What's Next?

By Frederick Golden

Anthrax is the current focus of the nation's post-Sept. 11 trauma, but it's just one of many potential weapons in bioterrorism's terrible arsenal. How serious a threat are they? Or, for that matter, how deadly are the many other disease carriers, ranging from salmonella to drug-resistant TB strains to "flesh eating" bacteria, that might be unleashed by terrorists? What do they portend for the safety of the food we eat, the air we breathe and the water we drink? Here are a few of the scenarios America may need to be prepared for.

FOOD

THE THREAT Health and Human Services Secretary Tommy Thompson said last week what worries him most is the safety of the nation's food supply, especially of imports, a concern reflected in all the talk in the makeshift antiterrorist war room he has opened in his Washington headquarters. Only a tiny fraction of the food coming into the U.S. undergoes inspection, officials note. One concern: imported gum arabic plants, the source of additives for many foodstuffs. These come largely from Sudan, once bin Laden's lair, via Canada, and because of the North American Free Trade Agreement may enter the U.S. uninspected. "Am I satisfied with the inspections we're doing?" Thompson asked rhetorically. "No, I am more fearful about this than anything else."

Michael Doyle, director of the center for food safety at the University of Georgia, says terrorists could lace such imports with not only botulism toxin but also other pathogens, including E. coli O157:H7, salmonella, dysentery, cyclospora and hepatitis. As if to underscore the point, investigators last week identified salmonella in two of several plastic vials of undisclosed substances included in a packet of papers sent to former President Clinton's office in Harlem, though the bacteria apparently grew naturally through fermentation and caused no harm. Still, the concerns of Thompson and his colleagues are understandable. Even without any diabolical intent, U.S. packing houses in recent years have accidentally passed along meat infected with deadly E. coli O157.

WHAT CAN BE DONE At Thompson's urging. Congress is considering greatly expanding the number of inspectors employed by the nation's two food-safety agencies, the Department of Agriculture, which inspects beef and poultry, including imports, and the Food and Drug Administration, which overlooks most other processed foods. Consumers can protect themselves by washing raw fruits and vegetables in soap and water or a dilute chlorine bleach solution.

AIR

THE THREAT Any of the CDC's A-list of deadly agents could be delivered through the air. But of these, smallpox may be the most worrisome. Killing 30% of those infected and leaving the rest scarred for life, it spreads easily from person to person, especially in a population that has largely lost its immunity; mass outbreaks would swamp hospitals. While vaccination in the first days after infection offers the only cure, enough freeze-dried vaccine left over from the early 1980s remains on hand to inoculate, by some estimates, just 7.5 million people. In this state of unpreparedness, smallpox could take many lives.

In the chill of the cold war, the Soviet Union is said to have loaded enough germs and viruses, including smallpox, aboard intercontinental ballistic missiles targeted on the U.S. to infect an entire city, a tactic Saddam Hussein is thought to have tried to copy on a more modest scale with rocket-borne smallpox "bombs" that could hit targets up to 70 miles away. He never used them. Not that restraint has always been practiced. During World War II, Japanese planes dropped plague-infested fleas on Chinese and Soviet targets, while Britain plotted to kill German cattle with anthrax.

But even without high-tech delivery systems, a single suicidal terrorist spraying a few drops of smallpox virus--or a liquid solution of Ebola or even plague--in a crowded mall or into the ventilation system of a large building could cause untold harm.

WHAT CAN BE DONE The government has ordered stepped-up smallpox-vaccine production, so that 300 million fresh doses should be ready in 12 months. There is no vaccine for plague--though the recent decoding of its genome could accelerate that quest.

WATER

THE THREAT Thriller writers often confect plots that turn on the poisoning of a city's water supply with a few tablets of some very lethal substance. But while the idea has a long history (Roman legionnaires tossed animal corpses into the water supplies of their enemies), the tactic isn't very practical. Even in high concentrations, germs would probably be quickly diluted in a large reservoir, if not killed off later during chlorination.

A likelier attack might be mounted against a smaller, enclosed system. A few drops of cholera bacteria, for example, could poison the water tank of an apartment house. Or a terrorist might use pathogens, including botulism, to attack a bottler of specialty water or a dairy. But overall these are poor options for biowarriors.

WHAT CAN BE DONE Besides increased vigilance at municipal reservoirs, keeping an eye out for the initial flulike symptoms could let doctors initiate early and effective treatment.

So how serious are any of these threats? Almost anyone with undergraduate training in biology can raise colonies of dangerous microbes. Delivering them is much harder, as the technologically savvy extremist Japanese cult Aum Shinrikyo learned in the early 1990s when it tried to spread botulism in the streets of Tokyo before finally settling on sarin gas. Moreover, germ weapons have a tendency to boomerang, as gas attacks often did during World War I when winds suddenly shifted. Highly infectious agents also are difficult to handle, a risk underscored by at least one major anthrax accident in the Soviet biowarfare program that killed scores of Russians--though that wouldn't stop the suicidally minded. And then there's something else for germ warriors to think about: an attack on Americans, if traced back to a state sponsor, could trigger nuclear retaliation, as the U.S. quietly made clear to Saddam during the Gulf War.

--By Frederick Golden