Biological Weapons: From the Invention of State-Sponsored Programs to Contemporary Bioterrorism
http://www.100md.com
《新英格兰医药杂志》
Jeanne Guillemin, a professor of sociology at Boston College and the author of Anthrax: The Investigation of a Deadly Outbreak (Berkeley: University of California Press, 1999), a definitive study of the 1979 anthrax attack by terrorists in the former Soviet Union, wrote Biological Weapons to "bring historical context to present concerns about biological weapons and the potential for bioterrorism." She has far surpassed that goal. The scholarship and the clarity of the writing are remarkable.
(Figure)
Disaster Response Drill in Brooklyn, New York, 2003.
Robert Spencer, AP/Wide World Photos.
In recent years bioterrorism has become a potent subject that invokes fear in our society. Guillemin brings light to the history of biologic weapons as she traces the checkered history of the United States in relation to control of weapon-grade pathogens. She tracks the rise of state-sponsored programs for the development of offensive biologic weapons since the end of World War I and details the horrible story of General Ishii Shiro, the Japanese military biologist who developed and deployed plague-infected fleas and bacterial pathogens to contaminate food and water in "total war" attacks on Chinese civilians in Manchuria. The rise of biologic-warfare programs in the United Kingdom, the United States, and the former Soviet Union after World War II is succinctly documented and annotated. Guillemin pulls no punches in blasting the covert development of biologic weapons, which the Soviets began immediately after they had signed the Biological Warfare Convention in 1972.
But Guillemin also notes that the United States failed to ratify the Geneva Protocol of 1925, the original international agreement prohibiting the development of such weapons. President Richard Nixon gets full credit for the United States's decision to abandon work on offensive biologic warfare at the end of 1969 and to sign the Biological Warfare Convention, but Guillemin points out that the United Kingdom was the first nation to renounce such weapons, 10 years earlier. She dryly comments that the United States finally ratified the Geneva Protocol in 1975 but recently withdrew from international attempts to strengthen the accord by adding inspection and verification of conformity to it.
The U.S. government argues that our military and commercial interests must be protected from outside access. Guillemin's unveiled concern is that U.S. secrecy only promotes doubt among other nations about this country's intentions that may well lead to a biologic arms race and would exclude our allies from information and access that are important for their own protection. She pushes for creating more transparency in our defense programs, arguing that failure to do so will be interpreted as evidence that we have something to hide — such as the development of offensive biologic weapons. Biological Weapons deserves to be read widely, not just by those directly involved in research on or responses to biologic attacks by terrorists.
Matthew Meselson, who long has championed the elimination of chemical and biologic weapons, makes a further plea for transparency in his foreword to Biological Weapons Defense, a collection of review articles that document recent work by scientists at the U.S. Army Medical Research Institute of Infectious Diseases at Fort Detrick, Maryland, and their academic collaborators. Detailed chapters are devoted to the pathogenesis of, molecular taxonomy of, and genomic variability among several major bacterial pathogens. The innate immune system and its possible future use as broad-spectrum emergency prevention and therapy for infections after a terrorist attack are carefully described. There is an excellent chapter on the range of agents that may emerge as new threats, not the least of which are potential hybrid pathogens intentionally created by sophisticated enemies.
Unstated, but evident to me, is that the United States has a very long road to travel before it can be said to be well prepared to deal with biologic weapons as they might be deployed against civilian populations. Diagnostic technology (especially for hemorrhagic fever viruses) is far from ready for final validation exercises; protocols for real-time surveillance of infectious disease are blizzards of government and commercial acronyms and include no coordination of effort and no evident path for development and decisions with regard to national implementation. This book, too, is not well prepared in terms of references, which are from 2001 or earlier, almost without exception. A CD-ROM version of the book is included with each copy, providing convenient access for scientists, journalists, and administrators.
The book presents virtually nothing, however, concerning the United States's expensive air-sampling program, which was initiated by the Department of Defense and then transferred to the Department of Homeland Security. It could be argued that information about sites, agents, and methods of sampling should be classified, to keep terrorists in the dark. But leaks to the public about false positive results for aerosols or even true positive results for natural aerosols (e.g., Francisella tularensis in New England) send mixed messages about the effectiveness and extent of coverage that urban areas of our country do or do not enjoy. Scientifically validated, sensitive, and specific air sampling is crucial, so that drugs or vaccines, or both, when available, can be administered after exposure. Secrecy has a history of thoughtless use, as well as use in hiding from the public the fact that things are simply not working. Meselson's warning against secrecy should be heeded.
Medical Response to Terrorism takes up the disparate challenges involved in coping with a terrorist assault on innocent civilians. Tightly written, this book has a standard, detailed outline, numerous summary tables, and a short multiple-choice quiz at the end of each chapter. It is clearly a textbook for the many groups of individuals and organizations that will be called into action after an attack — whether chemical, biologic, or explosive — or even a hit on the computerized systems that run hospitals and communication networks.
This book is probably destined to be the basic textbook for training sessions supported by the Department of Homeland Security and various state agencies, and it would help immensely if it, like Biological Weapons Defense, were available as a CD-ROM, for immediate reference. Because chemical and biologic attacks are not likely to become everyday events, it also might be valuable to create separate, terse summary documents for those in the medical and general communities who respond in such emergencies. These documents should be readily available by computer, so that a quick refresher is at hand if suddenly needed. I recall that in 1976, colleagues from other countries, who worked with us at the Centers for Disease Control and Prevention during the initial Ebola epidemic in what was then Zaire, promised readiness to respond to any new outbreak of that virulent virus. We had a roster of names, many units of immune plasma obtained from patients during convalescence stored in three locations, and boxes of other supplies just hours from central Africa. But because the next Ebola outbreak didn't occur until 19 years later, completely new personnel, supplies, and field protocols had to be organized.
These three books, each with a distinct content and focus, remind us all of the huge investment the United States has made (and will continue to make) to prevent a biologic attack by terrorists on our citizens. Taken together, they provide a powerful portrayal of where we've been and where we are likely to go in the relatively near future. Today, many in government who have access to classified information are convinced that a biologic attack is not a matter of if, but a matter of when. This prophecy will surely drive a search for answers for years to come.
Karl M. Johnson, M.D.
10 Calle Final
Placitas, NM 87043(By Jeanne Guillemin. 258 )
(Figure)
Disaster Response Drill in Brooklyn, New York, 2003.
Robert Spencer, AP/Wide World Photos.
In recent years bioterrorism has become a potent subject that invokes fear in our society. Guillemin brings light to the history of biologic weapons as she traces the checkered history of the United States in relation to control of weapon-grade pathogens. She tracks the rise of state-sponsored programs for the development of offensive biologic weapons since the end of World War I and details the horrible story of General Ishii Shiro, the Japanese military biologist who developed and deployed plague-infected fleas and bacterial pathogens to contaminate food and water in "total war" attacks on Chinese civilians in Manchuria. The rise of biologic-warfare programs in the United Kingdom, the United States, and the former Soviet Union after World War II is succinctly documented and annotated. Guillemin pulls no punches in blasting the covert development of biologic weapons, which the Soviets began immediately after they had signed the Biological Warfare Convention in 1972.
But Guillemin also notes that the United States failed to ratify the Geneva Protocol of 1925, the original international agreement prohibiting the development of such weapons. President Richard Nixon gets full credit for the United States's decision to abandon work on offensive biologic warfare at the end of 1969 and to sign the Biological Warfare Convention, but Guillemin points out that the United Kingdom was the first nation to renounce such weapons, 10 years earlier. She dryly comments that the United States finally ratified the Geneva Protocol in 1975 but recently withdrew from international attempts to strengthen the accord by adding inspection and verification of conformity to it.
The U.S. government argues that our military and commercial interests must be protected from outside access. Guillemin's unveiled concern is that U.S. secrecy only promotes doubt among other nations about this country's intentions that may well lead to a biologic arms race and would exclude our allies from information and access that are important for their own protection. She pushes for creating more transparency in our defense programs, arguing that failure to do so will be interpreted as evidence that we have something to hide — such as the development of offensive biologic weapons. Biological Weapons deserves to be read widely, not just by those directly involved in research on or responses to biologic attacks by terrorists.
Matthew Meselson, who long has championed the elimination of chemical and biologic weapons, makes a further plea for transparency in his foreword to Biological Weapons Defense, a collection of review articles that document recent work by scientists at the U.S. Army Medical Research Institute of Infectious Diseases at Fort Detrick, Maryland, and their academic collaborators. Detailed chapters are devoted to the pathogenesis of, molecular taxonomy of, and genomic variability among several major bacterial pathogens. The innate immune system and its possible future use as broad-spectrum emergency prevention and therapy for infections after a terrorist attack are carefully described. There is an excellent chapter on the range of agents that may emerge as new threats, not the least of which are potential hybrid pathogens intentionally created by sophisticated enemies.
Unstated, but evident to me, is that the United States has a very long road to travel before it can be said to be well prepared to deal with biologic weapons as they might be deployed against civilian populations. Diagnostic technology (especially for hemorrhagic fever viruses) is far from ready for final validation exercises; protocols for real-time surveillance of infectious disease are blizzards of government and commercial acronyms and include no coordination of effort and no evident path for development and decisions with regard to national implementation. This book, too, is not well prepared in terms of references, which are from 2001 or earlier, almost without exception. A CD-ROM version of the book is included with each copy, providing convenient access for scientists, journalists, and administrators.
The book presents virtually nothing, however, concerning the United States's expensive air-sampling program, which was initiated by the Department of Defense and then transferred to the Department of Homeland Security. It could be argued that information about sites, agents, and methods of sampling should be classified, to keep terrorists in the dark. But leaks to the public about false positive results for aerosols or even true positive results for natural aerosols (e.g., Francisella tularensis in New England) send mixed messages about the effectiveness and extent of coverage that urban areas of our country do or do not enjoy. Scientifically validated, sensitive, and specific air sampling is crucial, so that drugs or vaccines, or both, when available, can be administered after exposure. Secrecy has a history of thoughtless use, as well as use in hiding from the public the fact that things are simply not working. Meselson's warning against secrecy should be heeded.
Medical Response to Terrorism takes up the disparate challenges involved in coping with a terrorist assault on innocent civilians. Tightly written, this book has a standard, detailed outline, numerous summary tables, and a short multiple-choice quiz at the end of each chapter. It is clearly a textbook for the many groups of individuals and organizations that will be called into action after an attack — whether chemical, biologic, or explosive — or even a hit on the computerized systems that run hospitals and communication networks.
This book is probably destined to be the basic textbook for training sessions supported by the Department of Homeland Security and various state agencies, and it would help immensely if it, like Biological Weapons Defense, were available as a CD-ROM, for immediate reference. Because chemical and biologic attacks are not likely to become everyday events, it also might be valuable to create separate, terse summary documents for those in the medical and general communities who respond in such emergencies. These documents should be readily available by computer, so that a quick refresher is at hand if suddenly needed. I recall that in 1976, colleagues from other countries, who worked with us at the Centers for Disease Control and Prevention during the initial Ebola epidemic in what was then Zaire, promised readiness to respond to any new outbreak of that virulent virus. We had a roster of names, many units of immune plasma obtained from patients during convalescence stored in three locations, and boxes of other supplies just hours from central Africa. But because the next Ebola outbreak didn't occur until 19 years later, completely new personnel, supplies, and field protocols had to be organized.
These three books, each with a distinct content and focus, remind us all of the huge investment the United States has made (and will continue to make) to prevent a biologic attack by terrorists on our citizens. Taken together, they provide a powerful portrayal of where we've been and where we are likely to go in the relatively near future. Today, many in government who have access to classified information are convinced that a biologic attack is not a matter of if, but a matter of when. This prophecy will surely drive a search for answers for years to come.
Karl M. Johnson, M.D.
10 Calle Final
Placitas, NM 87043(By Jeanne Guillemin. 258 )