Bioterrorism In History

Biological warfare has its roots in antiquity, when the practical applications of using biologically active agents on the battlefield were recognized. One of the earliest descriptions of battlefield use of biological weapons arose from the sea battle between the forces of Hannibal and King Eumenes of Pergamum (184 B.C.). Sailors on Hannibal's ships tossed earthen pots filled with venomous snakes on board the Eumenean vessels. The resultant terror and confusion among the Eumeneans assured Hannibal's rapid victory.

Throughout the Middle Ages, the easiest and most effective form of biological assault was contamination of water supplies by tossing corpses and carcasses of animals into wells and rivers supplying besieged cities. Siege warfare led to a new form of attack where rapid surrender was assured by catapulting plague-ridden bodies into besieged towns. The practice continued well into the 18th century. More gruesome examples of germ warfare evolved during the conquest of the Americas; smallpox was the primary offensive agent. Pizarro used variola-contaminated clothing to spread smallpox among South American Indians in the 15th century. The English used the same method and distributed smallpox-contaminated blankets to North American Indians during the wars conducted from 1754 through 1767. The resulting epidemic decimated tribes in the Ohio region. One of the lesser known facts about biological warfare is the introduction of mandatory smallpox vaccination by George Washington during the Revolutionary War.

The First World War gained the dubious honor of providing the stage for the introduction of chemical warfare. Unproven accusations that the Germans used anthrax and glanders as weapons against the U.S., and attempted to spread plague and cholera in Italy, Russia, and Romania, were rife at that time. The German military was also alleged to have dropped plague-contaminated chocolate and toys from airplanes in attempts to spread the disease among children. Subsequently, the League of Nations absolved the German forces of conducting germ warfare. However, the horrifying casualties resulting from the use of toxic gases on the battlefield led to the Geneva Protocol of 1925 prohibiting implementation of chemical and bacteriological agents in war. The protocol was signed by 108 nations. Libya and Iraq, future proponents of the use of chemical and biological weapons, were among the signatories. Late in the 20th century, Iraq employed chemical warfare agents in a war with Iran and against its own Kurdish population.

Although the Germans experimented with infectious diseases in warfare during the second World War (using Russian prisoners of war as guinea pigs), they were not charged with such offenses during the subsequent war crime trials. The Japanese, on the other hand, conducted extensive experimentation and actively participated in germ warfare against Chinese and Russian civilians and military units as early as 1939. Soon after the commencement of hostilities involving Japan, the U.S., and Great Britain, Unit 731 of the Japanese Imperial Army embarked on a series of very extensive experiments on Chinese and Mongolian civilians and prisoners of war. American, Australian, British, and Russian prisoners of war were also used to test the effects of various bacteriological agents. The "effectiveness" of these experiments was assured by the construction of special facilities in Manchuria, China, and Singapore. During post-war trials, the commanding officer of Unit 731 testified that each year up to 600 war prisoners were killed during the tests. On the Allied side, British trials of small munitions containing anthrax bacteria caused heavy and persistent contamination on Gruinard Island. The contamination prevented habitation on the island for several years after the war.

Numerous allegations of the use of bacteriological warfare agents by the Western Powers, particularly the U.S., ensued during and after the Korean War. However, declassified documents obtained from both sides indicate beyond a doubt that the allegations were nothing but propaganda spread by the Eastern Bloc. In 1970, South Korea accused North Korea of preparing biological attacks. The charges, based on North Korea's large purchase of several biological agents, were ultimately abandoned, but the rumors about using such agents in wars in Southeast Asia persist. "Yellow rain," a weaponized form of trichothecene myc-otoxin purportedly used by North Vietnamese forces in Laos, remains controversial. On the other hand, the use of antipersonnel traps containing sharpened, feces-covered sticks is a well documented form of biological warfare used by the Viet Cong.

A major step in the control of germ warfare was the signing of the 1972 Convention on the Prohibition of the Development, Production, and Stockpiling of Bacteriological (Biological) and Toxin Weapons and Their Destruction, signed by 103 nations. The agreement became effective in March 1975, but contained a major loophole: the convention allowed defensive research to continue providing a convenient platform for the continuation of work on biological warfare agents and methods of their dissemination. The Soviet Union used this opportunity extensively and created a number of research facilities. The vast nature of the Soviet program came to the attention of the U.S. after an explosion at a research institute in Sverdlovsk that caused several deaths from inhalation of anthrax spores, and led to virtually total isolation of the region by the Soviet armed forces. Soviet authorities denied accidental release of anthrax spores into the atmosphere and claimed the cause was accidental contamination of meat. The truth emerged in 1992, when Boris Yeltsin confirmed longheld suspicions about atmospheric release.

Soviet intelligence services pioneered the operational terrorist use of biological agents by constructing ingenious umbrella-like explosive devices capable of inserting biotoxin-contaminated pellets into human targets. This close-range weapon was used at least twice against prominent Bulgarian exiles in France. Unconfirmed reports indicate that a similar assassination was attempted in Virginia.

Operations Desert Shield and Desert Storm and events during the subsequent decade brought the attention of the world back to the issues of threats posed by biological weaponry. Although Iraq did not use its capacity during the conflicts, the threat revealed serious deficiencies in the preparedness of the U.S. military to wage war in the presence of a large-scale battlefield release of biological agent. After surrender of the Iraqi forces, the United Nations instituted an inspection program (UNSCOM) that revealed convincing evidence of a major effort by Iraq directed at manufacturing and stockpiling a wide range of bioweapons.

The nations of the Desert Storm Coalition (particularly the U.S. and Great Britain) attempted to interrupt the Iraqi program of biowarfare through economic sanctions and direct military action, but many intelligence sources cited the continuing capacity of Iraq to wage war based on the use of biological agents via terrorism and in conventional military operations. Continuing failure by Saddam Hussein to eliminate Iraqi weapons of mass destruction and dismantle all relevant manufacturing and research programs led to a series of UN resolutions and renewed intensity of international inspection. Despite intense international pressure to accept UN resolutions and disarm, the government of Iraq persisted in its deception and ultimately led to Operation Iraqi Freedom, a military invasion by U.S. and British armed forces supported by units provided by a coalition of over 35 countries. Although the regime of Saddam Hussein has been dislodged, intelligence sources indicate possible presence of weapons of mass destruction in several countries of the Middle East. Despite the recent war, it remains to be seen whether the region has been permanently freed from threats of war waged by means of chemical and biological weapons.

While Libya, Syria, and possibly Iran are among the prime suspects that harbor Islamic fundamentalist groups willing to use biological agents in their terrorist activities, other subversive organizations eager to employ similar tactics have been uncovered in the countries as unlikely as Japan and France. Members of the Aum Shinrikyo cult released sarin in the Tokyo subway in 1995 and also prepared large quantities of Clostridium difficile intended for terrorist use. In France, a considerable supply of botulinum toxin was discovered in the Parisian safe house of a radical Red Army Faction.

Anthrax dispersal represents the latest in the history of bioterrorism in the U.S. The first reported event occurred in 1984 when members of the Bhagwan Shree Rajneesh cult attempted to poison several people in Dalles, Oregon, in order to eliminate opposition and win local elections. While no fatalities occurred, this largely underreported incident clearly indicated the vulnerability of the U.S. to the determined actions of a well-organized terrorist group. Several incidents of bioterrorist threats followed during the intervening years. In most cases, threats were not converted into actions, but real dangers materialized as results of a few incidents. In 1989, the U.S. Food and Drug Administration was forced to conduct its largest safety investigation while searching for contaminated fresh fruit following a threat by a terrorist wishing to draw the nation's attention to the plights of Chilean agricultural workers. In 1995, a white supremacist was found to possess explosive devices intended to disperse plague-causing bacteria ( Yersinia pestis). Also in 1995, members of a militia group were convicted for planning to use ricin toxin against U.S. marshals and the Internal Revenue Service. Several hoaxes also were reported and, as evidenced by the arrest of a federal worker in an Eastern Seaboard state, the criminal attitude persists in a small circle of attention seekers. The most unfortunate consequence of bioterrorism hoaxes is the major dissipation of national resources needed to contain real threats.

The September 11 attacks and the discovery of anthrax-containing letters sent to several media organizations and to the Senate brought international terrorism to U.S. territory. Until September 11, few people paid much attention to the dangers of terrorism despite vivid pictures of victims from France, Ireland, Israel, Germany, and Spain. Even before the direct attack, the U.S. had clear indications that the danger of terrorist attack was real. Studies have shown that a bioterrorist assault would threaten the very fabric of U.S. society. In 2000, a highly realistic simulation exercise was performed in Denver. It involved release of plague bacteria into the ventilation ducts of the Performing Arts Center. By the end of the exercise 4 days later, the simulated epidemic spread beyond control. The estimated death toll was 1000 to 2000 people and nearly 4000 cases of nonfatal infections were projected. More importantly, the exercise demonstrated a virtually complete collapse of the local healthcare system, the government, and massive strain on law enforcement authorities. The lack of adequate preparedness among pre-and in-hospital healthcare providers in dealing with a major infectious disease outbreak caused by a highly virulent and easily transmitted agent was equally disconcerting.

The sobering results that emerged from Denver and similar tests point to the essential nature of appropriate training at all levels of the healthcare system. Today, authorities have no doubt that effective training is paramount for rapid identification of the disease, immediate initiation of the appropriate treatment, and the introduction of relevant isolation and containment procedures, all of which are crucial ingredients in preventing a small outbreak from becoming a national catastrophe.

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