NEWS RELEASE

4/16/03

Lisa Trei, News Service: (650) 725-0224, lisatrei@stanford.edu

Beefed up disease surveillance overseas key to guarding Americans from bioterrorism attacks at home, scientist argues

More than 140 million people fly into the United States from overseas every year. Most flights take less than one day -- far less than the 12-day incubation period for smallpox. The upshot? A contagious disease outbreak overseas, whether natural or due to bioterrorism, could spread to the United States long before an epidemic is recognized.

Christopher Chyba, co-director of the Stanford Center for International Security and Cooperation, talked about the growing need for biological security and how it differs from nuclear security at an April 3 talk sponsored by Biomedical Ethics Grand Rounds in the Medical School. Chyba, an associate professor of geological and environmental sciences, argued that early detection and containment of a biological attack is the most effective response to this growing threat.

"Not only is there a moral argument for improving international disease surveillance and response, there is a pure national interest argument," Chyba said. "We want to detect outbreaks as quickly as possible and shut them down. There's a huge impact in terms of reduction of casualties and economic harm if you can recognize it's happening quickly and therefore can respond quickly."

Unlike the production of nuclear weapons, which still largely depend on large, expensive facilities, biological weapons can be made in a variety of settings that can be harder to detect and monitor because they can be designed for more than one purpose, he said. Established strategies used to combat the spread of nuclear weapons -- nonproliferation and deterrence -- are less effective in combating the spread of biological weapons. Unlike nuclear weapons that require highly enriched uranium or weapons-grade plutonium -- substances that are complicated and expensive to manufacture -- biological agents can be obtained from natural disease outbreaks or even from laboratories. Furthermore, a strategy of deterrence is unlikely to be effective in a biological or chemical terrorist attack, he said. For example, it is still unknown who carried out the deadly anthrax attacks in the United States in October 2001.

Since the mid-1990s, Chyba has called for improved disease surveillance as part of a broader effort to combat bioterrorism. On April 10, his lobbying efforts and those of other experts paid off when Sen. Joseph Biden (D-Del.) introduced legislation aimed at combating the worldwide spread of infectious diseases. The Global Pathogen Surveillance Act would enhance disease surveillance worldwide by providing $150 million in assistance for developing nations during the next two fiscal years to improve their capability to link up with the World Health Organization's global surveillance network. The legislation would help recognize and contain infectious disease outbreaks such as Severe Acute Respiratory Syndrome (SARS) as well as combat potential bioterrorism attacks. Funds would be used to train public health personnel and obtain lab and communications equipment to diagnose pathogens and report data on disease patterns.

During the lecture, Chyba said theoretical war games show how a deadly epidemic could unfold in the United States. But real cases are scary enough, he added. In 1972, it took four weeks before health officials in the former Yugoslavia realized they were dealing with a smallpox epidemic ­ caused by a single person returning from Mecca in Saudi Arabia. In response, the country's leader, Josip Broz Tito, vaccinated his entire population and quarantined about 10,000 people in commandeered hotels and apartment complexes surrounded by barbed wire and guarded by soldiers. The draconian measures worked -- the smallpox epidemic was contained after nine weeks but not before 175 people contracted the disease and 35 died.

Explosion of biotechnology

During the 1990s, established views on terrorism changed alongside security issues related to the explosion of biotechnology. In 1975, Chyba noted, Brian Jenkins, a terrorism expert at the Rand Corporation, wrote, "Terrorists want a lot of people watching and a lot of people listening but not a lot of people dead."

Chyba said this statement largely reflected how experts thought about terrorism for several decades until events in the 1990s proved otherwise. The World Trade Center attack in 1993, the 1995 Oklahoma City bombing and the sarin gas attack on the Tokyo subway system by the Aum Shinrikyo religious cult made mass terrorism appear credible, he said.

The changing nature of terrorism was coupled with disturbing discoveries of secret biological weapons programs developed despite the 1975 Biological and Toxin Weapons Convention that established a global ban on biological arms.

With the end of the Cold War and the first Gulf War, it was discovered that Iraq was producing anthrax and the former Soviet Union supported a continental-scale smallpox program. "This was a shock to the United States and the United Kingdom," Chyba said. "It was thought that nations would use infectious agents but not contagious agents because that would run the risk of an outbreak boomeranging back to one's own population. And yet, according to defectors, the Soviet program had produced many tons of smallpox."

Despite the potential danger it poses, Chyba said, the biotechnology explosion is essentially unstoppable. "Broadly speaking, much of the applicable technology -- whether interested in genetically engineering crops or genetically engineering microbes -- is similar. We're faced with a world where it becomes increasingly easy for small groups of people to produce pathogens that are extremely deadly."

In 1998 and 1999, for example, scientists from Australian National University conducting research on mousepox -- which is analogous to smallpox -- inadvertently developed a lethal strain of the virus that could defeat the disease's vaccine. Chyba said the researchers were so concerned about the results that they waited until 2001 to publish them. While many scientists supported this decision, some security experts argued the findings never should have been made public. "Whether right or wrong, the scientific community needs to show it is thinking hard about it," Chyba said. "If it doesn't, solutions -- whether good or not -- are going to be imposed."

The biotechnology revolution inevitably will lead to greater concentrations of power in smaller groups of people, Chyba said. Experts do not know how to respond to this. "The models we have from the Cold War -- bilateral arms control models or multilateral nonproliferation models -- are not good models for this new threat," he said. "I find this deeply disturbing."

In response, Chyba said, the Global Pathogen Surveillance Act is a step in responding to a biotechnological future. "Homeland security requires that we recognize disease outbreaks overseas quickly, so that they can be controlled as fast as possible," he said after the legislation was introduced. "Yet, the global disease surveillance system remains surprisingly weak -- outbreaks can go unrecognized for too long, allowing contagious disease to spread before we know what's happening. The [act] tackles this problem head on by building infrastructure, communications and training."

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By Lisa Trei