Germ bombs

We're a nation ripe for the infecting, authors say. And there's no easy defense.


Felt all right lately? Health fine, nothing to complain about? You’re ready for whatever flu and cold season might be holding just around the corner and you’ve got good medical coverage, just in case?

Yeah, like that’s going to help.

We hear about biological terrorism once in a while, usually in Hollywood films and television news’ what-if scenarios or from pundits wondering, for a few sound bites, whether it could happen here. Now it’s come up again, with the publication of a new book by Michael T. Osterholm and John Schwartz, which led to Osterholm’s recent appearance on “60 Minutes” and his mention in a major Boston Globe article last week.

According to Osterholm, an internationally recognized expert on infectious diseases, and Washington Post science reporter Schwartz, Americans should be a lot more worried about the possibility of biological attack than we ever were about nuclear bombs during the Cold War.

In Living Terrors, Osterholm and Schwartz outline the three biological weapons most likely to be used in (or against) the United States. From the once-thought-eradicated smallpox, to anthrax and food-borne diseases such as E. coli, the threat, they say, is more a matter of when than how.

Mixing fictional scenarios with hard facts, the authors flesh out the possibilities with believable characters and situations. A lone bioterrorist plans to dust a crowded sports stadium with microscopic anthrax spores. A disgruntled Russian expatriate unleashes freshly cultured smallpox virus on throngs of holiday shoppers. A misanthrope infects the population of an elementary school with E. coli.

The common message is that it could happen here. It could happen today. And you, no matter how well-prepared you might think you are, can do nothing about it.

Clearly, these scenarios make this book entertaining and pointedly bring home the idea that an attack with biological weapons is so simple it’s a wonder it hasn’t happened yet. But they also blur the boundaries between what is and what could be.

Without them, however, the book might be perceived as either too scientific or as an extremist report on the alarmist topic du jour. And that’s not the effect Osterholm, who has assessed the possibility of such epidemics for most of his career, is trying to create. Rather, he’s hoping to get us checking our pulses and feeling our foreheads in a healthy sort of worry, because if biological weapons are unleashed on this — or any other — country, we’re going to have a lot more worries indeed.

So, how likely are we to wake up with smallpox’s high fevers and characteristic pus-filled blisters? The disease, says Osterholm (in whose voice the book is written) might have been eradicated in the natural world, but it still exists in laboratories in the United States, the former Soviet Union, and probably also Iraq and North Korea. The U.S. government acknowledged this possibility in recent months by its decision to stockpile millions of doses of the smallpox vaccine for emergency military and civilian use.

Otherwise, should the virus fall into the wrong hands, Osterholm contends, we’re a nation ripe for the infecting. Smallpox killed about 500 million people during the 20th century, and is so infectious you can catch it from simply being in a room that someone with smallpox has recently occupied. To use this as a biological weapon is to be able to infect not just hundreds, but millions, with one act. And despite our anti-bacterial soaps and our daily echinacea-laced orange juice, we’ll be hit, and hard.

Ah, it can’t happen to me, you’re saying. I’ll admit that as I read, I reassured myself by touching the scar on my shoulder where I received a smallpox vaccine back in 1969, as part of the global effort to eradicate the disease. But then came Osterholm’s assertion that most of those vaccinations have likely worn off by now, leaving the world with reduced, or no, immunity.

It makes anthrax, which cannot be transmitted from person to person, seem much less terrifying. Until you think about how you can breathe in the microscopic bacteria’s spores, giving them someplace warm and moist to multiply without much apparent effect on you, until it finally produces so much toxin that you die within days. Or how you could be at the company buffet dinner, and like everyone else who chooses the pasta salad, you invite a nasty strain of E. coli into your body. You know how freaked out everyone gets when there’s a report of E. coli at a fast-food restaurant. Picture that on a national scale. The fear is as infectious as the diseases themselves, which of course makes them even more effective as terrorist weapons.

But according to Osterholm, we have good reason to worry here, too, especially when we consider whether our health care infrastructure is equipped to handle a widespread epidemic of diseases many doctors aren’t even able to readily diagnose. All the military and governmental efforts aren’t going to amount to much when it’s health care workers who will need to be most prepared.

And that’s why, on a national level, this kind of terrorism gets us where we’re most vulnerable: in our medical and health care systems. The military and government hold their own types of power, but the medical system is inadequate as it is. Until that, too, is shored up, we’re sure to find that, at the very least, bioterrorism is nothing to sneeze at.

Alisa Gordaneer is MT features editor. E-mail her at [email protected].

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