For Immediate Release
Contact: Donna Krupa
703.527.7357 or
Cell: 703.967.2751 or
[email protected]
IS THE U.S. PREPARED TO RESPOND IN
CASE OF CHEMICAL OR BIOLOGICAL TERRORISM?
Clinical laboratories will play a vital role in the initial detection of the causative agent and the subsequent diagnosis and treatment of victims should a chemical or biological terrorist event occur. A discussion of the role of laboratorians will take place at the 52nd Annual Meeting of the American Association for Clinical Chemistry.
SAN FRANCISCO--In a society that is technology-enabled, economically-driven, and politically unstable, the threat of terrorism is a grim reality. If and when such an event is threatened or actually occurs, clinical laboratorians will be consulted for their expertise in explaining the modes of transmission and the clinical signs and symptoms of the agent.
An overview of bioterrorism (the release of a chemical or biological agent to harm a population for political, personal, or religious reasons), a review of the response plan in the United States, discussions of the clinical manifestations and identification of biological and chemical agents, and the specific actions laboratorians should take in order to incorporate the information presented into a preparedness plan for their facility, will be presented on Thursday, July 27, at the 52nd Annual Meeting of the American Association for Clinical Chemistry (AACC), being held at the Moscone Center in San Francisco, CA, from July 23-27, 2000.
The panel, to be moderated by Dr. Larry Broussard, associate professor, Louisiana State University Health Sciences Center, will include Dr. Jane Willis, National Laboratory Training Network, Centers for Disease Control and Prevention (CDC); Dr. Scott Decker, Federal Bureau of Investigation (FBI); Richard Spiegel, DVM, MPH, Office of Bioterrorism, CDC; Dr. Mark Kortepeter, U.S. Army Medical Research Institute of Infectious Diseases; and Dr. Dennis Reutter, U.S. Army Soldier and Biological Chemical Command.
Bioterrorism is not new. Chemical terrorism dates back as early as 400 BC with the use of smoke from lighted coals, sulfur, and pitch against enemies. The first large-scale use of chemical agents was by Germany during World War I. More recently, in 1995, Sarin gas was released in a Tokyo subway.
Biological agents were used as early as the summer of 1763, when Chief Pontiac's forces at Fort Pitt were given smallpox-infected blankets and handkerchiefs that started an epidemic among them. More recent episodes include the Salmonella-contaminated salad bars in Oregon in 1984, and the Shigella-tainted pastries in Texas in 1996. These, however, were all small-scale attempts.
Though bioterrorism itself is not new, what is new is that the threat of bioterrorism has increased because access to information is much easier and because many Third World countries have the capacity to create organisms and chemicals in large numbers and large amounts. With the political instability found in so many countries, according to Dr. Broussard, those organisms can change hands, resulting in a much higher risk of an event actually occurring.
Leading the list of potential agents are anthrax (Bacillus anthracis), tularemia (Francisella tularensis), plague (Yersina pestis), brucellosis (Brucella species), smallpox (Variola virus), botulism (Clostridium botulinum), viral encephalitis, and viral hemorrhagic fevers.
These biological agents are of particular concern because they can be aerosolized and distributed over large geographic areas, and have defined incubation periods, which would permit terrorists to escape before the event occurs. Terrorists may use biological over chemical agents because the former are easy to procure, inexpensive to produce, difficult to detect, and have the capacity to rapidly overwhelm medical defenses; therefore, it is important for laboratorians to be aware of the clinical characteristics of the most probable biological agents, early recognition of key clinical signs and symptoms, and accurate diagnosis and treatment of exposed persons.
Chemical agents range from warfare agents to toxic chemicals commonly used in industry. Categories include nerve agents (e.g. Sarin); blood agents (e.g. hydrogen cyanide), blister agents (e.g. nitrogen and sulfur mustards); heavy metals (e.g. arsenic, lead, or mercury); volatile toxin (e.g. benzene, chloroform); pulmonary agents (e.g. phosgene), and Ricin, a lethal plant toxin. These are just some of the examples the public may recognize, says Dr. Broussard. Since chemical agents can act very quickly, timely detection and warning are critical to the protection of the public.
The FBI, designated the lead federal agency for crisis management of matters involving the use of weapons of mass destruction (WMD), has field procedures for screening suspected WMD, and, together with federal and state partners, also has laboratory protocols for identification of biological threat agents (BTA). The Laboratory Response Network (LRN), has been developed to integrate local authorities, such as public health, fire, safety, emergency management officials, and public health laboratories, and to manage use, or threatened use, of biological threat agents. The Laboratory Response Network is expected to provide epidemiological surveillance for use of biological threat agents and assistance in mitigating the threatened use of biological threat agents; this assistance provides intended victims with a rapid scientific analysis, while ensuring preservation of evidence for criminal prosecution.
Because terrorists may employ a wide range of biological and chemical agents, the country's infectious disease surveillance networks, with the support of the CDC, are enhancing their capacity to detect unusual events, investigate and contain outbreaks, expedite laboratory diagnosis, and strengthen the coordination and communication among clinicians, emergency rooms, infection control practitioners, hospitals, pharmaceutical companies, and public health personnel.
Everything we see and read leads us to believe that a bioterrorism event is not a matter of if, but of when, Dr. Broussard says, saying that there is a 1 in 10 chance that there will be a serious incidence in the next 5 to 10 years. With concern mounting regarding the probability of terrorism events throughout the country in coming years, the panelists stress that it is important for the public to realize that the pieces are being put into place to deal with such an emergency.
AACC, founded in 1948, is the world's most prestigious professional association for clinical laboratorians, clinical and molecular pathologists, and others in related fields. Clinical laboratorians are specialists trained in all areas of human laboratory testing, including genetic and infectious diseases, the presence of tumor markers and DNA. The primary professional commitment of clinical laboratorians is the understanding of these tests and how to use them accurately to detect and monitor the treatment of human disease.
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Editor's Note: Dr. Broussard, Dr. Willis and others will be part of a press briefing on bioterrorism preparedness on Wednesday, July 26, beginning at l2:00 in Room 114 of the Moscone Center. For further information or to schedule an interview with Dr. Broussard, contact Donna Krupa at 703. 527.7357; cell: 703.967.2751 or at [email protected]. Or log on to the AACC website at www.aacc.org.
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