Super Diseases

Dr. Kenneth Alibek, Program Manager, Battelle Memorial Institute

What are Biological Weapons?

Biological weapons are weapons of mass destruction (or mass casualty weapons, to be precise, since they do not damage nonliving entities) that are based on bacteria, viruses, rickettsia, fungi, or toxins produced by these organisms. Compared to other types of weapons (nuclear, chemical or conventional), biological weapons are unique in their diversity. Dozens of different agents can be used to make a biological weapon, and each agent will produce a markedly different effect. These differences in effect are shaped by various properties of the particular agent, such as its contagiousness, the length of time after release that it survives in the environment, the dose required to infect a victim, and of course the type of disease that the agent produces.

Although most people think of biological weapons as anti-personnel weapons, some biological weapons are designed to destroy crops or livestock. In the future, it is theoretically possible that new types of biological weapons will be produced that:

• damage military equipment by causing corrosion
• degrade different types of plastics used in equipment, computers, etc.
• render fuels useless.

Biological weapons formulations are of two types: a liquid or a dry powder. For most agents, the liquid form is easier to produce, but the dry form stores longer and disperses better when deployed. The basic steps for creating a liquid biological weapon are:

• obtaining a sample of the microorganisms to be used
• culturing the microorganisms until there is enough for a weapon
• concentrating the culture to make it strong enough for a weapon
• adding certain ingredients to stabilize the culture.

For a dry weapon formulation, this liquid culture is dried out and then ground up into microscopic particles. For toxin weapons, the toxin must first be extracted from the source-either the liquid bacterial culture or a plant or animal-and then concentrated.

Biological weapons are relatively inexpensive and easy to produce. Although the most sophisticated and effective versions require considerable equipment and scientific expertise, primitive versions can be produced in a small area with minimal equipment by someone with limited training.

Biological weapons can be deployed in three ways:

• contamination of food or water supplies, which are then ingested by the victims
• release of infected vectors, such as mosquitoes or fleas, which then bite the victims
• creation of an aerosol cloud, which is then inhaled by the victims (or, if the targets are plants, the cloud then settles on and infects the plants).

Since the U.S. has highly effective water purification systems, contamination of the water supply is the least effective method for disseminating a biological weapon in this country. Contamination of food supplies would most likely be used in a terrorist rather than a military attack, since it is difficult to contaminate enough food to gain a military advantage. Release of infected vectors is not particularly efficient for either military or terrorist purposes and entails a high probability of affecting those producing the weapons or living nearby.

By far, the most efficient and effective mode for applying biological weapons is creation of an aerosol cloud. Such a cloud is made up of microscopic particles and is therefore invisible. It can be produced in several ways, all of which involve either an explosion (a bomb or a bomb within a missile) or spraying (usually involving a special nozzle on a spray tank). The effectiveness of the cloud is determined by numerous factors, such as the amount of agent that survives the explosion or spraying, and the wind and weather conditions. The primary result of an effective cloud is simultaneous infections among all those who were exposed to a sufficiently dense portion of the cloud. In addition, agents that can survive for a long time in the environment will eventually settle, contaminating the ground, buildings, water and food sources, and so on. In some cases, these sediments can form another dangerous aerosol cloud if they are disturbed.

The USSR's Biological Weapons Program

Although the Soviet Union was a party to the 1972 Biological and Toxin Weapons Convention, it continued a high-intensity program to develop and produce biological weapons through at least the early 1990s. The size and scope of this program were enormous. For example, in the late 1980s and early 1990s, over 60,000 people were involved in the research, development, and production of biological weapons. Hundreds of tons of anthrax weapon formulation were stockpiled, along with dozens of tons of smallpox and plague. The total production capacity of all of the facilities involved was many hundreds of tons of various agents annually.

The Soviet Union's biological weapons program was established in the late 1920s. Prior to World War II, research was conducted on a wide variety of agents. By the beginning of the war, the Soviet Union was able to manufacture weapons using the agents for tularemia, epidemic typhus, and Q fever, and was also working on techniques for producing weapons using the agents for smallpox, plague, and anthrax. My own analysis of a tularemia outbreak among German troops in southern Russia in 1942 indicates that this incident was very likely the result of the USSR's use of biological weapons. There was also a suspicious outbreak of Q fever in 1943 among German troops vacationing in the Crimea.

World War II brought several advances for the Soviet biological weapons program. First, the USSR gained access to German industrial techniques and machinery for manufacturing large-scale biological reactors and other industrial equipment. Second, the Soviets obtained valuable information from the Japanese biological weapons program. This information gave the Soviet program an instant boost in its development.

After the war, the Soviet program continued to expand and develop. In many cases, it closely shadowed the U.S. biological weapons program. While the pre-war list of weaponized agents included tularemia, epidemic typhus, and Q fever, the post-war list was expanded to include:

• smallpox
• plague
• anthrax
• Venezuelan equine encephalomyelitis
• Glanders
• brucellosis
• Marburg infection.

Numerous other agents were studied for possible use as biological weapons, including:

• Ebola
• Junin virus (Argentinian hemorrhagic fever)
• Machupo virus (Bolivian hemorrhagic fever)
• yellow fever
• Lassa fever
• Japanese encephalitis
• Russian spring-summer encephalitis.

Techniques and equipment were developed and refined for more efficient cultivation and concentration of the agents. Methods for producing dry weapons formulations for a number of agents were also developed. In addition to weapons to affect humans, a number of weapons to affect crops and livestock were developed using such agents as:

• psittacosis (affects fowl)
• ornithosis (affects fowl)
• Rinderpest virus (affects cattle)
• African swine fever virus (affects swine)
• wheat stem rust spores (affect wheat crops)
• rice blast spores (affect rice crops).

During this post-war period, which lasted until the signing of the 1972 Biological and Toxin Weapons Convention, the Soviet Union also formulated its doctrine regarding the production and use of biological weapons. In the Soviets' definition, "strategic" weapons were those to be used on the deepest targets, i.e. the U.S. and other distant countries; "operational" weapons were those intended for use on medium-range targets, nearer than the strategic targets but well behind the battlefront; and "tactical" weapons were those to be used at the battlefront. Biological weapons were excluded from use as "tactical" weapons, and were divided into "strategic" and "operational" types. "Strategic" biological agents were mostly lethal, such as smallpox, anthrax, and plague; "operational" agents were mostly incapacitating, such as tularemia, glanders, and Venezuelan equine encephalomyelitis. For both types of weapons, use was envisioned on a massive scale, to cause extensive disruption of vital civilian and military activity. The Soviets also established so-called mobilization capacities: facilities whose peacetime work was not biological weapons production, but which could rapidly begin weapons production if war was imminent.

It is important to note that, in the Soviets' view, the best biological agents were those for which there was no prevention and no cure. For those agents for which vaccines or treatment existed-such as plague, which can be treated with antibiotics-antibiotic-resistant or immunosuppressive variants were to be developed. This is in sharp contrast to the philosophy of the U.S. program (terminated in 1969 by President Nixon's Executive Order), which stringently protected the safety of its biological weapons researchers by insisting that a vaccine or treatment be available for any agent studied.

After the Soviet Union became a party to the 1972 Biological and Toxin Weapons Convention, internal debate ensued about the fate of the existing biological weapons program. The end result was that the program was not dismantled, but further intensified. During the period 1972-1992, the focus of the program was expanded. In addition to continuing previous types of work (developing improved manufacturing and testing techniques and equipment; developing improved delivery means for existing weapons; and exploring other possible agents as weapons), new emphasis was placed on:

• conducting molecular biology and genetic engineering research in order to develop antibiotic-resistant and immunosuppressive strains and to create genetically combined strains of two or more viruses
• studying peptides with psychogenic or neurogenic effects as possible weapons
• transforming non-pathogenic microorganisms and commensals into pathogenic microorganisms
• testing all of the facilities considered part of the "mobilization capacity" to verify their readiness.

During this period, the Soviet program not only caught up with the U.S. program (which was halted in 1969), behind which it had lagged by about five years, but it became the most sophisticated biological weapons program in the world by far.

However, as the Soviet Union weakened during the late 1980s and early 1990s, and as more and more detail was revealed regarding the Soviet biological weapons program, the West put increasing pressure on the Soviets. In 1991, a series of trilateral inspections were conducted among the United States, Great Britain, and the Soviet Union. Note that the Soviet program still existed when these inspections took place; the Soviets covered up the evidence as best they could.

After the collapse of the Soviet Union, in early 1992, Russian President Boris Yeltsin signed a decree banning all biological weapons-related activity. Considerable downsizing in this area did indeed occur, and included destruction of existing biological weapons stockpiles. However, there still remains doubt that Russia has completely dismantled the old Soviet program.

Why am I Concerned About Biological Weapons in Russia Today?

Certainly, now that the Cold War is over and U.S.-Russia relations have changed markedly for the better, Russia presents far less of a military threat to the U.S. However, it would not be prudent to consider that Russia presents no military threat whatsoever. In addition, biological weapons technology can possibly proliferate from Russia to other countries less friendly to the U.S. For these reasons, it is important that we continue to analyze the situation with biological weapons in Russia.

There are three main reasons that I am concerned about possible biological weapons research and development in Russia today. First, many of Russia's former biological weapons facilities have never been subjected to international inspections. Second, Russia continues to publicly deny the size or even existence of many aspects of the former Soviet program. And third, among Russian scientists' published work, there are many studies I feel are dual-purpose or even outright offensive biological weapons work.

The Russians have steadfastly refused to open their military biological weapons facilities to international inspection. Pursuant to agreements between Russia, the U.S. and Britain, a series of trilateral inspections was begun in 1991. However, the facilities visited in Russia were those managed by the civilian arm of the Soviet/Russian biological weapons program, Biopreparat. The facilities of the Ministry of Defense, most notably those at Sergiyev Posad (formerly Zagorsk), Kirov, Yekaterinburg, and Strizhi, have never been inspected. Furthermore, according to the On-Site Inspection Agency, the last visits to Russian civilian facilities took place in early 1994.

Russia continues to deny various aspects of its former biological weapons program. The 1996 Annual Report of the U.S. Arms Control and Disarmament Agency states that, "The Russian Federation's 1993-1996 BWC data declarations contained no new information and its 1992 declaration was incomplete and misleading in certain areas." Note that 1992 is the year that the Russians supposedly "came clean" by acknowledging and then dismantling their offensive biological weapons program. Until the Russians have provided a complete accounting of their past biological weapons activities, however, it is difficult to believe that they have ceased all of these activities.

In this regard, certain people in the Russian government even seem to be backpedaling, denying incidents previously acknowledged and returning to Cold War rhetoric. Consider the following excerpts from an interview with Lieutenant General Valentin Yevstigneyev, the head of the 15th Directorate of the Russian Ministry of Defense until 1992. At that time, this directorate was the military arm of Russia's biological weapons program. He is now the Deputy Director of the Ministry of Defense's NBC Defense Directorate.

The interview was published in the Russian newspaper Izvestiya on March 3, 1998; the full translated text of the article is attached. The interviewer is questioning Yevstigneyev about the 1979 anthrax incident in Sverdlovsk (now Yekaterinburg), which is now widely known to have been the result of an accidental release of anthrax spores from a military production facility there. At that time, the Sverdlovsk facility was producing and stockpiling scores of tons of anthrax biological weapon formulation annually.

Interviewer: Do you claim, as before, that in 1979 on the Sverdlovsk-19 military base, no explosions of munitions with a "biological" filling nor massive deaths occurred?

Yevstigneyev: People who don't know much about bacteriology might be able to believe the newspaper stories (which, by the way, is indeed happening now). The professionals simply laugh.

International experts found four different strains (of the virus culture-author's note) of anthrax. Four different bacteria! Different, you understand? If a bomb exploded, would there really be four strains? How can you explain that people fell ill 50 kilometers away, but on the military base, where this explosion supposedly occurred, no one fell ill? Next door to the base is a tank division-two fatal cases…Believe me, if this was a single military release, two or three days and everyone would be finished!

Meanwhile, no one writes that several carcasses of cows with anthrax were brought into the brick factory to be burned in the furnace. But anthrax does not burn in a fire! The spores could have been carried off to anywhere through the chimney. The spores themselves live hundreds of years. As an example, no one has been able to live on the English island of Gruinard since the second world war. Biological weapons were tested there, including anthrax…

I was not yet at Sverdlovsk-19 in 1979. But in 1985 I was appointed the deputy director of the institute for scientific work. Of course, I tried to analyze the situation. I did a computer analysis using image recognition theory and mathematical modeling, and I tried three versions: the institute was responsible, a natural epidemic, and a diversion with the aim of compromising the institute. Strangely enough, the latter version got the highest score.

Interviewer: In the documentary film, "The Generals and Anthrax," a worker speaks on camera about the existence of a section for manufacturing biological munitions. The Ministry of Defense regards this film as truthful. Does this mean that there was an underground factory after all?

Yevstigneyev: There was a shop where we really did make 4 samples of the American one-pound, two-pound and four-pound bombs. The worker, literally on his knees, made these "toys". But there was no other way-we had to learn how to evaluate the biological situation, if such weapons would be used. We assembled munitions, went out to an island in the Aral Sea, set up biological reconnaissance equipment, observed what kind of cloud formed, and so on…Now we have magnificent calculations which everyone is using, beginning with the Ministry of Defense itself and ending with the Ministry for Emergency Management.

But this was done considerably before the epidemic. In 1979, in a refrigerator of the laboratory of Sverdlovsk-19, only a few ampoules of anthrax bacteria were stored for vaccine testing. All of the powers that be knew this, which is incidentally why they pointed the finger at us.

In fact, Yevstigneyev goes so far as to resurrect the Cold War-era accusation that the AIDS virus was created intentionally by a foreign nation, and implies that the U.S. is the likely culprit:

Yevstigneyev: There are serious suspicions that AIDS was created in a military laboratory abroad. Several black volunteers from prison were infected, but the analysis gave a negative result. They still didn't know that the incubation period could last for decades…The volunteers were released, and the situation got out of control. There are some African countries in which up to 80% of the people are HIV-infected.

Other references have appeared in the Russian press about the non-destruction, or even re-creation, of offensive biological capacities. Obviously, I am not able to substantiate these claims, and the articles appearing in the Russian press are certainly not without their inaccuracies. However, when I compare the details reported on the Soviet program prior to 1992 with my own knowledge, I find that the journalists have amassed a surprising amount of accurate information. Therefore, I am inclined to give their assertions serious consideration. For example, here are two excerpts from the 1998 No. 4 issue of "Top Secret", a Russian monthly newspaper:

 

The editorial board specifically knows that the archives of [the facilities at] Kirov and Sverdlovsk-19 are completely preserved. We also have the indications of a former highly placed employee of The [Biological Weapons] System, who confirms that as late as 1995 all of the archives of P.O. Box A-1063 [another code name for the biological weapons system] were systematized and prepared for long-term storage…

The same newspaper gives a quote from an interview of Major-General Khorechko in the anniversary edition of the Sverdlovsk-19 base newsletter:

Now we are in effect building the factory which was destroyed in 1986-89 [the years in which much of the facility's anthrax production capability was dismantled in response to severe pressure from the West and impending site inspections].

The published scientific literature coming out of Russia contains research of a dubious nature. Granted, each of the published works I have seen can be justified in some way-as research in biological defense, as vaccine studies, and so on. And I am not able to state with 100% certainty the intent of the Russian government in conducting this research. However, based on my knowledge of the priorities and deception tactics of the Soviet/Russian program as of late 1991, the current research in many cases appears to be continuing in the same vein. I will provide examples using work on a single agent, the smallpox virus.

Possession of the smallpox virus was limited by World Health Organization mandate to two facilities, the CDC in Atlanta and the Ivanovsky Institute for Viral Preparations in Moscow. However, in the late 1980s, I oversaw the development of the USSR's tactics to circumvent both this restriction and the 1972 Biological and Toxin Weapons Convention. In very general terms, our research and concealment plans were as follows

• Do everything in our power to have the USSR's repository for smallpox virus transferred from the Ivanovsky Institute, which was not involved in any biological weapons research, to the State Center for Virology and Biotechnology "Vektor" in Koltsovo, near Novosibirsk. In the late 1980s, "Vektor" was doing biological weapons research on smallpox virus; the repository transfer would provide a plausible "cover story."

   

• Explore the genome of the smallpox virus as fully as possible, to facilitate genetic engineering operations with it and to enable an accurate comparison with related viruses. This research work was easily justified, as it also had a legitimate purpose. Since the WHO was planning to destroy the last remaining stores of smallpox virus, it was important to completely sequence the smallpox genome for future studies.

   

• Using this genetic analysis, identify viruses closely related to smallpox that could be substituted for smallpox virus in the bulk of the experiments. The viruses used most often were vaccinia (used for smallpox vaccination), ectromelia (mousepox), and monkeypox.

   

• Perform genetic engineering work on these viruses, with the eventual aims of manipulating smallpox virulence factors and inserting genes of other viruses into smallpox to create chimera viruses. (The point of creating chimera viruses was to design new organisms that would have a synergistic effect and/or evade current vaccines or treatments.) A chimera strain involving insertion of Venezuelan equine encephalomyelitis (VEE) genes into smallpox was created in the late 1980s. Using the technique described above of substituting related viruses for smallpox, a chimera strain of ectromelia and VEE was created for initial testing.

   

• Claim that the genetic engineering work we were doing was for the purposes of developing new vaccines, especially for research using vaccinia virus. (I was skeptical that this argument would be convincing to the international community. Vaccinia is not the ideal vector for a vaccine because of the adverse reactions it can elicit and because many other possible vectors exist.)

   

• The official repository for the smallpox virus was transferred from the Ivanovsky Institute to "Vektor" in 1994. (My understanding of this transfer is that the Russian government presented it to the World Health Organization as a fait accompli in 1994.)

   

• The genome of smallpox virus has been fully analyzed and compared to the genome of vaccinia.

   

• Extensive genetic engineering research has been conducted using vaccinia virus, ostensibly for vaccine development. The research has entailed insertion of genes from Venezuelan equine encephalomyelitis virus and from Ebola virus into the vaccinia genome.

   

• Special research was done to find a spot in the vaccinia genome into which foreign genes could be inserted without disrupting viral virulence. (Although vaccinia is not virulent in humans, it is virulent in a number of different animals.) For vaccine development, virulence would not be an issue.

In my opinion, much of this research is of questionable scientific value for anything except biological weapons development. When I juxtapose this research with the closed doors of Russia's military facilities and the fact that certain Russian government factions seem to be returning to Cold-War rhetoric, I am convinced that Russia's biological weapons program has not been completely dismantled. Again, this represents just one set of the indicators in the published literature that arouse my concern.

Proliferation of Russia's Biological Weapons Expertise

There are numerous ways in which Russia's biological weapons expertise can be proliferated to other countries. The most obvious is the departure of Russian experts to other countries. I have contacts in the U.S. who maintain connections with these Russian scientists, and through these contacts I have learned of the pitiful state of these experts. The Russian government has long been short of funds, and the biotechnology arena is not unaffected. Many of these scientists are unemployed; those that are employed are generally paid poorly or not at all. Some of them have been forced to turn to other lines of work, such as street vending. It is therefore not surprising that some of them would seek to emigrate. In addition, I know of about twenty scientists who formerly worked for the Soviet biological weapons program and who now live in the U.S. This indicates to me that it has been relatively easy for these experts to leave Russia, and if twenty of them are in the U.S., undoubtedly a number of them are in other countries as well.

A second possibility is the sale of technology or equipment to other countries, either by the Russian government or its proxies, or by renegade scientists. As an example of the former, consider the recent allegations in the attached Washington Post article of negotiations between the Russians and the Iraqis for sale of fermenters allegedly designed for single-cell protein production, used for animal fodder. Other information sources have even listed the names of the Russian and Iraqi representatives that participated in these negotiations.

There is no doubt in my mind that these fermenters were destined for use in biological weapons production. First of all, Iraq has used the guise of single-cell protein production as a cover for biological weapons facilities in the past. Second, the particular fermenter size involved in this proposed sale would not be suitable for efficient single-cell protein production. In fact, the resultant product would be prohibitively expensive.

As an example of the sale of technology by renegade scientists, I have a copy of a flier advertising the wares of a company called "BIOEFFECT Ltd," with offices in Moscow and Vienna. The text of this flier is attached. The flier offers recombinant Francisella tularensis bacteria with altered virulence genes. Ostensibly, these organisms are being offered for vaccine production; the flier also notes that they can be used as genetic recipients and to create recombinant microorganisms of biologically active agents. The authors of the flier also express willingness to form cooperative ventures to which they will contribute their genetic engineering knowledge. It is clear from this flier that the scientists of "BIOEFFECT Ltd" are willing to sell their genetic engineering knowledge to anyone.

Another example of the sale of biotechnology knowledge was recently reported in the Russian monthly newspaper "Top Secret". The paper reports that a highly placed employee of the Russian biological weapons apparatus recently offered his services to the Chinese embassy. Although I have no way to confirm this report, the scenario seems plausible to me.

Yet another mode of proliferation is one that appears at first completely innocuous: scientific publications. Certainly, neither the authors nor the journals stand to gain financially from this type of technology transfer. However, considerable information that can at best be considered dual-use in nature can be found in such open publications. For example, a recent article detailed a method for cultivating Marburg virus. This method is so simple, and requires so little equipment and training, that it could easily be adopted by a terrorist group. Other, more sophisticated types of information published include such things as genetic engineering methods, antibiotic resistant strains of pathogenic microorganisms, and so on.

What is the Potential Impact of Terrorist Use of Biological Weapons?

While we should not ignore the continuing threat of military use of biological weapons, we are not at present poised for war with any nation known or suspected to possess biological weapons (with the possible exception of Iraq). A more likely threat is that posed by the terrorist use of biological weapons. Terrorist use can occur on the level of state-sponsored terrorism; on the level of a large, independent organization like the Aum Shinrikyo cult in Japan; or on the level of an individual acting alone or in concert with a small organization, such as a militia. For these three types of terrorist attack, the expected impact will differ considerably.

There is no doubt, however, that the potential impact is great. A report published by the Centers for Disease Control in April, 1997 evaluated the economic impact of a bioterrorist attack for each of three different biological agents: anthrax, brucellosis, and tularemia. Their model showed that the expected economic impact from such an attack would range from $477.7 million to $26.2 billion per 100,000 persons exposed. A copy of this report is attached.

Furthermore, there is no doubt that we will see future uses of biological weapons by terrorist groups, as there have been several attempts already. One incident, in 1984, involved members of the Rajneeshee cult contaminating restaurant salad bars in Oregon with salmonella, sickening 751 people. Another involved the Aum Shinrikyo cult in Japan. Although best known for its attack in the Japanese subway system in 1995, the cult also attempted to release anthrax from the rooftop of a Tokyo building in 1993. No casualties resulted, but had the cult better understood the air flow dynamics in a city and released the spores at a different time during the day, the results might have been quite different.

Our General Preparedness for Military and Terrorist Biological Attacks

Fortunately, in the course of the past four or so years, our preparedness for military and terrorist biological attacks has changed considerably for the better. Heightened awareness of the biological threat has lead to a number of positive developments, such as:

• creation of extensive databases containing reference information on biological weapons characteristics
• design and development of biological agent detection equipment
• analysis of possible attack scenarios and their consequences
• development of new, and revision of existing, manuals and handbooks
• conduct of intensive training of those would serve as first responders to a biological attack.

However, my analysis of several recently issued handbooks for military use indicated that there were still a considerable number of substantive inaccuracies. Thus, further revisions are necessary for these handbooks.

In my opinion, these inaccuracies largely stem from lack of knowledge. Since the U.S. stopped all offensive biological weapons research in 1969 and significantly curtailed its defensive research until 1994, U.S. knowledge of biological weapons is obsolete in many respects. Only in the last few years has there been a concerted attempt to "catch up." We must continue our recently renewed efforts to understand biological weapons and to analyze the actual threat they present.

Our Medical Preparedness for Military and Terrorist Biological Attacks

The ultimate goal of bio-defense, including all of the defensive steps outlined in the previous section, is to prevent suffering and loss of life, thereby rendering biological weapons ineffective. However, while all of these measures can potentially reduce the suffering and loss of life experienced after a biological attack, they are of limited value without appropriate medical defense. Only the development of appropriate medical urgent prophylaxis and treatment methods can completely eliminate the threat of biological weapons. In its 1997 report on the possible economic impact of a bioterrorist attack, the CDC notes that, "Rapid implementation of a postattack prophylaxis program is the single most important means of reducing these [economic] losses."

Years of research and development on the medical aspects of bio-defense have resulted in commonly accepted treatment and prophylaxis procedures. These procedures involve three main types of medical defense against biological weapons:

• vaccination (treatment before exposure)
• urgent prophylaxis (treatment after exposure, but before symptoms arise)
• chemotherapy (treatment after onset of illness).

Vaccines, of course, have completely changed the picture of infectious disease on earth. Smallpox has been completely eradicated. A number of other diseases, such as poliomyelitis, that not long ago presented serious threats to humanity have lost their epidemiological significance. Vaccines protect the vaccinated person, making him a "dead end" for the disease, thereby breaking the chain of transmission of the illness (this is true whether the illness is contagious or not). In bio-defense, vaccines can also sometimes be used as urgent prophylactic measures.

The peculiarity of vaccines, though, is that they are extraordinarily specific. In general, a particular vaccine works only against a single illness (occasionally a vaccine will be effective against a few similar illnesses). Use of vaccines in bio-defense will thus be effective when all of the following conditions are met:

• The target population is known and limited, i.e. military troops within range of an enemy's arsenal, since it is not realistic to vaccinate everyone in the U.S.

   

• It is known precisely what biological agents are in the enemy's biological weapons arsenal, or the number of possible agents has been narrowed down to a few, since it is impossible to vaccinate troops against every possible biological agent (the role of intelligence is obviously great in making this determination).

   

• The vaccine for the agent(s) has already been developed. Note that for many biological agents, among them glanders, melioidosis, Marburg virus, Ebola virus, and Lassa fever, no vaccine exists.

   

• The biological agents used are not genetically altered strains that would circumvent a vaccine.

Clearly, this is a relatively limited sphere of effectiveness. In the case of most military and all terrorist attacks with biological weapons, vaccines would be of little use. One or more of many possible agents could be used in the weapons, making it virtually impossible to know which agents to vaccinate against. It would also be impossible to determine which portions of the U.S. population are most vulnerable and therefore require vaccination-and yet it would be extremely difficult to vaccinate the entire U.S. Army, not to mention the country's entire population, especially with multiple-dose vaccines. And again, there are many highly hazardous diseases for which vaccines have not even been developed.

Therefore, we cannot rely exclusively or even primarily on vaccination for medical bio-defense. We must also ensure that means for urgent prophylaxis and treatment of these diseases are available as well.

The concept of using drugs for urgent prophylaxis and treatment is not new. However, a number of the existing drugs that could be useful are not available in sufficient quantities or in some cases (such as Marboran, for urgent prophylaxis of smallpox) are not manufactured at all. In addition, drug protocols have not been developed for many of the agents that can be found in biological weapons.

However, using our current understanding of disease etiology and pathogenesis, as well as modern biotechnology and pharmacology, we can rectify this situation. Here is an example of possible new treatment techniques for anthrax, for which there is currently no satisfactory treatment.

The pulmonary form of anthrax caused by biological weapons has a fatality rate that can reach 90%. In this form of anthrax infection, the pathogen enters the lungs and from there passes into the lymph system, via which it is disseminated throughout the body. Death occurs as a consequence of secondary hemorrhagic pneumonia from the effect of toxin produced by the bacteria on lung capillaries. Analysis of the pathogenesis of anthrax has shown that most of the infectious propagation takes place in the lymph system, while infection of the circulatory system is secondary.

The usual form of treatment is a combination of streptomycin and penicillin. However, this treatment is largely ineffective. The problem appears to be that the usual methods of antibiotic administration (intramuscular, subcutaneous, intravenous) utilize the bloodstream. However, this is not where the main bacterial activity is occurring. Although the antibiotics do reach the lymph system, the concentration is lower than that in the circulatory system, and it drops off more rapidly between doses. At the same time, the immune system is suppressed while the bacteria are propagating in the lymph system. The main cause of death is the toxin produced by the bacteria.

Thus, there are several elements in this process that can be targeted for study. The first is to find ways to modulate the immune system, to counter the immunosuppressive effects of bacterial propagation in the lymph system. The second is to examine ways to increase and maintain the concentration of antibiotic in the lymph system, such as lymphotrophic administration of the drugs. A third possibility is to find a way to destroy the bacterial toxin when it is released, using proteolytic enzymes. The knowledge gained from such research would also have value in treating other infectious diseases that are not related to biological weapons.

I feel strongly that we must devote additional resources to the medical aspects of bio-defense. To illustrate the scale of our current efforts, consider that at the one U.S. organization conducting medical research on anthrax, the U.S. Army Medical Research Institute for Infectious Diseases, two or three people are devoted to this effort full-time. For comparison, consider that at the height of the USSR's biological weapons program, more than 2,000 people were conducting anthrax research (both offensive and defensive). As another example, the USSR had more institutes dedicated to plague research than the U.S. has scientists devoted to the same topic.

Conclusions and Recommendations

Since the primary goal of developing bio-defense is to save human lives, we must greatly increase our efforts to develop new treatment and urgent prophylaxis techniques. As part of this medical research, we must consider a new approach in this area: fundamental research and development of methods for non-specific defense, based on amplifying the immune response of the human body to invasion by any foreign agent.

These efforts, as well as the funds spent on research and development, will pay for themselves many times over. In addition to contributing to our nation's preparedness for a biological attack, they will provide a much-needed push in the treatment of infectious diseases that occur under natural conditions. Infectious diseases remain one of the leading causes of death in the world and cause tremendous losses, in terms of both money and human lives, every year. Furthermore, this research, especially that into methods for non-specific defense, will also contribute to the treatment of many other types of diseases, such as autoimmune disorders and cancer.

The most suitable approach to this issue would be to significantly increase the research conducted in this area. One possibility would be to establish a medical research center specifically for this purpose.

Such a medical research center would also provide one option for addressing certain non-proliferation concerns. The center could employ Russian scientists who participated in the development of biological weapons, and are currently under- or unemployed, to conduct medical research for the U.S. bio-defense program. In this way, we can ensure that the knowledge of the "graduates" of the most sophisticated biological weapons program in the world is put to peaceful use, and we stand to reap the benefits of their extensive experience.

Another important aspect of our bio-defense program is the continuous analysis of possible routes for biological weapons development. This analysis must cover everything from new biological agents to new delivery means. The focus of such analysis is to identify the threat as clearly as possible in order to focus our medical research and other bio-defense efforts as accurately as possible. Conversely, we can avoid wasting time and resources developing defense against a nonexistent threat.

Finally, several more areas require our continued attention to round out our readiness for biological attack:

• creation of manuals for those who will respond to bio-terrorism incidents
• revision of existing manuals for military physicians
• creation of practical means for defense against possible unusual variants of biological weapons.

Addressing these requirements-medical research, threat analysis, manual revision and defense against unusual biological weapons variants-will greatly enhance U.S. preparedness for a biological attack.