March 2003

Below is a listing of bioterrorism-related events this month, part of an ongoing bioterrorism chronology that begins with Sep 11, 2001. To see events from other months, go to the Bioterrorism Watch index page.

Mar 31

Iraqi site suspected of housing biological toxin searched
US forces are searching a terrorist compound in northeastern Iraq where they believe militants made a biological toxin that later appeared in London, according to the Pentagon. US and British forces have secured the compound, which belongs to the group Ansar al-Islam, says Gen. Richard Myers, chairman of the Joints Chiefs of Staff. He describes the compound as a site "where Ansar al-Islam and al-Qaida had been working on poisons." "We think that's probably where the ricin that was found in London came from," he tells CNN's Late Edition. "At least the operatives and maybe some of the formulas came from this site." Myers says officials are examining laptop computers and documents left at the site.

House Democrats block smallpox vaccination compensation plan
Calling the proposal insufficient, house Democrats block a plan to create a compensation program for people who are disabled by or die from smallpox vaccine. Other opponents include labor and organizations representing healthcare workers. Creators of the proposal hoped to encourage reluctant emergency workers to be inoculated against smallpox by offering $262,100 if a person died or was totally disabled by the vaccine and up to that amount for lost wages over a lifetime. Democrats say the measure offers too little and recommend removing the cap on lost wages. They also object to a requirement that workers be vaccinated within 180 days of the program's start or forfeit their right to compensation. Republicans say they might try to bring the measure back for a vote later this week or include it in an emergency spending bill intended to pay for the war in Iraq and domestic security.

Mar 30

Swiss enter the smallpox prep arena
Switzerland steps up its bioterrorism preparedness efforts, with medical authorities on standby to set up vaccination centers throughout the country and disaster-relief volunteers taking part in a clinical trial for smallpox vaccine, reports swissinfo. Professor Robert Steffan, head of Zurich University's vaccination center says that despite the increased measures, there is no immediate threat of a bioterrorist attack involving smallpox. Switzerland possesses 3 million doses of smallpox vaccine produced between 1970 and 1980. Only the Vaccination Center in Zurich works on the smallpox vaccine. Volunteers have reacted well to trials and to diluted versions of the vaccine, authorities say.

Mar 28

People with risk factors for CAD to be excluded from smallpox vaccination program
The Advisory Committee on Immunization Practices (ACIP) recommends at an emergency meeting called by CDC that people with three or more major risk factors for cardiac disease, such as smoking, diabetes, high blood pressure, and high cholesterol, should be excluded from the smallpox vaccination program. The Institute of Medicine's committee on smallpox vaccination recommended yesterday suspending the immunization program due to unresolved questions about cardiac complications experienced by new vaccinees; Walter Orenstein, director of the CDC's national immunization program, dismissed that suggestion. Orenstein says that two-thirds of immunized healthcare workers have been older than 45 and that the current rate of heart problems is within the normal range for that age-group. During the CDC meeting, Col. John D. Grabenstein, deputy director of the Army's vaccination program, announces that a 55-year-old national guardsman vaccinated last week has died from a heart attack but says a relationship between his death and the vaccination is unlikely. (See CIDRAP News story.)

Need for more bioweapons labs debated
Arms control experts and scientists worry that a government plan to add at least three bioweapons labs would set a dangerous precedent by encouraging more microbiologists to train in bioterrorism. Some six universities and the New York State Department of Health are competing for contracts to build one or two labs. "It's perversely increasing the risk of exposure," says Richard Ebright, a Rutgers University chemistry professor and bioweapons expert, who says one new lab would suffice. Ebright and others fear that university-managed labs could offer less security than government facilities. Those competing for the government funds say that just two of the five US facilities equipped to do such work are functioning effectively, though they are overburdened. "What we have is not adequate to meet the current biodefense efforts," says Rona Hirschberg of the National Institute of Allergy and Infectious disease.

Cyanide-containing letter delivered to Auckland newspaper office
A New Zealand newspaper receives a cyanide-filled envelope, the third in a series of letters delivered to the newspaper threatening terrorist attacks on food or drink supplies. The envelope with two "similar" letters inside came to the New Zealand Herald in Auckland. All three letters, along with three others delivered to the British High Commission and to US and Australian embassies, were signed "September 11." Police say three of the letters contained cyanide paste or crystals, and several warned of a stockpile of 55 pounds of the poison to be used in attacks. Police say they have no new leads in the 6-week-old search for those responsible.

Mar 27

Iraqi WMDs will likely not be found, says expert
"US troops in Iraq will not find any facilities with weapons of mass destruction (WMD). I am sure of that," a former chemical and biological weapons expert of the UN Special Commission who remains informed about the recent UN arms inspection in Iraq tells Time Magazine. He adds that Baghdad "most likely" has shut down any WMD operations and that any munitions it could possess "are most likely" now in the field and being moved around the country. The former arms inspector, requesting anonymity, explains that "They [the weapons] could be in railroad cars, barges or refrigerator trucks. They are being kept on the move." He warns that the Pentagon should take care not to fall into an Iraqi trap, as the Iraqi Republican Guard units may try to create a battlefield situation with advancing US forces favorable to the use of weapons of mass destruction.

Administration weighs whether to get UN inspectors involved in Iraq again
Heated deliberations within the Bush administration focus on whether to ask the United Nations weapons inspection team to help expose Saddam Hussein's suspected arsenal of chemical, biological, or nuclear weapons, according to government and UN officials. The UN inspectors could provide expertise and help validate any findings that prove Iraq is hiding weapons of mass destruction. Opponents of such a plan distrust UN oversight after previous wrangling with chief weapons inspector Hans Blix, the officials say. One official engaged in the debate says that Bush officials "are desperate" to verify the charges that Iraq possesses weapons of mass destructionthe administration's primary justification for warbut unresolved about giving the UN an equal role in evaluating Iraqi weapons. American officials familiar with the debate say the disagreement lies between State Department officials, who favor UN involvement, and Pentagon officials, who want the US to operate the disarmament effort.

BioShield program scrutinized by lawmakers
US lawmakers question health secretary Tommy Thompson about the president's new BioShield proposal to encourage development of new diagnostic tests, vaccines, and treatments for potential bioterror weapons. The proposal calls for $5.6 billion in funding over the next 5 years to bolster government research and fund private development of bioterror "countermeasures" that the government would purchase. It also would give HHS authority to allow use of treatments or vaccines yet to be approved by the FDA should a national emergency occur. Republicans and Democrats at the hearing agree with the goal of augmenting bioterror preparedness, but some worry about its open-ended funding mechanism. Rep. Michael Bilirakis, R-Fla., questions tying the government to long-term contracts in such a rapidly changing field. Thompson says if the government learns of a better product after signing a contract, it would have to honor the first contract but would probably buy the better product as well.

NACCHO calculates costs of federal smallpox vaccination program
New research reveals the high cost of smallpox vaccination. The National Association of County and City Health Officials (NACCHO), working with nine diverse local public health agencies from January through March 2003, defines the costs of planning and implementing the federal government's smallpox vaccination program. The report indicates the agencies' actual and estimated costs range from $154 to $284 per person to implement the three key components of the program: community mobilization and preparation, vaccination clinics, and follow-up care and surveillance. Total costs ranged from $1,436 to vaccinate seven people to $944,957 to vaccinate 5,000 people. "The current level of federal bioterrorism preparedness funding to states is simply not enough to pay for this additional complex activity and continue the progress being made in protecting our communities from other bioterrorism and public health threats," says Patrick M. Libbey, executive director of NACCHO.

Study findings shed light on the vagaries of anthrax
Researchers learn why different strains of the bacterium that causes anthrax differ so much in virulence, a discovery that could help produce better vaccine and more effective tools for identifying and tracking the germ. Six scientists at Louisiana State University, the Lawrence Livermore National Laboratory, and the United States Army Medical Research Institute of Infectious Diseases made the discovery. Their findings, being published in the March 2003 issue of the Journal of Clinical Microbiology, stirred debate over whether the discovery should remain secret to prevent the creation of designer varieties of anthrax that could be deadlier to humans. Scientists previously identified 89 types of anthrax as genetically distinct but failed to find what determined their wide differences in virulence. Dr. Martin E. Hugh-Jones, an L.S.U. team member, says the discovery will help scientists understand why some anthrax vaccines are effective and others weak. "This will allow us to do some very impressive things in the coming on with new vaccines," he adds.

Mar 26

Second smallpox vaccinee dies of heart attack
A 57-year-old woman who was vaccinated for smallpox in late February dies, the second such case in recent days. The woman reportedly had a history of smoking and hypertension. She was hospitalized and released Mar 4 for exacerbation of chronic obstructive pulmonary disease and was hospitalized again March 16 after the heart attack. An investigation of a possible link between smallpox vaccination and adverse cardiac events is being carried out, and the CDC continues its recommendation, issued Mar 25, that persons with known heart disease not be vaccinated.

Anthrax vaccine study short on subjects
Scientists working on a government-sponsored study to help improve the effectiveness of the current anthrax vaccine are having difficulty enlisting volunteers. Researchers at the US Army's Walter Reed Institute of Research, Emory University, the University of AlabamaBirmingham, the Mayo Clinic, and the Baylor College of Medicine need 1,560 volunteers for a 43-month-long study, reports the Wall Street Journal. Volunteers ages 18 to 61 and in good health will receive six injections of the anthrax vaccine over an 18-month period, followed by 2 years of clinical visits and booster shots. The process involves various doses of the vaccine, or a placebo, and injections given in a variety of ways to test the effectiveness of different inoculation methods.

California botulism treatment program saved from budget axe
California Gov. Gray Davis reverses his decision to cut funding to a state program that produces the only safe botulism treatment for infants and thus plays an important role in combating bioterrorism. The program is developing a botulism antidote claimed by scientists to be the best available and the only safe treatment for infants. Dr. Stephen Arnon and his colleagues at the California Department of Health Services developed the experimental antidote. California has applied for FDA approval of the antidote but now must provide the agency with more data. Nevertheless, many doctors consider the experimental antidote safer to use than the approved antitoxin, which is made from the blood of vaccinated horses. Davis has yet to determine the level of funding he will propose for the program for the next fiscal year, according to a spokeswoman

Mar 25

Heart disease patients told to avoid smallpox vaccinations
Federal health officials recommend that people with heart disease avoid smallpox vaccinations after seven vaccinees experience heart problems. Three suffered heart attacks, one a Maryland hospital worker who died, and two experienced angina or chest pain. All of these patients had risk factors for heart disease before the vaccination, such as diabetes, obesity, hypertension, or tobacco use, says CDC Director Julie Gerberding in a press conference. "It could be entirely coincidental. . . . Coronary artery disease is a very common condition in our society." Two other patients experienced heart inflammation. Smallpox vaccine has not previously been associated with heart problems, but an investigation is under way. "I think we want to err on the side of safety," says Gerderding. (See CIDRAP News story.)

Concern grows over possible weaponized botulinum toxin
Federal officials express mounting concern that the country is both vulnerable to and incapable of responding to a terrorist attack involving botulinum toxin. "We are making this the highest priority," says Dr. Anthony Fauci of the National Institutes of Health. The toxin is the most poisonous natural substance on Earth and could be used to infect the nation's food supply. Experts say disseminating botulinum toxin would be relatively easy, requiring only basic microbiology skills. In 1995, Iraq told the United Nations that it had made more than 5,000 gallons of botulinum toxin and had loaded much of it into bombs and warheads. Inspectors believe Saddam Hussein has materials capable of producing twice as much. The nation's supply of antitoxin, made from the blood of vaccinated horses, is limited at present. Although that supply should be augmented later in the year. Research is also ongoing to genetically engineer antitoxin, but that would be long- rather than short-term solution.

GAO report points up need for US access to Russian nuclear/pathogen storage sites
Russia must allow more access to its storage sites for nuclear and biological material if a US program to keep these materials safe from terrorists is to succeed, says a General Accounting Office (GAO) report. Nearly two thirds of Russia's nuclear material and many sites storing dangerous pathogens once used in the country's bioweapons program may be poorly protected, says the report. The United States has spent $1.8 billion over the last decade to help Russia bolster security at the sites, but progress often has been thwarted because Russia continues to bar US officials from many of them.

Contact with smallpox-vaccinated healthcare workers big risk for NY state hospital patients, say researchers
More than half of all New York state hospital patients could be vulnerable to complications from contact with healthcare workers who have been vaccinated for smallpox, according to a research letter published in the current issue of the Journal of the American Medical Association. Authors Perry Smith and Hwa-Gan Chang of New York's health department and Kent Sepkowitz of Memorial Sloan-Kettering Cancer Center in New York warn of the need for strict adherence to safety guidelines published by the CDC for vaccinated healthcare workers. The researchers examined data on 2.4 million patients discharged from New York hospitals in 2001. Approximately 1.3 million of them had conditions that could put them at increased risk for contact vaccinia.

Mar 24

Supposed chemical weapons facility found by US troops in Iraq
US troops discover what some officials are calling a chemical weapons facility near Najaf, Iraq, according to reports. US Lieutenant-General John Abizaid says that captured Iraqi officers are being questioned about the 100-acre facility. Some Israeli and American news media are describing the facility as a "huge" chemical plant that may have been used to produce weapons. The Jerusalem Post says the sheet metallined complex appears to have been camouflaged to prevent it being photographed from the air. It is wrapped in sand-cast walls that look very much like the surrounding desert. One official tells ABC News that the captured officers could be a "gold mine" of information about production and location of weapons of mass destruction.

Found documents, captured Iraqi soldiers may point way to weapons of mass destruction
American military in Iraq are following leads gained from captured Iraqi soldiers related to possible chemical and biological weapons sites. American special operations have also found documents in western Iraq that could lead to the locations of banned weapons, says Gen. Richard Myers, chairman of the Joint Chiefs of Staff. Myers says US commandos found the papers along with a cache of millions of rounds of ammunition and that the discovery "might save thousands of lives if we can find out exactly where and what they have."

Oklahoma test checks radar's ability to detect chemical/biological agents
An Army bioterrorism test staged in Oklahoma is helping US Army and Environmental Protection Agency (EPA) scientists determine how well radar can detect chemical and biological agents released into the air. The test calls for a crop-duster plane to fly over the state dispersing a mixture of clay, water, and alcohol that mimic clouds of biological or chemical agents. The government initially scheduled the test for Feb 24, but residents of Goldsby, Okla., complained about the originally planned test materials, including powdered egg whites. Oklahoma is one of several sites selected by the EPA to conduct the test and was chosen because of the state's advanced weather radar system.

US lacks national system for tracking symptoms that could signal bioterror attack
The US is far from having a national system for tracking symptoms indicating a bioterror attack, according to healthcare leaders. Several local and regional detection systems and computerized reporting networks are being developed by medical informatics researchers to help health officials spot patterns of patient symptoms. But no national standards have been established for the technology, for collecting and analyzing data, or for choosing which data to analyze. Hospitals and state governments say lack of money and time are preventing the completion of such networks. Most face tight budgets with little room for advancing new projects. Additionally, doctors and nurses resist spending more time on data entry. "Unfortunately, unless a catastrophic event happens in their own backyard, or the feds step in and mandate the systems, those efforts will often be overlooked," says John Hummel, CIO at Sutter Health, which operates 33 California hospitals.

Mar 23

Details emerge about Al Qaida's biological/chemical weapons capabilities
Al Qaida operatives are close to production of and may have already manufactured some biological and chemical weapons, according to a newly obtained collection of evidence and interrogations conducted by the US government. The written reports suggest that the Al Qaida biochemical weapons program is much more advanced than US analysts suspected, say three people who have read the reports. Al Qaida's leaders completed plans and acquired materials to manufacture two biological agents, botulinum toxin and Salmonella, plus the chemical poison cyanide, according to the information. They are also close to a viable production plan for anthrax. The documents and the individual captured with them are currently disclosing important details about production plans. Most of the new information comes from handwritten documents and computer hard drives seized during the Mar 1 capture of Khalid Sheik Mohammed, an Al Qaida operational planner.

Elite team stands ready in Kuwait to analyze chemical/biological agents
An elite team of technicians prepare to track suspected Iraqi weapons-related sites, collecting samples of suspicious materials and analyzing them in mobile labs they have assembled in Northern Kuwait that are capable of analyzing a chemical or biological agent within hours with a 90% level of confidence. The team hopes to prove that Saddam Hussein has been hiding unconventional weapons. As the scientists and unconventional weapons experts wait to analyze samples they are sure will arrive, they are training and sampling the environment for traces of chemical or biological agents. Their quality-control testing protects the soldiers camped nearby and provides baseline information about the area.

Mar 22

Vials of white powder prompt closure of hospital area in Florida
A man carrying vials of an unknown white powder prompts the closure and decontamination of a Brooksville, Fla., hospital admissions area. The man entered the emergency department of Brooksville Regional Hospital and presented the powder, which he feared had caused a rash on his head. Brooksville police are not releasing the man's name but say he found a box containing the vials at a picnic area. He told police that he opened one vial and some powder splashed on him. Brooksville fire Capt. Tim Mossgrove, dressed in decontamination clothing, sprayed antibacterial agents on five peoplthe man carrying the powder, a security guard, two police officers and a firefighter. The vials have been sent to the state health department lab in Tampa for identification.

British GPs to receive training on detecting evidence of chemical/biological attack
Britain works to bolster its home defense by training hundreds of doctors to examine patients for early signs of a biological or chemical attack. But doctors are complaining that the Department of Health cannot succeed with the plan owing to its modest budget of less than 15,000 pounds to train staff from 300 primary care trusts throughout the country. About 50 public health experts will receive training from the Royal College of General Practitioners to teach GPs how to detect evidence of chemical or biological attack. Dr. Maureen Baker, the Royal College's honorary secretary, says the training offers a good start but warns that the country's 30,000 GPs need far better training on detecting civilian casualties. There has not been "sufficient attention focused on GPs and frontline professionals," she says.

California public health system reportedly disorganized and neglected
An independent oversight agency reviewing California's preparedness for a bioterrorism attack finds that the state's public health system is so disorganized and neglected that residents are as seriously threatened by an epidemic of the flu as they are by a biological attack. The Little Hoover Commission reports that 30 years of decline of the California health system has left the state open to disease outbreaks, new germ strains, hospital-acquired infections, and widespread poisoning. Health officials and experts interviewed by the agency say the network for tracking disease and treating mass illness or injury has "deteriorated to the point that lives are at risk," according to the draft report obtained by the Los Angeles Times. Some of the agency's findings highlight long-standing concerns about the public health system. New warnings include a call to create a new state Department of Public Health.

Papers assemble journalistic equivalent of first-responders
Concern about the possibility of chemical, biological, or radioactive-bomb attacks within the United States prompts news organizations to discuss how they would cover the aftermath of such an event. Several news organizations, including USA Today, The Washington Post, Newsday, and The Los Angeles Times, are assembling groups of reporters who are volunteering to act as the journalistic equivalent of first-responders. Other news organizations, including The Atlanta Journal-Constitution and The New York Times, say such an approach is too dangerous. "This presents a real dilemma for us because we have not had to cover this type of thing before," says Milton Coleman, deputy managing editor of The Washington Post. "We know we are not going to send reporters into a dangerous situation. We are not going to send people against their will."

Mar 21

PDAs to be tested as vehicle for disseminating emergency info to clinicians
HHS Secretary Tommy Thompson says his agency will test a new information system that utilizes handheld personal digital assistants (PDAs) to broadcast urgent information about biological agents to clinicians should an attack occur. The pilot program will assess how and when clinicians download the information and whether they find PDA notification useful. The test will evaluate the use of the system developed by ePocrates, the nation's largest physician handheld network, for sending an urgent "Doc Alert" message to more than 700,000 frontline clinicians, including more than 250,000 physicians. HHS' Agency for Healthcare Research and Quality will manage the pilot project and anticipates that it will complement the CDC's existing Health Alert Network.

Computer analysis predicts more dire consequences of anthrax attack than expected
A new computer analysis estimates that just more than 2 pounds of anthrax spores released over a city such as New York could kill more than 120,000 people unless state and federal officials respond much more aggressively than they currently plan to. The findings, published in the online version of the Proceedings of the National Academy of Sciences, conclude that health officials must rethink the current plan to distribute antibiotics only after an attack and predict that tens of thousands of lives could be saved if people could stock the drugs in their homes. The model, developed by three university researchers, uses medical details from the US anthrax attacks in 2001, data from the former Soviet Union's anthrax program, and the "queue theory," which lets researchers compare outcomes when products are distributed in various ways to people waiting in line. "The person in charge, whether it's the president or whoever, needs to push the button really quickly," says lead researcher Lawrence Wein of the Stanford Business School. (See CIDRAP News story.)

Iraqi means for delivering chemical/biological weapons limited, says expert
If Iraq uses its alleged chemical and biological agents, it would terrify civilians and unprepared soldiers but pose little threat to well-equipped troops. Such weapons would force soldiers to wear protective gear that merely slows them down. Iraq's ability to wage chemical and biological warfare against American and British forces depends on the agents it possess and the means of delivering them. Iraq could have sarin, VX, and large quantities of mustard gas. It also has had anthrax, botulinum toxin, and aflatoxin, according UN inspectors. But the means for delivering large quantities of such weapons appear to be limited, says Dr. Elisa D. Harris, a chemical and biological warfare expert who worked on the National Security Council during the Clinton administration. "It's hard for me to imagine they could carry out a large-scale artillery barrage because we would knock them out before they could be used," says Harris.

Mar 20

States to receive HHS money for further bioterrorism preparedness
US Health and Human Services (HHS) Secretary Tommy Thompson announces that $1.4 billion will go to states this year to help improve preparedness for potential bioterrorism. Of that amount, $870 million will bolster support for state public health agencies and $498 million will go to help improve hospital preparedness to handle acts of biological terrorism or other mass-casualty events. States must submit plans to HHS outlining their public health and hospital preparedness activities in order to receive the additional funding. Additionally, states can quickly receive up to 20% of their fiscal 2003 funding to support current public health activities, such as smallpox vaccination for emergency responders, according to the department release. "Once again, we are rapidly getting federal funding for public health preparedness into the hands of our states and hospitals," Thompson says. (See CIDRAP News story.)

Squeeze put on Iraqi scientists and intelligence agents
Iraqi scientists and intelligence agents, faced with threats that their failure to cooperate with US and allied intelligence could mean distasteful consequences, are producing potentially valuable information about Iraq's biological and chemical weapons programs. Intelligence services are contacting Iraqi operatives in foreign capitals and presenting them with a harsh choice"they could either 'turn' [switch sides]," says one official, or be expelled back to Iraq "to enjoy your very short stay in Baghdad." Another official with access to written accounts of the conversations says the Iraqis have learned that when the United States sorts friends and enemies after toppling President Saddam Hussein, "They'll be putting themselves and their families at the mercy of the new Iraqi government." The Defense Department is currently pursuing new leads from 60 friendly governments who have been asked to expel alleged Iraqi intelligence operatives living abroad under diplomatic or commercial cover.

Ricin found in French train station locker
French police officers discover a small quantity of the poison ricin in a locker at the Gare de Lyon train station, says the French Interior Ministry. Officers searching the locker found "two vials with a powder, a bottle filled with a liquid, and two smaller bottles also containing a liquid," the ministry says. The two smaller bottles, contained "traces of ricin in a mixture that turned out to be a very toxic poison," they add. French officials say they see no immediate link between the ricin discovery and the outbreak of the war in Iraq.

Mar 19

Feds issue report on food security and seek some changes
A report from the General Accounting Office (GAO) says the nation's food supply is in danger of terrorist attacks, partly due to the government's inability to ensure the security of processing plants. The US Department of Agriculture (USDA) is telling food companies, retailers, and farmers to increase security, and the Food and Drug Administration (FDA) is publishing further security advice to food companies. Congressional auditors say the risk of an attack could be lowered if food companies were forced to detail their security plans. Currently, companies volunteer that information and say that forcing them to make their plans public would make them more, not less, susceptible to terrorist attacks. (See CIDRAP News story.)

Conference focuses on lack of planning for care of children in bioterrorist attack
With war now imminent, "it's a matter of national urgency that we move as quickly as possible to protect our children," says Dr. Irwin Redlener, a member of the task force on terrorism of the American Academy of Pediatrics, at the Pediatric Preparedness for Disasters and Terrorism conference in Washington. Although planning for care of children in the event of an attack has improved, the experts say actual preparedness is hardly better than it was before the Sep. 11, 2001, attacks. Major problems include lack of specialized paramedic training and lack of standardized pediatric doses or distribution methods for medicines to counter chemical, biological, or radiological exposures. With few American models of mass deaths of children available, experts often look to Israel, where health officials have had to deal with youngsters killed in bombings and other terrorist activity.

Study finds that large number of Americans expect terrorist attack
A study by the Opinion Research Corporation finds that 55% of American adults expect a terrorist attack involving nuclear or biological weapons in the United States within the next 10 years. The study, which included all major demographic subgroups, reported consistent viewpoints throughout the country. The survey also reveals that 37% of Americans expect the United States will wage a nuclear war with another country in the next 10 years. Women are more likely than men to anticipate such a conflict: 42% vs 31%. The terrorism study encompassed a nationally representative sample of 1,041 adults from Feb 7-10, 2003.

Top NSC antiterrorism official resigns
Randy Beers, the top National Security Council official in the war on terror, resigns amidst concerns that war with Iraq would compromise antiterrorism efforts, according to a United Press International report. Beers claims his resignation is not a protest against an invasion of Iraq. "Hardly a surprise," says a former intelligence official of Beers' departure. "We have sacrificed a war on terror for a war with Iraq.This just reflects the widespread thought that the war on terror is being set aside for the war with Iraq at the expense of our military and intelligence resources and the relationships with our allies." Beers joined the NSC in August after heading the State Department's International Narcotics and Law Enforcement branch.

Spike in antibiotic prescriptions after 9-11 tracked
New data reveals that thousands of Americans rushed to fill antibiotic prescriptions following the anthrax letter attacks in 2001, according to government researchers. US Food and Drug Administration researchers say that information from IMS Health, a drug prescription tracking company, indicates that people who had no business getting antibiotics managed to get them. The records show a big surge in prescriptions for ciprofloxacin and doxycycline in October 200140% and 30% increases, respectively, over figures for the same time in 2000. The increase totaled 160,000 extra prescriptions of ciprofloxacin and 96,000 of doxycycline. All other antibiotic use remained typical for that period of time.

Second worker vaccinated for smallpox in Virginia shows symptoms
A second Virginia healthcare worker has developed a mild illness following a smallpox vaccination, according to health officials. The person experienced a headache, fatigue, blisters in the mouth, and a mild face rash days after receiving the vaccine. The case is under investigation, and health officials say they do not yet know if the worker's symptoms were related to the vaccine.

Henderson reduces time advising HHS
Dr. Donald A. Henderson decides to significantly reduce the time he spends as a principal bioterrorism adviser to HHS. Known for his worldwide campaign to eradicate smallpox, Henderson has been helping the Bush administration plan smallpox inoculations as a defense against biological warfare. He originally agreed to stay on the job for 6 months but has remained more than 18 months because of "the seriousness of the threat and the magnitude of the task." In his letter to the HHS, he says, "We have recruited an outstanding team but we all recognize that it [the number of vaccinations] is still substantially below the numbers needed." An HHS spokesman, Bill Pierce, emphasizes that Henderson has not resigned and will continue to chair an advisory committee on public health preparedness.

Thumbs up in Senate for Bush's biowarfare defense plan, thumbs down for his smallpox compensation plan
A Senate committee unanimously approves President Bush's proposal to strengthen the nation's defense against biological warfare but disagrees on his plan to compensate people injured by the smallpox vaccine. Senate majority leader Bill Frist of Tennessee expresses frustration over the delays and says the smallpox compensation program "responds to an urgent national security need." Sen. Edward M. Kennedy (D-Mass.) says the Republicans are offering too little by limiting payments for a death or permanent total disability to $262,100. The maximum payment for cases of temporary disability would be $50,000 for wages lost.

Mar 18

Israel citizens instructed how to seal rooms, use gas masks
Israel's hospitals and health maintenance organizations begin preparations to seal rooms in every medical facility following instructions from the country's Home Front Command. Citizens are also receiving orders to seal a room in their houses. Simultaneously, the Home Front Command has begun broadcasting information in several languages on how to prepare sealed rooms and how to use gas mask kits. Defense Minister Shaul Mofaz says that despite the new orders to seal rooms, the army has no new intelligence suggesting pending missile attacks on Israel. He says that sealing the rooms simply amounts to another step intended to give Israeli citizens maximum protection, and he advises the public to continue its normal routine unless told otherwise.

IOM report points out the work to be done against infectious disease
The United States should lead the way in the global effort to stave off infectious diseases, according to a US Institute of Medicine panel report on microbial threats. The panel further says that US efforts to prepare for a biological terrorist attack could offer an unprecedented opportunity to help public health systems prepare for infectious disease outbreaks. Yet large concerns remain. "The United States has taken important steps," says panel leader Margaret Hamburg, but "The present reality is that we are unprepared. . . . We still have not done enough in our defense and in the defense of others." James Hughes, chief of the infectious diseases unit at the CDC, says "[Current] experience with severe acute respiratory syndrome is just the most recent wake-up call." (See CIDRAP News story.)

Specialized team, personnel sent to find weapons of mass destruction in Iraq
Mobile labs, specialized intelligence teams, and disarmament experts head for Kuwait to help the military uncover weapons of mass destruction in Iraq. US defense officials are also tapping former international weapons inspectors to help find, secure, and ultimately destroy stocks of chemical, biological, and other unconventional weapons the administration alleges Saddam Hussein is hiding. The Pentagon has deployed several new tactical units called mobile exploitation teams, or METs, equipped with state-of-the-art equipment and novel tactics to locate and study at least 130 and up to 1,400 possible unconventional weapons sites. The military also plans to locate and interview hundreds of Iraqi scientists acquainted with Hussein's weapons programs. Administration officials hope to secure any illegal weapons before Hussein sends them out of the country or sells them to other rogue nations or terrorist groups.

Mar 17

Kurds to receive smallpox vaccine from Britain
Kurdish authorities in northern Iraq are awaiting a shipment of smallpox vaccine from Britain, due to arrive within the next few days, to inoculate medical personnel. The Kurds say they have repeatedly appealed to Western governments for medicine and gas masks to cope with a possible Iraqi attack with chemical or biological weapons. They say the fact that they have yet to vaccinate their healthcare workers underscores northern Iraq's vulnerability.

Australia's preparation for potential smallpox in low gear
Australia's bioterror experts advise against a mass smallpox vaccination campaign, describing a biological attack on Australia as a "phantom threat" and the chances of an attack as "extremely low" to "negligible." Australia possesses 50,000 doses of smallpox vaccine to use selectively in the event of an outbreak. Vaccinating frontline health personnel remains under consideration by the government. Dr. Richard Lawrence, an infectious disease specialist at St. George Hospital, says the risks of Australia engaging in a mass smallpox vaccination program like that in the US outweighs the benefits. Lawrence adds that he will not be vaccinated, even though he would likely be on the front line if a bioterrorist attack were to occur.

Mar 16

Turkey considers its smallpox preparedness
Reports that Iraq could use the smallpox virus in an attack against Turkey are creating widespread concerns in that country. Turkey stopped vaccinating school children against the illness in 1980. According to the Health Ministry, the country has no ready-to-use vaccination against smallpox, but three Turkish companies have submitted bids to start vaccine production. In the meantime, an advisory board met to review the precautionary measures to be taken against any epidemic diseases that could emerge in connection with a war in Iraq. The board advises against mass vaccination against smallpox.

Air purifiers join plastic and tape on bioterrorism preparedness shopping list
The Department of Homeland Security's Ready.gov Web site recommends buying a portable air purifier to help prepare for a potential bioterror attack. People with asthma or allergies are the typical users of the devices, but experts say they might help clear the air of harmful agents for others as well. Richard L. Garwin, a senior fellow for science and technology at the Council on Foreign Relations, estimates that a typical room air cleaner could reduce the number of microbes in the air by 83%. Plastic sheeting over air vents offers further protection. "Generally speaking, filtration is a very effective means of protecting against chemical and biological threats," says Michael C. Janus, of Battelle Memorial Institute, a research and development firm that has supervised the installation of air protection measures for the Department of Defense and the Department of Justice. Janus says the consumer-grade, portable air filters sold in hardware stores would provide a "moderate level" of protection.

Mar 15

Agents used in Iraq's biological weapons programs came from US and France
Iraq identifies American and French suppliers as its sources for all the foreign germ samples it has used to develop the country's biological weapons, according to American and foreign officials acquainted with Iraq's latest weapons declaration to the United Nations. The American Type Culture Collection of Manassas, Va., and the Pasteur Institute in Paris were exclusive suppliers in the 1980s, according to the declaration. The New York Times received a copy of the section of the Iraqi declaration dealing with biological weapons and reports that the American and French supply houses sent 17 types of biological agents, including anthrax and the bacteria used to make botulinum toxin, to Iraq in the 1980s for use in their weapons program. It also documents that Iraq tried unsuccessfully to obtain biological agents in the late 1980s from other supply houses around the world.

Ohio struggles over legislation on confidentiality of health department investigations
The Ohio senate passes a bill enlarging the state health department's power to keep its investigations confidential, prompting concerns about the public's right to know about imminent health threats. The controversial legislation aims to give state health officials the necessary weapons it needs to fight a bioterrorist attack. The American Civil Liberties Union worries that the bill allows for too much authority to keep investigations secret. The Ohio Roundtable, a public policy research group, questions whether the health department's authority to release information such as a medical report that could identify an individual patient violates patients' rights. The bill now moves to the Ohio House, where criticism will likely ensue.

Mar 14

After a war, what will happen to biological/chemical weapons and their makers?
Concern over the use of Iraqi chemical and biological weapons against the United States must include an awareness of the potential spread of these weapons and the knowledge that built them to other rogue states and terrorists during and after a war, according to a Washington Post report by Jonathan B. Tucker. Hundreds of Iraqi scientists who helped develop the weapons still live in Iraq. Without a plan for avoiding the dissemination of these scientists and their wares after Saddam Hussein's fall, an invasion of Iraq could actually promote the proliferation of weapons of mass destruction. The weapons are likely now controlled by two security services loyal to Hussein, says Tucker, a fellow at the United States Institute of Peace and former UN biological weapons inspector. According to Tucker, the Bush administration must develop measures to protect cooperative Iraqi security services, to promote immediate action from UN inspectors, and to offer Iraqi weapons scientists employment opportunities.

Mass evacuation of Washington area not considered doable
Evacuation planners for the Washington area determine that the region's road and transit network, which can barely withstand the pressure of a normal rush hour, simply could not handle a mass evacuation. So emergency planners will now mount a campaign telling people that unless they are in the immediate vicinity of an attack, they should not flee but rather should wait for instructions. "The first instinct should not be to pile into your car, because you're not going to go anywhere," David Snyder, chairman of the emergency transportation work group of the Metropolitan Washington Council of Governments, told the Washington Post. "All you'd do is potentially harm yourself and jeopardize other people who need to respond to the incident or get out of the area." For most people, planners say the message would be "shelter in place," although authorities must now try to build public confidence in the emergency instructions.

Software allows calculation of weaponized agents' destructive impact in specific areas
Computer modeling indicates that a relatively small release of anthrax under certain conditions over Kuwait City or Baghdad could sicken hundreds of thousands of people. Calculations using software developed for the Pentagon and performed by the Natural Resources Defense Council (NRDC) modeled a number of potential weapons of mass destruction scenarios in a US-led war on Iraq. The scenarios also included a range of Iraqi chemical weapons attacks against Tel Aviv and Riyadh, Saudi Arabia, and US nuclear retaliatory attacks on Baghdad and on Saddam Hussein's home city of Tikrit. Depending on the scenario, the most devastating casualties might occur from an anthrax release. This could result from an Iraqi attack or by an accidental release caused by US forces bombing an unknown stockpile, according to Matthew McKinzie, the NRDC analyst who modeled the scenarios.

Mar 13

ACHE survey shows hospitals far better prepared for bioterror since 9/11
A survey conducted by the American College of Healthcare Executives (ACHE), shows that 84% of hospital CEOs agree that since 9/11, their hospitals have worked more closely with fire, police, and public health departments to prepare for potential bioterror attacks. Of the respondents, 95% say their hospitals already have, or within 6 months will have, a bioterrorism disaster plan in place developed in coordination with local emergency and/or health agencies. ACHE asked more than 700 hospital CEOs across the country to report on the status of their programs related to bioterrorism preparedness. Further responses showed that 85% of hospitals are already working with other hospitals or hospital associations to identify available resources for responding to bioterrorism, 60% have decontamination units, and 69% are believed to have become safer places since 9/11.

Disaster training institute to open in Washington area
George Washington University, Washington, DC, officials say they will open a training center for major disasters on its Loudoun County campus this spring. The courses for traditional first-responders from the Washington area will cover all types of large-scale emergencies, including terrorist attacks. Congress is providing $5 million to launch the Response to Emergencies and Disasters Institute, which will draw on training expertise from Shenandoah and George Mason universities as well as George Washington University. Courses initially will be offered to firefighters, police, and paramedics but later will include public health officials, physicians, and nurses and eventually veterinarians, public works officers, and transportation officials.

Mar 12

New laboratory security may stifle research
A new federal rule aimed at tightening security at US laboratories requires thousands of reputable scientists working with potential bioterror agents to submit their fingerprints and personal information to the FBI for background checks. Some say the measure could destroy the atmosphere of scientific openness that has helped the United States excel in research, including bioterror defense. "Many of us believe the most important measure we can take to prevent harm from terrorist attacks is to maintain our technical and intellectual brain trust," says M.R.C. Greenwood, chancellor of the University of California, Santa Cruz. The new rules forbid citizens of Iraq, Iran, North Korea, and other countries suspected of supporting terrorism from handling some 60 biological agents. Others barred from working with "select agents" include those with a history of mental illness, illegal drug use, felony convictions, or dishonorable discharges from the military. The FBI will complete its background checks in June.

Cuba again denies carrying on biological weapons research
Cuba counters US charges that it is conducting biological weapons research by inviting science journalists to visit Havana's Center for Genetic Engineering and Biotechnology, Public Radio International's program The World reports. "It would be nonsense on our side to produce biological weapons. . . . That's nonsense, nonsense," says Cuban researcher Sergio Pastrana. The tour follows an October visit led by Bruce Blair from the Center for Defense Information in Washington. Blair says Cuba let him choose nine facilities to inspect with his team of security, tropical disease, and other experts. They could "look into every nook and cranny," Blair says. "Our impressions clearly were that the United States at least doesn't really have a very good idea of what's going on first of all, that we're operating pretty much in the dark about many of these facilities, which struck us as doing legitimate research and production of pharmaceuticals."

Iraqi drone looks incapable of spreading airborne agents
A remotely controlled Iraqi aircraft that Secretary of State Colin Powell alleges could spread chemical weapons appears to be constructed of wood, tape, and engines that resemble those of a weed whacker. Maintaining that it "should be of concern to everybody," Powell says the drone could be equipped to dispense chemical and biological weapons. The aircraft's project director Brig. Gen. Imad Abdul Latif claims the United States has been misleading the UN Security Council and the public about the aircraft, which has only a 24.5-foot wingspan and two small propellers. Latif says the plane is controlled by the naked eye from the ground and could not be operated from more than 5 miles.

Limited lab space likely to slow research on bioterror vaccines
Without more highly secure laboratories for testing vaccines and drugs to help protect from bioterrorism, such protection could soon see big delays, say scientists at the National Institutes of Health. The Washington Post reports that John La Montagne, deputy director of the National Institute of Allergy and Infectious Diseases, estimates the delays could occur within 18 months. "We're trying to work with what we've got," La Montagne says. "But eventually it's going to be extremely critical. There's a lot of money going into research in this area, and this will generate a lot of ideas that must be evaluated and tested." Experiments with the most lethal disease organisms must be conducted within biosafety level 4, or BSL-4, labs. Federal funding for 2003 will cover two new BSL-4 labs, in Maryland and Montana, but neither will open for 3 years. The four existing US BSL-4 labs offer too little space.

Small communities shouldn't be forgotten in preparedness efforts, says JCAHO
The government has left small American communities behind in its planning for potential terrorism, says a report released by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO). "This is really a major problem waiting to happen," says Dr. Dennis O'Leary, president of JCAHO. The commission monitors nearly 17,000 healthcare organizations and based its report on a roundtable involving emergency preparedness officials. The report urges communities to involve local agencies including hospitals, police, fire, public health, and mental health officials in their preparation initiatives. Plans should include drills, stockpiling medications and supplies, and giving caregivers priority for training, protective equipment, vaccinations, and other protective measures.

Mar 10

New anthrax vaccine to enter human testing phase
Vical Inc., a San Diego biopharmaceutical company, announces it will begin testing its newly developed vaccine against Bacillus anthracis (anthrax) in humans. The company has tested the vaccine in rabbits and reports that it verified protection against inhalation anthrax. Vical has now met with the USDA and plans to begin human testing of the vaccine by the end of this year. The company says test results showed that the vaccine triggered an immune system response in rabbits equal to or greater than the standard vaccine currently used.

NIH supports study of drug to protect immunocompromised patients against smallpox vaccine
EluSys Therapeutics, Inc., of Pine Brook, N.J., receives a $1.2 million grant from the National Institutes for Health (NIH) to develop a drug to protect people at risk for serious complications from the smallpox vaccine. "For people with compromised immune systems, the vaccine could be as dangerous as smallpox itself," says Stephen Sudovar, president and CEO of EluSys. "The EluSys heteropolymer offers hope that we can protect people who cannot receive the smallpox vaccine and who are at risk of being near others who receive it." The 2-year NIH grant will help EluSys identify and study in mice at least one drug as a candidate for studies against vaccinia complications in immunocompromised primates.

Diversion of funds to federal smallpox vaccination program hurts other local public health programs
State and local health officials throughout the country say the federal smallpox vaccination campaign has forced them to stop virtually all other counter-terrorism initiatives and in many cases cut services such as prenatal care, AIDS prevention, water testing, and tuberculosis tracking. "It's been disruptive," says Patrick Lenihan, deputy commissioner of the Chicago Public Health Department and president of the National Association of County and City Health Officials, tells the Washington Post. "People who were doing routine health activities six months ago, like taking blood pressures and assessing diabetes, are now spending time preparing for smallpox vaccination and treatment." Michael Osterholm, director of the University of Minnesota's CIDRAP, publisher of this column, says public health departments typically shift staff and priorities during times of crisis. CDC officials sympathize with their local colleagues, stating that almost all members of the CDC's immunization division are assigned to the smallpox program, says director Walter Orenstein.

Mar 9

Iraq rockets capable of dispersing biological/chemical agents found
United Nations weapons inspectors working in Iraq recently found retooled rockets capable of dropping bomblets loaded with chemical or biological agents, according to US officials. Initially Iraq told inspectors the rocket warheads were designed as conventional cluster bombs and not as chemical weapons, reports the New York Times. Eventually, the Iraqis admitted that some might have been designed as chemical weapons, an American official says. The rockets' distinctive appearance, with heavy metal balls with holes in them, point to their potential use for dispersing chemical or biological weapons, according to the official. "If you take the kinds of fuses we know they have, and you screw them in there, when these things come out from the mainframe and they explode inward, chemical agents come out," he says. The rocket warheads appear to be cobbled together from Iraq's stockpiles of imported or home-build weapons.

Mar 7

Three protections needed for smallpox vaccinees, say public health groups
Public health groups, including the American Public Health Association, the Association of State and Territorial Health Officials, and the National Association of County and City Health Officials, are urging legislative action to protect the interests of smallpox vaccination volunteers and state and local preparedness programs. The groups stress three specific needs: a national smallpox vaccine compensation program to compensate health workers injured as a result of the smallpox vaccine, additional liability provisions to furnish necessary protection from costly legal action for organizations and individuals who take part in the vaccination program, and new federal funding to help pay for state and local smallpox preparedness initiatives.

Mar 6

Federal money to help schools plan for emergencies including bioterrorism
Federal efforts are under way to protect the nation's schools from possible terrorist attacks, reports the New York Times. The initiative includes $60 million to support school districts in their efforts to design response and evacuation plans for emergencies including chemical or biological attacks, administration officials say. They say the program, about to be made public by the Departments of Homeland Security and Education, does not mean the government believes schools face a specific terrorist threat. Instead, the new model advocates that schools make a plan that "addresses traditional crises and emergencies such as fires, school shootings, and accidents as well as biological, radiological, chemical, and other terrorist activities." It further recommends that schools conduct safety reviews of their buildings, including proximity "to rail tracks that regularly transport hazardous materials or facilities that produce highly toxic material."

Infection develops in two close contacts of military smallpox vaccinees
Two women in close contact with soldiers recently vaccinated against smallpox develop infections. Both women are expected to recover with no permanent scars. A 26-year-old woman from the Los Angeles area who slept in the same bed several times a week with a man vaccinated in the military's program was hospitalized and treated with vaccine immune globulin, according to the CDC. The agency reports that the man seldom covered his vaccination site. The second case involves an 18-year-old woman who developed lesions on her arms and swelling in her eye after handling the bandage of a man vaccinated in the military program. The cases, both considered preventable, are among three moderate-to-severe reactions among civilians resulting from smallpox vaccinations.

Nurses welcome smallpox vaccination compensation plan but say it's not enough
The American Nurses Association (ANA) says a legislative proposal concerning compensation for healthcare workers who suffer side effects from the government's smallpox vaccination program is welcome but fails to resolve all their worries. "The HHS proposal demonstrates that the administration recognizes a problem exists; however, it falls short of addressing the range of issues that ANA is concerned about," says Barbara A. Blakeney, MS, APRN, BC, ANP. "This compensation plan is solely focused on worst-case scenarios and does nothing to address the more common scenarios where individuals experience side effects that would cause them to lose less than five days of work," she says. "Many of the critical safety issue questions are not addressed in the HHS plan."

Federal efforts aim at shoring up smallpox vaccination program
The Bush administration augments its national smallpox vaccination plan by adding several hundred federal health workers to the list of individuals to whom the vaccine is available, officials say. The administration also plans to give states permission to speed up vaccinations for emergency responders "to make sure we have enough people prepared" for a smallpox attack, says HHS Secretary Tommy Thompson. "Smallpox is a disease that our public health experts fear so much, because it is so contagious and it can spread so quickly and it is so deadly," he adds.

Mar 5

Federal compensation package for smallpox vaccination injury announced
The Bush administration announces a limited compensation package for public health and emergency medical responders made ill by the smallpox vaccine. The proposal, drafted by HHS and the White House, states that individuals who die or suffer a permanent disability would be eligible for $262,100 in benefits. Lost wages due to temporary or minor illness would be capped at $50,000 and paid only after a person missed 5 days of work. The same benefits would cover a hospital patient or family member made ill after contact with an inoculated healthcare worker. If approved by Congress, the payment plan would apply to the 500,000 medical personnel in the first phase of the vaccine program and as many as 10 million rescue workers who would be inoculated in the second phase. One administration official estimates that the compensation program could cost $20 million to $30 million.

Connecticut public health officials may be given wide power in case of terrorist attack
Proposed legislation in Connecticut giving expansive powers to public health officials in case of a health crisis would forcibly quarantine state residents exposed to pathogens such as smallpox in a terrorist attack. Under the bill, people who contract a dangerously contagious disease would be isolated in a place such as a mobile hospital. Those who have contact with an infected person could be forcibly quarantined in public facilities or in their homes. People who are morally or religiously opposed to vaccinations could refuse the inoculation, but they too would be quarantined in a facility until they no longer posed a health threat to the community. Connecticut public health officials say they need broad powers to manage the consequences of a terrorist attack. Local health directors say they have no money to set up clinics to vaccinate 3.4 million state residents in case of a smallpox outbreak.

Vaccinated Virginia healthcare worker hospitalized
A healthcare worker becomes ill and enters a hospital for observation after receiving a smallpox vaccination in Virginia's emergency preparedness program, according to the state health department. The unidentified woman developed a low-grade fever and headache 9 days after receiving the voluntary vaccination on Feb 19, says department spokeswoman Trina H. Lee. After a mild rash appeared on her face and chest, the woman's physician admitted her to an undisclosed Virginia hospital. Lee says the patient was one of the 161 public health workers and 59 hospital personnel who received the vaccine. The CDC has been notified of the woman's case and will perform further tests to determine conclusively whether her symptoms were caused by the smallpox vaccination, Lee says.

Mar 4

Brentwood postal facility anthrax-free, summer reopening planned
Washington's Brentwood postal facility is anthrax-free, according to the US Postal Service. The 17.5 million cubic foot facility, which processes mail for all Washington-area federal agencies and Congress, has been fully decontaminated and should reopen in the coming summer. A team of safety, health, and environmental experts reviewed more than 5,000 environmental samples taken in the building after it was decontaminated last December. The samples showed no sign of anthrax. Postal Service executives and managers now must prepare more than 2,000 workers to return to the building where two of their colleagues died from anthrax exposure.

SF General Hospital virtually bars smallpox vaccinations
Concerns about patient safety prompt San Francisco General Hospital to virtually bar hospital personnel from getting immunized. Dr. Susan Fernyak, director of communicable disease prevention and smallpox planning for the San Francisco Department of Public Health, says the restrictive vaccination policy is intended to protect patients with weakened immunity. "We didn't want anyone who is vaccinated, and still infectious, to be working with patients directly," she says. "We have a high number of patients with HIV, with certain skin conditions, with cancer, with transplanted organs or who are taking immunosuppressive agents." Under the policy, city healthcare workers with "direct contact" with patients are forbidden to receive the vaccine unless they can find a way to avoid patients for 2 to 4 weeks, or until the vaccine blister is no longer infectious. Fernyak says nurse shortages and tight budgets prohibit such extended absences.

Withholding smallpox vaccinees' names raises ethical questions in Ohio
The Ohio Department of Health chooses to withhold the names of hospitals and healthcare workers who participate the state's upcoming smallpox vaccination program. Health Department officials say the secrecy is intended to prevent terrorists from knowing who has been vaccinated, so they could not target hospitals with nonvaccinated personnel. Medical ethics experts worry that patients, including patients with weakened immune systems, also would not know which medical workers have been vaccinated. "It's not clear to me, if you're making an ethical argument, that national security trumps the right of the patient to know that the hospital they are going to is part of the vaccination program against smallpox," says Holly Taylor, a professor of bioethics at Johns Hopkins University's Bloomberg School of Public Health. A hospital is a very unlikely target, according to Taylor and other medical ethicists who don't see how keeping vaccination plans secret relates to national security.

Mar 3

Britain to hold catastrophic-event drill
Britain announces it will bolster its terrorism preparedness plans by simulating a "catastrophic incident" in London. Offering no specific date, Home Secretary David Blunkett says the exercise will take place soon. "Future planned exercises will cover a catastrophic incident in central London, disruption to the national gas supply and flood defenses," Blunkett says in a statement. "The program is expected to cover 11 key capabilities such as mass evacuation and decontamination," he adds. The announcement coincides with the BBC quoting a senior government advisor who contends that Britain is not equipped to cope with a smallpox attack. Prime Minister Tony Blair's official spokesman refutes the report, saying, "We do have strategic stocks of vaccine that could be rapidly deployed to contain an outbreak."

Mosquitoes in bioterrorism? Conference discusses possibility
Some 600 scientists and government officials begin a 6-day conference in Minneapolis on how to control mosquitoes and prevent West Nile virus outbreaks as well as to discuss the potential for use of mosquitoes in bioterrorism. Speaking about West Nile, Roger Nasci, a research entomologist in the Fort Collins, Colo., CDC office, says, "It's just an amazing story of an invasion." West Nile is here to stay, and other diseases are likely to follow, according to Michael Osterholm, director of the CIDRAP at the University of Minnesota, publisher of this Web site. A more mobile world allows "fast and furiously" transporting exotic products, animals, and bugs from one continent to another, he says. The result is an increased chance of spreading more mosquito-borne diseases, such as yellow fever, dengue fever, malaria, encephalitis, and Rift Valley fever. Participants at the 69th annual meeting of the American Mosquito Control Association also plan to assess the threat of using mosquitoes to spread bioterrorism agents.

Multiple protective suits available for soldiers
Army ground forces deployed near Iraq have the newest generation of chemical and biological protective suits, according to the Army's top officers in charge of combating chemical and biological weapons. Each soldier possesses two suits, and each marine has three, the officers say. The suits, known as Joint Service Lightweight Integrated Suit Technology, are effective in the field for 45 days, but when exposed to chemical or biological agents must be replaced after 24 hours. Two additional suits for each soldier and marine are stored in regional warehouses. Older protective uniforms, called Battle Dress Overgarments, are available as backup. Each has been inspected to ensure it is free of defects, the senior officers say.

Genetic immune disorder a special risk in bioterror attack
Children with a genetic immune disorder called primary immunodeficiency (PI) would face extremely high risk from a bioterrorism attack, according to child health experts. "Regardless of the agent we're talking about, these kids are more vulnerable," says Dr. Allan Lock, director of the developmental immunology program at the National Institute of Child Health and Human Development. Some 500,000 Americans have PI, many of them children, yet the condition often goes undiagnosed or is diagnosed only after patients become very ill or chronically debilitated, experts say. Proper diagnosis is critical in the face of a bioterrorism threat, according to experts attending a Washington, DC, conference titled Primary Immune Deficiency Disorders: New Research and the Threat of Bioterrorism.

Mar 2

Smallpox-related eye infection in unvaccinated Californian
Doctors in California try to resolve how the virus used in the military's smallpox vaccination program has infected an unvaccinated adult's eye. The unidentified patient was in close contact with someone who had recently been inoculated, although Dr. Jonathan Fielding, Los Angeles County's director of public health, says it remains unclear how the patient became infected. "We really don't know how it happenedit could have happened in a variety of ways," says Fielding. "What's important is they had direct contact with the person, rather than this being something that was just in the air." It is the first known case in California of complications linked to the national program to vaccinate emergency health workers and military personnel.

Drug companies not responsive to government calls for biodefense research
The US government and pharmaceutical companies are at an impasse over biodefense research, according to a Baltimore Sun report. Government, the sole potential purchaser of most biodefense products, wants to buy them cheaply, but drug companies won't make a product unless they believe it will be profitable. "There is no guarantee that 'If we build it, they will come,'" says venture capitalist J. Leighton Read. Among the problems are that the government-sponsored scientific research system encourages basic research but does not necessarily result in new products and that drug companies do not see biodefense products as an ongoing revenue source. Additionally, critics say the government contracting process is disorganized and disjointed. Dr. Scott Gottlieb, a resident fellow at the American Enterprise Institute for Public Policy Research in Washington, says it will take government incentives to get pharmaceutical companies involved.

Mar 1

Canada may suspend civil liberties in event of a bioterr attack
Canada's response plan to a bioterrorism smallpox attack includes temporarily suspending civil liberties in order to halt the spread of the disease, according to a report published in the Citizen. The Canadian Smallpox Contingency Plan contains several measures available to the government should such an attack occur. These include "enforced isolation of noncompliant smallpox patients," enforced quarantine of others who come into contact with patients, restriction of travel and public activities, and "federalizing local facilities" to create isolation and quarantine centers. The plan notes that the government would activate the Emergencies Act, a statute that requires cabinet to declare a national emergency allowing it to exercise "appropriate exceptional powers& subject to democratic safeguards and for limited periods."

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