Chapter 78 Biochemical terrorism
Biochemical terrorism is defined as the use of biological or chemical agents to intimidate, incapacitate or eradicate crops, livestock, civilian and military personnel.1 It is well suited for attack by poorer nations against the rich, and is known as a poor man’s atom bomb, or asymmetric method of attack. The large scale use of mustard and nerve gases in the Iran/Iraq war,2 the dissemination of nerve gas sarin on the Tokyo underground,3 and the discovery by UN inspectors in Iraq of SCUD missiles, rockets and aerial bombs primed with Botulinum and aflatoxins4,5 have highlighted the need for planning.
CHARACTERISTICS OF BIOLOGICAL WEAPONS (TableS 78.1 and 78.2)
Intended target effects are due either to infection with disease-causing micro-organisms and other replicative entities, including viruses, fungi and prions, or to the toxins they elaborate. Their effects depend on the ability to multiply in the person, animal or plant attacked.6 Sequelae depend on host factors (state of nutrition, immunocompetence) and environment (sanitation, temperature, humidity, water quality, population density).7
Biological diseases | Chemical agents |
---|---|
Bacillus anthracis (anthrax) | Blisters/vesicants |
Clostridium botulinum toxin (botulism) | Distilled mustard (HD) |
Yersinia pestis (plague) | Lewsite (L) |
Variola major (smallpox) | Mustard gas (H) |
Francisella tularensis (tularaemia) | Nitrogen mustard (HN-2) |
Viral haemorrhagic fever | Phosgene oxime (CX) |
Coxiella burnetii (Q fever) | Blood |
Brucella melitensis (brucellosis) | Arsine (SA) |
Burkholderia mallei (glanders) | Cyanogen chloride (CK) |
Ricin toxin (Ricinus communis – castor beans) | Hydrogen chloride |
Staphylococcus enterotoxin B | Hydrogen cyanide (AC) |
Niaph virus | Choking/pulmonary damage |
Hantaviruses | Chlorine (CL) |
Nitrogen oxide (NO) | |
Phosgene (CG) | |
Nerve | |
Sarin (GF) | |
Soman (GD) | |
Tabun (GA) | |
VX | |
Incapacitating | |
LSD | |
Cannabinoids |
Assailant |
Target population |
Bioweapon |
CLASSIFICATION
ROUTES OF DISSEMINATION
DETECTION OF A BIOTERRORIST EVENT (Table 78.3)
This may be obvious if large numbers of military personnel become ill with similar syndromes, but any release is likely to be a covert event. Furthermore, genetic engineering may result in altered pathogenicity, incubation periods, clinical effects and response to treatment or immunisation.
SPECIFIC AGENTS
ANTHRAX
Anthrax8 is an acute infectious zoonosis caused by Bacillus anthracis, a Gram-positive, spore-forming bacillus. The infective dose is 8000–50 000 spores and routes of transmission include inhalation, ingestion and skin contact. Person-to-person transmission does not occur for the pulmonary form but secondary cutaneous lesions may occur after direct exposure to vesicle secretions. As spraying by aircraft is a potential threat to a large city, pulmonary exposure is the most likely route in a mass casualty situation.