Thursday, Oct. 18, 2001 (HealthDayNews) -- The government's continuing call for public alertness has highlighted the fact that terrorists have many guns in their arsenal other than anthrax. Some are known substances and others may be things we've never seen before, say experts.
Tommy G. Thompson, secretary of the Department of Health and Human Services, testified before Congress this week that government agencies are stepping up surveillance for foodborne pathogens and "to address chemical and nuclear food safety issues of concern." The Centers for Disease Control and Prevention also called upon doctors to be on the lookout for the possibility of smallpox and other such arcane diseases.When it comes to bioterrorism, Rudy Richardson, a toxicology professor at the University of Michigan School of Public Health, puts it bluntly: "Everything is toxic. It's only a matter of the dose."
Fortunately, figuring out the dose is just one part of the puzzle.
"To produce those things is one thing," says Dr. Tareg Bey, one of only about 200 board-certified medical toxicologists in the United States. "But to deliver the agents on a large scale is a totally different thing, and the logistics of transport is yet another thing."
Then he adds, "That's reassuring to me as a private individual."
Here's what the experts say the full spectrum of possibilities reveals:
Biological weapons. These are basically variants of human diseases, of which there are many different types.
The American public is only too familiar these days with anthrax, a bacterial infection. But botulism is another bacterial infection, one that is usually picked up from food or water. "It's probably the deadliest toxin known to man," says Michael Sailor, a biochemistry professor at the University of California, San Diego. "About 400 grams, which you could hold in a coffee cup, would kill off half the planet."
Theoretically, many other bacteria could be harnessed as weaponry, even if they don't produce severe symptoms. "This is psychologically devastating for the people who go through it," says Bey. "They don't necessarily all have to lead to death. Just being sick is enough."
Viruses. Always a lurking threat, they are another potential form of biological weapon because they are usually spread between people. They can include anything from the common cold to small pox to Ebola, the deadly hemorrhagic fever that has struck recently several times in Africa.
"If you infected 50 terrorists with small pox and had them shaking hands and spitting on people and eating at salad bars, you'll end up getting a lot of people sick," says Sailor.
Although small pox has been eradicated from the world's population, there are at least two strains in existence in laboratories around the world. But because many of these viruses can easily run rampant -- particularly small pox -- they are also a threat to whoever spreads them. "This could get easily out of hand and could end up haunting the people who started it," says Bey.
Chemical agents. Sarin, which was unleashed in the Tokyo subway system in 1995, was originally developed as an agricultural pesticide and, like most chemical agents, can be highly toxic. But because there is no lag time between exposure and symptoms, healthcare experts are able to act quickly to counteract any effects.
Other chemical agents include cyanide, which is easy to produce and disseminate, says Richardson, though dangerous to handle. Carbon monoxide is also in plentiful supply but, again, treacherous to handle and transport.
The unknown. Experts say bioterrorism could also herald something entirely new and, therefore, unpredictable. "A snake in the biotech Eden," Sailor calls it.
"It's important not to be fixed on a few classical agents that are already being talked about, such as small pox and anthrax," says Richardson. "There could be people getting really clever and designing new agents or different twists on old ones, kind of like designer drugs."
But such "designer toxins" require a sophisticated biochemist or molecular biologist to engineer them, so they are probably not an immediate threat from any of today's terrorists. "This is much further down the road, hopefully," Sailor says.
So is there a silver lining to all this biowarfare talk?
Richardson thinks so.
"Perhaps all this concern about bioterrorism is that it might get our public health infrastructure better prepared to deal with these other things," he says. "As we prepare for bioterrorism in an ancillary way, we're preparing for emerging infections and the reemergence of things like flu pandemics."
"And that could be a very positive thing," he adds.
What To Do
Believe it or not, Bey recommends that everyone get a flu vaccine this season. "With flu season, a lot of people are going to be coming in with respiratory symptoms and are going to be asking if this is anthrax or the flu," he says. A flu shot should rule out the simplest factor, in case there's a need to diagnose anthrax or any other unusual condition, he says.
Advanced HAZMAT Life Support is a two-day course designed to train fire departments as well as EMS and other health-care professionals for hazardous materials incidents, including chlorine accidents as well as bioterrorism. Non-medical personnel are eligible to intend but Bey, who is a licensed instructor, emphasizes that a science background is helpful.
For information on how to defend against bioterrorism, visit the Center for Civilian Biodefense Studies or the Association for Professionals in Infection Control and Epidemiology.
For information on the various bioterror weapons, try the American Medical Association.