Scientific termpaper on anthrax

Anthrax (Bacillus anthracis) is an acute infectious disease caused by the spore-forming bacterium. The most common victims of anthrax are warm-blooded animals, but it can also infect humans. Anthrax spores can be produced in a powdery form for biological warfare. When inhaled by humans, these particles cause respiratory failure and death within a week. Because anthrax is considered to be a potential agent for use in biological warfare, the Department of Defense (DOD), in 1998, announced it would begin a systematic vaccination of all U.S. military personnel. (DOD, 1998) Anthrax infection occurs in three forms: cutaneous (skin), inhalation, and gastrointestinal. B. anthracis spores can survive in the soil for many years and handling animal products from infected animals or inhaling anthrax spores from contaminated animal products can cause humans to become infected. Anthrax can also be spread by eating undercooked meat from infected animals. Anthrax is diagnosed by isolating B. anthracis from the blood, skin lesions, or respiratory secretions or by measuring specific antibodies in the blood of suspected cases. (Dire, 2001)
Demographics
Anthrax is most common in the agricultural regions where it occurs in animals, such as South and Central America, Southern and Eastern Europe, Asia, Africa, the Caribbean, and the Middle East. When anthrax affects humans, it is usually because of occupational exposure to infected animals or their products. Workers who are exposed to dead animals and animal products from other countries where anthrax is more common may become infected with B. anthracis. Anthrax in animals rarely occurs in the United States. Most reports of animal infection are received from Texas, Louisiana, Mississippi, Oklahoma and South Dakota. Symptoms of disease vary depending on how the disease was contracted, but symptoms usually occur within seven days. (Dire, 2001)
Types of Anthrax

Cutaneous: Most anthrax infections occur when the bacterium enters a cut or abrasion on the skin, such as when handling contaminated wool, hides, leather or hair products (especially goat hair) of infected animals. Skin infection begins as a raised itchy bump that resembles an insect bite but within 1-2 days develops into a vesicle and then a painless ulcer, usually 1-3 cm in diameter, with a black necrotic area in the center. Lymph glands in the adjacent area may swell. About 20% of untreated cases of cutaneous anthrax will result in death. Deaths are rare with appropriate antimicrobial therapy.
Inhalation: Initial symptoms may resemble a common cold. After several days, the symptoms may progress to severe breathing problems and shock. Inhalation anthrax usually results in death in 1-2 days after onset of the acute symptoms.
Intestinal: The intestinal disease form of anthrax may follow ingestion of contaminated meat and is characterized by an acute inflammation of the intestinal tract. Nausea, loss of appetite, vomiting and fever are followed by abdominal pain, vomiting of blood, and severe diarrhea. Intestinal anthrax results in death in 25% to 60% of cases. The incubation period is usually within seven days. There are no reports of the disease spreading from human to human. Direct person-to-person spread of anthrax most likely does not occur. Once a person has been infected with anthrax and survived, a second bout with this disease is unlikely.

To treat anthrax, doctors can prescribe antibiotics. Usually penicillin based antibiotics such as Cipro are preferred, but erythromycin, tetracycline, or chloramphenicol can also be used. To be effective, treatment should be initiated early. The disease could be fatal if left untreated. (Sofaer, et al, 1999)
Anthrax Vaccine
Anthrax vaccine is available for people in high-risk occupations. To prevent anthrax, carefully handle dead animals suspected of having anthrax; provide good ventilation when processing hides, fur, hair or wool; and vaccinate animals. In countries where anthrax is common and vaccination levels of animal herds is low, humans should avoid contact with livestock and animal products, and avoid eating meat that has not been properly slaughtered and cooked. For high risk occupations, such as those exposed to potentially contaminated animal hair, wool or hides, vaccination is recommended. An anthrax vaccine has been licensed for use in humans. The vaccine is reported to be 93% effective in protecting against cutaneous anthrax. (Sofaer, et al, 1999)
The anthrax vaccine uses dead bacteria as opposed to live bacteria, and is indicated for individuals who come in contact in the workplace with imported animal hides, furs, bonemeat, wool, animal hair and bristles. It is also indicated for individuals engaged in diagnostic or investigational activities which may bring them into contact with anthrax spores. Now, the terroristic use of anthrax in this country has caused us to vaccinate our armed service and certain governmental personnel.
BioPort Corporation is the sole manufacturer of the anthrax vaccine. The vaccine is US Food and Drug Administration (FDA)-licensed and has been routinely given in the US since 1970. The immunization consists of three subcutaneous injections given two weeks apart followed by three additional subcutaneous injections given at 6, 12, and 18 months. Annual booster injections of the vaccine are required to maintain immunity. Like all vaccines, anthrax vaccine may cause soreness, redness, itching, swelling, and lumps at the injection site. About 30% of men and 60% of women report these local reactions, but they usually last only a short while. Lumps can persist a few weeks, but eventually disappear. Injection-site problems occur about twice as often among women. For both genders, between 1% and 5% report reactions at the injection site of 1 to 5 inches in diameter. Larger reactions at the injection site occur in about one in a hundred vaccine recipients. Beyond the injection site, from 5% up to 35% will notice muscle aches, joint aches, headaches, rash, chills, fever, nausea, loss of appetite, malaise, or related symptoms. Again, these symptoms usually go away after a few days. Serious events, such as those requiring hospitalization, are rare. They happen about once per 50,000 doses. Severe allergic reactions can occur after any vaccination, less than once per 100,000 doses. A moderate local reaction can occur if the vaccine is given to anyone with a past history of anthrax infection. Acute symptoms have varied. Depending on the vaccine lot used. The most common side effects reported are: mild discomfort (localized swelling and redness at the site of injection), joint aches, and in a few cases, nausea, loss of appetite, and headaches. There have been no long term side effects from the vaccine. Sofaer, et al, 1999)
Small quantities of anthrax vaccine are made available as needed to civilians who are exposed to anthrax hazards in their work environment such as veterinarians, lab workers and others. Anthrax vaccine is produced exclusively by the Michigan Biologic Products Institute under contract to the Defense Department. Virtually all vaccine produced is earmarked for military use in recognition of the documented threat to military personnel. (Cordesman, 2001)
Biological Warfare

The use of bacteriological agents in an armed conflict can be dated back to 1346, at Kaffa (now Feodossia) where the bodies of Tartar soldiers who died from the plague were thrown over the walls of the besieged city. It is hypothesized by some medical historians that the action resulted in the infamous pandemic that spread over the entire continent of Europe from Genoa, via the Mediterranean ports. USAMARIID (2001) Since that time, various forms of biological warfare have been used in many countries. Boris Yeltsin acknowledged in a press conference, prior to meeting with President Bush in the summer of 1992, Washington, D.C., that an incident in Sverdlovsk where civilians came down with a "mysterious illness," resulting in many fatalities was in fact a massive biological warfare accident involving an aerosol of anthrax spores. Presumptive evidence acquired by United Nations Biological Warfare Inspection Team in 1992 indicated that Iraq could have been in the early stages of developing an offensive BW capability. On-site inspections revealed several laboratories with state-of-the-art equipment that could have been used for agent production. No evidence, to date, has been established for munitions development and/or agent weapons. The experience of the U.N. team emphasizes the difficulty of locating a Smoking Gun relative to BW programs. This type of program is much easier to hide from inspection than either chemical or nuclear programs. USAMARIID (2001)
U.S. Offensive Program

The United States initiated a review of the potential of BW in 1941-1942, implemented a program in 1943 and had established its feasibility by 1969. In 1969, President Nixon disestablished offensive studies including the destruction of all stock piles of agents and munitions. As important events of this program are to be described, the political climate in which the program was implemented must be considered. The policy of the United States was first and foremost to deter its use against U.S. forces, and secondarily to retaliate if deterrence failed. When the biological warfare program was established, the United States was fighting World War II on two fronts, Europe and Asia. When World War II ended, a cold war developed in which the security of the country was still threatened. The tempo of world attitudes and times have changed significantly in the 23 years following the elimination of U.S. biological warfare programs. Because a potential BW threat still exists, the U.S. maintains a defensive biological program. USAMARIID (2001)
According to the Centers for Disease Control and Prevention (CDC), biological agents pose a risk to national security because they are easily disseminated; cause high mortality, which would have a major impact on public health systems; cause panic and social disruptions; and require special action and funding to increase public preparedness. 5 As the following facts and figures show, the challenges facing the Bush Administration, the new Office of Homeland Security, and Congress in responding to the growing threat of bioterrorism are immense. (Heritage Foundation, 2001)
The following map shows the countries known and suspected to have biological weapons programs:


According to a recent U.S. General Accounting Office (GAO) report, coordination of federal terrorism research, preparedness, and the responsible programs thus far has been fragmented. Several agencies are responsible for coordinating functions, and this both limits accountability and hinders unity of effort. Moreover, several agencies have not been included in bioterrorism-related policy and response planning meetings, and different agencies have developed lists of biological agents as well as disaster response assistance programs for state and local governments. The Federal Emergency Management Agency (FEMA), the Department of Justice, the CDC, and the Office of Emergency Preparedness (OEP), for example, offer separate assistance to state and local governments in planning for emergencies that include bioterrorism. (USGAO, 2001)

Bioterrorism Agents

As many as 17 nations, including several the U.S. State Department considers "state sponsors of terrorism," have developed lethal biological agents as weapons of war. The list of bacteria, viruses, and toxins explored by these weapons programs is vast -- running in the dozens. We focus on eight agents that may pose the greatest threats. Most of these deadly pathogens are difficult to obtain, process, and most critically, deploy to cause mass casualties. Yet we must understand these agents -- how they would be used and the diseases they trigger -- to prepare for even the most unlikely bioterrorist attack. (Nova, 2001) Some of these agents include anthrax, cholera, botulism, the plague and smallpox. Of these, the popularity of anthrax could be explained by the fact that there is a vaccine for it, so that it can be safely handled by someone who has been vaccinated. Also, it has a relatively short incubation period, and, while all types can be treated with antibiotics, the inhaled version is often confused with the flue and by the time it is diagnosed, it usually proves fatal. (Nova, 2001)
Production of biological warfare agents such as anthrax does not require specialized equipment or advanced technology. When comparing equivalent amounts of biological and chemical warfare agents, the biological agent is farmore potent. Small amounts can produce large numbers of casualties. Delivery vehicles include: aerial bombs, artillery shells, long-range missiles, agricultural sprayers, and spray tanks carried by aircraft. Many of the materials and equipment that are used to produce biological warfare agents are available from legitimate sources and intended for other uses. It is difficult to limit spread of biological warfare agents because of the dual-use nature of the equipment and technologies. There is a legitimate market for legal products which can be produced with this equipment, i.e., pharmaceuticals, biopesticides, etc. (DOD, 1998)
Conclusion
After reviewing the research, it is apparent that the threat bioterrorism with the use of anthrax and other agents is of worldwide proportions. It is difficult to find laboratory sites, because of the ease of acquisition of the minimal equipment used and the agent itself, in some countries. Another factor is the different modes of relaying the biological agent, which range from massive amounts to small amounts, as distributed through the post office via mail. Even the ongoing infections through the mail are forms of terrorism, since they make a large number of people fearful of being contaminated, although the numbers actually infected are minimal. This is because the mail is something that is usually taken for granted and trusted.
As far as the governments capabilities for handling these threats, on a small-scale, the government does have large numbers of antibiotics on hand to treat people once they have become infected. However, there is certainly not enough vaccine available to pre-inoculate people so that they do not have to worry about becoming infected. Even if they did have enough vaccine for anthrax, there are many other diseases that could be used in biological warfare, and vaccines, if available, would have to be given for all of these. Should we be attacked on a large scale, i.e. through a missile containing a large number of spores, the devastation would be of pandemic proportions if there were not enough antibiotics available to treat everyone. The United States government is taking the threat of bioterrorism seriously, however there is a long way to go before it can be said that we are fully prepared.
It is difficulty in a country where freedom is a top priority to efficiently fight these and other methods of terrorism. People should not have to give up their freedom, however they also need to be protected. It is possible, for instance, that it may become necessary for people to receive mandatory vaccinations. Right now, to provide more intense screening of packages shipped through the mail, people are required to provide identification when shipping packages from their local post office. Mail is delayed because of the anthrax scares. This is an inconvenience few would complain about. Hopefully, a plan will be devised for maximum safety at minimum loss of freedom.









References
Abraham D. Sofaer, George D. Wilson, and Sidney D. Dell, The New Terror: Facing the Threat of Biological and Chemical Weapons (Stanford, Cal.: Hoover Institution, 1999), pp. 79-81.
Anthony H. Cordesman, Asymmetric and Terrorist Attacks with Biological Weapons (Washington, D.C.: Center for Strategic and International Studies, 2001), pp. 74-76
Daniel J. Dire, "CBRNE-Biological Warfare Agents," eMedicine Journal, Vol. 2, No. 7 (July 3, 2001), Section 2.
U.S. Department of Defense. News Release. Defense Link. "Accelerated Anthrax Vaccination Program to Enhance Force Protection Announced," March, 1998.
U.S. Department of Defense. Defense Link. " Information Paper; DOD Biological Warfare Threat Analysis," 1998.
USAMARIID. (2001) "History of Biological Warfare," http://www.gulfwarvets.com/biowar.htm.
Nova (2001) "Bioterror," http://www.pbs.org/wgbh/nova/bioterror/agents.html
U.S. General Accounting Office, Bioterrorism: Federal Research and Preparedness Activities, GAO-01-915, September 2001, pp. 15-16.