Amerithrax

If you don't know much about the 2001 anthrax attacks on the US then the UCLA Department of Epidemiology has a nice website with lots of links.

The FBI website has a lot of images of original material and presents a fairly compelling case that U.S. Army Medical Research Institute of Infectious Disease researcher Bruce Ivins was solely responsible. However since Ivins killed himself in 2008 as the investigation closed in there was no trial and, for some people, no closure.


In response to this the FBI asked the National Academy of Sciences (NAS) to conduct an independent review of the scientific evidence that led the agency to implicate Ivins in the anthrax letter attacks. The NAS committee released its report three years later after exhaustively covering all the evidence and conducting public hearings. They concluded that it was "impossible to reach any definitive conclusion about the origins of the anthrax in the letters, based solely on the available scientific evidence". The report also challenged the FBI and U.S. Justice Department's conclusion that a single-spore batch of anthrax maintained by Ivins at his laboratory at Fort Detrick in Maryland was the parent material for the spores in the anthrax letter.

This conclusion was welcomed by various conspiracy theorists although it really only points out the weaknesses in the governments case. Of course the fact that the FBI had previously been convinced that someone else was the perpetrator doesn't exactly inspire confidence. Dr Steven Hatfill eventually sued the FBI, the Justice Department, John Ashcroft, Alberto Gonzales, and others for violating his constitutional rights and the government settled the case for $5.8 million.

Regardless of whether he was the perpetrator or not (my guess is that he was) Bruce Ivins was clearly a few sandwiches short of a full picnic which raises the question that everyone seems to overlook:

Why was a mentally disturbed person allowed to continue working with highly dangerous pathogens?

Answer: Because the army wants them to.


"Individuals will be mentally alert, mentally and emotionally stable, trustworthy, physically competent....."

This is part of the US army regulation covering scientists working on bioweapons. (Actually bioweapon 'defence' since the US doesn't work on bioweapons).

Unfortunately it appears that this modest list of conditions - which, let's face it, isn't that different to the characteristics you might look for in a date - is too much for the workers at the US Army Medical Research Institute of Infectious Diseases (USAMRIID). In 2007 the deputy commander for safety wrote:
'The possibility of losing talented and well-trained researchers to other facilities.... with less stringent programs.... may impact the ability of the Defense Threat Reduction Agency to provide research personnel to combat biological agent use.'

Coming back to bite you

Would Bubonic Plague make a good weapon?

A 1970 World Health Organization assessment asserted that in a worst-case scenario a dissemination of 50 kg of Yersinia pestis in an aerosol cloud over a city of 5 million might result in 150,000 cases of pneumonic plague. Of those, 80,000 to 100,000 cases would require hospitalization, and 36,000 victims would be expected to die.

Of course there are numerous difficulties involved in getting 50kg of bacteria into an aerosol cloud. You could just breed infected fleas instead but, as the video says, they may well come back to bite you...

die.

Amerithrax

The American Anthrax attacks of 2001, which the FBI itself have named 'Amerithrax', provide an insight into how we might respond to a major bioterror threat.

UCLA's department of epidemiology in the School of Public Health has gathered together virtually every piece of publicly available information to create an incredibly detailed timeline with information on every single case.

Epidemiologists are often called "disease detectives," using many of the same methods as regular detectives to determine the cause of disease outbreaks, epidemics (i.e., larger excess in disease cases), or even pandemics (i.e., worldwide excess in disease cases). The anthrax outbreak in the United States which occurred during the latter part of 2001 has many of the same characteristics as a typical outbreak. What is different, however, is that there was no transmission from infected to susceptible persons that linked one case with another. Instead, all of the cases were generated by a terrorist or group of terrorists who sent letters containing anthrax spores through the postal system.

Bioterrorism in Japan

Spraying scenes from the Aum Shinrikyo headquarters building (photographs taken July 1, 1993, by the Department of Environment, Koto-ward).

I've posted this before but I think this odd tale is worthy of repeat.

Terrorists and microbiology don't seem to mix well. The meticulous and laborious work involved in microbiology seems challenging for the average terrorist who would probably rather be blowing something, someone, or themselves, up.

From the pages of 'epic fail' I bring you the surprisingly little known story of Aum Shinrikyo and anthrax. I am not making this up, everything that follows is fairly well documented (eg. this CDC report), it just isn't very well reported.

Aum Shinrikyo, who have apparently changed their name to Aleph, are a Japanese religious movement, or cult depending on where you draw the line. They are most notorious for their Sarin attack on the Japanese subway in 1995 that killed 12 commuters, seriously injured 54 and affected about a thousand more.

Two years before this, in July 1993, Aum Shinrikyo members dispersed a liquid suspension of Bacillus anthracis (anthrax) from the roof of an eight-story building in Tokyo. Although residents complained of foul odors the spraying went on for at least four days until demands from local residents forced Aum Shinrikyo to stop. There were no known human cases and, at the time, no-one realized an attack had even taken place. The incident was largely forgotten until the 1995 subway sarin gas attacks. Confessions of Aum Shinrikyo members revealed the plot and samples collected in 1993 were eventually analyzed in 1999 and found to be anthrax. The obvious question is why the anthrax attack plot had failed. The consensus seems to be that the would be bioterrorists did just about everything wrong.

• Spraying during the day was a bad move, sunlight inactivates the spores and heat radiating from concrete and asphalt makes the spores rise rather than fall.
• The spore concentration that was sprayed was about 10⁴/mL - many orders of magnitude less than the 10⁹ to 10¹⁰ organisms/mL considered to be optimal.
• The spraying device was very inefficient and apparently the nozzles clogged repeatedly and the device itself broke down several times.
• But I saved the best for last. The strain of anthrax used was an attenuated (weakened) strain used to vaccinate animals in Japan. This strain is generally regarded as nonpathogenic for immunocompetent people.

Bioterrorism - it's not as easy as they make it look in the movies.

BSL-4

Okay, one last post on last week's topic - biosafety.

Popular Mechanics magazine had an article about Biosafety labs in May last year. In particular they got a look at the new $105 million BSL-4 facility at Fort Detrick.

The first rule in any fight is to know the enemy—and that places this outwardly normal office building on the front line of a war against invisible foes that can mutate into more powerful strains. Jahrling, one of the nation’s most seasoned virus hunters, has no illusions as to which organisms have the upper hand: “The bugs are always one step ahead.”

There is no mention in the article of the fact that Fort Detrick was the source of the anthrax used in the 2001 anthrax attacks. It didn't 'escape' from the building, it was deliberately removed by a scientist who worked there. I presume that there are now new procedures in place to prevent this happening again. At least I hope so.

Smallpox 2002

I saved this for the weekend because it is a bit of a potential time sink. Smallpox 2002 is a FICTIONAL 'documentary' made in 2001 by the BBC. It was commissioned and largely completed before both the 9/11 attacks and the anthrax attacks that followed. The film has been shown in the US as "Smallpox", on FX. Although the program has some flaws, on the whole I thought it was well done. If it gets people to think in advance about what will happen in the next pandemic, whether it is influenza or bioterror, then that's a good thing. What parts of the program did you find unrealistic? Do you think events would have played out differently? Do you think this program is unnecessarily fear-mongering or do you think it is a valuable warning? The tagline for the movie was, "Drama, until it happens". Good one.

The program is rather addictive and lasts 90 minutes so don't start watching if you have other things to do!

For those whose history is shaky, let me repeat, this is fiction. There wasn't a smallpox epidemic in 2002 that killed 60 million people! For reference though, the 1918 influenza pandemic killed somewhere between 20 and 100 million people worldwide.

Part 2
Part 3
Part 4
Part 5
Part 6
Part 7

Attenuated? Ooo, that sounds dangerous....

Spraying scenes from the Aum Shinrikyo headquarters building (photographs taken July 1, 1993, by the Department of Environment, Koto-ward).

Terrorists and microbiology don't seem to mix well. Terrorists seem better suited to explosives and have managed to successfully carry out numerous devastating bombings. But the meticulous and laborious work involved in microbiology seems challenging for the average terrorist who would probably rather be blowing something, someone, or themselves, up.

From the pages of 'epic fail' I bring you the surprisingly little known story of Aum Shinrikyo and anthrax. I am not making this up, everything that follows is fairly well documented (eg. this CDC report), it just isn't very well reported.

Aum Shinrikyo, who have apparently changed their name to Aleph, are a Japanese religious movement, or cult depending on where you draw the line. They are most notorious for their Sarin attack on the Japanese subway in 1995 that killed 12 commuters, seriously injured 54 and affected about a thousand more.

Two years before this, in July 1993, Aum Shinrikyo members dispersed a liquid suspension of Bacillus anthracis (anthrax) from the roof of an eight-story building in Tokyo. Although residents complained of foul odors the spraying went on for at least four days until demands from local residents forced Aum Shinrikyo to stop. There were no known human cases and, at the time, no-one realized an attack had even taken place. The incident was largely forgotten until the 1995 subway sarin gas attacks. Confessions of Aum Shinrikyo members revealed the plot and samples collected in 1993 were eventually analyzed in 1999 and found to be anthrax. The obvious question is why the anthrax attack plot had failed. The consensus seems to be that the would be bioterrorists did just about everything wrong.

• Spraying during the day was a bad move, sunlight inactivates the spores and heat radiating from concrete and asphalt makes the spores rise rather than fall.
• The spore concentration that was sprayed was about 10⁴/mL - many orders of magnitude less than the 10⁹ to 10¹⁰ organisms/mL considered to be optimal.
• The spraying device was very inefficient and apparently the nozzles clogged repeatedly and the device itself broke down several times.
  
• But I saved the best for last. The strain of anthrax used was an attenuated (weakened) strain used to vaccinate animals in Japan. This strain is generally regarded as nonpathogenic for immunocompetent people.

Bioterrorism - it's not as easy as they make it look in the movies.

It all balances out in the long run....

Although I talked about this very issue on Friday I somehow missed the news this week that research at the US Army Medical Research Institute of Infectious Diseases (USAMRIID) at Fort Detrick in Maryland has been suspended following the discovery of four undocumented vials of Venezuelan equine encephalitis. This is a zoonotic viral disease of horses, donkeys etc that can also affect humans. When the U.S. biological warfare program ended in 1969 Venezuelan equine encephalitis virus was one of seven biological weapons it had developed. I have not seen any reports on whether the additional samples are the 'regular' strain or the weaponized strain.

The shutdown, that could last three months, is intended to allow a complete inventory of hazardous bacteria, viruses and toxins stored in refrigerators, freezers and cabinets. The Commander, Col. John P. Skvorak, said there was a high probability that some germs and toxins in storage were not in the database. Whilst this doesn't appear as serious as losing vials, the issue of lax record keeping is worrying. The danger with undocumented samples is that anyone with access could walk out with them and no-one would know they were gone.

Army officials insist there are no missing vials of lethal substances and no danger to the public - but if you don't know what you have how do you know what is missing? What the army should say is that there are no missing samples from their inventory and that their inventory includes x% of all samples - determined after an exhaustive search. New procedures should then be put in place to ensure that all samples are, in future, included in an inventory.

Weaponized Pneumonic Plague

According to Colonel Bryon Weeks, M.D., the best weaponized form of pneumonic plague was developed in Russia. This system utilizes canisters that release the plague in powdered form from a cruise missile, which is difficult to detect. While the Japanese attempted to weaponize the plague via the use of infected fleas, the Soviets met more success with creating an aerosol form. This form can be quite dangerous, due to the contagiousness of the plague. This weaponized form is resistant to at least 16 different antibiotics, and a vaccine used against the bubonic plague up until 1998 was not effective against this form.

Details can be found here:
http://archive.newsmax.com/archives/articles/2001/10/16/134822.shtml

According to this CDC video, the plague has been used as a weapon as early as the Tartars, who catapulted infected corpses into the city of Kaffa in an attempt to spread the disease. However, scientists believe that the city got the disease through flea-ridden rats. The Japanese unit 731, under General Shiro Ishii, also used the plague by dropping infected flea-filled bombs in China. The United States researched an offensive use of the plague but had difficulties maintaining its virulence. The Soviets, however, overcame the problem and according to defector, Dr. Alibek, are said to have 1,500 metric tons of the plague.

Video can be found here:
http://www.bt.cdc.gov/training/historyofbt/03plague.asp

Plague sweeps al-Qaida camp in Africa

There are reports this week that an outbreak of bubonic plague has killed 40 members of AQLIM (al-Qaida in the Land of the Islamic Maghreb), the largest and most powerful al-Qaida group outside the Middle East, at a training camp in Algeria in North Africa. Although Bubonic plague is still endemic to this region there are rumors that the deceased were victims of al Qaeda biological warfare experiments at a camp in the forested hills of coastal Algeria. Although picked up by a number of international newspapers and media organizations, the original source appears to be the British Sun newspaper - not exactly well known for breaking stories of international terrorism. Curiously this week old story has not received much press in the US although the Washington Times does claim to have confirmation of the story from an anonymous 'senior US intelligence official':

The official, who spoke on the condition he not be named because of the sensitive nature of the issue, said he could not confirm press reports that the accident killed at least 40 al Qaeda operatives, but he said the mishap led the militant group to shut down a base in the mountains of Tizi Ouzou province in eastern Algeria.

He said authorities in the first week of January intercepted an urgent communication between the leadership of al Qaeda in the Land of the Maghreb (AQIM) and al Qaeda's leadership in the tribal region of Pakistan on the border with Afghanistan. The communication suggested that an area sealed to prevent leakage of a biological or chemical substance had been breached, according to the official.

Japan’s Secret Weapon

In scientist-writer Barclay Newman’s 1944 book, “Japan’s Secret Weapon,” there is evidence of a weaponized form of spirochetes, including borrelia microbes which cause Lyme disease. These spirochetes do not have a cell wall, which renders antibiotics ineffective. According to Newman, many of these spirochetes resistant to antibiotics are a result of weapon experimentation during World War II. Journalists of the 1980s finally uncovered the activities of Japanese Unit 731, including the experimentation of infectious disease on innocent civilians. Despite the atrocities, the United States allowed the bio-weapon engineers to continue their research, including Erich Traub, stationed on Plum Island, which is quite close to Lyme, Connecticut, where the first documented outbreak of Lyme disease occurred in the 1970s.

Details can be found here:
http://www.lyme-rage.info/spirowarfare.html

Sciencedebate 2008

An organization called Science Debate 2008 has been working to restore science and innovation to America’s political dialogue. As part of this process they came up with a list of 14 science related questions for the candidates to answer. Barack Obama has submitted answers which you can see here. John McCain has said he will also answer the questions.

Of particular interest for this class is question 6:

Pandemics and Biosecurity. Some estimates suggest that if H5N1 Avian Flu becomes a pandemic it could kill more than 300 million people. In an era of constant and rapid international travel, what steps should the United States take to protect our population from global pandemics or deliberate biological attacks?

Here is Senator Obama's answer (in white) with my comments interspersed in black. This is a non-partisan blog, if Senator McCain submits answers before the class ends I'll comment on that too.

It’s time for a comprehensive effort to tackle bio-terror. We know that the successful deployment of a biological weapon—whether it is sprayed into our cities or spread through our food supply—could kill tens of thousands of Americans and deal a crushing blow to our economy.

Overseas, I will launch a Shared Security Partnership that invests $5 billion over 3 years to forge an international intelligence and law enforcement infrastructure to take down terrorist networks. I will also strengthen U.S. intelligence collection overseas to identify and interdict would-be bioterrorists before they strike and expand the U.S. government’s bioforensics program for tracking the source of any biological weapon. I will work with the international community to make any use of disease as a weapon declared a crime against humanity.

Hmm, I rather wish that they had left the last four words out of the question. I'm going to be disappointed if the answer is solely about bioterror when the intent of the question was about pandemics more generally. There's nothing here that is very interesting from a disease perspective except perhaps the mention of bioforensics. We now have the capability to trace strains of bacteria and viruses to particular source strains and often particular labs.

And to ensure our country is prepared should such an event occur, we must provide our public health system across the country with the surge capacity to confront a crisis and improve our ability to cope with infectious diseases.

This is a bit more interesting. Hospitals have been losing 'surge capacity' (aka empty beds) for years - either in search of greater efficiency or greater profits. There's no mention how this will be done, but the acknowledgment that we need it is a good sign.

I will invest in new vaccines and technology to detect attacks and to trace them to their origin, so that we can react in a timely fashion. I have pledged to invest $10 billion per year over the next 5 years in electronic health information systems to not only improve routine health care, but also ensure that these systems will give health officials the crucial information they need to deploy resources and save lives in an emergency.

This is getting more interesting. Funding for health information systems is a great idea. This will allow us to catch an epidemic in the early stages AND even when there isn't an epidemic we will still help improve people's health by tracking any long term changes in endemic diseases and making causal connections.

I will help hospitals form collaborative networks to deal with sudden surges in patients and will ensure that the U.S. has adequate supplies of medicines, vaccines, and diagnostic tests and can get these vital products into the hands of those who need them.

Ah, interesting, but what does it mean when a presidential hopeful promises to 'help hospitals form collaborative networks'? Does he mean there will be funds available or incentives or he will push for new legislation?

We also have to expand local and state programs to ensure that they have the resources to respond to these disasters. I will work to strengthen the federal government’s partnership with local and state governments on these issues by improving the mechanisms for clear communication, eliminating redundant programs, and building on the key strengths possessed by each level of government. I introduced legislation which would have provided funding for programs in order to enhance emergency care systems throughout the country.

Sounds like some obligatory politician phrasing.

I will build on America’s unparalleled talent and advantage in STEM fields and the powerful insights into biological systems that are emerging to create new drugs, vaccines, and diagnostic tests and to manufacture these vital products much more quickly and efficiently than is now possible. Unfortunately, the Bush administration has failed to take full advantage of the Bioshield initiative. Because of the unpredictability of the mode of biological attack, I will stress the need for broad-gauged vaccines and drugs and for more agile and responsive drug development and production systems. This effort will strengthen the U.S. biotech and pharmaceutical industry and create high-wage jobs.

Whilst no-one will be surprised that Senator Obama got a shot in at President Bush I would have advised him to take the high road and to praise President Bush's commitment to both malaria and HIV programs in Africa. He could have pledged to match or increase funding.

Mentally and emotionally stable

"Individuals will be mentally alert, mentally and emotionally stable, trustworthy, physically competent....."

This is part of the US army regulation covering scientists working on bioweapons. (Actually bioweapon 'defence' since the US doesn't work on bioweapons).

Unfortunately it appears that this modest list of conditions - which, let's face it, isn't that different to the characteristics you might look for in a date - is too much for the workers at the US Army Medical Research Institute of Infectious Diseases (USAMRIID). In 2007 the deputy commander for safety wrote:
'The possibility of losing talented and well-trained researchers to other facilities.... with less stringent programs.... may impact the ability of the Defense Threat Reduction Agency to provide research personnel to combat biological agent use.'

This is all coming to light now because of the case of Bruce Ivins, accused of killing five people in the anthrax attacks of October 2001. Regardless of how fishy you think the whole thing smells a big question needs to be answered - how can we prevent our own bioweapon 'defence' labs from being the source of bioweapon attacks? There have been a few articles along this line but we need a much bigger debate on this and whether the huge expansion in 'biodefence' facilities will cause a greater risk than the risk of a terrorist or other bioweapon attack they seek to prevent.

National Bio- and Agro-Defense Facility

One of the new BSL-4 labs in the USA will be associated with a proposed federal animal disease research laboratory. The proposed National Bio and Agro-Defense Facility (NBAF) would research high-consequence biological threats involving zoonotic and foreign animal diseases. There are six sites that are still in the running:

Athens, Georgia
Manhattan, Kansas
Flora, Mississippi
Plum Island, New York
Butner, North Carolina
San Antonio, Texas

The new lab will essentially replace the current Plum Island animal disease center, which does not have a BSL-4 lab. One option is to build it on the Plum Island site but the cost of this is much higher.

Choosing the location for the facility is creating some tension between the local residents, who don't want the lab and local politicians, businesses and universities who do want the lab, either for the research possibilities it would provide or the money and jobs it would provide, or both. The average cost for the six finalists is $721 million. Residents in Athens, Georgia who don't want the lab there have a very active website, as do opponents of the lab in North Carolina and Kansas. What do you think? Is this just nimbyism? FYI, the University of California submitted an 'expression of interest' in hosting the lab but was not invited to submit a full proposal by the Department of Homeland Security. UC's plan was to build the lab at the Lawrence Livermore National Laboratory.

Zoonoses as Biological Weapons

While it is generally known that throughout the 19th century numerous countries have utilized various programs to develop biological agents as weapons for war, what is lesser known is that a majority of these agents are zoonoses. Anthrax, plague, tularemia, and rabies are just a few examples of the many zoonoses used in biological warfare. The fact that most zoonoses are not highly contagious and are relatively easy to control and deploy makes them a favorable choice for biological weapons. Furthermore, Dr. David R. Franz, the Vice President of the Chemical and Biological Defense Division Southern Research Institute claims that they are also appealing as bio weapons because their threat to public health may, "justify a state-sponsored research program, which may serve as a cover for a biological warfare program".

Terrorists have also utilized zoonotic agents as a means of weaponry. Although biological weapons are much more complicated and dangerous to deal with than typical terrorist bombs, the immense consequences that they are capable of producing make them appealing. Not until recently has the United States instituted programs to confront the growing threat of biological warfare. The response to such weapons includes advancements in the physical protection of soldiers against bio agents, monitoring research programs around the world, and participating in many large scale treaties. For more: Click Here