With Daesh on the retreat in the Middle East, the threat to the West from returnees and homegrown radicalised advocates is persistent and growing. So is their M.O. for attacks: from guns and bombs to vehicles and – it is feared – a possible incipient capability in CBRN, having already used chlorine and mustard in dozens of IEDs Daesh have laid in occupied areas of Iraq and Syria. Among the CBRN panoply of threats, bioterrorism lurk in the background of priorities for prevention.

Food and water – the bases of life – have long been feared to be terrorist targets, although documented and fully verified instances are less common than biological warfare launched by nation states.

Threats from Daesh

In April 2016 a plastic bag full of excrement, animal testicles and explosives was found on Mohamed Abrini – the so-called “man in the hat” who fled following the suicide bombings he perpetrated at Brussels airport and Maelbeek subway station on 22 March, killing 32 and injuring 270. Police were warned of the contents of the plastic bag to prepare them to avoid infection while they were hunting down Abrini.

According to Dr Amesh Adalja of the University of Pittsburgh Medical Center for Health Security: “such crude preparations hearken back to… when warriors would coat their spears and swords in animal excrement to heighten the chance of a post-traumatic infection.” In the Vietnam War the Vietcong placed stakes dubbed Punji sticks laden with faeces to impale and infect US troops with faecal bacteria.

In February 2016 Moroccan authorities apprehended a cell that was harbouring substances that could be used to make either a bomb or what was described as a “deadly toxin”.

The long list of bioterrorism agents and diseases documented by the US Centers for Disease Control and Prevention (CDC) covers a vast range of organisms. However, there is less detail on how they could be used to poison the population.

The main non-state bioattack is regarded as the anthrax mailings one month after 9/11, said to have been perpetrated by a government scientist with access to weapons-grade spores. Five died, 10,000 citizens took a powerful prophylactic antibiotic – ciprofloxacin – and several government buildings had to be decontaminated at a cost of $320 million.

Water supplies

It is believed terrorists could attempt to bypass a municipal water purification process and introduce a biological pathogen such as Cryptosporidium at a later entry point within the potable water distribution system. Infectious agents have infiltrated swimming pools. Private well-water supply systems may be more vulnerable due to a smaller volume of water and less extensive purification system.

Following the Daesh-inspired terror attacks in Paris in January and November 2015, security measures for the French water supply system were stepped up and the company responsible for its production, distribution and storage, Eau de Paris, increased chlorination of the public drinking water. Similarly, German authorities were on high alert for a Daesh attack on drinking water following the December 2016 Christmas market attack in Berlin.

Away from the pathogenic infiltration threat is the growing risk of a cyberterrorist attack to sabotage a poorly protected computer control system at a water facility with little personal risk.

Biosecurity found wanting

A recent WHO survey highlighted in the Global Health Security Agenda (GHSA) ministerial conference in Kampala, Uganda in October revealed that 74% of assessed countries demonstrated limited or no capacity for a whole-of-government national biosafety and biosecurity system; 64% demonstrated limited or no capacity for biosafety and biosecurity training and practices; and 41% demonstrated limited or no capacity for linking their public health and security authorities during a suspected or confirmed biological event.

The report also indicated that international assistance to improve biosecurity and biosafety is insufficient to yield what’s needed most: a safe and secure laboratory and disease surveillance infrastructure.

The results indicate a lack of capability in areas vital to countering biological threats, all of which are vital in biodefence:

  • updated inventories of dangerous pathogens and toxins;
  • consolidation of dangerous pathogens and toxins into a minimum number of facilities;
  • biosafety and biosecurity legislation;
  • standards for containing and handling dangerous pathogens and toxins;
  • use of effective modern diagnostic technologies that do not require culturing;
  • comprehensive biosafety and biosecurity training; best practices for safe, secure, responsible conduct; and mechanisms for linking public health, animal health, and security authorities to investigate and attribute biological attacks.

The results also highlight remaining biosecurity and biosafety shortcomings among countries receiving assistance to improve biosecurity and biosafety capability.

A question of attribution

Of prime difficulty in working through biothreats and response to them is that the production of pathogens for warfare and terrorism – as is also the case with many chemicals – often have dual-use purposes in medicine, pharmaceuticals and agriculture. Pathogens are a necessary part of the process of making vaccines. All of this makes global or even local control virtually impossible.

Globalization, the growing world population, and consequent increasing encroachment of humans onto animal habitats have also increased the risk for spillover and natural outbreaks of disease. So there are multiple problems of ascertaining the causes of a bio-attack and diagnosing diseases when many symptoms at first resemble naturally occurring and common illnesses like flu. After the US anthrax attacks on 21 October a postal worker from Washington’s Brentwood postal facility went to the emergency room of an area hospital and was sent home diagnosed with influenza. The next day he was taken back to hospital and both he and another Brentwood postal worker died from anthrax later that day.

Only when an epidemiological analysis is made – which can take time – would the clues emerge as to the origin and precise causality of an outbreak.

Emergency departments, community pharmacists, general practitioners and laboratories are in the front line of spotting the ‘presence of the abnormal’ in the population – and these are health workers already under massive strain in most countries.

Captions

ANTHRAX

Laboratory technician holding an anthrax-laced letter addressed to Senator Leahy after safely opening it at the US Army’s Fort Detrick bio-medical research laboratory in November 2001, one month following the anthrax spore mailings that targeted sundry recipients and sparked the administration of prophylactic antibiotics to thousands of the ‘worried well’.©FBI

SANDIA SPORES

Electron microscopy of the anthrax sent to media outlets and politicians in 2001 provided vital clues to how spores were prepared.©Sandia National Laboratory