Preparedness

Bioterrorism in a Technologically Advanced World

by Christina M. Flowers

Recent advances in genetics, genomics, and biotechnology could have devastating implications for bioweapons and genetically engineered diseases. As such, these developments raise the question of whether it makes sense to pull attention away from “ic” biothreat targets, in favor of more technologically advanced options. Immediacy and ease of use may be determining factors.

Terrorism over the past few decades has accelerated into a major strategy of contemporary conflict, and those who utilize its tactics will continue to exploit developments in emerging technologies. It is imperative then to advance preparedness practices as well as to meet this increased sophistication.

However, with constrained budgets, limited time, and so many other threats to plan for, it can be difficult to determine where to best localize efforts. Bioterrorism especially raises concerns because biological pathogens can be difficult to understand even in their most basic, natural state. Still, it can be argued that advances in genetics, genomics, and biotechnology could have disturbingly equal impacts on things like prion-based bioweapons, agroterrorism, and genetically engineered diseases, just to name a few. This raises the question, “Does it make sense to pull attention away from ‘ic’ biothreat targets in favor of the more technologically advanced options?”

Prion-Based Bioweapons Transmissible spongiform encephalopahies (TSEs) are diseases caused by prions, which are misfolded proteins devoid of nucleic acids (DNA or RNA), yet still highly infectious. Prions are known to cause fatal neurodegenerative disease and are highly resistant to heat, harsh chemical treatments, and irradiation. Recombinant prions can be bound to other substances in order to be spread through the air, or persist for years in the soil.

Symptoms of infection are a byproduct of brain degeneration, where “spongy” holes in brain matter cause sudden personality changes, impaired thinking, difficulty in performing normal functions such as speaking or swallowing, and sudden movements such as twitching or tremors. There are no treatments to halt the progression of TSEs, only to alleviate symptoms as the disease progresses. Fatality rates are described as 100 percent. The most notable TSEs in humans are Creutzfeldt-Jakob disease, kuru, and fatal familial insomnia.

With such a destructive resume, prions appear initially to be a relativelyeal terrorist weapon, except that their incubation periods prior to manifestation of clinical symptoms can take up to 40 years or more. With such an extended latency, the risks associated with handling the infectious particles relative to the immediate effects associated with their dissemination do not add up. In addition, because terrorists traditionally prefer to announce their involvement within a timely manner after an attack, it would be theoretically just as psychologically impactful to institute a hoax event, or to defer to something immediate or broadly recognized by the general population.

Agroterrorism Diseases in agriculture have far-reaching economic impacts on any country affected. For example, the 2001 British outbreaks of hoof-and-mouth disease (HFM) – a highly infectious aphthovirus spread through cloven-hoofed animals – resulted in the slaughter of over 6 million livestock and the loss of an estimated $5.4 billion in tourism revenue. In the United States, farmers are currently battling highly pathogenic avian influenza (HPAI) H5 infections in poultry – shedding light on the biosecurity issues surrounding mass poultry production facilities, which could serve as entry points and transmission routes for previously unknown diseases. 

As devastating as these losses are, it is not highly likely that responses to such incidents would change if terrorists as opposed to natural causes perpetrated these events. The HFM outbreak in Britain had a net economic effect of less than 0.2 percent of the country’s gross domestic product, and the HPAI outbreak in the Midwestern United States has gone relatively underreported, except in relation to the increased price of eggs and Thanksgiving turkeys. This is not to say that the effects are not damaging, or that the media would not have a field day with alternate reporting strategies, or that formal retaliation of some kind (as a direct result of the terrorist action) would not be pursued. It is just not “ideal” in the scope of a terrorist weapon deployed in search of policy change, or to illicit massive amounts of fear.

There would be a higher likelihood of destruction and coercion possible in certain foreign nations where specific cash crops contribute heavily to the overall gross domestic product (GDP). In these scenarios, it would be feasible that an invasive species bioweapon could cause significant loss, and thereby make more sense as a potential weapon. The problem (for terrorists) then is that no nation that relies on the same product would likely release such a weapon unless they had the safeguards themselves to counteract it. In traditional bioterrorism, this is typically seen as vaccines, antivirals, or antibiotics. In the scope of agroterrorism, it would have to take on the form of resistance mechanisms – innate or applied to the plants or livestock affected – or through some other medicinal cure. The amount of time, money, and effort required for such safeguards leaves the use of such tactics questionable.

Genetically Engineered Diseases Of course, the above scenarios assume that an unscrupulous geneticist has not already dedicated his or her life’s work to addressing these caveats. Therein lies the real concern, which is probably the hardest one to plan around in regards to preparedness efforts: genetically engineered diseases.

There are multiple ways biothreat pathogens could be potentially manipulated using modern technology. These range from inserting a small piece of plasmid DNA into bacteria with the intention of changing the bacteria’s virulence or pathogenic properties, to replacing a single gene (otherwise known as gene therapy) with the intention of possibly eluding existing vaccines. There is even the theoretical possibility of cutting and pasting gene sequences together to create brand new synthetic organisms.

However, swapping genes is also not as easy as it sounds. Molecular pathways influence many different components of the bacteria or viruses’ life cycles, and in many unpredictable ways. What might make the virus more virulent might also hinder its ability to evade the immune system. What might make the bacteria more environmentally hearty might also prevent them from replicating so quickly. The possibilities are endless, and not likely to yield mutations that “Mother Nature” herself has not already taken into consideration. For example, RNA viruses – such as Ebola – circumvent deleterious mutations by replicating with mutations in such high numbers that problematic mutations are able to “revert” to their original states. Influenza virus is also highly genetically variant (hence why flu shots are needed every year, as opposed to only once or twice as a child), and has found many opportunities to jump from one type of organism to another – such as from a bird or pig to a human.

The Next Step Still, these topics vastly underrepresent the broad scope of what communities could potentially face in the future. It is difficult to determine what needs to be done next and, frankly, it depends on one’s job profile. At the highest levels of the military and government, scientists will continue to conduct investigative research. It is imperative for the brightest minds to use their knowledge for good and to preserve humanity. In the private sector, security-based companies will continue to innovate, provide recommendations, and work with the highest echelons of preparedness leadership across the country and the world. All efforts must stay “one step ahead” of whatever warfighters, responders, and citizens are faced with in the future.

At the routine surveillance and response levels, though, little can be accomplished by worrying about the specifics of such threats until they have been deemed credible by higher authorities. After all, many agencies and organizations have difficulty executing effective detection and response mechanisms for the existing “traditional” bioterrorism threats – for example, Ebola, anthrax, botulism, ricin, smallpox, plague, tularemia, Q-fever, and Marburg. These threats are the ones that are current, viable, and persistent. As such, continued training and exercises in handling biohazardous substances and other infectious agents – such as sample collection methods, specimen handling, isolation and quarantine procedures, field-forward detection andentification of biothreat agents, and interagency coordination plans for large-scale biohazard attacks – will be the most essential tactics for combating all future incidents as they occur.

 

Christina M. Flowers has a Master of Public Health and a Bachelor of Science in Biology. She is currently responsible for U.S. sales management and business development for BioFire Defense: A technology innovation and product development company that has been supplying solutions to field forces and laboratories for biothreat detection and disease surveillance since 1990. She was recently instrumental in BioFire Defense’s clinical rollout of the first commercial test for Ebola Zaire virus in the United States. Before BioFire, she was an emergency planner for the Virginia Department of Health, and provided technical laboratory assistance during the 2001 anthrax attacks. Other professional certifications have included tropical and emerging vector-borne infectious diseases and Level-1 Hazmat Instructor. She has organized and participated in a number of emergency preparedness and response efforts across the United States.