The Biological ThreatWhy should we be worried about biological terrorism?Many of the agents used as biological weapons occur in nature and are therefore available for use among both the military and civilians. The ease with which biological weapons can be delivered also makes dissemination of these agents easy. In 1995, two members of a militia group in Minnesota were convicted of possession of ricin, a biological agent that they had produced themselves. The ease with which harmful biological agents may be obtained is probably best exemplified by the 1996 episode in which Bubonic plague cultures were obtained through the postal service, by a man in Ohio.By dividing every 20 minutes, a single bacterium gives rise to more than a billion copies in 10 hours. A small vial of microorganisms can yield a huge number in less than a week. For some diseases, such as anthrax, inhaling a few thousand bacteria--which would cover an area smaller than the period at the end of this sentence--can be fatal. There are a number of candidate organisms terrorists could weaponize, but the Working Group identifies only a few that are widely known and feared and that would cause disease and deaths in sufficient numbers to cripple a city.Preparing Your FamilyThere are a number of considerations that should be taken into account when undergoing therapy for Biological Contamination or immunizing your body against the possibility of infection. A few are mentioned below, and some product examples are given. The Institute for Molecular Medicine is a nonprofit institution and does not endorse commercial products. The products mentioned below are only examples of the types of substances that could be beneficial to patients. Increase your intake of fresh vegetables, fruits and grains. This will give you an increase in the level of Sterols and Sterolins, which in turn will act as a regulator for your immune system. One such product is Vidatol. Dosage: 3 tablets daily between meals. This tablet is not meant to treat the disease associated with Biological Infection, it is meant as a preparatory treatment. Infections such as Anthrax are fatal if your immune system is depleted. This is child safe. Decrease your intake of fats and eliminate simple or refined sugars that can suppress your immune system. Potential Biological Agents, Associated Infections, and TreatmentBacillus anthracis. Causes anthrax. If bacteria are inhaled, symptoms may develop in two to three days. High fever, vomiting, joint ache and labored breathing, and internal and external bleeding lesions follow initial symptoms resembling common respiratory infection. Exposure may be fatal. Vaccine and antibiotics provide protection unless exposure is very high. Adult: Vidatol: 900 mg daily Child: Vidatol: 600 mg daily Botulinum toxin. Cause of botulism, produced by Clostridium botulinum bacteria. Symptoms appear 12 to 72 hours after ingestion or inhalation. Initial symptoms are nausea and diarrhea, followed by weakness, dizziness and respiratory paralysis, often leading to death. Antitoxin can sometimes arrest the process. Yersinia pestis. Causes bubonic plague, the Black Death of the Middle Ages. If bacteria reach the lungs, symptoms--including fever and delirium--may appear in three or four days. Untreated cases are nearly always fatal. Vaccines can offer immunity, and antibiotics are usually effective if administered promptly. Adult: Vidatol: 900 mg daily Ebola virus. Highly contagious and lethal. May not be desirable as a biological agent because of uncertain stability outside of animal host. Symptoms, appearing two or three days after exposure, include high fever, delirium, severe joint pain, bleeding from body orifices, and convulsions, followed by death. No known treatment. CFIDS/GWI. Following military duties during the Gulf War, soldiers and DOD civilians based in Iraq experienced symptoms which started out as a relative benign series of flu-like illnesses becoming progressively worse with; intermittent fever, coughing, nausea, gastrointestinal problems, skin rashes, joint pain, memory loss, vision problems and severe headaches. This raises the possibility of these symptoms being the result of an unknown weapon designed by Iraq and made available to the terrorist networks. Treatment: Heavy regiment of antibiotics. PLI Pharmaceuticals, San Jose, Costa Rica, International 506-283-4216, Toll Free 888-247-1601, www.purelife.cc |
Plague, the disease caused by the bacteria Yersinia pestis (Y pestis), has had a profound impact on human history. In AD 541, the first great plague pandemic began in Egypt and swept over the world in the next four years.
Population losses attributable to plague during those years were between 50 and 60 percent. In 1346, the second plague pandemic, also known as the Black Death or the Great Pestilence, erupted and within 5 years had ravaged the Middle East and killed more than 13 million in China and 20-30 million in Europe, one third of the European population.
Advances in living conditions, public health and antibiotic therapy make such natural pandemics improbable, but plague outbreaks following an attack with a biological weapon do pose a serious threat.
Plague is one of very few diseases that can create widespread panic following the discovery of even a small number of cases. This was apparent in Surat, India, in 1994, when an estimated 500,000 persons fled the city in fear of a plague epidemic.
In the 1950s and 1960s, the U.S. and Soviet biological weapons programs developed techniques to directly aerosolize plague particles, a technique that leads to pneumonic plague, an otherwise uncommon, highly lethal and potentially contagious form of plague. A modern attack would most probably occur via aerosol dissemination of Y pestis, and the ensuing outbreak would be almost entirely pneumonic plague.
More than 10 institutes and thousands of scientists were reported to have worked with plague in the former Soviet Union.
Given the availability of Y pestis in microbe banks around the world, reports that techniques for mass production and aerosol dissemination of plague have been developed, the high fatality rate in untreated cases and the potential for secondary spread, a biological attack with plague is a serious concern.
An understanding of the epidemiology, clinical presentation and the recommended medical and public health response following a biological attack with plague could substantially decrease the morbidity and mortality of such an event.
A plague outbreak developing after the use of a biological weapon would follow a very different epidemiologic pattern than a naturally occurring plague epidemic.
The size of a pneumonic plague epidemic following an aerosol attack would depend on a number of factors, including the amount of agent used, the meteorological conditions and methods of aerosolization and dissemination.
A group of initial pneumonic cases would appear in about 1-2 days following the aerosol cloud exposure, with many people dying quickly after symptom onset. Human experience and animal studies suggest that the incubation period in this setting is 1 to 6 days.
A 1970 World Health Organization assessment asserted that, in a worst case scenario, a dissemination of 50 kg of Y pestis in an aerosol cloud over a city of 5 million might result in 150,000 cases of pneumonic plague, 80,000-100,000 of which would require hospitalization, and 36,000 of which would be expected to die.
There are no effective environmental warning systems to detect an aerosol cloud of plague bacilli, and there are no widely available rapid, diagnostic tests of utility. The first sign of a bioterrorist attack with plague would most likely be a sudden outbreak of patients presenting with severe symptoms.
A U.S. licensed vaccine exists and in a pre-exposure setting appears to have some efficacy in preventing or ameliorating bubonic disease. The mortality of untreated pneumonic plague approaches 100%.
Research and development efforts for a vaccine that protects against inhalationally acquired pneumonic plague are ongoing. A number of promising antibiotics and intervention strategies in the treatment and prevention of plague infection have yet to be fully explored experimentally.
Given that naturally occurring antibiotic resistance is rare and the lack of confirmation of engineered antibiotic resistance, the Working Group believes initial treatment recommendations should be based on known drug efficacy, drug availability and ease of administration.
People with household or face-to-face contacts with known pneumonic cases should immediately initiate antibiotic prophylaxis and, if exposure is ongoing, should continue it for 7 days following the last exposure.
In addition to antibiotic prophylaxis, people with established ongoing exposure to a patient with pneumonic plague should wear simple masks and should have patients do the same.