Medill News Service article - Published: Nov. 14, 2001

U.S. not ready for bioterror, experts say

By Patrick Cooper
Medill News Service

A panel of public health experts at the University of Illinois at Chicago on Wednesday predicted dire consequences if the United States does not better prepare itself for domestic bioterrorism.

The United States is "embarrassingly caught" in the situation of not having enough vaccines and other protections to fight potential biological weapons, Dr. Gary Slutkin said.

"It doesn't require complexity to put into a ventilation system or a subway system some of these organisms," Slutkin said. He predicted that biological attacks would "likely occur from time to time" in the country's future.

During the outbreaks of anthrax in recent months, the Centers for Disease Control and Prevention has identified 22 cases of the disease. Ten of these cases have been the inhaled form, the most dangerous, and four of the ten people have died.

Slutkin listed shortages of treatments and vaccines for the most dangerous biological threats, ranging from anthrax to the plague. He said the country was in a "gap period," just realizing holes in its awareness and preparedness and struggling to catch up.

In one result of the gap, doctors were surprised when their patients' flu-like symptoms "suddenly, catastrophically reverted to something extremely serious" -- anthrax, Slutkin said.

Looking at the number of anthrax patients who were initially mis-diagnosed, Dr. Ron Hershow said doctors need to search for symptoms other than the flu symptoms that have been heavily publicized by national health officials.

Anthrax symptoms have not been exact matches of viral or flu-like symptoms, and chest X-rays on all of the anthrax patients have showed similar abnormalities, Hershow said.

The success of antibiotics against the disease has been encouraging because it has made mass vaccinations unnecessary, he said.

But he also pronounced that the health profession has been lucky to deal so far with a non-contagious disease. "In that aspect, anthrax is a more fortunate pathogen for us than smallpox."

Meanwhile, professions other than the health industry need to have plans in place to avert biological attacks, industrial hygiene expert Lorraine Conroy said.

Organizations need to anticipate the attacks and be ready to recognize biological agents if attacks have possibly occurred already, according to Conroy. Then to recover from an attack, leaders need to determine its severity and move on to eliminating potential hazards.

A prime example of threat elimination was the United States Postal Service's new dust control procedures, she said. The Postal Service is now vacuuming its sorting machines instead of blowing the dust--and possibly anthrax spores--out of the machines and into the air.

But while the United States struggles to deal with anthrax in the present day, Dr. Douglas Passaro said history remains important.

Passaro discussed the century-long testing and use of the disease as a biological weapon, and he said the most recent events, the U.S. outbreaks, need to be examined as well.

All of the cases in Washington, D.C., and Florida were inhalation anthrax, but only a few of the New York and New Jersey were of that form, he noted.

"We are clearly narrowing down on the form of preparation," Passaro said, but authorities have found no answer.

Substantial doubts also linger as to whether all of the anthrax used in the attacks was from the same source, he said. In these broad uncertainties, all of the experts nodded their heads in agreement.