Bioterrorism: the Modern Warfare

Bioterrorism is the new era of starting a war. It is an intentional way of releasing harmful biological agents such as bacteria, viruses and harmful toxins. In some cases, these viruses and toxins are created and then released in to the outside world. Bioterrorism has been disregarded for a long time and the risk it caused throughout the years must be openly tended to. It could occur without being noticed by the experts and it must have immediate attention to save lives.

The United States came up with a few mechanisms that could help minimize the effects of bioterrorism at its early stages. This paper will argue the need to address publicly the threat caused by bioterrorism, which has been ignored for years, and the requirement of immediate attention to educate and enhance the abilities of physicians and hospitals to tackle the attack efficiently.  It will also examine the measures taken by the government to counter attack the bio war and preparedness of the state and existing biosecurity protocols.

Bioterrorism agents are potential pathogenic organisms or biological toxins that can produce death and disease in humans, plants or animals. According to Dobric Silva in the article "Defense Against Bioterrorism, Methods for Prevention and Control" these agents are usually microorganisms found in nature, but these microorganisms are studied and modified to make them resistant to antibiotics or vaccines. Any attempted use of these agents, whether a success or failure, could cause mass destruction to humanity. As they takes some research and comes with a low cost, terrorists are using biological agents as their conventional tools for attack. The pathogens that are used for attack are smallpox, Ebola and Marburg viruses, yellow fever, Venezuelan equine encephalitis and the bacteria anthracis. These specialists are spread through sustenance or water. They can also be transmitted by aerosols like spray devices, bombs or missiles.

According to Dahlia Schweitzer in the article "When Terrorism Met the Plague: How 9/11 Affected the outbreak Narrative" the first known bio agent that was used for Bioterrorism was Rye Ergot, in the 6th Century BCE by the Assyrians to contaminate the water supply of Israel. The goal was to infect the Israelites with Ergotism, which created symptoms such as gastrointestinal upset, gangrenous development on the fingers and toes, and hallucination. However, the Assyrians were unsuccessful as they did not realize that the poisoning had to be chronic to show any sign of infection. Hence the first incident of bioterrorism was a failure. In the same century, the citizens of Delphi revolted against Kirrha, who were abusing them with their power of taxing and tolling pilgrims traveling to Delphi. The people poisoned the water supply of Kirrha with Hellebore, a poisonous plant that causes nausea, vomiting and diarrhea. Kirrha ended up losing to Delphi. With this, people began to do research on bio agents to use them against their enemies constituting the new age of waging the war between nations.

The first bioterrorism attack in the United States happened in the fall of 1984. Members of Rajneeshee, a Buddhist cult, brewed a salsa of salmonella (a food poising agent) into some restaurants. Judges, attorneys, dentists and doctors were among the people who were poisoned. According to Schweitzer, this attack happened during elections because the Rajneeshee's goal was to gain control of the area by pressing the surveying stalls with vagrants making the inhabitants excessively wiped out, making it impossible for them to cast a ballot. Despite that fact, no one died in the assault; however, about 751 individuals got sick. More recently on October 2, 2001 in Florida illness was caused due to the circulation of Anthrax. As similar attacks are likely to emerge in the future, the United States government should develop efficient biodefense mechanisms.

According to Paul Renard Jr., et al., in the article "Improvements in State and Local Planning for Mass Dispensing of Medical Countermeasures" the United States government has been preparing biodefense protocols at the state and federal levels. The government has three solutions to do this. One is to provide vaccinations nationwide against all the agents/chemicals that could possibly lead to bio war. The second is to educate people about possible symptoms and how to identify them once they have been contaminated so that they can protect themselves from the effects of already released bio agents. The last one is to prevent the act from occurring is to detect and destroy the bio agents. However, these mechanisms depend on the abilities of physicians and hospitals to work efficiently, and therein lies the problem.

After the 9/11 attack in 2001, the requirement for the coordination of federal, state and local governments has increased. According to Schweitzer, the effect of this is that around $1 billion was allotted annually to local and state emergency preparedness. In 2006, Congress authorized the Pandemic and All-Hazards Preparedness Act (PAHPA) to improve the public preparedness by focusing more on the natural disasters, emerging infectious diseases rather than concentrating on bioterrorism. Another program, which is called Public Health Emergency Preparedness (PHEP) program, provides funding to the local, federal and state governments to prevent, protect, react and rapidly recover from chemical, biological, nuclear, radiological threats and attacks. PHEP is supporting National Health Security Strategy by following the tactics: within the state, territorial and local public health agencies to introduce robust management and programs that will help preparedness for the public health security, supporting key public health capabilities required for emergency planning and response, assuring the response readiness for public health emergencies and disasters, and promoting the health security of communities (Schweitzer).

The government has to take precautions against the bio-terrorism. Each department takes care of certain aspect of public life, for example, the U.S federal, state and local agencies take care of the public health emergency preparedness; the U.S Department of Health Services takes care of the public health emergency response; the U.S Department of Homeland Security takes care of addressing the potential bioweapon threats. So, when the work is divided among many departments, the task becomes more transparent thus reducing the chances of being attacked. According to Silva, all departments are affiliated with biodefence, they will be collaboratively monitoring all the water or food supplies as they are more prone to a bio attack. The U.S Department of Health takes care of preparing the vaccines way before the attack could occur. The department is responsible for developing one common neutral vaccine that could reduce the effect in the body caused by the attacks, so that it would give some time in finding the right vaccine for the bio-attack.

Due to the harmful effects of the bio agents addressed in the bioterrorism act, there is a need for the quick supply of vaccines available for immediate use in this wide-scale of emergency. The Strategic National Stockpile (SNS) of the United States has sufficient smallpox vaccine to provide vaccination for everyone in the country to sustain a bio weapons attack. It also has millions of anthrax vaccines, antiviral medications and other vaccines and medical supplies. They are some organizations like strategic national stockpile who fund on storing the drugs, vaccines and medical supplies. These storage places run under the higher authorities like the U.S department of health services (HHS) houses as the emergency response time would be very fast when the organizations run under a government surveillance.

According to Ali S. Kahn and Alexandra M. Levitt in the scholarly article "Biological and Chemical Terrorism: Strategic Plan for Preparedness and Response" early detection for the biological or chemical terrorism is crucial. Without having any proper precautions in the local regions (as states would have some access points therefore neglecting local levels) a large-scale attack with variola virus, aerosolized anthrax spores, a nerve gas, or a foodborne biological or chemical attack could overwhelm the national public health infrastructure. Large number of patients and the injured people would get worried and seek medical attention. The people will also need food and medical supplies at that time. The state access points can provide enough medical supplies but due to few state access points people may not be able to reach on time for the medical supplies. So, having camps in local areas would be more beneficial for the people at the time of attacks.

It is important to detect bio agents at the early stages and prevent bioterrorist attacks. Some key focus areas according to Ali S. Kahn and Alexandra M. Levitt, are known to be CDC's strategic plan:

1. preparedness and prevention
2. detection and surveillance
3. diagnosis and characterization of biological and chemical agents
4. response
5. communication

(Kahn and Levitt)

With preparedness and prevention certain organizations will provide some public health guidelines, support and some technical assistance for the people and provide some public awareness on how the biological and chemical attacks would occur or how they spread: like the source of communication for the disease from one person to the other. The organizations will concentrate on those factors and educate people on how to take precautions to and the tools that will be required to keep the disease out from the people.

Next in the detection and surveillance the role of CDC is more than the people. Under this process CDC would setup some offices in local areas and they would be assigned with some works. They will be some CDC agents working on the floor, they would keep an eye on the important sectors like the food supplies system and the water supplies system as these are the two important areas where the biological agents can be reached to people at the time of attacks immediately.

The diagnosis and characterization of biological and chemical agents is also run under the organization. For this the CDC organization will be having a few agents, their work would be to take the sample of the food supplies and the water supplies of the county for every one or two months and run check up on those samples. By doing so we can ensure up to a level that there is no harm for the people.

Under response and communications, the CDC organizations should be always in a position for a fast response when an attack is recorded. Even having local camps, they would require more medical and food supplies when the attack is on a large scale. So, by following up the five above factors, threat can be reduced up to certain level and people's safety can be ensured.

In conclusion, to minimize the effects of bioterrorism in early stages, the government needs to give immediate attention to educate and develop the skills of physicians and hospitals and improve mechanisms to counter attack bioterrorism. These can be achieved by implementing strategic plans which include preparedness and prevention, detection and surveillance, diagnosis and characterization of biological and chemical agents, responding and communicating to the public efficiently

Works Cited

1. Dobri, Silva. "Defense Against Bioterrorism, Methods for Prevention and Control. Vojnosanitetski Pregled: Military Medical & Pharmaceutical Journal of Serbia, vol. 75, no. 6, June 2018, pp. 634635. EBSCOhost, doi: 10.1007/978-94-024-1263-5.
2. Perry, Ijeoma A., et al. "Use of Medical Countermeasures in Small-Scale Emergency Responses. American Journal of Public Health, vol. 108, Sept. 2018, pp. S196S201. EBSCOhost, doi:10.2105/AJPH.2018.304491.
3. Katz, Rebecca, et al. "Funding Public Health Emergency Preparedness in the United States. American Journal of Public Health, vol. 107, Sept. 2017, pp. S148S152. EBSCOhost, doi:10.2105/AJPH.2017.303956.
4. Renard Jr., Paul G., et al. "Improvements in State and Local Planning for Mass Dispensing of Medical Countermeasures: The Technical Assistance Review Program, United States, 20072014. American Journal of Public Health, vol. 107, Sept. 2017, pp. S200S207. EBSCOhost, doi:10.2105/AJPH.2017.304037.
5. Von Lubitz, Dag K. J. E. Bioterrorism: Field Guide to Disease Identification and Initial Patient Management. Boca Raton, FL: CRC Press, 2004.
6. SCHWEITZER, DAHLIA. "When Terrorism Met the Plague: How 9/11 Affected the Outbreak Narrative. Cinema Journal, vol. 56, no. 1, Fall 2016, pp. 118123. EBSCOhost
7. D, Arcangelis, Gwen. "Reframing the 'Securitization of Public Health': A Critical Race Perspective on Post-9/11 Bioterrorism Preparedness in the US. Critical Public Health, vol. 27, no. 2, Apr. 2017, pp. 275284. EBSCOhost, doi:10.1080/09581596.2016.1209299.
8. Ali S. Khan, M.D. and Alexandra M. Levitt, M.A., Ph.D. "Biological and chemical Terrorism: Strategic Plan for Preparedness and Response.

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