What Has Anthrax Taught Us About Public Health?

Texas A&M Health Science photo

Texas A&M Health Science photo

The 2001 anthrax attacks in the United States marked the first time public health was deemed central to emergency response and national security, and has since served as a catalyst for national, state, and local efforts to ensure public health preparedness efforts are in place. The attack was the first case of intentional, deliberate release of anthrax in the United States. Thought to be devised by a mentally ill, lone scientist, the threat spawned from only a few grams of Anthrax, but infected 22 individuals and resulted in five deaths causing wide-spread public fear, significant government disruptions and a direct economic cost over a billion dollars.

So what would happen if a terrorist group got their hands on several hundred grams of anthrax? Consequences could be catastrophic, with casualties potentially in the thousands with untold economic, social and political consequences, underscoring the need for collaborative public health preparedness and response efforts between health departments, emergency management, law enforcement and private entities from local to national levels. Gerald Parker, D.V.M., Ph.D., associate vice president for public health preparedness and response at Texas A&M Health Science Center, offers information on the realities of a bioterrorist attack and what is currently being done to prepare for the next unknown threat.

Q:  How dangerous is anthrax from a national security standpoint?
A:  Attempts to use biological warfare agents date back to antiquity, but biological warfare increased in sophistication during the 20th and into the 21stcentury.  For example, the German Army developed anthrax as a strategic weapon in World War I to undermine allied cavalry operations and logistics. The United States initiated a biological weapons program in World War II in response to the fact that our enemies had biological weapons.  By the time the United States terminated its biological weapons program in 1969, the feasibility of manufacturing biological weapons had been demonstrated and civilian population vulnerabilities were established through simulations.

The Soviet Union began a biological weapons program in the 1920’s, but when the United States terminated its weapons program in 1969, the Soviet Union took that opportunity to greatly expand their offensive program even though the Soviets were a signatory to the Biological and Toxins Weapons convention of 1972.  Through the end of the Cold War, the Soviets maintained an immense, clandestine and sophisticated offensive biological weapons enterprise employing thousands of scientists, engineers and technicians. The Soviet program went largely undetected by the west until 1991, when two defectors made their way to the United Kingdom and the United States. We learned that anthrax spores and other pathogens, including smallpox, were produced in ton quantities and coupled to strategic weapon delivery systems. After becoming aware of the extent of the former Soviet enterprise after the end of the Cold War, the threat of proliferation of scientific expertise and biological weapons materials from Russia to other state and non-state actors was real. Although much of the Russian enterprise has since been redirected through cooperative threat reduction programs to peaceful purposes, Russia has not allowed western inspectors and scientist to visit a few key Russian military facilities thought to have been involved in illicit biological weapons production activities to this day. In addition to Russia, there continues to be concern that China, North Korea, Iran and Syria may still harbor clandestine biological weapons capabilities. For this reason, in addition to the growing bioterror threat from non-state actors, the Department of Defense, Department of State, Department of Justice and Director of National Intelligence maintain biological weapon counter-proliferation and non-proliferation programs in partnership with our strategic allies to prevent, mitigate and interdict illicit use of pathogens as biological weapons.

Since the anthrax attacks in 2001, dozens of policy, intelligence, technical reports and other open source publications have affirmed that terrorist groups and violent extremists, to include the Islamic State, intend to acquire and use biological pathogens to cause death, suffering, and socio-economic disruption on a catastrophic scale. Today, anthrax is near, or at the top of most bioterror threat lists.

Anthrax spores are easily found in nature, can last for a long time in the environment, and are maintained in research and diagnostic laboratories around the world. Many of these laboratories are in the developing world within a terrorist nexus, and most lack biosecurity, biosafety and personnel reliability controls.

The knowledge and tools needed to acquire and disseminate anthrax as a bioterror threat are accessible and easily concealed.  Anthrax can be released on a civilian population quietly and covertly, without anyone knowing, making it a prime bioterror agent.  The consequences of an anthrax attack can range from a few casualties to thousands; and environmental contamination that may require months or years to remediate.

An anthrax attack on a city in the United States could be catastrophic, yet several bi-partisan commissions and reports have consistently reported major gaps in our bioterror preparedness.  The most recent was the bi-partisan report from the blue ribbon panel on biodefense:  A National Blueprint for Biodefense (October 2015).  For these reasons, public health emergency preparedness planning and action have become a national security imperative.

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