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DC hones bio-terrorism prep

How were the recent DC area sniper shootings like a bio-terrorist attack?

BY SUSAN KIM | WASHINGTON, D.C. | December 10, 2002


"The sniper incident brought all the same response issues to the forefront."

—Dr. Ivan Walks


How were the recent DC area sniper shootings like a bio-terrorist attack? "The sniper incident brought all the same response issues to the forefront," explained Dr. Ivan Walks, former director of health for Washington, D.C.

An effective bio-terrorism response -- and arguably an effective response to any local disaster -- involves the incident being handled by officials from one jurisdiction with support from neighboring jurisdictions. "With the sniper incident we saw a lot of that. There was work by a lot of jurisdictions with a common front.

"In October 2001 we tried to do that after the anthrax attacks with varying degrees of success," he said.

A bio-terrorism attack in the future of a much larger scale than the anthrax attacks is a distinct possibility, he said. "You can alphabetically go through the bio-terrorism threats: anthrax, botulism, cholera..."

Another similarity between the sniper attacks and a potential bio-terrorist attack is the killers weren't contained in jurisdictional boundaries.

"This is not like when something goes 'boom.' You don't know it has peaked until it's over the peak."

In the aftermath of the 2001 anthrax attacks, said Walks, "we were writing our game plan as we went."

Two types of anthrax attacks took place in the DC area, he explained -- announced and unannounced. When Senators Tom Daschle and Patrick Leahy received anthrax-laced letters in the mail, it was an announced attack.

"We began a prophylaxis program. Nobody died from the announced attacks."

But there was an insidious other issue, he said -- unannounced attacks. "All five victims who died of anthrax died of an unannounced attack."

At that time Washington officials struggled with a unified response, even though the Metropolitan Washington Council of Governments had written in 1999 a bio-terrorism response plan.

"The first thing we discovered is that a bio-terrorism response is a health systems response" that involves federal, state and local governments, as well as private physicians and hospitals, said Walks.

Now response plans are focusing on another potentially devastating type of attack: smallpox. "Smallpox probably killed 500 million to one billion people in the 20th century alone," said Walks.

Smallpox vaccines ended in the U.S. about 30 years ago, and smallpox was eradicated as a naturally occurring disease in the mid-1980s worldwide.

After that, said Walks, "the Soviet Union held on to smallpox packages and the U.S has it. Smallpox may also be held by Iraq as well as North Korea and France."

Iraq's last naturally occurring smallpox outbreak was in the early 1970s, when some 800 people caught the disease. "They had the opportunity to weaponize it," said Walks. "We know what they could have done."

The smallpox threat has long been acknowledged by national leaders. In June 2001, the Senate examined a scenario in which 3,000 people were infected with smallpox by terrorists secretly attacking three cities. Within six weeks of the attack, up to 3 million Americans would succumb to the disease, and 1 million would die.

The question of whether to vaccinate every American against smallpox has been a topic of debate among health officials, said Walks. "One out of every million people who get vaccinated for smallpox dies."

That means, should a smallpox attack never happen, innocent people would be pointlessly killed by the vaccine.

According to Walks, Vice President Dick Cheney believes all Americans should be vaccinated, while President Bush favors vaccinating only health responders.

"I would not want to be the president and have to make that decision," said Walks.


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