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Anthrax Background Information and Accidents
Wednesday, May 12, 1999
The News Journal
REPORT: Doctors Need Anthrax Training
Associated Press
Baltimore-Doctors need training on the symptoms of anthrax so they don't think an infected person just had a bad flu, according to scientists studying the possibility of a terrorist anthrax attack.
In a report being published in today's Journal of the American Medical Association, the Working Group on Civilian Biodefense says an anthrax attack could happen, and larger amounts of the vaccine need to be at the ready.
Anthrax is colorles, odorless, inexpensive to make and easy to transport.
The group cited a 1993 government report that said it would take only about 20 pounds of anthrax to kill 3 million people, the death toll equal or more than what could result from a hydrogen bomb.
The possiblity of a terrorist attack using bioweapons would be especially difficult to predict, detect, or prevent, and thus it is among the most feared terrorist scenarios," the report says.
In an attack, nearly half of those infected would die within 24 to 48 hours, probably well before doctors knew what was going on, the report says. Because anthrax infections can be controlled with antibiotics if administered early, doctors and radiologists need to know what to look for, the report says. Shortness of breath, an early sign of infection, could be mistaken for pneumonia. Other early symptoms include fever, cough, headache, vomiting, and chills, which could be mistaken for flu.
"The trick here is to identify as quickly as possible and recommend antibiotic treatment of all those who might have been exposed...and treat them for two months, which is a huge task," said Dr. D.A. Henderson, co-author of the report and director of the Center for Civilian Biodefense Studies at John Hopkins University.
The doctors found that anthrax remains deadly far longer than previously understood. It was believed that infection would occur within six days of exposure. But the group found the danger period lasts up to 46 days.
| Published articles |
| Aral Sea |
| Deadly Soviet legacy threatens fishing villagers A microscopic quantity can kill a human being; thousands of tons are buried. Vozrozdeniya Island is the biggest burial ground of anthrax in the world. In 1988, Russian scientists dumped the pink powder in sandpits when evidence mounted that the Soviet Union was violating the biological weapons convention. Although they decontaminated the poisonous powder, some spores seemed to have survived. This is not the first disaster that hits the people living around the Aral Sea in Uzbekistan and Kazakhstan. Excessive irrigation of cotton fields caused the Aral Sea to dry up, leaving soil with pesticides spread hundreds of kilometres by sand storms, causing a multitude of diseases. Now a hazardous biological time bomb is threatening their lives. By Petra Wijnsema ARALSK - Friday 31 March 2000 "The only signs of life were a few vipers startled by our footsteps. It was eerily quiet, as if the black plague had struck and life had just stopped. There were gas masks strewn about and I saw hundreds of animal cages, one of them over two meters high." Andrew Weber, special advisor of the US department for Threat Reduction, was the first American citizen to visit the island in 1995. He was wearing a protective suit to safeguard him from possible biological hazards. During this first American mission scientists took soil samples from different locations on the island. There are strong rumours that life spores of anthrax were found, although the result of the tests has never officially been made public. The test result has been enough reason for American scientists to do supplementary research. "We fear that terrorists dig up the life spores and use them for the production of biological weapons", Weber says five years after his first visit. Anthrax spores can survive in a dormant state for years, even decades. Infection with anthrax is difficult to recognise because the first symptoms resemble the onset of a cold or flew. By the time the skin begins to turn bluish - the first visible symptom - the person has already begun to die. The lungs fill with liquid, gradually cutting off their supply of oxygen. Every breath becomes more painful. The end comes suddenly: some victims have been reported to die in de middle of saying a sentence. Untreated, anthrax is fatal in ninety percent of the cases. Tests Vozrozdeniya Island, or Renaissance Island, has expanded from 200 to 2,000 square kilometres due to the dropping water level. Two third of the island belongs to Uzbekistan and one third to Kazakhstan. The Russians chose Vozrozdeniya in 1936 as a testing site for biological weapons. "It was situated far from the main land and waterways. On top of that, the coast of the Aral Sea was sparsely populated, which reduced the chance of unwanted visitors." These are the words of former colonel Gennadi Leposhkin, director of ‘Stepnogorsk’ in Kazakhstan, once the biggest biological weapon plant in the world. The dry climate and the sandy soil, which can reach temperatures of up to sixty degrees centigrade in summer, minimised the risk of harmful organisms surviving after the tests. In the summer months, Russian scientists experimented with the latest supply of manipulated bacteria. Leposhkin: "I wasn’t really living there, but visited the island on a regular bases over a period of ten years. During the testing months, approximately hundred people lived on the island, including women and children." Deadly secret In 1992, shortly after the collapse of the Soviet Union, the deputy director Ken Alibek of ‘Biopreparat’, defeated to the United States. The in Moscow situated institute ‘Biopreparat’ was co-ordinating a chain of biological weapon factories. Alibek revealed Russia’s most deadly and best kept secret of the cold war. At dozens of locations in Russia and Kazakhstan, ten thousands scientists claimed to produce vaccines. In reality, they tried to produce viruses and bacteria with an increased resilience and resistance to antibiotics. According to Alibek’s book ‘Biohazard’, that was published last year, attempts were even made to weaponize AIDS, Ebola and Legionnaire’s disease. The tests on Vozrozdeniya were the last step in the development process. In order for the Ministry of Defence to accept an agent as a weapon, the test had to be successful, complete with a recipe for reproduction by any scientist. In his book, Alibek describes how the tests on Vozrozdeniya were performed. From a distance, he saw hundreds of monkeys inhaling the bacteria, pulling their chains and screaming while they were dying a painful death. Biggest outbreak With the rising suspicion in the eighties that Russia was producing biological weapons, the West increased pressure to get access to several facilities. The most obvious proof was buried on Vozrozdeniya. Although Ken Alibek does not mention this in his book, he now confirms that hundreds of tons of anthrax were dumped. "The anthrax was stored in 250 litre containers, was shipped by train from the storage facility at Zima station to Aralsk, and from there by boat to Vozrozdeniya. The containers were opened and the anthrax was decontaminated with hydrogen peroxide before it was buried. It is not known whether the decontamination was hundred percent effective", according to Alibek. The biggest threat for the people in the area is that animals spread the anthrax, once the island is connected to the main land. "I predict this will happen within three years. If we get a hot summer maybe even in one year", fears Leposhkin, a former colleague of Alibek. How dangerous anthrax can be, proves an accident in 1979, when at least 66 people died of infection with anthrax. A small amount was released into the open air due to a missing filter in a biological factory in Sverdlovsk in the Ural. It was the biggest outbreak of anthrax in the twentieth century. Russia’s explanation for the outbreak until today is the consumption of contaminated meat. After the accident, the factory in Sverdlovsk was closed, but the production capacity of anthrax in the factory in Stepnogorsk was increased. ‘Stepnogorsk’ became the biggest biological factory this planet has ever known. In 1987, when Leposhkin became director, the factory was capable of producing 2,000 kilos of anthrax a day. Forty kilos is enough to kill the entire population of a city the size of New York. Today, the United States supervises the conversion of ‘Stepnogorsk’ into a factory for civilian use. Ignorance In the fishing village Zhanalas, North of the Aral Sea, nobody has ever heard of the dumped anthrax. "It was a big secret what happened on the island. Nobody dared to ask questions, fearing the KGB", says fisherman Zhalgazbay Isbasarov. He does remember the massive fish mortality in the seventies. The fish mortality is only one of the unsolved mysteries occurring in and around the Aral Sea during and after the tests. A study dated May 1999 from the Monterey Institute in California on the past, present and future of biological weapon facilities in Kazakhstan, reports that entire flocks of sheep lost their wool in 1986. In 1988, half a million Saiga antelopes died on the Turgay steppe Northeast of the Aral Sea. In addition, several plague cases were reported through the years. According to Alibek, it is possible that the tests with plague bacteria contributed to the incidence of plague, although the disease already exists on the mainland for centuries. He thinks it is likely that rodents were infected with plague during tests with these bacteria. Plague bacteria were tested until the early nineties. Once the island is connected to the main land, rodents could spread plague as well. Cleaning operation To avoid the spread of diseases, the island has to be cleaned. Uzbekistan and Kazakhstan have asked the United States independently for assistance in cleaning up this biological heritage. The plan is to determine the level of contamination and to decontaminate the soil. Apart from that, the flora and fauna has to be exterminated. Special advisor of the US Department of Threat Reduction Weber: "We hope to sign an agreement with Uzbekistan to start the cleaning operation." According to Leposhkin, border disputes between Uzbekistan and Kazakhstan block the way to an agreement on the cleaning operation. Financing the cleaning operation and getting the expertise is not the biggest problem: both countries have to put their conflicts aside if they want to prevent the explosion of the biological time bomb. This is a translation of the article published on Friday 31 March 2000 in the Dutch newspaper ‘De Volkskrant’
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Background
In April and May of 1979 an Anthrax epidemic broke out in humans in the city of Sverdlovsk in the former Soviet Union. While Soviet officials attributed this outbreak to contaminated meat, the US Government maintains its position that the outbreak was due to a leakage from a biological weapons facility. This case seeks to explore the sources of the anthrax spores as well as the methods of treatment used by the Soviets according to both US and Soviet sources.
Anthrax Facts (from the The Encyclopedia Brittanica Online i):
Anthrax in humans occurs as a cutaneous, pulmonary, or intestinal infection; the most common type occurs as a primary localized infection of the skin in the form of a carbuncle bacteremia. It usually results from handling infeced material, lesions occurring mostly on the hands, arms, or neck as a small pimple that develops rapidly into a large vesicle with black necrotic centre (the malignant pustule). Should this condition become generalized, a fatal septicemia (blood poisoning) may ensue. The pulmonary form (woolsorters' disease) affects principally the lungs and pleura and results from inhaling anthrax spores in areas where hair and wool are processed. This form of the disease usually runs a rapid course and terminates fatally. The intestinal form of the disease, which sometimes follows the consumption of contaminated meat, is characterized by an acute inflammation of the intestinal tract, vomiting, and severe diarrhea. Anthrax is occasionally transmitted to humans by spore-contaminated brushes or by weraing apparel such as futs and leather goods. Prompt diagnosis and early treatment are of great importance. Antianthrax serum, arsenicals, and antibiotics are used with excellent results.
Case
"Anthrax is an acute disease that primarily affects domesticated and wild herbivores and is caused by the spore-forming bacterium Bacillus anthracis."ii Anthrax outbreaks among humans usually occur as skin infections resulting from touching contaminated hides, leather, and animals. It is rare that that an infection results from inhalation or ingestion. While the outbreak sparked an international debate as to whether the outbreak was the result of natural causes or an accidental release, the reported methods of dealing with the case are similar.
According to Soviet sources, "people had become sick...from eating bad meat they bought from 'private butchers'."iii According to a report given by visiting Soviet doctors, the crisis began on the morning of the 7th of April, when Soviet officials were notified of a 'spate of deaths' over the previous weekend.iv Vladimir Nikiforov, infectious diseases chief at the Moscow Institute for the Advanced Training of Physicians, was flown out to Sverdlovsk and "treated suspected victims with near-toxic doses of antibiotics"v upon deeming the infection to be anthrax, which was confirmed by laboratory tests 3 days later.
The epidemic ran intensely from 4 April to 19 April, the day the epidemic reached its peak with ten new cases...There were 96 victims in all, according to Nikiforov. Seventeen had skin infections and survived. Seventy-nine had intestinal infections; of these, 64 died. ...The source of the outbreak was traced to a single 29-ton lot of bone meal (cattle feed) sold in March from a factory in Aramil, 15 kilometers to the southeast of Sverdlovsk. vi
While "many scientists" at the time said the new evidence supported the Soviet view, Science Magazine released a study in 1994, that appears to corroborate the US Government view.
...Most people who contracted anthrax worked, lived, or attended daytime military reserve classes during the first week of April 1979 in a narrow zone, with its northern end in a military microbiology facility in the city and its other end near the city limit 4 km to the south; livestock died of anthrax in villages located along the extended axis of this same zone, out to a distance of 50 km...
...We conclude that the outbreak resulted from the windborne spread of an aerosol of anthrax pathogen, that the source was at the military microbiology facility, and that the escape of pathogen occurred during the day on Monday, 2 April. ... Most or all infections resulted from the escape of anthrax pathogen on that day.
...A single date of inhalatory infection is also consistent with the steady decline of onset of fatal cases in successive weeks of the epidemic.
Accepting 2 April as the only date of inhalatory exposure, the longest incubation period for fatal cases was 43 days and the modal incubation period was 9 to 10 days...Experiments with nonhuman primates have shown, however, that anthrax spores can remain viable in the lungs for many weeks ant that the average incubation period depends inversely on does, with individual incubation periods ranging between 2 and approximately 90 days.ii
The Soviets claimed that accusations about the epidemic's source being an airborne infection were false, because there would not have been a trend in the number of victims. However, since incubation time can vary based on the health of the individual, there still could have been a trend reflective of other sources of infection.
While the source of the anthrax infection and whose account is accurate may seem irrelevant, when considering methods of treatment it is essential. Treatment of an anthrax infection is contained mainly to penicillin. However, if the source of the infection is indeed inhalatory, the chances of curtailing and surviving the infection are much lower.
...Inhalation anthrax is characterized by the severe local effects of the toxin at its primary site of production, thoracic hemorrhagic necrotizing lymphadenitis and hemorrhagic necrotizing mediastinitis, as well as the systemic effects of bacteremia and toxemia. These thoracic lesions are not expected to occur in toxemic cutaneous or intestinal anthrax because spread from the cutaneous or intestinal portal of entry by the lymphatic vessels would involve the regional lymphatic drainage of the primary skin or intestinal lesion, but there would be no spread to the lymphatic drainage of the lungs in the mediastinum.vii
Unfortunately, while a 1993 report in the Proceedings of the National Academy of Sciences in the USA contains an analysis of the autopsy reports of 42 victims, the secrecy that surrounded the outbreak prevented any significant knowledge to be gained from the treatment of anthrax inhalation.viii The lack of
... clinical information impairs extensive clinicopatholigic correlations including the effects of various therapeutic approaches. Some deaths occurred outside the hospital, at home, or even in the street or in a field. Medical personnel accompanying the emergency transport vehicles often made an initial diagnosis of pneumonia. The chest pain, which was severe enough to suggest an initial diagnosis of myocardial infarction, undoubtedly resulted from the hemorrhagic thoracic lymphadentisis and mediastinitis.ix
While the medical personnel at the time had difficulty identifying the cases of inhalation anthrax, the secrecy surrounding the release has served to prevent another outbreak from being less lethal. According to the same report, curtaneous anthrax infections reported at the same time could conceivably have come from animals infected by the same airborne anthrax spores as humans.x
Conclusion
While it may not be entirely clear whose account of the Sverdlovsk anthrax outbreak is correct, it is certain that if indeed the source was airborne anthrax spores, the medical community has gained little from the events in Sverdlovsk. Medical personnel must undertake to diagnose mass casualties with pneumonia like symptoms carefully, especially during warfare. In order to prevent digestive tract anthrax infection, the monitoring of food sources must remain precise and consistent. Lastly, any outbreak in an infectious disease must be monitored and reported openly, despite the potential embarrassment, in order to further science and the human conditions.
Further Resources
Sverdlovsk information
Sverdlovsk City now Ekaterinburg:http://dasun3.essex.ac.uk/ekaterinburg.html
Anthrax information
New York State Department of Health gopher site. http://gopher.health.state.ny.us:70/00/.consumer/.files/anthrax.txt. 7/22/96
Army Field Manual 8-9: Handbook On The Medical Aspects Of NBC Defensive Operations..<PART II, chapter4.htm
iThe Encyclopedia Britanica Online http://www.eb.com/. 8/1/96
ii Meselson, Matthew, Jeanne Guillemin, Martin Hugh-Jones, Alexander Langmuir, Ilona Popova, Alexi Shelokov, Olga Yampolskaya. The Sverdlovsk Anthrax Outbreak of 1979. Science: 266, 18 Nov., 1994; 1202-1208.
iii Eliot Marshall. Sverdlovsk: Anthrax Capital?. Science. 240:4851; 383-385.
iv Ibid.
v Ibid.
vi Ibid.
vii Abromova, et al. Pathology of Inahalational Anthrax in 42 Cases from the Sverdlovsk Anthrax Outbreak. Proceedings of the National Academy of Sciences of the USA. 90, Mar 15, 1993; 2291-4.
viii Ibid.
ix Ibid.
x Ibid.
On April 2, 1979, there was an unusual anthrax outbreak which affected 94 people and killed at least 64 of them in the Soviet city of Sverdlovsk (now called Ekaterinburg), roughly 850 miles east of Moscow. The first victim died after four days; the last one died six weeks later.
The Soviet government claimed the deaths were caused by intestinal anthrax from tainted meat, a story some influential American scientists found believable. However, officials in the Carter administration suspected the outbreak was caused by an accidental release of anthrax spores from a suspected Soviet biological weapons facility located in the city. The US believed that the Soviet Union was violating the Biological Weapons Convention signed in 1972 and made their suspicions public. But the Soviets denied any activities relating to biological weapons and at numerous international conferences tried to prove their contaminated meat story.
It wasn't until thirteen years later - 1992- that President Boris Yeltsin admitted, without going into details, that the anthrax outbreak was the result of military activity at the facility. During those thirteen years, while an intense debate raged within the international scientific and intelligence communities on whether the Russians were telling the truth, the Soviet Union continued its offensive biological warfare program unabated.
Around the time Yeltsin admitted the military facility was responsible for the incident, Russia allowed a team of Western scientists to go to Sverdlovsk to investigate the outbreak. The team visited Sverdlovsk in June 1992 and August 1993 and included Professor Matt Meselson.
Although the KGB had confiscated hospital and other records after the incident, the Western scientists were able to track where all the victims had been at the time of the anthrax release. Their results showed that on the day of the incident all the victims were clustered along a straight line downwind from the military facility. Livestock in the same area also died of anthrax. After completing their investigation, the team concluded the outbreak was caused by a release of an aerosol of anthrax pathogen at the military facility. But they were unable to determine what caused the release or what specific activities were conducted at the facility.
According to FRONTLINE's interview with Dr. Kanatjan Alibekov, former first deputy chief for Biopreparat (the civilian part of the Soviet biological weapons program), the anthrax airborne leak had been caused by workers at the military facility who forgot to replace a filter in an exhaust system. The mistake was realized shortly after, but by then some anthrax spores were released. Alibekov says if the wind had been in the opposite direction that day--toward the city of Sverdlovsk--the death rate could have been in the hundreds of thousands.
To this day, Western inspectors have not been allowed to visit this military facility.
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Meselson, Matthew; Guillemin, Jeanne; Hugh-Jones, Martin; Langmuir, Alexander; Popova, Ilona; Shelokov, Alexis; Yampolskaya, Olga. "The Sverdlovsk Anthrax Outbreak of 1979." Science, November 18, 1994: 1202-1208.
Venter, Al J. "Sverdlovsk Outbreak: A Portent of Disaster." Jane's Intelligence Review, May 1, 1998: 36
UF researcher says common pesticide will kill anthrax
By RON WORD
Associated Press Posted
March 29 2002, 4:57 PM EST
JACKSONVILLE –
A Florida researcher claims a common pest-control agent, used to kill
termites and fumigate citrus for shipment overseas, could also be used
to clean anthrax spores out of buildings.
The chemical, methyl bromide, would be more effective and cheaper than
current methods used for anthrax decontamination of spaces inside
buildings.
``Tests indicate the fumigant, used for more than 50 years to control
insect pests in buildings, grain elevators and fresh fruit, is a better
option than current treatments, such as chlorine dioxide, for killing
anthrax and other bacterial spores,'' said Rudolf Scheffrahn, a
professor of entomology with the University of Florida's Institute of
Food and Agricultural Sciences.
Using anthrax cleanup guidelines developed by the U.S. Army and the
Environmental Protection Agency, he tested methyl bromide in a vacant
mobile home at the school's Fort Lauderdale Research and Education
Center.
Instead of using anthrax, he used harmless spores of a related
bacterium, Bacillus subtilis, which he said is even more resistant to
chemicals than anthrax.
Eighty paper strips, each containing as many as 100 million spores of
the anthrax-like surrogate, were placed in walls, under carpets, inside
computers and file cabinets, and in other hidden places that might
harbor spores in an actual anthrax contamination.
``The tests killed the spores and proved that methyl bromide is more
effective than chlorine dioxide gas as a building fumigant for
anthrax,'' Scheffrahn said.
Jeff Kempter, senior adviser at EPA's Office of Pesticide Programs in
Arlington, Va., said the results are promising.
``It has the potential to be as effective as the chlorine dioxide,''
Kempter said Friday.
Kempter said the use of methyl bromide would be considered on a
case-by-case basis.
Scheffrahn said methyl bromide fumigation would have cost less than
one-fourth the estimated $23 million spent to clean up the anthrax
contamination in the 3,000-square-foot Daschle Suite in the Hart Senate
Office Building in Washington, D.C.
Scheffrahn also said it could be used to clear up any remaining
contamination at the American Media Inc. office building in Boca Raton,
site of the nation's first fatal anthrax infection in October.
``Another advantage of using methyl bromide fumigant is that it will not
damage equipment, furnishings or sensitive materials,'' he said.
Kempter said the EPA discussed the decontamination options with American
Media at a meeting earlier this month.
Gerald McKelvey, a spokesman for American Media Inc., said Friday that
company officials haven't determined a cleanup method and is still
negotiating with its insurance company to determine how much it will pay
toward a cleanup.
``It's not going to be cheap,'' he said.
Scheffrahn said emergency use of methyl bromide fumigant shouldn't be
affected by a looming 2005 phaseout of the gas. It is one of many gases
that deplete the Earth's protective ozone layer, and many uses will be
eliminated after 2005.
``When national security is a stake, we need to have the option,'' he
said.
http://www.sun-sentinel.com/news/nationworld/sfl-329anthrax.story?coll=sfla%2Dnewsnation%2Dfront