Bioterrorism

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United States Airman wearing an M-17 nuclear, biological, and chemical warfare mask and hood

Bioterrorism is terrorism involving the intentional release or dissemination of biological agents. These agents are bacteria, viruses, fungi, or toxins, and may be in a naturally occurring or a human-modified form, in much the same way in biological warfare.

Terrorism use of violence and intimidation against civilians in order to further a political goal

Terrorism is, in the broadest sense, the use of intentionally indiscriminate violence as a means to create terror among masses of people; or fear to achieve a religious or political aim. It is used in this regard primarily to refer to violence during peacetime or in war against non-combatants. The terms "terrorist" and "terrorism" originated during the French Revolution of the late 18th century but gained mainstream popularity in the 1970s in news reports and books covering the conflicts in Northern Ireland, the Basque Country and Palestine. The increased use of suicide attacks from the 1980s onwards was typified by the September 11 attacks in New York City and Washington, D.C. in 2001.

Biological agent pathogen that can be weaponized

A biological agent—also called bio-agent, biological threat agent, biological warfare agent, biological weapon, or bioweapon—is a bacterium, virus, protozoan, parasite, or fungus that can be used purposefully as a weapon in bioterrorism or biological warfare (BW). In addition to these living and/or replicating pathogens, toxins and biotoxins are also included among the bio-agents. More than 1,200 different kinds of potentially weaponizable bio-agents have been described and studied to date.

Bacteria A domain of prokaryotes – single celled organisms without a nucleus

Bacteria are a type of biological cell. They constitute a large domain of prokaryotic microorganisms. Typically a few micrometres in length, bacteria have a number of shapes, ranging from spheres to rods and spirals. Bacteria were among the first life forms to appear on Earth, and are present in most of its habitats. Bacteria inhabit soil, water, acidic hot springs, radioactive waste, and the deep portions of Earth's crust. Bacteria also live in symbiotic and parasitic relationships with plants and animals. Most bacteria have not been characterised, and only about 27 percent of the bacterial phyla have species that can be grown in the laboratory . The study of bacteria is known as bacteriology, a branch of microbiology.

Contents

Definition

According to the U.S. Centers for Disease Control and Prevention, bioterrorism is the deliberate release of viruses, bacteria, toxins or other harmful agents to cause illness or death in people, animals, or plants. [1] These agents are typically found in nature, but could be mutated or altered to increase their ability to cause disease, make them resistant to current medicines, or to increase their ability to be spread into the environment. Biological agents can be spread through the air, water, or in food. Terrorists tend to use biological agents because they are extremely difficult to detect and do not cause illness for several hours to several days. Some bioterrorism agents, like the smallpox virus, can be spread from person to person and some, like anthrax, cannot. [2] [3]

Centers for Disease Control and Prevention government agency

The Centers for Disease Control and Prevention (CDC) is the leading national public health institute of the United States. The CDC is a United States federal agency under the Department of Health and Human Services and is headquartered in Atlanta, Georgia.

Anthrax Infection caused by Bacillus anthracis bacteria

Anthrax is an infection caused by the bacterium Bacillus anthracis. It can occur in four forms: skin, lungs, intestinal, and injection. Symptoms begin between one day and two months after the infection is contracted. The skin form presents with a small blister with surrounding swelling that often turns into a painless ulcer with a black center. The inhalation form presents with fever, chest pain, and shortness of breath. The intestinal form presents with diarrhea which may contain blood, abdominal pains, and nausea and vomiting. The injection form presents with fever and an abscess at the site of drug injection.

Bioterrorism is an attractive weapon because biological agents are relatively easy and inexpensive to obtain, can be easily disseminated, and can cause widespread fear and panic beyond the actual physical damage. [4] Military leaders, however, have learned that, as a military asset, bioterrorism has some important limitations; it is difficult to use a bioweapon in a way that only affects the enemy and not friendly forces. A biological weapon is useful to terrorists mainly as a method of creating mass panic and disruption to a state or a country. However, technologists such as Bill Joy have warned of the potential power which genetic engineering might place in the hands of future bio-terrorists. [5]

Bill Joy American computer scientist

William Nelson Joy is an American computer engineer. He co-founded Sun Microsystems in 1982 along with Vinod Khosla, Scott McNealy, and Andy Bechtolsheim, and served as chief scientist at the company until 2003. He played an integral role in the early development of BSD UNIX while a graduate student at Berkeley, and he is the original author of the vi text editor. He also wrote the 2000 essay Why The Future Doesn't Need Us, in which he expressed deep concerns over the development of modern technologies.

The use of agents that do not cause harm to humans but disrupt the economy have been discussed. [6] A highly relevant pathogen in this context is the foot-and-mouth disease (FMD) virus, which is capable of causing widespread economic damage and public concern (as witnessed in the 2001 and 2007 FMD outbreaks in the UK), whilst having almost no capacity to infect humans.

Foot-and-mouth disease infectious and sometimes fatal viral disease that affects cloven-hoofed animals and caused by apthovirus

Foot-and-mouth disease or hoof-and-mouth disease is an infectious and sometimes fatal viral disease that affects cloven-hoofed animals, including domestic and wild bovids. The virus causes a high fever for between two and six days, followed by blisters inside the mouth and on the feet that may rupture and cause lameness.

2001 United Kingdom foot-and-mouth outbreak Epidemic in 2001 in the UK

The outbreak of foot-and-mouth disease in the United Kingdom in 2001 caused a crisis in British agriculture and tourism. This epizootic saw 2,026 cases of the disease in farms across most of the British countryside. Over 6 million cows and sheep were killed in an eventually successful attempt to halt the disease. Cumbria was the worst affected area of the country, with 893 cases.

2007 United Kingdom foot-and-mouth outbreak

A contained four-site outbreak of foot-and-mouth disease in the United Kingdom was found by regular livestock testing by the Department for Environment, Food and Rural Affairs (DEFRA), namely in August 2007 three times, and once the following month, all in the west of Surrey, England.

Twentieth century

By the time World War I began, attempts to use anthrax were directed at animal populations. This generally proved to be ineffective.

World War I 1914–1918 global war originating in Europe

World War I, also known as the First World War or the Great War, was a global war originating in Europe that lasted from 28 July 1914 to 11 November 1918. Contemporaneously described as "the war to end all wars", it led to the mobilisation of more than 70 million military personnel, including 60 million Europeans, making it one of the largest wars in history. It is also one of the deadliest conflicts in history, with an estimated nine million combatants and seven million civilian deaths as a direct result of the war, while resulting genocides and the 1918 influenza pandemic caused another 50 to 100 million deaths worldwide.

Shortly after the start of World War I, Germany launched a biological sabotage campaign in the United States, Russia, Romania, and France. [7] At that time, Anton Dilger lived in Germany, but in 1915 he was sent to the United States carrying cultures of glanders, a virulent disease of horses and mules. Dilger set up a laboratory in his home in Chevy Chase, Maryland. He used stevedores working the docks in Baltimore to infect horses with glanders while they were waiting to be shipped to Britain. Dilger was under suspicion as being a German agent, but was never arrested. Dilger eventually fled to Madrid, Spain, where he died during the Influenza Pandemic of 1918. [8] In 1916, the Russians arrested a German agent with similar intentions. Germany and its allies infected French cavalry horses and many of Russia’s mules and horses on the Eastern Front. These actions hindered artillery and troop movements, as well as supply convoys. [7]

Anton Dilger German physician

Anton Casimir Dilger was a German-American medical doctor, and the main proponent of the German biological warfare sabotage program during World War I. His father, Hubert Dilger, was a United States Army captain who had received the Medal of Honor for his work as an artilleryman at the Battle of Chancellorsville (1863) during the American Civil War.

Glanders is an infectious disease that occurs primarily in horses, mules, and donkeys. It can be contracted by other animals, such as dogs, cats, goats and humans. It is caused by infection with the bacterium Burkholderia mallei, usually by ingestion of contaminated feed or water. Signs of glanders include the formation of nodular lesions in the lungs and ulceration of the mucous membranes in the upper respiratory tract. The acute form results in coughing, fever, and the release of an infectious nasal discharge, followed by septicaemia and death within days. In the chronic form, nasal and subcutaneous nodules develop, eventually ulcerating. Death can occur within months, while survivors act as carriers.

Chevy Chase, Maryland Unincorporated community in Maryland, United States

Chevy Chase is the name of both a town and an unincorporated census-designated place that straddle the northwest border of Washington, D.C. and Montgomery County, Maryland. Several settlements in the same area of Montgomery County and one neighborhood of Washington, D.C. include "Chevy Chase" in their names. These villages, the town, and the CDP share a common history and together form a larger community colloquially referred to as "Chevy Chase".

In 1972 police in Chicago arrested two college students, Allen Schwander and Stephen Pera, who had planned to poison the city's water supply with typhoid and other bacteria. Schwander had founded a terrorist group, "R.I.S.E.", while Pera collected and grew cultures from the hospital where he worked. The two men fled to Cuba after being released on bail. Schwander died of natural causes in 1974, while Pera returned to the U.S. in 1975 and was put on probation. [9]

In 1980 the World Health Organization (WHO) announced the eradication of smallpox, a highly contagious and incurable disease. Although the disease has been eliminated in the wild, frozen stocks of smallpox virus are still maintained by the governments of the United States and Russia. Disastrous consequences are feared if rogue politicians or terrorists were to get hold of the smallpox strains. Since vaccination programs are now terminated, the world population is more susceptible to smallpox than ever before.

In Oregon in 1984, followers of the Bhagwan Shree Rajneesh attempted to control a local election by incapacitating the local population. This was done by infecting salad bars in 11 restaurants, produce in grocery stores, doorknobs, and other public domains with Salmonella typhimurium bacteria in the city of The Dalles, Oregon. The attack infected 751 people with severe food poisoning. There were no fatalities. This incident was the first known bioterrorist attack in the United States in the 20th century. [10] It was also the single largest bioterrorism attack on U.S. soil. [11]

In June 1993, the religious group Aum Shinrikyo released anthrax in Tokyo. Eyewitnesses reported a foul odor. The attack was a total failure, infecting not a single person. The reason for this is that the group used the vaccine strain of the bacterium. The spores recovered from the attack showed that they were identical to an anthrax vaccine strain given to animals at the time. These vaccine strains are missing the genes that cause a symptomatic response. [12]

In September and October 2001, several cases of anthrax broke out in the United States, apparently caused deliberately. Letters laced with infectious anthrax were concurrently delivered to news media offices and the U.S Congress, alongside an ambiguously related case in Chile. The letters killed 5. [13]

Types of agents

Under current United States law, bio-agents which have been declared by the U.S. Department of Health and Human Services or the U.S. Department of Agriculture to have the "potential to pose a severe threat to public health and safety" are officially defined as "select agents." The CDC categorizes these agents (A, B or C) and administers the Select Agent Program, which regulates the laboratories which may possess, use, or transfer select agents within the United States. As with US attempts to categorize harmful recreational drugs, designer viruses are not yet categorized and avian H5N1 has been shown to achieve high mortality and human-communication in a laboratory setting.

Category A

These high-priority agents pose a risk to national security, can be easily transmitted and disseminated, result in high mortality, have potential major public health impact, may cause public panic, or require special action for public health preparedness.

Tularemia or "rabbit fever"
[14] Tularemia has a very low fatality rate if treated, but can severely incapacitate. The disease is caused by the Francisella tularensis bacterium, and can be contracted through contact with fur, inhalation, ingestion of contaminated water or insect bites. Francisella tularensis is very infectious. A small number of organisms (10–50 or so) can cause disease. If F. tularensis were used as a weapon, the bacteria would likely be made airborne for exposure by inhalation. People who inhale an infectious aerosol would generally experience severe respiratory illness, including life-threatening pneumonia and systemic infection, if they are not treated. The bacteria that cause tularemia occur widely in nature and could be isolated and grown in quantity in a laboratory, although manufacturing an effective aerosol weapon would require considerable sophistication. [15]
Anthrax
Anthrax is a non-contagious disease caused by the spore-forming bacterium Bacillus anthracis. The ability of Anthrax to produce within small spores, or bacilli bacterium, makes it readily permeable to porous skin and can cause abrupt symptoms within 24 hours of exposure. The dispersal of this pathogen among densely populated areas is said to carry less than one percent mortality rate, for cutaneous exposure, to a ninety percent or higher mortality for untreated inhalational infections. [16] An anthrax vaccine does exist but requires many injections for stable use. When discovered early, anthrax can be cured by administering antibiotics (such as ciprofloxacin). [17] Its first modern incidence in biological warfare were when Scandinavian "freedom fighters" supplied by the German General Staff used anthrax with unknown results against the Imperial Russian Army in Finland in 1916. [18] In 1993, the Aum Shinrikyo used anthrax in an unsuccessful attempt in Tokyo with zero fatalities. [12] Anthrax was used in a series of attacks by a microbiologist at the US Army Medical Research Institute of Infection Disease on the offices of several United States Senators in late 2001. The anthrax was in a powder form and it was delivered by the mail. [19] This bioterrorist attack inevitably prompted seven cases of cutaneous anthrax and eleven cases of inhalation anthrax, with five leading to deaths. Additionally, an estimated 10 to 26 cases had prevented fatality through treatment supplied to over 30,000 individuals. [20] Anthrax is one of the few biological agents that federal employees have been vaccinated for. In the US an anthrax vaccine, Anthrax Vaccine Adsorbed (AVA) exists and requires five injections for stable use. Other anthrax vaccines also exist. The strain used in the 2001 anthrax attack was identical to the strain used by the USAMRIID. [21]
Smallpox
[22] Smallpox is a highly contagious virus. It is transmitted easily through the atmosphere and has a high mortality rate (20–40%). Smallpox was eradicated in the world in the 1970s, thanks to a worldwide vaccination program. [23] However, some virus samples are still available in Russian and American laboratories. Some believe that after the collapse of the Soviet Union, cultures of smallpox have become available in other countries. Although people born pre-1970 will have been vaccinated for smallpox under the WHO program, the effectiveness of vaccination is limited since the vaccine provides high level of immunity for only 3 to 5 years. Revaccination's protection lasts longer. [24] As a biological weapon smallpox is dangerous because of the highly contagious nature of both the infected and their pox. Also, the infrequency with which vaccines are administered among the general population since the eradication of the disease would leave most people unprotected in the event of an outbreak. Smallpox occurs only in humans, and has no external hosts or vectors.
Botulinum toxin
[25] The neurotoxin [26] Botulinum is one of the deadliest toxins known, and is produced by the bacterium Clostridium botulinum . Botulism causes death by respiratory failure and paralysis. [27] Furthermore, the toxin is readily available worldwide due to its cosmetic applications in injections.
Bubonic plague
[28] Plague is a disease caused by the Yersinia pestis bacterium. Rodents are the normal host of plague, and the disease is transmitted to humans by flea bites and occasionally by aerosol in the form of pneumonic plague. [29] The disease has a history of use in biological warfare dating back many centuries, and is considered a threat due to its ease of culture and ability to remain in circulation among local rodents for a long period of time. The weaponized threat comes mainly in the form of pneumonic plague (infection by inhalation) [30] It was the disease that caused the Black Death in Medieval Europe.
Viral hemorrhagic fevers
[31] This includes hemorrhagic fevers caused by members of the family Filoviridae (Marburg virus and Ebola virus), and by the family Arenaviridae (for example Lassa virus and Machupo virus). Ebola virus disease, in particular, has caused high fatality rates ranging from 25–90% with a 50% average. No cure currently exists, although vaccines are in development. The Soviet Union investigated the use of filoviruses for biological warfare, and the Aum Shinrikyo group unsuccessfully attempted to obtain cultures of Ebola virus.[ citation needed ] Death from Ebola virus disease is commonly due to multiple organ failure and hypovolemic shock. Marburg virus was first discovered in Marburg, Germany. No treatments currently exist aside from supportive care. The arenaviruses have a somewhat reduced case-fatality rate compared to disease caused by filoviruses, but are more widely distributed, chiefly in central Africa and South America.

Category B

Category B agents are moderately easy to disseminate and have low mortality rates.

Category C

Category C agents are emerging pathogens that might be engineered for mass dissemination because of their availability, ease of production and dissemination, high mortality rate, or ability to cause a major health impact.

Planning and response

Planning may involve the development of biological identification systems. Until recently in the United States, most biological defense strategies have been geared to protecting soldiers on the battlefield rather than ordinary people in cities. Financial cutbacks have limited the tracking of disease outbreaks. Some outbreaks, such as food poisoning due to E. coli or Salmonella , could be of either natural or deliberate origin.

Preparedness

Biological agents are relatively easy to obtain by terrorists and are becoming more threatening in the U.S., and laboratories are working on advanced detection systems to provide early warning, identify contaminated areas and populations at risk, and to facilitate prompt treatment.[ citation needed ] Methods for predicting the use of biological agents in urban areas as well as assessing the area for the hazards associated with a biological attack are being established in major cities. In addition, forensic technologies are working on identifying biological agents, their geographical origins and/or their initial source. Efforts include decontamination technologies to restore facilities without causing additional environmental concerns.

Early detection and rapid response to bioterrorism depend on close cooperation between public health authorities and law enforcement; however, such cooperation is currently lacking. National detection assets and vaccine stockpiles are not useful if local and state officials do not have access to them. [39]

Aspects of protection against bioterrorism in the United States include,

On a CNN news broadcast in 2011, the CNN chief medical correspondent, Dr. Sanjay Gupta, weighed in on the American government’s recent approach to bioterrorist threats. He explains how, even though the United States would be better fending off bioterrorist attacks now than they would be a decade ago, the amount of money available to fight bioterrorism over the last three years has begun to decrease. Looking at a detailed report that examined the funding decrease for bioterrorism in fifty-one American cities, Dr. Gupta stated that the cities “wouldn’t be able to distribute vaccines as well” and “wouldn’t be able to track viruses”. He went on to say that movie portrayals of global pandemics, such as Contagion, were actually quite possible and may occur in the United States under the right conditions. [47]

A news broadcast by MSNBC in 2010 also stressed the low levels of bioterrorism preparedness in the United States. The broadcast stated that a bipartisan report gave the Obama administration a failing grade for its efforts to respond to a bioterrorist attack. The news broadcast invited the former New York City police commissioner, Howard Safir, to explain how the government would fare in combating such an attack. He said how “biological and chemical weapons are probable and relatively easy to disperse”. Furthermore, Safir thought that efficiency in bioterrorism preparedness is not necessarily a question of money, but is instead dependent on putting resources in the right places. The broadcast suggested that the nation was not ready for something more serious. [48]

In a September 2016 interview conducted by Homeland Preparedness News, Daniel Gerstein, a senior policy researcher for the RAND Corporation, stresses the importance in preparing for potential bioterrorist attacks on the nation. He implored the U.S. government to take the proper and necessary actions to implement a strategic plan of action to save as many lives as possible and to safeguard against potential chaos and confusion. He believes that because there have been no significant instances of bioterrorism since the anthrax attacks in 2001, the government has allowed itself to become complacent making the country that much more vulnerable to unsuspecting attacks, thereby further endangering the lives of U.S. citizens. [49]

Gerstein formerly served in the Science and Technology Directorate of the Department of Homeland Security from 2011 to 2014. He claims there has not been a serious plan of action since 2004 during George W. Bush's presidency, in which he issued a Homeland Security directive delegating responsibilities among various federal agencies. He also stated that the blatant mishandling of the Ebola virus outbreak in 2014 attested to the government's lack of preparation. This past May, legislation that would create a national defense strategy was introduced in the Senate, coinciding with the timing of ISIS-affiliated terrorist groups get closer to weaponizing biological agents. Last August,[ when? ] Kenyan officials apprehended two members of an Islamic extremist group in motion to set off a biological bomb containing anthrax. Mohammed Abdi Ali, the believed leader of the group, who was a medical intern, was arrested along with his wife, a medical student. The two were caught just before carrying out their plan. The Blue Ribbon Study Panel on Biodefense, which comprises a group of experts on national security and government officials, in which Gerstein had previously testified to, submitted its National Blueprint for Biodefense to Congress in October 2015 listing their recommendations for devising an effective plan. [49]

Bill Gates said in a February 18 Business Insider op-ed (published near the time of his Munich Security Conference speech) that it is possible for an airborne pathogen to kill at least 30 million people over the course of a year. In a New York Times report, the Gates Foundation predicted that a modern outbreak similar to the Spanish Influenza pandemic (which killed between 50 million and 100 million people) could end up killing more than 360 million people worldwide, even considering widespread availability of vaccines and other healthcare tools. The report cited increased globalization, rapid international air travel, and urbanization as increased reasons for concern. [50] In a March 9, 2017 interview with CNBC, former U.S. Senator Joe Lieberman, who was co-chair of the bipartisan Blue Ribbon Study Panel on Biodefense, said a worldwide pandemic could end the lives of more people than a nuclear war. Lieberman also expressed worry that a terrorist group like ISIS could develop a synthetic influenza strain and introduce it to the world to kill civilians. [50] In July 2017, Robert C. Hutchinson, former agent at the Department of Homeland Security, called for a "whole-of-government" response to the next global health threat, which he described as including strict security procedures at our borders and proper execution of government preparedness plans. [50]

Also, novel approaches in biotechnology, such as synthetic biology, could be used in the future to design new types of biological warfare agents. [51] [52] [53] [54] Special attention has to be laid on future experiments (of concern) that: [55]

  1. Would demonstrate how to render a vaccine ineffective;
  2. Would confer resistance to therapeutically useful antibiotics or antiviral agents;
  3. Would enhance the virulence of a pathogen or render a nonpathogen virulent;
  4. Would increase transmissibility of a pathogen;
  5. Would alter the host range of a pathogen;
  6. Would enable the evasion of diagnostic/detection tools;
  7. Would enable the weaponization of a biological agent or toxin

Most of the biosecurity concerns in synthetic biology, however, are focused on the role of DNA synthesis and the risk of producing genetic material of lethal viruses (e.g. 1918 Spanish flu, polio) in the lab. [56] [57] [58] Recently, the CRISPR/Cas system has emerged as a promising technique for gene editing. It was hailed by The Washington Post as "the most important innovation in the synthetic biology space in nearly 30 years." [59] While other methods take months or years to edit gene sequences, CRISPR speeds that time up to weeks. [59] However, due to its ease of use and accessibility, it has raised a number of ethical concerns, especially surrounding its use in the biohacking space. [60] [61] [62]

Biosurveillance

In 1999, the University of Pittsburgh's Center for Biomedical Informatics deployed the first automated bioterrorism detection system, called RODS (Real-Time Outbreak Disease Surveillance). RODS is designed to draw collect data from many data sources and use them to perform signal detection, that is, to detect a possible bioterrorism event at the earliest possible moment. RODS, and other systems like it, collect data from sources including clinic data, laboratory data, and data from over-the-counter drug sales. [59] [63] In 2000, Michael Wagner, the codirector of the RODS laboratory, and Ron Aryel, a subcontractor, conceived the idea of obtaining live data feeds from "non-traditional" (non-health-care) data sources. The RODS laboratory's first efforts eventually led to the establishment of the National Retail Data Monitor, a system which collects data from 20,000 retail locations nationwide. [59]

On February 5, 2002, George W. Bush visited the RODS laboratory and used it as a model for a $300 million spending proposal to equip all 50 states with biosurveillance systems. In a speech delivered at the nearby Masonic temple, Bush compared the RODS system to a modern "DEW" line (referring to the Cold War ballistic missile early warning system). [64]

The principles and practices of biosurveillance, a new interdisciplinary science, were defined and described in the Handbook of Biosurveillance, edited by Michael Wagner, Andrew Moore and Ron Aryel, and published in 2006. Biosurveillance is the science of real-time disease outbreak detection. Its principles apply to both natural and man-made epidemics (bioterrorism).

Data which potentially could assist in early detection of a bioterrorism event include many categories of information. Health-related data such as that from hospital computer systems, clinical laboratories, electronic health record systems, medical examiner record-keeping systems, 911 call center computers, and veterinary medical record systems could be of help; researchers are also considering the utility of data generated by ranching and feedlot operations, food processors, drinking water systems, school attendance recording, and physiologic monitors, among others. [63] Intuitively, one would expect systems which collect more than one type of data to be more useful than systems which collect only one type of information (such as single-purpose laboratory or 911 call-center based systems), and be less prone to false alarms, and this appears to be the case.

In Europe, disease surveillance is beginning to be organized on the continent-wide scale needed to track a biological emergency. The system not only monitors infected persons, but attempts to discern the origin of the outbreak.

Researchers are experimenting with devices to detect the existence of a threat:

New research shows that ultraviolet avalanche photodiodes offer the high gain, reliability and robustness needed to detect anthrax and other bioterrorism agents in the air. The fabrication methods and device characteristics were described at the 50th Electronic Materials Conference in Santa Barbara on June 25, 2008. Details of the photodiodes were also published in the February 14, 2008 issue of the journal Electronics Letters and the November 2007 issue of the journal IEEE Photonics Technology Letters. [65]

The United States Department of Defense conducts global biosurveillance through several programs, including the Global Emerging Infections Surveillance and Response System. [66]

Another powerful tool developed within New York City for use in countering bioterrorism is the development of the New York City Syndromic Surveillance System. This system is essentially a way of tracking disease progression throughout New York City, and was developed by the New York City Department of Health and Mental Hygiene (NYC DOHMH) in the wake of the 9/11 attacks. The system works by tracking the symptoms of those taken into the emergency department—based on the location of the hospital to which they are taken and their home address—and assessing any patterns in symptoms. These established trends can then be observed by medical epidemiologists to determine if there are any disease outbreaks in any particular locales; maps of disease prevalence can then be created rather easily. [67] This is an obviously beneficial tool in fighting bioterrorism as it provides a means through which such attacks could be discovered in their nascence; assuming bioterrorist attacks result in similar symptoms across the board, this strategy allows New York City to respond immediately to any bioterrorist threats that they may face with some level of alacrity.

Response to bioterrorism incident or threat

Government agencies which would be called on to respond to a bioterrorism incident would include law enforcement, hazardous materials/decontamination units and emergency medical units, if they exist.

The US military has specialized units, which can respond to a bioterrorism event; among them are the United States Marine Corps' Chemical Biological Incident Response Force and the U.S. Army's 20th Support Command (CBRNE), which can detect, identify, and neutralize threats, and decontaminate victims exposed to bioterror agents. US response would include the Center for Disease Control.

Historically, governments and authorities have relied on quarantines to protect their populations. International bodies such as the World Health Organization already devote some of their resources to monitoring epidemics and have served clearing-house roles in historical epidemics.

Media attention toward the seriousness of biological attacks increased in 2013-2014. In July 2013, Forbes published an article with the title "Bioterrorism: A Dirty Little Threat With Huge Potential Consequences." [68] In November 2013, Fox News reported on a new strain of botulism, saying that the Centers for Disease and Control lists botulism as one of two agents that have “the highest risks of mortality and morbidity”, noting that there is no antidote for botulism. [69] USA Today reported that the U.S. military in November was trying to develop a vaccine for troops from the bacteria that cause the disease Q fever, an agent the military once used as a biological weapon. [70] In February 2014, the former special assistant and senior director for biodefense policy to President George W. Bush called the bioterrorism risk imminent and uncertain [71] and Congressman Bill Pascrell called for increasing federal measures against bioterrorism as a “matter of life or death.” [72] The New York Times wrote a story saying the United States would spend $40 million to help certain low and middle-income countries deal with the threats of bioterrorism and infectious diseases. [73]

Bill Gates has warned that bioterrorism could kill more people than nuclear war. [74]

In February 2018, a CNN employee discovered on an airplane a “sensitive, top-secret document in the seatback pouch explaining how the Department of Homeland Security would respond to a bioterrorism attack at the Super Bowl.” [75]

2017 U.S. budget proposal affecting bioterrorism programs

President Donald Trump promoted his first budget around keeping America safe. However, one aspect of defense would receive less money: "protecting the nation from deadly pathogens, man-made or natural," according to the New York Times. Agencies tasked with biosecurity get a decrease in funding under the Administration's budget proposal. [76]

For example: [76]

“The next weapon of mass destruction may not be a bomb," Lawrence O. Gostin, the director of the World Health Organization’s Collaborating Center on Public Health Law and Human Rights, told the New York Times. “It may be a tiny pathogen that you can’t see, smell or taste, and by the time we discover it, it’ll be too late." [76]

Lack of international standards on public health experiments

Dr. Tom Inglesy, the CEO and director of the Center for Health Security at the Johns Hopkins Bloomberg School of Public Health and an internationally recognized expert on public health preparedness, pandemic and emerging infectious disease said in 2017 that the lack of an internationally standardized approval process that could be used to guide countries in conducting public health experiments for resurrecting a disease that's already been eradicated increases the risk that the disease could be used in bioterrorism. He was referring to the lab synthesis of horsepox in 2017 by researchers at the University of Alberta. Those researchers recreated horsepox, an extinct cousin of the smallpox virus, in order to research new ways to treat cancer. [77]

Related Research Articles

Biological warfare Use of biological toxins or infectious agents as an act of war

Biological warfare (BW)—also known as germ warfare—is the use of biological toxins or infectious agents such as bacteria, viruses, and fungi with the intent to kill or incapacitate humans, animals or plants as an act of war. Biological weapons are living organisms or replicating entities that reproduce or replicate within their host victims. Entomological (insect) warfare is also considered a type of biological weapon. This type of warfare is distinct from nuclear warfare and chemical warfare, which together with biological warfare make up NBC, the military initialism for nuclear, biological, and chemical warfare using weapons of mass destruction (WMDs). None of these are considered conventional weapons, which are deployed primarily for their explosive, kinetic, or incendiary potential.

Biosecurity has multiple meanings and is defined differently according to various disciplines. The original definition of biosecurity started out as a set of preventive measures designed to reduce the risk of transmission of infectious diseases in crops and livestock, quarantined pests, invasive alien species, and living modified organisms. The emerging nature of biosecurity threats means that small scale risks blow up rapidly, thus an effective policy becomes a challenge for there are limitations on time and resources available for analysing threats and estimating the likelihood of their occurrence.

Biodefense refers to measures to restore biosecurity to a group of organisms who are, or may be, subject to biological threats or infectious diseases. Biodefense is frequently discussed in the context of biowar or bioterrorism, and is generally considered a military or emergency response term.

Ken Alibek former Soviet physician, microbiologist, and biological warfare expert

Colonel Kanatzhan "Kanat" Alibekov – known as Kenneth "Ken" Alibek since 1992 – is a former Soviet physician, microbiologist, and biological warfare (BW) expert. He rose rapidly in the ranks of the Soviet Army to become the First Deputy Director of Biopreparat, where he oversaw a vast program of BW facilities.

Stewart Simonson was the first Assistant Secretary for Public Health Emergency Preparedness at the U.S. Department of Health and Human Services (HHS). He assumed office on April 28, 2004. He told the president in a resignation letter dated May 13, 2006 that he had accomplished what he had set out to do, and it was time to pursue other opportunities. Simonson joined HHS in August 2001 and was instrumental in building the HHS preparedness and response organization that grew out of the September 11th attacks.

United States Army Medical Research Institute of Infectious Diseases U.S Armys main institution and facility for defensive research into countermeasures against biological warfare

The United States Army Medical Research Institute of Infectious Diseases is the U.S Army's main institution and facility for defensive research into countermeasures against biological warfare. It is located on Fort Detrick, Maryland and is a subordinate lab of the U.S. Army Medical Research and Materiel Command (USAMRMC), headquartered on the same installation.

In the United States government, the Office of Public Health Emergency Preparedness used to be a branch of the U.S. Department of Health and Human Services. It has since been renamed to Office of the Assistant Secretary for Preparedness and Response.

Michael Osterholm American scientist

Michael T. Osterholm is a public health scientist and a biosecurity and infectious disease expert in the United States. Osterholm is the director of the Center for Infectious Disease Research and Policy (CIDRAP) at the University of Minnesota and a Regents Professor, the McKnight Presidential Endowed Chair in Public Health, a Distinguished Teaching Professor in the Division of Environmental Health Sciences, School of Public Health, a professor in the Technological Leadership Institute, College of Science and Engineering, and an adjunct professor in the University of Minnesota Medical School, all at the University of Minnesota. He is also on the Board of Regents at Luther College in Decorah, Iowa.

Under United States law, "Biological Select Agents or Toxins" (BSATs) — or simply select agents for short — are bio-agents which since 1997 have been declared by the U.S. Department of Health and Human Services (HHS) or by the U.S. Department of Agriculture (USDA) to have the "potential to pose a severe threat to public health and safety". The agents are divided into (1) HHS select agents and toxins affecting humans; (2) USDA select agents and toxins affecting agriculture; and (3) overlap select agents and toxins affecting both.

The Health Protection Agency (HPA) was a non-departmental public body in the United Kingdom. It was an organisation that was set up by the UK government in 2003 to protect the public in England from threats to their health from infectious diseases and environmental hazards. It did this by providing advice and information to the general public, to health professionals such as doctors and nurses, and to national and local government. There were four HPA centres – at Porton Down in Salisbury, Chilton in Didcot, South Mimms in Hertfordshire, and Colindale in NW London. In addition, the HPA had regional laboratories across England and administrative headquarters in Central London. On 1 April 2013, the HPA minus the South Mimms site became part of Public Health England, a new executive agency of the Department of Health (DoH). The National Institute for Biological Standards and Control (NIBSC) located in South Mimms was merged with the Medicines and Healthcare products Regulatory Agency (MHRA).

The National Biodefense Analysis and Countermeasures Center (NBACC) is a government biodefense research laboratory created by the U.S. Department of Homeland Security (DHS) and located at the sprawling biodefense campus at Fort Detrick in Frederick, MD, USA. The NBACC is the principal U.S. biodefense research institution engaged in laboratory-based threat assessment and bioforensics. NBACC is an important part of the National Interagency Biodefense Campus (NIBC) also located at Fort Detrick for the US Army, National Institutes of Health and the US Department of Agriculture.

Project Bioshield Act

The Project Bioshield Act was an act passed by the United States Congress in 2004 calling for $5 billion for purchasing vaccines that would be used in the event of a bioterrorist attack. This was a ten-year program to acquire medical countermeasures to biological, chemical, radiological, and nuclear agents for civilian use. A key element of the Act was to allow stockpiling and distribution of vaccines which had not been tested for safety or efficacy in humans, due to ethical concerns. Efficacy of such agents cannot be directly tested in humans without also exposing humans to the chemical, biological, or radioactive threat being treated, so testing follows the FDA Animal Rule for pivotal animal efficacy.

ACAM2000 is a smallpox vaccine manufactured by Emergent BioSolutions, an American specialty biopharmaceutical company.

The Biomedical Advanced Research and Development Authority (BARDA) is a U.S. Department of Health and Human Services office responsible for procurement and development of countermeasures principally against bioterrorism, but also including chemical, nuclear and radiological threats as well as pandemic influenza and emerging diseases. BARDA reports to the Office of the Assistant Secretary for Preparedness and Response and manages Project BioShield. BARDA also procures materials, such as vaccines, for the Strategic National Stockpile, and more broadly is an established interface between the U.S. Government and the biomedical industry. BARDA also manages the governmental inter-agency Public Health Emergency Medical Countermeasures Enterprise, providing coordination across the government in development and deployment of such countermeasures.

Pandemic and All-Hazards Preparedness Act

On December 19, 2006, the Pandemic and All-Hazards Preparedness Act (PAHPA), Public Law No. 109-417, was signed into law by President George W. Bush. PAHPA has broad implications for the United States Department of Health and Human Services's (HHS) preparedness and response activities. Among other things, the act amended the Public Health Service Act to establish within the department a new Assistant Secretary for Preparedness and Response (ASPR); provided new authorities for a number of programs, including the advanced development and acquisitions of medical countermeasures; and called for the establishment of a quadrennial National Health Security Strategy.

Operation Dark Winter was the code name for a senior-level bio-terrorist attack simulation conducted from June 22–23, 2001. It was designed to carry out a mock version of a covert and widespread smallpox attack on the United States. Tara O'Toole and Thomas Inglesby of the Johns Hopkins Center for Civilian Biodefense Strategies (CCBS) / Center for Strategic and International Studies (CSIS), and Randy Larsen and Mark DeMier of Analytic Services were the principal designers, authors, and controllers of the Dark Winter project.

The United States biological defense program—in recent years also called the National Biodefense Strategy—began as a small defensive effort that parallels the country's offensive biological weapons development and production program, active since 1943. Organizationally, the medical defense research effort was pursued first (1956-1969) by the U.S. Army Medical Unit (USAMU) and later, after publicly known discontinuation of the offensive program, by the U.S. Army Medical Research Institute of Infectious Diseases (USAMRIID). Both of these units were located at Fort Detrick, Maryland, where the U.S. Army Biological Warfare Laboratories were headquartered. The current mission is multi-agency, not exclusively military, and is purely to develop defensive measures against bio-agents, as opposed to the former bio-weapons development program.

Biological warfare (BW) — also known as bacteriological warfare, or germ warfare — has had a presence in popular culture for over 100 years. Public interest in it became intense during the Cold War, especially the 1960s and ‘70s, and continues unabated. This article comprises a list of popular culture works referencing BW or bio-terrorism, but not those pertaining to natural, or unintentional, epidemics.

The Alliance for Biosecurity is a consortium of companies that develop products to respond to national security threats, including bioterrorism pathogens and emerging infectious diseases. It is headquartered in Washington DC.

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