The scenario sounds farfetched to most Americans. But at least 16 nations and an unknown number of terrorist groups can now produce biological weapons. And they can easily expose unwitting victims to them in airports, shopping centers and subways, not just on battlefields. This is not science fiction.
The proliferation is partly due to the collapse of the former Soviet Union. Its biological-warfare experts have been for hire to any nation or group willing to pay. The horror of the bombings at the World Trade Center and the Oklahoma City federal building may soon be followed by ““biological bombings,’’ like the gassing of Tokyo subway stations with sarin gas. The only question is when and where they will occur.
Perhaps the most terrifying threat is an ancient one–smallpox. U.S. intelligence reports indicate that this agent is in the hands of several governments, possibly including Iraq’s. Smallpox was once the most feared of all the epidemic diseases, and for good reason. Thirty percent of smallpox patients die a miserable, painful death. At first the symptoms can be confused for other common diseases like chicken pox. But, as the disease progresses, the symptoms become more grotesque. Pustules all over the body harden to resemble infected bee stings. Hemorrhagic smallpox rivals the worst of Ebola-virus infections. Blood oozes from the victims’ mouths, noses and other orifices. After smallpox was eradicated in 1980, we stopped vaccinating against it. People under the age of 25 have never been vaccinated, and immunity has long since waned in those who were once immunized.
An invisible aerosol release of smallpox virus in a busy public place would sicken hundreds or even thousands of people, but not until 10 to 14 days later. In the first few days, it’s unlikely that a doctor would recognize the illness. Because the virus is spread through the air, family members, friends, co-workers and health-care personnel would be exposed to itbefore steps could be taken to minimize transmission. Then there would be a second wave of cases.
Smallpox would quickly overwhelm the public-health and health-care-delivery systems of any city or state in the country. We would need to quarantine entire communities, something we haven’t had to do for almost a century. Widespread vaccination could quickly bring the epidemic under control, but there is so little vaccine left in our stockpiles that we couldn’t vaccinate more than 3 percent of the U.S. population. Other nations face the same problem.
We need to strengthen our fragmented public-health and disease-surveillance systems so we can quickly detect episodes of biological terrorism and respond to them in order to prevent additional illness. If we are fortunate, we may also be in a better position to treat those who do become ill. This week’s events in Iraq should not paralyze us. They should shock us into action.
