Imagine an enemy so diminutive, so obscure, that the ramification of failing to apprehend “him” could prove deadly! This is a real and definable problem that plagues (pun intended) the response community today and will remain a dilemma for the foreseeable future…
“Getting it wrong” when it comes to timely and accurate detection of Biological Warfare Agents (BWA) is, and remains, a critical issue faced by the response community on a global scale.
In March 2005, Interpol stated that “there is no criminal threat with greater potential danger to all countries, regions and people of the world than the threat of bio-terrorism, and there is no crime area where the police generally have as little training as they do as in preventing or responding to bio-terrorist attacks.”
The response community is provided with a very finite set of tools to detect, mitigate and adjudicate limited bio-agent threats. Many of these tools are poorly designed, have high margins of error, have minimal shelf lives, or worse yet, end up in the hands of untrained personnel. The search for microbial organisms in the micron size range is a daunting task. Waiting for victim symptomatology to appear post-attack is not a viable response tactic.
Finding an enemy the human eye is not even capable of seeing (a benefit, in the eyes of a terrorist organization) leaves the response community in a severe and certain dilemma…
The dilemma is the passing of time in regard to a BWA attack and the latent onset of illness. Unfortunately, once a BWA is dispersed and a few days pass and victims begin to present illness, the mortality rate increases exponentially! For this reason, early, substantial and accurate field detection performed by trained and competent responders is paramount in the fight against biological terrorism. If the appropriate prophylaxis is not administered in a timely manner after an attack, lives will most certainly be in jeopardy.
A high probability exists that the task of field screening a high volume of suspected biological agents in the field could arise in any community at any time. As discussed, current technologies available to the response community are limited.
What is needed to more effectively and efficiently screen for the initial presence of potential BWA is a “back to the basics” approach; a readily available tool that is easy to operate, not constrained by costly consumables, potentially expired reagents, or even dead batteries…
An easy solution does exist, but is not being commonly utilized. The addition of field-microscopy is a powerful tool that should be adopted into the “toolbox” of every response team involved in the business of BWA field detection. It is not suggested here that the response community attempts to replace or forego a skilled microbiologist; rather the idea is to add a simple and basic tool to include in their personal “toolbox” of readily available response equipment.
Adding a microscope to this “toolbox”, contributes to an additional layer of safety when dealing with BWA field detection. With regimented and minimal training, an operator can easily visualize the presence of a microbial organism (bacterial, not viral). As stated earlier, BWA is not visible with the naked human eye. Many of the bacterial agents of concern are in the micron (mm) size range and can be easily and readily seen in a common microscope with proper magnification and lighting.
Different morphologies: Table salt (above), Yersinia pestis – plague (below)
Properly trained operators can easily discern with their own eyes the distinctive difference of a chemical structure versus a microbial organism (bacterium) including the morphology (shape) of the bacterium. Looking at a sample of Bacillus anthracis compared to a talc or salt is as relatively easy as comparing circles to squares. Sizing of the organism is also very easy with an ocular scale. Recognition of “artifact” in the prepared sample versus viable organisms is also very important.
It is important to note that the operator is not using the microscope to identify the specific bacteria in the prepared sample (wet-mount). The microscope should be used only to assist in ruling-in or ruling-out the potential for the presence of unknown bacteria. Specific identification is better left to the trained and qualified microbiologist at the receiving lab.
An operator with a properly equipped scope, could take a photo of what they see in the ocular and send it digitally, in real-time, to a trained microbiologist or investigator back at the lab or command post for further interpretation.
It is incontestable that Anthrax spores were mailed via an envelope on the east coast, causing the loss of life. It is paramount that the response community as a whole does not become complacent in handling these potentially deadly incidents. It only takes a few inhaled organisms of some undetected BWA’s to cause disease and/or death!
The response community must be ever vigilant in the pursuit of accurate and proficient BWA detection techniques. Any addition to the response community’s capabilities would prove viable.
The consequence of improper detection could prove lethal.