Bioterror lecture held at BSPH

The Center for Civilian Biodefense Studies hosted a week-long lecture series in response to the recent anthrax attacks in New York and Washington, D.C. Held at the Hopkins Bloomberg School of Public Health, the event addressed the growing public concern over the threat of bioterrorism.

A diverse group of expert physicians, pathologists and epidemiologists gathered to discuss the growing threat of bioterrorism and address the current strategies being developed within the public health system to counter bioterrorist attacks in America.

Tom Inglesby, deputy director of the Center for Civilian Biodefense Studies, addressed the recent anthrax attacks as a harbinger of a new era. Bioterrorism is "a serious national security concern that will grow over time," said Inglesby.

In a lecture entitled "Bioterrorism 101: The Past, Present, and Future," Inglesby discussed the emergence of biological weaponry as a serious threat to modern society. He described the rapid growth of biotechnology as a phenomenal accomplishment with an unfortunate price, that is, the potential for more potent bioweapons.

One of the main problems Inglesby addressed was the relative ease of manufacturing biological weapons. Inglesby cited a case in the former Soviet Union where the same machinery that once manufactured biological weaponry is now being used to make shampoo. These are "inexpensive, accessible weapons," he said. Currently, there are at least a dozen states that have or are seeking the capacity for offensive bioweaponry. Every nation that is a state sponsor of terrorism is included in that group.

Iraq is known to have manufactured at least 8,000 liters of anthrax in the 1980's and may actually have made twice as much. In the Soviet Union, the top scientific minds were at one point sought after and trained to develop an offensive biological weapons program.

Inglesby stated that there is evidence that after the Soviet Union dissolved, emerging governments like Iran sought this scientific expertise to develop their own biological weapons programs.

In 1993, the Congressional Office of Technology Assessment estimated that 100 kilograms of anthrax could cause up to three million fatalities if dispersed over a large metropolitan area.

Inglesby equated the devastation of a full-blown anthrax attack to a nuclear assassination. "Biological weapons were abandoned for political reasons," said Inglesby. "They we're not abandoned because they didn't work." In response to recent threats of bioterrorism, experts discussed the role of the public health system.

Over the past few years the Center for Civilian Biodefense Studies (CCBS), a department of the School of Public Health, has studied the weaknesses in the public health system, developing programs to prepare the medical community in the event of a biological attack.

One of the most notable programs was the "Dark Winter" exercise, a fictional scenario designed to test the capabilities of the public health system in a biological disaster.

Set in 2002, the scenario was a covert smallpox attack in three cities. The exercise lasted 13 days.

The results were devastating. At the end of the exercise, there were an estimated 1,000 casualties.

No vaccine had been developed, hospitals were overrun, and the disease had progressed to the second stage, with an estimated 16,000 people contaminated.

The CCBS concluded that the public health care system was drastically unprepared in the case of a biological disaster.

Inglesby cited inadequate funding and staffing as the two major weakness in the country's public health system.

In a lecture entitled "Frontline: Preparations at the Health Department," Dipti Shah and Sophia Tong of the MD State Health Dept. discussed the progress being made within the health care system to prepare for possible biological emergencies.

The Epidemic and Disease Control Program (EDCP), a branch of the State Health Department, is working with hospitals in Washington D.C. to create a system of bioterrorism teams to track and predict possible bioterrorist attacks.

The EDCP is working on an electronic coding program that will allow them to efficiently gather data on ER patients and detect possible outbreaks of infectious disease before an epidemic occurs.

A panel of experts held a joint lecture entitled "One Eye Open: Risk Perception and Management." Faculty from the School of Public Health and other universities joined Inglesby in emphasizing the need for further preparation, including the diagnostic improvement of labs as well as extensive training of clinicians.

While the U.S. government is taking steps to manufacture and stockpile vaccines, many hospitals lack the capacity to handle mass casualties or isolate those contaminated with infectious agents.

Organizations like the EDCP and the Center for Civilian Biodefense have taken major steps to prepare the medical community for a biological crisis, but there is still much work to be done.

Inglesby, Lynn Goldman, and other speakers have worked with the School of Public Health to develop an effective plan to deal with the current anthrax outbreak.

Inglesby and many of the other panelists have also provided important testimony and advice to Congress in light of the events since Sept. 11.

David Walker, a pathologist who has studied anthrax outbreaks extensively, warned that while the current anthrax attacks may seem trivial, the implications are very serious.

"We are in an era of bioterrorism," said Walker. Thomas Burke, a professor at the School of Public Health, joins in this sentiment, warning that the recent anthrax attacks are merely the tip of the iceberg.

"The warning shot was fired. We have to wake up. It is incumbent for us to move forward."

Yet Burke and the other panelists view this expanding threat as a challenge.

"This is a defining moment for public health," Burke said. "Public health professionals are at their best when things are at their worst."

The lecture series will conclude on Friday with a discussion entitled "Are You Worried? Addressing Psychological Concerns.