Biological Weaponry – A Medical Faux Pas?
Just as a “disasters are an opportunity for development”, the Second World War is known to give birth to “huge advances in medical knowledge and surgical techniques”. This article would provide you with the highlights in history of the friendly use of medicine out of which some good and bad has resulted. If I poisoned your fields with bio-agents as an answer to your attempt to poison mine; it can be dually regarded as good and bad. Biological warfare is a deliberate use of various agents to spread disease amongst plants, animals, humans and everything and anything.
Some of the most common, deadly agents known to have wiped out populations are as follows: Among bacteria are Anthrax, Plague, Tularemia, Brucellosis, Q Fever. Among viruses are Smallpox, Viral Equine Encephalitis and those responsible for Hemorrhagic Fever (Filo/Flavi Viruses); and toxins include Ricin, Botulinum, Mycotoxins and Saxitoxin.
Wars forced companies to develop highly effective medicine and techniques on an industrial scale. Pre-war penicillin discovery by Sir Alexander Fleming increased the chances of survival of appalling casualties and henceforth the treatment. In addition to pioneering the work on skin grafts and blood transfusion, refining in the war years were preventive medicine for malaria, tetanus, gangrene, pneumonia and gonorrhoea.
Poor man’s atom bomb: The Romans attempted the first ever use of biological weapons (BW) by poisoning water supply of the enemies using battered animals. Later, this thought was elaborated by the Mongols in 1346 who used corpses infected with plague instead of animals to stretch a bigger picture. In 1710, the Russians defeated Swede enemies by plague-infected corpses. The British didn’t lag behind who in 1767 aided the Indians with blankets initially used to protect smallpox victims.
A popular weapon, Anthrax was first used by the Germans in 1916. They also used Glanders, which is an infectious disease cause by Bacterium Burkholderia Mallei to infect equestrians and feed to allied forces. Romanian sheep, Argentinean mules and American horses, all had been used to feed the human agenda.
The Japanese stepped in to poison Soviet water supply with intestinal typhoid at the former Mongolian Border in 1937. Ever since, Japan began its Offensive program in to which at least 10,000 prisoners have given their lives to. Japanese plague-fans dropped rice and wheat mixed with plague carrying fleas over China and Manchuria.
In 1942, the US began their Biological Offense program. Various tests were conducted henceforth in San Francisco and New York. Germans too tasted the use of offense in 1945 followed by Iraq which embarked to develop a biological offensive program which included toxins like botulium toxin, aflatoxin and anthrax.
In 2001, the anthrax attacks in the United States, also known as Amerithrax, occurred over the course of several weeks beginning on Tuesday, September 18, 2001, one week after the September 11 attacks. The Daschle Letter contained 2gm powder in an envelope, containing 100 billion – 1 trillion spores (10 (11) – 10 (12) cfu) were mailed to several media offices and two Democratic U.S Senators, killing 5 people and infecting 17 others.
Several reasons may advocate bioterrorism. A biological agent self-replicates within the victim, has relatively low costs of production, requires a small dose (1gm of toxin could kill over 1 million people), appropriate particle size and stability in aerosol, ease of dissemination, insidious symptoms, prolonged incubation period and difficult detection. Owing to multiple feasibility features, a biological attack could be planned and placed on a moving or stationary position. Also, the ease of modes (frozen/dried) and methods of delivery (bomblets) have also been described.
BW still depends upon the susceptibility of the aggressors and Mother Nature; temperature and sunlight, environment persistence of some agents like anthrax, relatively longer incubation period, advanced and specialized infrastructure for development among others maybe limiting parameters. Not only are a wide variety of biological agents genetically being modified to withstand antibiotics and other treatment regimens, but also mocking sensitive detection systems. I find it extra-ordinary to have SARS, MERS and other challenging diseases with resistance patterns escalating regions. Some difficult whereas some easy to grow; incapacitating agents like VEE, Bacillus Anthrax, Plaque, Yersinia and various forms that cause Hemorrhagic fever have high fatality rates once established in a non-immune host.
Viruses are quite attractive weapons from a both engineering/harvesting technique which is a rather effortless and treatment complexity. If you sense an unusual disease entity, large numbers of civilian and military casualties, aerosol route, morbidity limited to the localized geographical area, multiple dead animals; run for your lives! The unusual pattern of victims showing at a health site and vague clinical features should raise suspicion for a covert biological poisoning. Accessible laboratory screening should be implemented immediately and common bio-agents should be cultured by standard methods until specifications can be made available.
More specific methods include Mass spectrometry for toxins, antibody and antigen tests, DNA probes and Detection of metabolic products. Vaccines, anti-virals, antibiotics and other antidotes should be available en masse to avoid overwhelming supplies. Common sources like food and water should be protected, vector control measures, indoor movement, issuing Personal Protective Equipment may all be temporary measures.
Conventional decontamination methods like chemical, heat or UV may also be utilized. Such detention tactics are deemed impractical and reason for terrorists to continue to implement attacking strategies. Development of the public health systems, public education and programs (workshops/drills), governmental incentives for research and development into biological attack and countermeasures since biological weapons are now being engineered; all have been undertaken to forbid the use of biological weapons.
The strategies have been targeted to enhance disaster preparedness and response capacity, when initiatives should strictly be taken to promote preventive tactics, interdicting arsenal, registering/documenting purchases, imposing strict penalties and regular screening and inspection of suspected regions. Disaster management should come into action when a biological intervention is suspected. Disaster Management should be an Integrated System of Hospital Management.
Dr.RezwanNaseer, General Director of Punjab Emergency Service (Rescue 1122) proposed a Disaster Preparedness program. Dr.Naseer anticipated a safety community development program through injury prevention research, school safety program, community safety officers and teams etc. The program is to expand to other provinces of Pakistan; in KPK, AJK, GB and Baluchistan.
Dr.SherazAfridi, Accident and Emergency – Khyber Teaching Hospital, introduced a MIMS course, Major Incident Medical Management Support. The aim of such a service was to provide the knowledge and skills needed to effectively manage the scene of a major casualty incident supported by a “Methane Message” for better understanding.
M: My call/sign/name. Major incident STANDBY or DECLARED.
E: Exact Location.
T: Type of Incident.
H: Hazards, present and potential.
A: Access and egress.
N: Number of severity of casualties.
E: Emergency services – present and required.
Certain systems which have been developed to detect biological attack are: SMART (Sensitive Membrane Antigen Rapid Test) JBPDS (Joint Biological Point Detection System) BIDS (Biological Integrated Detection System) IBAD (Interim Biological Agent Detector) and The Tactical Biological Standoff Detection System. Bio-terrorism Outlawing Washington Conference (1921–1922), the Geneva Conference (1923–1925), and the World Disarmament Conference (1933) forbade the use of BW.
However, The Geneva Protocol did not prohibit the development, production and stockpiling of biological weaponry. Failure to decommission the arsenal is perhaps best illustrated by the super powers. There are several events in history of a seemingly incidental or offense free warfare, while pushing agendas for peace, sponsoring and staging attacks and establishing grounds for hostile purposes. When our great doctors, health workers, activists and freedom fighters rising to the challenge of the civilian war magnificently are being shut out from raising their voice, who am I write this peace on warfare when the global voices are now silent?
There remains no time to ponder anxiety, panic or psychological effects among the civilians in attempt to train them against a possible biological attack, applying to both attacking and attacked nations. Rampant bio-agent use for a personal crusade has indoctrinated the methods and availability of sophisticated techniques without considering the consequences. For instance, product tampering (Tylenol tampering cases of the 1980s); attacks on specific ethnic population; sabotage of specific food item (the lacing with cyanide of Chilean grapes in March 1989); attacks directed at one of a country’s agencies or departments (anthrax mailings in 2001). Whether you call it an arms trade or a defense fair, weapons regardless of their kind will continue to be sold to the dictators, which would follow military intervention and a flow of protesters wrapped in an anti-intrusion agenda; giving rise to nothing but massacre; an exhausting merry-go-round.
Many nations now have begun their own offensive programs in order to prepare for the better or for worse. Would a military intervention stop the genocide of millions of people? What will it take to understand the gravity of the civilian massacre a biological attack can bring? Should resolutions bringing the arsenal under international control suffice? What sort of a timeline are we talking about from an agreement to a final disposal?
About the Author: Eman A. Khaled is a Medical Graduate from Sir Syed College of Medical Sciences, Pakistan. Currently, she works at King Fahd Medical City and Research Center in her hometown, Saudi Arabia. Eman can be contacted at [email protected]
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