From: believer@telepath.com Subject: IP: "Bioarmageddon" Date: Sat, 19 Sep 1998 06:56:14 -0500 To: believer@telepath.com Source: New Scientist http://www.newscientist.com/nsplus/insight/bioterrorism/bioarmageddon.html Bioterrorism Special Report: Bioarmageddon By Debora MacKenzie Sooner or later there is going to be a biological attack on a major city. Are we prepared to deal with it? Not a chance, says Debora MacKenzie It begins with a threat. A terrorist group declares that unless its demands are met within 48 hours, it will release anthrax over San Francisco. Two days later, a private plane flies across the Bay, spreading an aerosol cloud that shimmers briefly in the sunlight before disappearing. Scenario one: thousands are killed in the panic as 2 million people flee the city. Another 1·6 million inhale anthrax spores. Antibiotics are rushed in, but the hospitals are overwhelmed and not everyone receives treatment. Most of the country's limited stock of anthrax vaccine has already been given to soldiers. Emergency crews provide little help as there are only four germ-proof suits in the whole city. More than a million of the Bay Area's 6.5 million residents die. Scenario two: in the two days before the attack, citizens seal their doors and windows with germ-proof tape. They listen to the radio for instructions, their gas masks, drugs and disinfectants ready. Few panic. When sensors around the city confirm that the cloud contains anthrax spores, hospitals receive the appropriate antibiotics and vaccines. Trained emergency teams with germ-proof suits and tents set up in the places where automated weather analyses show the deadly cloud will drift. With advance preparation and rapid response only 100,000 people die. A terrorist who plans to drop anthrax over San Francisco tomorrow can count on causing the murder and mayhem described in the first scenario--at least according to the simulation that generated these scenarios last year. The question facing policy makers now is: how do we move toward the second scenario? That terrorists may someday turn to biological weapons is no longer a matter of debate (see "All fall down", New Scientist, 11 May 1996, p 32). "Terrorism has changed," says Brad Roberts of the US government-backed Institute for Defense Analyses in Virginia. "Traditional terrorists wanted political concessions," he says. "But now, some groups say their main aim is mass casualties. That makes biological weapons appealing." Terrorists would have little trouble getting their hands on the technology. Hearings in South Africa in June revealed that the apartheid government produced terrorist weapons containing anthrax, Salmonella and cholera. Soviet scientists who have prepared weapons-grade anthrax and smallpox are known to have emigrated, possibly to well-funded terrorist groups like the one run by Osama bin Laden in Afghanistan. Even small groups such as the Aum Shinrikyo sect in Japan have been able to cook up vats of Salmonella or botulin, the toxin that causes botulism. With bioweapons so readily available, how can governments protect us from a terrorist armed with anthrax, smallpox or plague? In May, scientists, policy makers and security experts gathered in Stockholm to discuss how to limit the devastation of a biological attack on civilians. Until now, most biological defence strategies have been geared to protecting soldiers on the battlefield rather than ordinary people in cities. The situations are quite different, and novel technologies are needed for civilian defence. Suppose a commuter stumbled across a time bomb filled with anthrax on an underground railway platform. Until this year, no police force in the world had any way to disarm such a device safely. One novel solution that attracted attention at Stockholm was a tent full of antiseptic foam. Researchers at Irvin Aerospace in Fort Erie, Ontario, have developed a dome-shaped tent made of ultratough Mylar that can be filled with a stiff foam--the exact composition of which is a closely guarded secret--that kills germs and also neutralises chemical weapons. Once covered by the foam-filled tent, the bomb can be safely detonated. But what if germs are already in the air? The protective suits and masks used by most emergency services don't have seals tight enough to exclude microorganisms, making them useless against biological attacks, says Jack Sawicki, a former fireman who now works for Geomet Technologies near Washington DC. And the lack of standards for gas masks sold to civilians in most countries makes it as likely that a mask will suffocate you as save you, he says. The suits developed for the military do work--their tight joints and zippers keep bugs out--but they are too pricey for the average fire department. Both Geomet and Irvin Aerospace are about to market civilian bio-suits. In the meantime, other companies are designing protective gear that actually kills pathogens. Molecular Geodesics in Cambridge, Massachusetts, for example, is developing a suit made of a tough, sponge-like polymer that traps bacteria and viruses, which are then destroyed by disinfectants incorporated into the fabric. Stealthy attack None of this gear will do any good, however, if the emergency services do not know there has been an attack. And an assault may not be obvious. A terrorist might not use a weapon that goes off with a dramatic bang, or even produces an obvious cloud of germs. The first hint of a biological attack may be a sudden cluster of sick people. Even that will be missed unless someone is watching. And few are. In the US, financial cutbacks have crippled programmes to track disease outbreaks, natural or deliberate. Some could be either, such as food poisoning caused by Escherichia coli O157 or Salmonella. Medical agencies fear that the extra money requested by President Bill Clinton this spring as part of an anti-terrorist initiative will not be enough to create an adequate surveillance network. In Europe, disease surveillance is only beginning to be organised on the continent-wide scale needed to track a biological emergency. But in addition to monitoring infected people, Nicholas Staritsyn of the State Research Centre for Applied Microbiology near Moscow says that more effort should be made to find out which bugs live where. For example, a particular variety of anthrax may occur naturally in South Africa, but not in Canada. Having access to such information could help authorities to distinguish between natural outbreaks and deliberate attacks. Even when infected people start turning up at local hospitals, early diagnosis of their illness might not be easy, says Steve Morse, who heads the US programme on new diagnostic technologies run by the Defense Advanced Research Projects Agency (DARPA). The first symptoms of anthrax, plague and many other potential agents of bioterrorism resemble those of flu: headaches, fevers, aching muscles, coughing. What's more, some of these symptoms might be brought on by panic attacks, which are likely to be widespread among people who have just been told that they are the victims of a biological attack. One answer discussed in Stockholm would be for hospitals to have the type of high-tech detectors being developed to identify airborne pathogens on the battlefield. With a detector at each bedside, doctors could pick out the volatile molecules released by damaged lung membranes at a very early stage of infection and instantly tell whether a patient was a victim of a biological attack, says Mildred Donlon, head of environmental detection research at DARPA. Eventually, DARPA would like to develop a detector that weighs no more than 2 kilograms, can identify as few as two particles of 20 different biological agents in a sample of air, costs less than $5000 and does not give false negatives. Such detectors could be deployed around cities to give early warning of airborne disease. In the meantime, researchers led by Wayne Bryden at Johns Hopkins University in Baltimore are working on revamping the traditional laboratory workhorse, the mass spectrometer, for use in the field or in hospitals. They've reduced this unwieldy piece of equipment to a suitcase-sized machine that can distinguish between, say, Shigella, which causes dysentery, and Salmonella. A shoebox-sized version, says Bryden, could be ready in five years. Other researchers are experimenting with devices that would not seem out of place in an episode of Star Trek: Voyager. Tiny electronic chips that contain living nerve cells may someday warn of the presence of bacterial toxins, many of which are nerve poisons. Like a canary in a coal mine, the neurons on the chip will chatter until something kills them. "Anything that stops it singing is immediate cause for alarm," says Donlon. While the "canary on a chip" could detect a broad range of toxins, other devices are designed to identify specific pathogens. One prototype consists of a fibre-optic tube lined with antibodies coupled to light-emitting molecules. In the presence of plague or anthrax bacteria, or the toxins botulin or ricin, the molecules light up. Outwitting our defences Devices based on antibodies are far from foolproof. First, you need to have the correct antibodies--not easy when you consider the vast number of pathogens you'd need to include, and their ever-changing repertoire of surface proteins. "And even the right antibodies can identify only what is on the outside of a particle," Donlon points out. Bugs can be encapsulated in gels or biological polymers to foil antibodies, or normally harmless bacteria engineered to carry nasty genes. "I want to know what is on the inside," she says. To do this, DARPA-funded researchers are developing identification techniques based on RNA analysis. Unlike DNA, which is now used to identify unknown organisms, RNA is plentiful inside cells and need not be amplified before identification begins. And messenger RNA molecules reveal not only what a microorganism is, but what toxins it is making. Once the biological agent has been identified, how do you combat it? Vaccinating people before they are exposed is one answer. This is the strategy the military is betting on. Last year, the US military launched a programme to develop vaccines against potential biological weapons. It will create jabs for diseases for which none exist, such as Ebola, and improve existing vaccines--including the 30-year-old anthrax vaccine being given to 2·4 million American soldiers. But vaccines are no cure-all. An attacker need only generate a germ that sports different antigens to those used in a vaccine to render that vaccine ineffective. Plus, as bioterrorists get more sophisticated, they will develop novel, possibly artificial, pathogens against which conventional vaccines will be useless, predicts Morse. To get around these problems, DARPA is looking at ways of developing vaccines quickly enough for them to be created, mass-produced and distributed after an attack. The first step, which many researchers including those in the fast-paced field of genomics are now working on, involves speeding up DNA sequencing so that an unknown pathogen's genes could be detailed in a day. The resulting sequences could then be the basis for developing an instant DNA vaccine. Making the vaccine is only half the problem, however. Soldiers can be ordered to take shots, but immunising the rest of the population is another matter. Civilians are unlikely to volunteer for the dozens of vaccinations that would be necessary to protect them against every conceivable biological threat. An attack would make many change their minds, but in such circumstances there might not be enough to go around. Although Clinton has called for the stockpiling of vaccines, the US has only 5 million doses of smallpox vaccine--not enough to contain a hypothetical attack, says Ken Berry, president of the American Academy of Emergency Physicians. Ken Alibek, the former second-in-command of the Soviet germ warfare programme who revealed earlier this year that the Soviets had weaponised tonnes of smallpox, argues that it is short-sighted to put too much effort into developing vaccines. Instead, says Alibek, who is now at the Batelle Institute in Virginia, researchers should concentrate on ways to treat victims of biological weapons. Today's antibiotics may be useless because germs could be equipped with genes for resistance to all of them. Russian scientists have already created such a strain of anthrax (This Week, 28 February, p 4). For any treatment to be effective amid the potential chaos of a bioterrorist attack, speed will be of the essence. At the Stockholm meeting, researchers reported their efforts to develop drugs that work against a wide variety of infections and so can be used even before definitive diagnosis. Some are trying to take advantage of recently identified similarities in the way many pathogens produce disease to develop broad-spectrum drugs. For example, Ebola, anthrax and plague all kill their victims by inducing a widespread inflammatory reaction similar to toxic shock syndrome. A team in Cincinnati is testing an anti-inflammatory drug that could stop all of them. Another gang of bacteria--including plague, Salmonella, Shigella and Pseudomonas aeruginosa (one of the bacteria that can cause pneumonia and meningitis)--relies on very similar proteins to latch onto human cells and inject toxins. Drugs that block this system might save people from all these germs, Åke Forsberg of the Swedish Defence Research Establishment in Umeå told the meeting. The trouble with all these new anti-bioweapon gizmos, gadgets and medicines is that it's far from certain that they would be available in time to shield the first major city targeted for a bioterrorist attack. At the moment, the US is one of the few countries taking the bioterrorist threat seriously. Sweden, France and Israel have trained emergency teams and stockpiled gas masks. Other countries do not seem concerned. "The threat of bioterrorism has not seized our European friends," says Mike Moodie of the Chemical and Biological Arms Control Institute, a think-tank near Washington DC. "They feel it's too improbable." Perhaps they should reconsider. Berry, who helped run the doomsday simulations that ravaged San Francisco, says: "Security experts are not asking if a biological attack on a civilian population is going to happen, but when."
From New Scientist, 19 September 1998 © Copyright New Scientist, RBI Limited 1998
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