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Introduction

Disease has long been the deadliest enemy of mankind. Infectious diseases make no distinctions among people and recognize no borders. We have fought the causes and consequences of disease throughout history and must continue to do so with every available means. All civilized nations reject as intolerable the use of disease and biological weapons as instruments of war and terror.

--George W. Bush (1)

To Robert Stevens, Wednesday September 19th, 2001 was just another day (2-4). He went to his photo-editing job at “The Sun”, a tabloid newspaper, in Boca Raton Florida, as he usually did; another set of photos had to be picked and made printable for routine deadlines. The only unusual event that occurred that day was an odd love letter to a celebrity that circulated around the office. This letter, unlike others, contained a fine white powder. As Robert read the letter, powder got in the air, on his hands and on the keyboard of his computer. After a quick reading, Robert placed the letter in the trash and went about his normal daily routine.

The next eight days were normal except for a 5-day trip to North Carolina. On the return trip, Wednesday September 27th, Robert started feeling ill. He felt feverish, chilled and tired. He was ready to go home and get in bed with hopes of getting over this nasty little illness. Unfortunately, for Robert Stevens the odd powder in that love letter was really a biological agent called Bacillus anthracis. Infection with this bacterium resulted in him getting a disease called inhalation anthrax. This disease ended Robert Stevens’ life on October 5th, 2001 (2-4).

Governments (states) have produced and stockpiled biological agents (BA) to intentionally use in a variety of ways (e.g. assassinations, covert operations, war, intimidate other countries) as biological weapons (BW). In the past some have used BW in war. The term biological warfare refers to the use of BW by a state to intimidate, threaten, kill and/or incapacitate opposing states’, civilians, military forces, and/or their water sources and agricultural industry. 

BW have also been used by several different nonstate actors. Nonstate actors include nongovernmental groups (ex. paramilitary, terrorist, guerrilla, cult and religious groups) and individuals (ex. lone criminals, disgruntled scientists and psychopaths). When individuals have illegally used or threaten to use BW to accomplish their personal objectives they have been called biocriminals. Terrorist groups or bioterrorists have used or threatened use of BW against civilian targets to further their political, religious or ideological goals (5). Another group proposed the following definition for bioterrorism, “Bioterrorism involves intentional use of an infectious agent- microorganism, virus, infectious substance, or biological product- to cause death or disease in humans or other organisms in order to influence negatively the conduct of government or intimidate a population (6).” When terrorists use BW to destroy or incapacitate livestock and crops they have also been called agroterrorists. 

BW unlike conventional weapons do not result in large ear-shattering explosions. No destruction of property or traumatic human injury is immediately evident. Once unleashed, the BW goes about its job of injuring humans quietly and deliberately. The means of disseminating the BW can escape detection. Only until several days later when the ill victims start showing up to see their physicians might anyone begin to suspect something unusual has happened. Meanwhile, if the BW is contagious then the disease can spread exponentially through a population. Modern means of travel can take these infected, contagious people around the world in less than a day spreading it to many others. BW are one of a few weapons systems that can result in mass causalities.  

Biological, chemical and nuclear weapons, are weapon systems that have frequently been called weapons of mass destruction (WMD; 7) All WMD have the capability of causing massive numbers of casualties when deployed. Many different countries have acquired WMD over the years. Several countries with chemical and/or nuclear WMD have also acquired BW capabilities. Several nonstate actors have, in the past, acquired and used BW (ex. Bhagwan Shree Rajneesh group in Oregon, U.S., Aum Shinrikyo group in Japan). WMD have been actively sought and acquired by some states and nonstate actors to accomplish a variety of objectives (e.g. intimidate opponents, influence elections, assassination enemies, maintain balance of power, tip the balance of power in their favor). 

Chemical WMD are man-made highly toxic chemicals that can incapacitate or kill humans, animals and plants. These agents can be dispersed as a gas, aerosol, vapor or liquid. Some of the agents that affect humans are nerve agents (sarin, tabun, soman, VX), blister agents (mustard gases, lewisite), choking agents (phosgene, chlorine gas), blood agents (hydrogen cyanide), and control agents (chloroacetophenone). Nerve agents quickly disrupt the nervous system causing convulsions and/or paralysis. Blister agents destroy exposed skin and other tissues causing blindness, blistering of the skin, and fatal respiratory damage. Choking agents cause blood vessels in the lungs to hemorrhage and fill up with fluid (pulmonary edema). Blood agents interfere with the body’s ability to take up oxygen. Control agents temporarily produce irritating or disabling effects when they contact the eyes, skin or are inhaled. The effects of these agents tend to occur within minutes to hours. Most chemical agents are short-lived however some agents like VX can remain in the environment as a toxic residue for days to weeks. During WWI chemical weapons were used on a massive scale on the battlefields in Europe (5, 7). To learn more about chemical weapons and the history of their use click on the following link: Wikipedia: Chemical Warfare.

Nuclear WMD are devices that cause atoms to split (fission) resulting in a tremendous release of energy. Following detonation of a fission weapon the blast itself uses about 50% of the energy. Heat energy (35%), radiation energy (14%) and an electromagnetic pulse (1%) are also unleashed during a nuclear explosion. These weapons have been known since WWII to cause tremendous amounts of damage to property and can result in massive numbers of casualties. The effects of the nuclear blast and high levels of radiation exposure are immediate following denotation. Many die instantly and those that do survive in the immediate blast area are oftentimes dead within a short period of time due to injuries (burns, trauma) or exposure to radiation. Following exposure to lower levels of radioactive fallout people and other living organisms can develop various maladies (cancer, birth defects, developmental deficits) months to years later. Nearing the end of WWII President Truman ordered the first use of atomic bombs in warfare. On August 6, 1945 an atomic bomb called, “Little Boy” was dropped on Hiroshima, Japan. Three days later another atomic bomb called, “Fat Man” was dropped on Nagasaki, Japan. Both cities were destroyed and by the end of that year over 200,000 people died (7). To learn more about nuclear weapons and the history of their use click on the following link: Wikipedia: Nuclear Weapon.

Biological WMD include any living organism or product of a living organism (toxins) that can be used to threaten, intimidate, incapacitate and/or kill humans, crops, and livestock. Following release of the BW it usually takes several days for the organisms growing in those infected to show signs and symptoms. However, since they do multiply in humans exposure to small numbers of organisms can result in disease. Some BW are contagious and can spread from person-to-person. They can be sprayed into the air as a wet or dried aerosol. They can also be placed in or on food or water sources. The Germans produced BW during WWI that were capable of infecting livestock. Many believe they only used the BW a couple of times resulting in few if any livestock deaths and to no military advantage (8). Some people place toxins in the chemical WMD category. Since living organisms produce these toxins (in vivo) they will be considered BW. 

Viruses, bacteria, fungi, and toxins produced by bacteria, fungi or plants have all been considered as potential BW. Viruses are extremely small (0.018 to 0.300 micrometers) infectious particles. Viruses contain either RNA or DNA (but not both) and the proteins they need to reproduce and cause disease. The RNA or DNA is enclosed in a protein coat. Some viruses also have a lipid envelope that covers the protein coat. To grow and reproduce viruses must infect other cells (host cell; 9). Examples of viruses that could be used as BW include: Smallpox virus, Rift Valley Fever virus, and Ebola virus. 

Bacteria are simple unicellular organisms, prokaryotes, which lack the intracellular structures seen in eukaryotic cells (nuclear membrane, mitochondria, Golgi bodies, endoplasmic reticula.).  They range in a size from 1 to 20 micrometers. Most of these organisms can grow and reproduce without a host cell. Some bacteria lack certain vital functions requiring that they also grow and reproduce in a host cell to survive. Coxiella burnetti (Q fever) and Rickettsia (typhus) both require host cells to survive (9). Examples of bacteria that could be used as BW are: Bacillus anthracis (anthrax), Francisella tularensis (tularemia), and Yersinia pestis (plague). 

Fungi are eukaryotic organisms that contain a nucleus, mitochondria, Golgi bodies and endoplasmic reticula. They can exist either in a unicellular form (yeast; 2-30 micrometers) that can replicate asexually or in a filamentous form (mold; 100-200 micrometers in length) that can replicate sexually or asexually (9). Fungi are common causes of disease in plants (stem rot, corn rust) and have been examined primarily by governments to determine what role they might play in destroying another state’s crops. Some fungal toxins have also been utilized as BW (aflatoxin; 8). 

Toxins are bacterial, fungal or plant components that directly damage host tissue or trigger the host’s immune system to cause tissue damage. Organisms produce these toxins and they must be purified before they can be used as a BW. Examples of BW toxins include botulinum toxin (Clostridium botulinum; bacteria), Staphylococcus enterotoxin (Staphylococcus aureus; bacteria), Ricin (Ricinus communis; Castor bean plant), and trichothecene mycotoxins (Yellow rain; Fusarium; fungus). Go to the following website to see how the various biological agents compare in size: Cells Alive: How Big.

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© 2005 Neal Chamberlain. All rights reserved. 
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Neal Chamberlain, Ph.D. A. T. Still University of Health Sciences/Kirksville College of Osteopathic Medicine.

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