Here we go again. Remember the global concern in the years after 11 September 2001 about the possibility of terrorists gaining access to biological agents and releasing them upon civilian populations? Now it seems that history is repeating itself and that Islamic State terrorists in Syria and Iraq have produced a manual on how to launch biological attacks utilizing bubonic plague culled from infected animals.
The manual is said to explore a variety of means of releasing and spreading the plague agent including the use of rockets, missiles, suicide vehicles and via the contamination of air conditioning systems, all targeting large gatherings of people in shopping malls, train stations and at football matches.
Already the Syrian civil war has seen the use of a variety of chemical bio-warfare agents, including sarin, chlorine and ammonia. The manual also contained a 26 page fatwa proclaiming that the use of chemical and biological weapons against non-believers was permitted.
During the early part of this century fear of a covert release of smallpox by terrorists ruled the roost. Although the disease was eliminated from nature in 1980, concern has focused on the fact that the Soviets and perhaps others had reproduced hundreds of tons of smallpox, plague and anthrax agents as well as carried out programs of genetic engineering to produce more deadly agents. The Soviet bioengineering program that extended from the 1960s for almost 40 years was by all accounts an enormous undertaking, employing well over 30,000 scientists.
Large stockpiles of disease agents were assembled and considered as part of a long-term biological weapons program.
In addition, the Soviets are reputed to have worked on ways of aerosolizing the plague bacteria so as to remove the need for the flea vector. Interestingly, given what is presently taking place in West Africa, one program also involved the mating of the smallpox and ebola viruses to produce a more virulent biological agent. At the time there was considerable concern about the security of such stockpiles, and the fear that some may have fallen into the hands of terrorists and rogue states.
The Soviets were not alone in such activities and in the 1960s the USA also assembled a large range of biological agents and carried out a number of simulated biological ‘attacks’ in a number of US cities.
By the early years of the 21st century, some observers believed that it was only a matter of time before terrorists managed to lay their hands on things like smallpox and utilize them in a bioterrorist attack. With such possibilities in mind, the US actually commenced a major program to try and vaccinate more than 400,000 civilian health care workers as well as 500,000 military personnel.
So is it now possible that terrorist groups have managed to obtain biological agents and that we are about to enter a new phase of biological weaponry? And if so, how likely is it that plague might be the weapon of choice?
Plague has been weaponised a number of times in history, whether it was by catapulting infected corpses over city walls or as in 1932 when the Japanese began a program of biological warfare against the Chinese population utilizing bubonic plague – by dropping infected fleas wrapped in cotton wool from aircraft onto crops, agricultural animals and villages and towns. As with smallpox, concern has been expressed that a terrorist organization could release an aerosol form of plague in a confined space causing significant mortality and immense panic.
Most of us think that plague is something from the distant past, but the reality is that today plague is more geographically widespread than at any time in history. Recently the WHO re-classified plague as a ‘re-emerging’ disease and every year there are of the order of 5,000 cases worldwide.
But could a terrorist group easily obtain plague so as to release it in a covert action?
Or indeed, could they lay their hands upon some of the ‘new’ biological strains developed by the Soviets? The answer to both questions is probably yes, and if they could obtain a virulent pneumonic form of plague then it would be relatively easy to release it in a shopping mall or railway station via the air conditioning system or in the bathrooms, or by aerial spray on a small town.
Imagine the human reaction that would sweep through our society at the mere hint of a plague case being discovered in an inner city shopping mall or at a transport hub.
One case would be enough to create an upsurge of fear, hysteria and panic. Untreated bubonic plague can produce a mortality rate in excess of 50% but quick diagnosis and appropriate treatment with antibiotics can substantially reduce this. Pneumonic plague is much more deadly and like influenza spreads by airborne droplets. An additional problem is that in the early stages the symptoms of plague closely resemble diseases like influenza; given that our GPs have probably never ever seen a case of plague would the medical response be quickly delivered?
Should such an event occur, communities would become traumatized by fear and panic. Witness, for example, the official Australian reaction to the threat of a covert smallpox incident following 9/11. The Commonwealth and States became consumed by the potential terrorist threat and produced a number of Counter Terrorism Plans as well moving to establish Response and Management structures. In 2004 the Australian Government actually produced a specific smallpox response plan and began to stockpile supplies of smallpox vaccine. For some it may have been an overreaction, but the advent of SARS and Avian/Swine Flu soon changed all that and people became exceedingly wary of infectious disease.
Are we currently looking at a replay of such events? There seems little doubt that the covert release of a biological agent whether in Syria, London or downtown Sydney would cause a tremendous wave of human reaction bordering on mass hysteria and panic. Such a reaction would totally overwhelm the actual number of cases and deaths caused by the disease.
Which is probably exactly what a terrorist group would plan on.
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