Bad Medicine--by Conrad Istock

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Bad Medicine

by Conrad A. Istock

BULLETIN OF THE ATOMIC SCIENTISTS, NOV-DEC 1998, PP. 21-23

Anthrax vaccinations of U.S troops send a politically explosive message.

They won't provide much protection, either.

THE U.S. DEFENSE DEPARTMENT ANNOUNCED A YEAR ago that it would vaccinate

all 2.4 million members of the U.S. armed forces against anthrax. Last

August, the program got into high gear with the first large-scale

vaccinations. Nonetheless, the anthrax vaccination program is a very bad

idea—one whose time should never have come.

The program will encourage and intensify several " biological arrns

races. " It will also create new incentives for the manufacture and use

of a wide variety of biological weapons. And it tells the world that the

United States expects anthrax to be used in war, thereby eroding the

force of the Biological Weapons Convention. Even in its primary

purpose—protecting U.S. military personnel against anthrax in battle—it

is certain to fail.

I do not mean to suggest that anthrax is not a nasty weapon. Its

destructive power was accurately portrayed by Defense Secretary

Cohen, who explained that a quantity the size of a bag of sugar could

kill half the people in Washington, D.C. It could produce victory in

battle within a few days if unleashed on unprotected soldiers. But the

biological, social, and political ramifications surrounding anthrax, or

any other bioweapon. are far more complex than the Defense Department

appears to realize. Although the military's vaccination program might

seem like a wise precaution, it is in fact an ill-conceived idea likely

to have a variety of unanticipated consequences—in short, a

misadventure.

To illustrate just one unpleasant consequence, consider the following

scenario: Immunized U.S. troops are locked in combat. Suddenly, the

enemv lays a cloud of anthrax spores over the entire battlefield. Within

a few days. U.S. soldiers are dying in droves, but no enemy soldiers

die.

Why? Because the enemy did not release the particular strain of anthrax

U.S. biologists used to make the vaccine. Instead, they used a strain

specifically devised to defeat U.S. immunizations. This lethal strain

had been developed years earlier by bioweaponeers in the former Soviet

Union, using the U.S. vaccine as a tool in the search for a resistant

strain. (The United States originally gave the vaccine to the Soviets

for humanitarian purposes.) The resistant strain—and again this is

strictly a hypothetical scenario—was secretly transferred to other

countries, and the enemy soldiers were protected by specific

immunization against the Soviet creation.

THE BACTERIUM BACILLUS ANTHRACIS, THE SOURCE OF THE anthrax toxin, is

easily grown in large quantities. It is also cultured to make vaccine.

To use anthrax as a weapon, dry spores are mixed with an aerosol

dispersant.

Anthrax spores can lie dormant for decades. possiblv for centuries. Two

extraordinary incidents attest to their durability. In 1942 British

bioweaponeers carried out experiments with anthrax bombs on part of the

island of Gruinard off the northwest coast of Scotland. Viable spores

persisted for more than 40 years until the island was decontaminated in

1987 by literally soaking the soil with hundreds of thousands of liters

of formaldehyde. Test data indicated that, without decontamination,

viable spores would have persisted until at least 2050. Then there is

the bizarre case of the sugar lumps laced with anthrax bacilli found in

Baron Otto Karl von Rosen's luggage when he was arrested in Norway

during World War I on suspicion of espionage and sabotage. The spores

were in a liquid medium in tiny sealed capillarv tubes embedded in the

sugar. Last year-- 80 vears later-- biologists at Britain’s Porton Down

bioweapons detection center revived living colonies of the bacillus from

the tube in the one lump of sugar tested.

The genes for the anthrax toxin do not reside on the bacterium's main

chromosome, but on a smaller, secondary DNA molecule called a plasmid.

In laboratorv experiments these plasmids have been transferred from

Bacillus anthracis to other species of bacteria. One transfer was to

Bacillus thuringiensis, a bacterium widely used to control insects in

gardens and in aerial spraying against gypsy moths. Another transfer was

to a common soil bacterium, Bacillus cereus. The transfer of plasmids

occurs naturally among many bacteria. Massive releases of anthrax spores

could easilv lead, through the infection of animals, to spontaneous

transfers of the plasmid to other bacteria as well.

While anthrax does not spread from one human to another, it can

propagate in the soil. In particular, its numbers increase in soils

soaked with blood. And the spores from the soil can infect both humans

and animals.

Humans become infected by inhaling or swallowing spores, or by spores

entering the body through cuts or scratches in the skin. Inhaling a

clump of spores not much larger than a speck of dust can result in

death. Anthrax is contracted most commonly by workers who handle wool,

hides, or other materials from diseased animals. About 20 percent of

untreated cases of cutaneous infection result in death. Ingested spores

kill in 20 to 60 percent of cases; and 90 percent or more of those who

become infected through inhalation die within a few days.

The battlefield use of anthrax is plausible—more than a dozen countries

have the weapon or are developing one, according to Pentagon officials.

Until recently, laboratories could readily order anthrax cultures from

U.S. suppliers. Before the Soviet Union abandoned its bioweapons

program, Soviet scientists not only harvested anthrax spores in large

quantity for use as a weapon, they also developed a highly effective

dispersant that could quickly spread an invisible cloud of concentrated

spores over a battlefield or a city. This dispersal technology may have

been transferred to other countries. The United States also experimented

with anthrax as a weapon.

WOULD A VACCINATED POPULATION OF U.S SOLDIERS ON A battlefield be fully

protected? If strains were used against which the immunization was

completely effective, the answer would be " Yes, for a little while. "

However, sending a large number of immunized individuals into contact

with enormous numbers of bacteria would almost certainlv reveal

spontaneous mutants against which the vaccine was no longer effective.

An " evolutionary arms race " would begin, pitting the human ability to

develop new vaccines against the microbes' ability to respond through

natural selection—a bitter struggle we are all too familiar with in the

case of newlv arising variants of flu viruses that repeatedly make

previous flu vaccines obsolete. The same battle is occurring in the

growing resistance of pathogenic bacteria to antibiotics.

Based on animal testing, the U.S. vaccine does not offer protection

against all strains of anthrax. In my scenario, an enemy used a strain

known to break through that immunization. Thus, a " microbial-genetic

arms race " would ensue in which newly developed strains rendered each

previous vaccine useless. Either routine mutagenesis followed by

selection, or genetic engineering, could be employed to produce

resistant strains. No nation that produces bioweapons would be deterred

by the Defense Department's use of a single vaccine.

The microbial-genetic arms race could escalate wildly as potential

combatants moved bevond anthrax to ever more deadly bacteria and

viruses. Dozens of potential bioweapons exist—weapons based, for

example, on the plague and Salmonella bacteria, or on the smallpox,

dengue, encephalitis, and Ebola viruses. This would be a full-blown

" pathogen-diversity arms race. "

As nations interpret Defense’s program of immunizations as an invitation

to dabble in bioweapons, the contest is likely to spiral. Could we

attempt to vaccinate the entire U.S. military against every conceivable

biological weapon? We cannot. There are no vaccines for many of these

potential agents. Furthermore, some nations may interpret the Defense

Department's move as a sign that the United States itself is considering

using anthrax in war, thus creating the incentive to vaccinate their

troops while developing their own alternative biological or chemical

weapons.

Were a large quantity of anthrax spores to be dispersed, the soil,

vegetation, local animals, equipment, supplies, clothing, and personnel

would be contaminated with dormant spores. Spores that adhere to objects

or collect in recesses or on fabrics will readily become airborne again—

and recalling Gruinard and the Baron's lumps of sugar, they will remain

viable for a long time. At some future time, and in a non-battlefield

location, unvaccinated people are likely to die after working with

spore-laden equipment or other war materials returned to U.S. bases.

Animals and unvaccinated people entering the contaminated battlefield

are also likely to die—the biological analog of suffering caused by

unexploded land mines. The numbers of post-war infections could be

enormous.

No human cases of anthrax have been reported in the United States (only

five states have reported cases in animals), but returning troops would

bring the disease home. The saddest of specters would be that of healthy

men and women returning home from war, only to infect their own families

and other unprotected civilians through contaminated duffel bags and

other paraphernalia. Could the troops and their belongings come home

after they had been exposed? Has the Defense Department thought about

the decontamination procedures needed to make their return safe?

THE UNITED STATES CURRENTLY HAS ABOUT SIX MlLLION doses of anthrax

vaccine, according to Defense estimates. The Defense Department

immunizations require six shots at two-week intervals, followed by three

more at six, 12, and - 18 months, with annual booster shots thereafter.

Vaccinating the military will require more than the present supply, and

though more vaccine can be made fairly quickly, a large continuing

supply will be required as new recruits enter the armed forces and

booster shots are administered. It will be a major undertaking.

If substantial numbers of the U.S. civilian population ever have to be

protected against " bioterrorist " releases of anthrax, an enormous supply

would be needed, with little guarantee that it could protect against the

particular strain used by terrorists.

We continue to live in a time of wars, with dangers from biological

weapons probably now as great or greater than those from nuclear

weapons. Biological weapons may pose a greater danger because they can

be produced by " lowtech " methods, though this is somewhat less true as

more and more genetic engineering is employed. These weapons can be

nearly invisible. And if, unlike anthrax, contagious microbes are used

as the basis for a weapon, they can create expanding epidemics—like a

bomb that keeps on exploding.

VACCINATING SERVICEMEN AND WOMEN WILL NOT EFFECTIVELY counter the threat

of biological weapons. Instead, the Defense Department's initiative

could erode the international strictures against the use of such

weapons. If the 1972 Biological Weapons Convention is insufficient to

prevent the production of biological weapons, then the 140 nations party

to that treaty need to adopt verification procedures, including on-site

inspections.

This appears to be the solution toward which the U.N.’ s recent review

conferences on the convention are moving. Treaty members should be urged

onward until comprehensive inspections are a reality. Instead of

encouraging perilous biological arms races, the United States should

join with the United Nations to create stronger strictures and plans for

immediate military reprisals that would send one clear message: " If you

use a biological weapon once, it will be the last time. "

Conrad A. Istock, a professor emeritus at the Department of Ecology and

Evolutionary Biolog!y at the Universit!/ of Arizona, is a permanent

visiting fellow in the Section of EcologIy and Systematics, Cornell

University, Ithaca, New York.

--

Meryl Nass, M.D.

Parkview Hospital, Brunswick, Maine 04011

email mnass@...

phone (207) 865-0875

fax (207) 865-6975