Anthrax Answers Page
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Reprinted from NewsMax.com
Anthrax Q & A
Kevin G. Briggs
Monday, Oct. 1, 2001The following question-and-answer sheet was prepared by Kevin G. Briggs, former president of the America Civil Defense Association and current director of the U.S. Disaster Preparedness Institute. His new book, "Preparing for Terrorism," will be released shortly.
Due to recent concerns and the growing interest in biological/chemical warfare preparedness and mitigation, we have extracted the following article from a recent issue of the Journal of Civil Defense in an effort to assist you in your preparations for a potential biological attack on the United States.
Frequently Asked Questions About Anthrax
Question 1:
Is the U.S. prepared for anthrax attacks?
Answer 1:
Generally, no. An anthrax attack can occur very quietly without any bombs going off or any observable "clouds" being present. Our abilities to detect anthrax rapidly are very limited at present, so the first sign that an attack occurred could be thousands of people rushing to the hospital after a few days of exposure. Most states rate biological attacks as one of their weakest preparedness areas.
Question 2:
Why worry about anthrax attacks?
Answer 2:
Many are concerned that U.S.-based terrorists with ties to Iraq or Osama bin Laden might try to unleash a biological attack against the U.S. population in response to any major U.S. anti-terrorism initiative or military actions.
Question 3:
Is this a credible threat?
Answer 3:
This is an unknown. We know that Iraq has hidden and lied about much of its biological warfare program. We do know that Iraq has claimed to have produced, and subsequently destroyed (so it says), roughly 9,000 liters of anthrax.
In addition, it has admitted testing anthrax and other agents as part of its biowarfare program. As a result of this and other perceived threats, former Secretary of Defense Cohen decided to vaccinate all active duty and reserve personnel against anthrax.
He shifted $500 million to new chemical and biological preparedness programs. Former President Clinton also added roughly $10 billion to the budget (in January 1999) into preparing for weapons of mass destruction terrorism – largely to help mitigate biowarfare attacks.
The bottom line is that Iraq has the technical expertise and demonstrated capability to support anthrax terrorism. Whether it or other terrorist organizations have successfully placed (or attempted to place) terrorists in the U.S. with anthrax is unknown – or at least unknown to the American public.
Many other countries have known or suspected biological warfare programs. Information and expertise from Russia's extensive biowarfare programs are likely to have leaked out to several other nations and terrorist groups.
Question 4:
How big a problem is anthrax?
Answer 4:
Anthrax weapons can be produced that can have the same killing capability as nuclear weapons for a fraction of the cost and expertise. For example, the Oak Ridge National Laboratory did a comparison of costs of various threats and came up with the following:
Weapon Lethality Versus Cost
From the late Dr. Conrad Chester
Oak Ridge National LaboratoryWeapons compared to cost for killing most people within a square-mile area
Conventional cluster bomb weapons: up to millions of dollars
Neutron bomb: roughly $2 million
One ton of GB nerve agent: up to $100,000
1 kilogram of anthrax (2.2 lb): less than $50
Question 5:
How deadly is anthrax?
Answer 5:
According to the late Dr. Chester of Oak Ridge National Laboratory, cultured anthrax has roughly 2 x 105 lethal doses per gram. Anthrax in a slurry has roughly 107 lethal doses per gram. Powdered Anthrax has roughly 108 lethal doses per gram.
Former Secretary of Defense Cohen illustrated this point on TV by saying that a five-pound bag of anthrax, if properly dispersed, could kill perhaps half of the population of Washington, D.C.
Dr. Harold Strunk, who retired from the U.S. military and has extensive experience with anthrax, stated that a sugar cube quantity of anthrax could theoretically kill 100 million people. He pointed out that in reality, the number of people potentially killed by this amount of anthrax is much less because of the problems of dispersal within a population.
Question 6:
How would an anthrax attack occur?
Answer 6:
According to the late Dr. Chester, the best method of spreading lethal anthrax is through spraying the spores into the wind, where it is subsequently inhaled and begins to multiply. Dr. Chester, while at Oak Ridge National Labs, looked at many anthrax attack scenarios, which resulted, in part, with the following estimations:
Scenario 1: A single-operator terrorist with a truck-mounted 55-gallon drum of anthrax and sprayer could cause tens of thousands of deaths within a city.
Scenario 2: A sophisticated and well-trained technical terrorist group with four medium-sized planes (DC-3 size) were shown to potentially kill 35 percent of the U.S. population with one night flight spraying anthrax over key population centers.
Question 7:
Some experts say anthrax is difficult to disperse through air and sunlight. Is this true?
Answer 7:
Presumably the terrorists would be trained on what the best weather conditions are for dispersing anthrax spores and how to effectively produce an aerosol laden with anthrax spores. According to experts, this would typically be done at night or on an overcast day with a gentle breeze so that the sun would not kill off the spores before they are inhaled. Terrorists can certainly wait for the right weather conditions to exist. According to studies performed by the Oak Ridge Labs and the U.S. Congressional Office of Technology Assessment, a well-executed attack can kill thousands to many millions. The Defense Department has formally stated that a large portion of a city could be killed in a well-executed anthrax attack (see http://www.anthrax.osd.mil/Flash_interface/default.html).
Question 8:
How vulnerable is the food supply to anthrax?
Answer 8:
Anthrax spores can fall upon food in either a dedicated attack on the food supply or as a secondary effect of an airborne release. If ingested in a sufficient dose, then an intestinal form of anthrax can occur that can be lethal for somewhere between 25 percent and 60 percent of those infected - if it is conventional anthrax for which we have clinical data resulting from the few cases where people ate infected meat. However, if the antibiotic supplies are limited, or a more drug-resistant strain is used, then a higher percentage of deaths would likely be expected.
Question 9:
What should be done at the governmental level?
Answer 9:
Educate the public on the threat and how to counter it. This should include candid (but sanitized) information on any known attempted threats that have occurred in the past. The public deserves to know what is fact and what is fiction with the many rumors that have spread. (For example, USA Today and other news outlets reported a few years ago that there were several attempts by terrorists with biological warfare agents from Iraq who were successfully thwarted as they tried to enter our country – and some news sources said that some actually did enter.)
Public education should also include how to prepare in advance to limit your exposure during any future biowarfare attack, as well as instructing medical personnel on how to treat this disease (see the USPDI website for some practical recommendations).
Learn more about the Russian and other strains of anthrax and develop new vaccines and antibiotics as required. Research on new non-drug-based antibiotics, such as the ASAP Solution being studied at BYU, should be accelerated. Expand the current vaccination program for people who live in high-threat areas or in high-risk professions. For example, a vaccination program similar to what is required of the military could be offered on a voluntary basis to medical personnel and Ffirst responders to blast/chem/bio/radiation scenes.
Encourage Congress to increase the vaccine production capabilities in the U.S. (currently only one company in the U.S. produces the vaccine) so that concerned citizens can be vaccinated, not just U.S. military personnel, and to allow for rapid mass immunizations should a large terrorist biowarfare attack occur.
Continue research on rapid detection devices for anthrax and other biological weapons and distribute these for real-time, 24-hour monitoring of major urban areas.
Increase the quantity of stockpiled antibiotics as well as the number of dispersal locations to respond to anthrax and other biowarfare attacks. Hours of delay in receiving antibiotics can translate to thousands or millions of additional deaths. Antibiotic stockpiles should be readily available to the medical community without having to wait 12 or more hours. Low-cost disposable respirator masks and latex gloves should also be stockpiled, as the current supplies (especially of respirators) could be quickly depleted and lead to many unnecessary deaths and prolonged social disruption.
Train and immunize emergency services personnel on how to identify/treat/triage biowarfare victims and how to limit the further spread of anthrax and other biological agents.
Upgrade intelligence, customs and law enforcement capabilities to thwart potential biological terrorists without infringing on citizens' rights.
Question 10:
What can the average American do to be prepared?
Answer 10:
Here are some practical steps to consider:
There is an extremely low risk of biological attack if you live far outside a major urban area. Hence, if you live tens of miles outside a major city, you probably do not need to do much to be prepared other than have food, water, power, and medical supplies, etc., stored up in case of long infrastructure outages due to biological attacks. Some low-cost medical supplies, such as disposable HEPA or N95 respirators and some latex gloves, would be needed if a highly infectious bio-warfare agent was used.
If you live in or near a large urban area, you should learn how to make bio-safe rooms at your home and place of business (see www.usdpi.org for details). If you learn of an attack that is imminent or has occurred in your area:
- Go inside your home or business and close your windows. Prepare a bio-safe room and don a HEPA or N95-style respirator mask, if available.
- Monitor the radio or TV and seek medical advice immediately. The USDPI website provides information resources on what the military and others recommend for anthrax and other biowarfare agents. If there is a known attack and you have previously been recommended to do so by your doctor, begin taking a safe dose of antibiotics. Be careful, because there is some wrong information out there produced by popular so-called biowarfare experts. This literature can be dangerous when it comes to dosages, especially as it pertains to mapping vet dosages of animals to humans.
If you really believe you've been exposed, you need to seek professional advice and antibiotic treatments immediately. If you wait until clear symptoms appear (normally after one to six days after exposure), in the case of anthrax, it will probably be too late to save yourself. However, be careful not to overreact to false warnings or rumors of attacks.
Dead animals or people who have died from anthrax should not be cut into but buried quickly and deeply or cremated to reduce spore spread, which occurs with exposure to air. Those treating suspected anthrax patients should wash their hands frequently and take preventive antibiotics [though sick human to well human transmission is unlikely].
- Try to obtain vaccinations for anthrax if really concerned. (Note: These are not currently available to the general public, only the military and certain other fields, like veterinarians). You can write to your congressman to see if Congress can work to make this an option to the average American. There are a lot of issues surrounding the effectiveness of the vaccination program. One argument is that if an attack occurs with a genetically engineered special strain of anthrax (as with the Russian versions), the vaccine will not help much. The counter argument is that in many scenarios, especially one with a less sophisticated adversary, the vaccine may prove helpful in reducing your risk.
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Health Issues
War on TerrorismFriday October 12 4:40 PM ET
New Anthrax Case Reported at NBC
By LARRY McSHANE, Associated Press Writer
Skin and inhaled forms of anthrax are caused by the same bacterium. The only difference is whether the microscopic spores enter the skin through a cut or if there are enough spores to be inhaled and thus cause infection through the lungs. It takes more than 8,000 spores to cause the inhalation form of anthrax.
Neither form can be spread directly from person to person.
Copyright © 2001 The Associated Press.
The first symptoms of skin - or cutaneous - anthrax are reddish-black sores on the exposed skin. If the disease is caught at that point and treated with antibiotics it is easily cured. Even without treatment, cutaneous anthrax is fatal in only one case out of 20.
NewsMax.com
Friday Oct. 12, 2001; 11:14 p.m. EDT
Health Expert: Anthrax Threat Greatly Exaggerated
The current media hysteria over a potential anthrax attack by terrorists is more hype than real health risk.
So claims health expert Steven Milloy, author of "Junk Science Judo: Self Defense Against Health Scares and Scams."
Writing in the New York Post Friday, Milloy slams the American Public Health Association for its claim that, "One-billionth of a gram (of anthrax), smaller than a speck of dust, can kill."
In fact, says Milloy, "one spore, even thousands, will not kill anyone."
"Wool sorters inhale 150 to 700 anthrax spores an hour continually without danger. Studies show that inhaling 10,000 spores is necessary for infection," he reports.
American Media's Bob Stevens, the only American to suffer a lethal dose of anthrax in the recent scare, is said to have been so farsighted that he held a letter believed to have been contaminated with anthrax especially close to his face in order to read it.
There may be more isolated cases like Stevens', says Milloy, but the dangers of widespread infection are slim.
"Even assuming terrorists knew how to make mass quantities of powdered anthrax without killing workers and surrounding populations, production would cost hundreds of millions of dollars," he argues. "Purchasing unemployed, ex-Soviet bioweapons experts is insufficient."
What about the reported plans of Twin Tower terrorist Mohamed Atta and his coconspirators to rent crop dusters and spay anthrax on population centers?
Airplanes dusting a city with spores aren't much use, Milloy contends.
"The few spores entering buildings would mostly settle; the few that didn't would likely be insufficient in concentration to cause infection. Outside, spores would mostly fall to the ground or be blown away and rendered harmless."
Milloy warns that while Americans have little to fear from anthrax, the panic caused by the current hype could be more dangerous.
"Anthrax infection initially resembles the flu.... More than 100 million people in the U.S. may well have flu-like symptoms in the near future. Should every cough, sore throat, runny nose and headache be considered a possible case of anthrax?
"Only if we want to bring our public health system to a grinding halt," says Milloy.
Read more on this subject in related Hot Topics:
95% of anthrax cases skin-related
Ranchers, textile workers prove spores hard to inhaleTuesday, October 16, 2001
By Paul Sperry
© 2001 WorldNetDaily.com
WASHINGTON -- More than 95 percent of anthrax cases recorded in the U.S. over the past 200-plus years have been skin-related, the non-lethal form of the disease, a Defense Department epidemiologist told WorldNetDaily.
"Pulmonary anthrax is very rare," said the doctor, who works for the Defense Department's Uniformed Services University of the Health Sciences in Bethesda, Md.
He emphasizes that it's extremely hard to inhale anthrax spores to a degree necessary to develop the kind of lung-related anthrax that killed an elderly Florida man on Oct. 5.
He cites, as an example, North Dakota ranchers who have been getting infected with cutaneous anthrax for years, but who have not developed pulmonary anthrax.
The ranchers picked up the anthrax spores through cuts or sores on their hands after handling livestock, which carry the spores on their hides.
But none have inhaled enough spores to develop the potentially lethal form of anthrax. Nor have textile workers in North Carolina, who work with wool, the military doctor says. Pulmonary anthrax used to be called "Wool-Sorter's Disease."
Cutaneous anthrax is very treatable. Typically, spores are washed from the skin and patients are put on antibiotics.
An NBC News employee in New York, who recently developed a skin lesion after opening an envelope filled with anthrax spores, is expected to fully recover from the infection.
So far, there have been 12 confirmed cases of people being exposed to anthrax spores sent through the mail in New York and Florida. Government officials suspect the letters may have been sent by terrorists tied to the 9-11 attacks by Islamic hijackers, but as yet they have no solid evidence linking the two events.
Through nasal-swab testing, health officials have found spores inside the noses of several people, but they have not shown symptoms of pulmonary anthrax.
The epidemiologist says ripping open an envelope filled with spores doesn't automatically mean you'll inhale enough spores to infect your lungs. You have to inhale an estimated 8,000 to 50,000 spores to develop the bacteria that causes pulmonary anthrax, which is not contagious.
To infect thousands of people at once, rather than picking them off one by one through the mail, terrorists would have to disperse tens of kilograms of spores in a fine mist over a city, bioterror experts say.
The low-tech delivery system of letter bombs supports experts' assertions that terrorists haven't found a way to overcome the technological hurdle of designing a spray nozzle to effectively aerosolize anthrax in the 1 to 5 micron range necessary to infect a large segment of the population.
Though creative -- and successful, insofar as they've caused mass hysteria and panic -- the current anthrax outbreak does not constitute a mass attack, the military doctor says.
"The goal of these anthrax letters is clearly to scare us," he said, "and so far it's working."
Previous story:
Experts debunk bioterror myths
Is Cipro safe for kids?
Amoxicillin effective alternative drug for anthraxTuesday, October 16, 2001
By Paul Sperry
© 2001 WorldNetDaily.com
In addition to an ABC News producer's 7-month-old son who has developed the skin form of anthrax after visiting his father's workplace, other children may also have been exposed to lethal spores at another media outlet -- American Media Inc. in Boca Raton, Fla.
Employees of the supermarket-tabloid publishing company were encouraged to bring their kids to the office with them, since many of the chain's reporters, editors and photographers worked long hours.
Doctors have prescribed AMI's more than 300 employees there Ciprofloxacin, the drug of choice to combat anthrax, as a prophylactic in case they've been exposed to the disease.
The powerful antibiotic is also safe for children.
But that hasn't always been the case.
"Cipro hasn't traditionally been given to kids under 21," said Dr. George Miceli, chief of emergency medicine at Boca Raton Community Hospital, which has tested and treated AMI employees exposed to anthrax.
The Food and Drug Administration and Centers for Disease Control and Prevention "only recently recommended it" as a first line of defense against anthrax for kids, as well as adults, he said.
Cipro, as a broad-spectrum antibiotic which can kill a lot of bugs, can cause liver damage, severe diarrhea and even miscarriages.
FDA guidelines for treating anthrax with Cipro call for patients to take one 500-mg tablet or liquid suspension twice a day for 60 days. The unusually long period of treatment is due to anthrax spores' ability to survive up to two months. They are remarkably resistant to heat and dryness.
With that in mind, pediatricians are prescribing a milder antibiotic -- amoxicillin -- as an alternative, albeit effective, drug for kids exposed to anthrax, Miceli said.
In fact, there's been a run on the drug at pharmacies in the Boca Raton area since the anthrax outbreak there, he says, although no children there have tested positive for anthrax.
One of Miseli's emergency-room physicians last week filled a prescription for bubble-gum-flavored pediatric amoxicillin for his 8-month-old baby, who had an ear infection. To his shock, he got the last batch available in the local area.
"The pharmacist told him he was getting the last dose of pediatric amoxicillin in the county," he said.
Tetracyline is also effective against anthrax, pharmacists say, particularly a newer relative of tetracyline, called vibramycin.
Other drugs in the Cipro family are effective as well. They include Floxin and Levaquin, according to pharmacists.
Paul Sperry is Washington bureau chief for WorldNetDaily.