at the Monterey Institute of International Studies, in California. Tucker tells WebMD, "[I tend] to be less alarmist than most, I think because [my colleagues and I] really have been looking at the data rather than just speculating in a vacuum."

Tucker has written that only one U.S. fatality can be linked to a bioterrorist act, and that involves the use of a cyanide-tipped bullet in 1973 by the Symbionese Liberation Army, the group responsible for kidnapping newspaper heiress Patty Hearst in 1974. He also says that the apparent ease with which a harmful organism could be used for mass murder is overplayed.

"The ease with which terrorists could both produce and weaponize biological agents has been vastly exaggerated in the popular press. There are a whole series of hurdles that would have to be overcome. ... There has to be the motivation to inflict mass casualties. There has to be the organizational structure that is able to resist infiltration and premature arrest, and then there has to be the technical capability to actually deliver the agent," Tucker tells WebMD.


He says that the subject has been overly politicized, leading to somewhat of a money grab by sometimes unwarranted sources. "I'm not saying that the government should not prepare or plan for this. It's a very unlikely possibility, but if it were to happen it would be devastating, so there needs to be an appropriate level of preparation," Tucker says. "I think the threat has been exaggerated, perhaps for political reasons."

Because a bioterrorist attack hasn't happened yet of course doesn't mean that it can't, according to Henderson. He tells WebMD, "The face of terrorism has changed. I think we were looking before primarily at groups wanting to make a statement ... but there was a restraint for many of them, in the sense of not wanting to get too extreme for the fear of alienating supporters. ... What we've seen now is [people such as] Osama Bin Laden and Aum Shinrikyo, whose clear intent is to kill as many people as they possibly can."


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