Article Two

Bioterrorism Risk May Be Overstated 
Fear of biological attack has stirred memories of the
sinister history of the remote Scottish island of
Gruinard, where an anthrax bomb was exploded during
World War II.

Now dubbed "anthrax island," Gruinard was
requisitioned by the British military for secret tests
to find out the potential of anthrax weapons following
fears that Germany was developing a biological warfare
capability.

Explosives testing with anthrax spores took place on
the deserted island in the early 1940s, killing 50
sheep and leaving the island so contaminated it
remained a no-go area for over 45 years.

Constant spraying with a mixture of 280 tons of
formaldehyde and 2,000 tons of sea water was needed
before Gruinard was finally declared decontaminated in
1987. Even today, 60 years on, it remains largely
uninhabited.

The experiment did not persuade the British war
cabinet to develop anthrax as a biological weapon,
possibly because its use was too gruesome to
contemplate, or possibly because the experiment showed
the difficulties of delivering the agent with any
accuracy or guarantee of effectiveness.

There is no doubt that anthrax -- delivered in the
right way -- is potentially a mass killer. A 1993
report by the US Congressional Office of Technology
Assessment estimated that between 130,000 and 3
million deaths could follow the aerosol release of 100
kilograms of anthrax spores upwind of Washington, DC.

However, a review published in The Journal of the
American Medical Association (JAMA) in 1999 by the US
Working Group on Civilian BioDefense stated that most
experts agree that:

the manufacture of a lethal anthrax aerosol "is beyond
the capacity of individuals or groups without access
to advanced biotechnology."

It points out that although the group responsible for
releasing the nerve agent sarin in a subway station in
Tokyo in 1995 dispersed aerosols of anthrax and
botulism throughout Tokyo on at least eight occasions,
for unclear reasons these attacks failed to produce
illness.

Paradoxically, it was the accidental, rather than
offensive, aerosolized release of anthrax spores from
a military microbiology facility in Sverdlovsk (now
Ekaterinburg) in the former Soviet Union in 1979 which
most clearly demonstrates the agent's lethal
potential. Of 79 people reportedly infected, 68 died.

Yet even this incident may offer some reassurance,
given that the military facility reportedly employed
15,000 people and that a residential area housing many
thousands more was exposed to the aerosol.

Underlining the importance of early diagnosis, the
JAMA article reported: The first evidence of a
clandestine release of anthrax as a biological weapon
most likely will be patients seeking medical treatment
for symptoms of inhalational anthrax.

The sudden appearance of a large number of patients in
a city or region with an acute-onset flu-like illness
and case fatality rates of 80% or more, with nearly
half of all deaths occurring within 24 to 48 hours, is
highly likely to be anthrax or pneumonic plague.

It adds that vaccine supplies are limited and that
even if vaccine were available, population-wide
vaccination "would not be recommended at this time,
given the costs and logistics of a large-scale
vaccination program and the unlikely occurrence of a
bioterrorist attack in any given community."

The Journal of the American Medical Association
1999;281:1735-1745 


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