The Biological Weapon Threat- (Part 2) Recognizing the problem     

Kevin Ryan

Part I of this series focused on defining, understanding threat levels, lab safety as well as some quick history of these weapons. Part II will cover recognizing an attack is occurring. 

The most difficult part of a bioweapons attack is recognizing the threat. Establishing the scope of an attack will allow you to get the necessary resources needed to mitigate the situation with minimal loss of life. Bio attacks can be obvious such as a threat letter with a substance in the letter. On the other hand, these incidents may not be as defined until treatment is rendered by the health care system.

The key agency involved for any scenario is your local health department. Your health department can monitor the health care system to track patients, determine the extent of the problem, provide treatments, and alleviate stress on the health care system. The CDC is a major player in this process. The CDC Electronic Case Reporting (ECR) system is a key piece of patient tracking. Here is the link for the CDC fact sheet on ECR, https://www.cdc.gov/ecr/docs/eCR-Fact-Sheet-508.pdf. Close coordination with the emergency response is necessary for a successful outcome.

Recognition of a bio incident is usually delayed unless symptoms are obvious. Some Bio agents have several days to weeks for incubation periods. Transmissive agents can be transferred from person to person in those time frames. Undetected transmissions only increase the scope and size of the attack. It can take days or weeks to fully recognize the extent of the attack. Common factors among the patients may be your best clue to determine the source of the contamination. Investigation needs to consider the medical findings, patient tracking, and detailed interviews from possible victims.

Once all available information is collected, it can then be evaluated for criminal intent. Criminal intent can be localized, widespread or large scale. Various bio agents work well for each level of intent.

Category A agents would be well suited for a threat of national or international proportions. Anthrax, plague, or smallpox if disseminated correctly can create high mortality rates with major public health impacts. Disease outbreaks can be tracked at this website: https://metabiota.com/epidemic-tracker. 

Category B agents would be best suited for targeted, individual attacks. A toxin such as Ricin would be able to be discreetly given to an unsuspecting victim. The assassination of Georgi Markov in Sept. 1978 is the perfect example of this. Here is a summary of the incident at PubMed.gov. https://pubmed.ncbi.nlm.nih.gov/19137875/. 

You can see from the summary that the cause was not known until the autopsy several days later. Several factors determine how effective these attacks would be. Expertise, equipment, facilities, and access to agents are some of these factors.

Large scale attacks need more of all these so it’s more likely state sponsored terrorism is the actor. Targeted attacks such as the Markov assassination can require the necessary expertise to be successful. A review of the Shelburne VT ricin attack is in direct contrast to the Markov assassination. The lady in VT had very little knowledge of using the internet for a crude ricin weapon that did not complete the job. The undetermined actor in the Markov hit used a sophisticated weapon made from an umbrella that had a very effective outcome.

Large scale disseminations can be very complicated and difficult to perform. Aerosolization of the biological would be the biggest obstacle. A method to apply the correct particle size that would infect the human respiratory system is necessary.

The respiratory system has a series of filters that perform very well. These filters prevent many biologicals from infecting our bodies. Consider this quick information bit from WebMD.com on these filters. Your respiratory system has built-in methods to keep harmful things in the air from entering your lungs. Hair in your nose help filter out large particles. Tiny hairs, called cilia, along your air passages move in a sweeping motion to keep the passages clean.  Cells in your trachea and bronchial tubes make mucus that keeps air passages moist and helps keep things like dust, bacteria, and viruses out of your lungs. A particle size of 1 to 5 micrometers allows the biological to be inhaled deeply into the lungs.  Your skin is also an effective protective mechanism against biological agents. Open cuts and sores are typically the only way an agent can penetrate the skin. Unprotected civilians do have some defense against a bio attack even without PPE.

History has shown that programs capable of these actions have been state sponsored. Japan’s Unit 731 is good example of this. As many as 300,000 deaths are attributed to research from Unit 731 during WW II. Information from the experiments were destroyed when the camp was lost although several scientists were given immunity for exchange of information that they possessed on the testing at Unit 731.

The Japanese cult Aum Shinrikyo provides an interesting case study in the contrast of chemical vs biological weapons. The group attempted 17 CBW attacks from 1990-1995. The details of these attacks and the failures of the biological ones are detailed here by the Monterey International Institute of Studies: https://www.nonproliferation.org/wp-content/uploads/2016/06/aum_chrn.pdf. All of their botox, ebola, and anthrax attempts failed for different reasons owing to the difficulties of a successful bio attack.

Part II of this series examined the recognition of a biological attack. We looked at size, scope and the difficulties in being successful. Your local health department is one of the most important agencies with recognition and response to an incident. Part III will highlight how the BCFD responds to a suspected biological.

Kevin Ryan

Kevin Ryan leads the Baltimore City FD Hazmat Operations Office. A 31-year veteran of the fire service with 26 years of experience in the world of hazmat response. He is a Level III instructor and adjunct at the BCFD Fire Academy.