Tuesday, June 11, 2013

Is Anthrax Preparedness Necessary?


Is Anthrax Preparedness Necessary?

 

 
Author: Manisha Samy




In spite of the lethality of anthrax, debate remains on the cost-benefit analysis of anthrax bioterrorism preparedness and to what extent we should focus efforts on bioterrorism countermeasures, surveillance, readiness programs. From experience, we know that the effects of an anthrax bioterror attack can be lethal, but predicting when the next attack will occur and the scale of the attack is far from difficult, if not impossible. The bioterrorism attacks of 2001 prompted extensive biodefense research, creation and implementation preparedness plans not limited to improving the effectiveness and timeliness of distributing and dispensing antimicrobials and vaccines (Wright). The Department of Homeland Security issued a statement in 2008 indicating that “anthrax poses a threat sufficient to affect US national security,” further substantiating the potential devastation an anthrax attack can cause (Wright). Despite the low probability of a catastrophic anthrax bioterrorist attack, there is ample room for concern due to the high-stake casualty an anthrax attack can cause.

According to the World Health Organization (WHO), 50 kg of B. anthracis  airborne spores released to a population of 500,000 people has the capacity to result in 95,000 deaths and 125,000 hospitalizations, while releasing double that amount near Washington, DC can result in an estimated death count of 130,000-3 million (Wright). The immensity of this figure can be illustrated if we note that less than 500,000 American deaths resulted from World War II in a span of 4 years in comparison to a span of 3-7 days from spore exposure. However, because the anthrax mailing of 2011 were “not the mass-casualty bioterrorism many had expected” many analysts criticize plans that overemphasize worst-case scenarios rather than focusing on “more probable middle- and low-casualty attack” (Powers).  This debate exists due to the unpredictable nature of threat assessment and appropriate size and structure of a planned response. Those in favor of planning responses based on low- to mid-sized attacks argue that, “although the military-grade anthrax agent was highly sophisticated, it was delivered in a relatively unsophisticated way—through the mail system” only resulting in localized incidents and a limited number of deaths (Powers).

Although we cannot know how massive an attack must be to overwhelm or system or whether the next attack will be large-scaled or mid-scaled, the fact of the matter is that anthrax bioterrorism has the facility to incapacitate our society. Regardless of the whether the 2001 anthrax attack was delivered in sophisticated manner and only affected a limited amount of people, it created fear, terror, and chaos. Imagine if the attack was large-scaled. Although analysts have suggested that “terrorists would not be able to orchestrate mass-casualty attacks using biological weapons” based on the 2001 incident, this could simply have been a demonstration of their ability to acquire high-grade anthrax (Powers). The World Trade Center and Pentagon attacks already underscore terrorist willingness to inflict a mass casualty attack and rapid advances in biotechnology and the “diffusion of expertise” in this field “may lower the technical bar over time” (Powers).

It does not make sense to only focus on large-scale bioterror attacks, yet we cannot undermine the possibility because terrorist attacks groups have made it plenty clear that they possess the resources to do so and feasibility is not an issue. Therefore, it may make more sense to plan an anthrax preparedness program that focus on both high-consequence and low-casualty incidents. It is without a doubt that a preparedness plan for anthrax bioterror is needed, it is just a matter of the scale of preparedness required. The uncertainty in when a bioterror attack can occur and the scale at which it is deployed rends planning a preparedness program that is both efficacious and cost-effective quite difficult.  

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Michael, Powers J., and Jonathan Ban. "Bioterrorism: Threat and Preparedness." Engineering and Homeland Security 32 (2002): n. pag. Print.

Wright, Jennifer G., and Conrad P. Quinn. "Use of Anthrax Vaccine in the United States Recommendations of the Advisory Committee on Immunization Practices (ACIP), 2009." Morbidity and Mortality Weekly Report 59.RR-6 (2009): n. pag. Print.

 

 

 

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