ZKEA

Biological Warfare : Biological Terrorism : Emerging Diseases

Archived News
Week ending December 9th, 2006

Five years after the anthrax attacks that killed five people, the FBI is now convinced that the lethal powder sent to the Senate was far less sophisticated than originally believed, widening the pool of possible suspects in a frustratingly slow investigation.

The finding, which resulted from countless scientific tests at numerous laboratories, appears to undermine the widely held belief that the attack was carried out by a government scientist or someone with access to a U.S. biodefense lab.

What was initially described as a near-military-grade biological weapon was ultimately found to have had a more ordinary pedigree, containing no additives and no signs of special processing to make the anthrax bacteria more deadly, law enforcement officials confirmed. In addition, the strain of anthrax used in the attacks has turned out to be more common than was initially believed, the officials said.

As a result, after a very public focus on government scientists as the likely source of the attacks, the FBI is today casting a far wider net, as investigators face the daunting prospect of an almost endless list of possible suspects in scores of countries around the globe.

"There is no significant signature in the powder that points to a domestic source," said one scientist who has extensively studied the tan, talc-like material that paralyzed much of Washington in the deadliest bioterrorism attack in U.S. history.

The FBI says it remains optimistic that it will find whoever killed five people -- two of them from the Washington area -- in a series of bioterrorism-by-mail attacks that rocked a nation still in shock from the Sept. 11 terrorist strikes. The bureau has assigned fresh leadership to the case -- Special Agent Ed Montooth -- and retains a full-time investigative force of 17 agents and 10 postal inspectors. "There is confidence the case will be solved," said Joseph Persichini Jr., acting assistant director in charge of the FBI's Washington field office.

The prevailing views about the anthrax powder, meanwhile, have been coalescing among a small group of scientists and FBI officials over several years but rarely have been discussed publicly...

The last of the anthrax-laced letters was still making its way through the mail in late 2001 when top Bush administration officials reached an obvious conclusion: The nation desperately needed to expand its medical stockpile to prepare for another biological attack.

The result was Project BioShield, a $5.6 billion effort to exploit the country's top medical and scientific brains and fill an emergency medical cabinet with new drugs and vaccines for a host of threats.

"We will rally the great promise of American science and innovation to confront the greatest danger of our time," President George W. Bush said in starting the program.

But the project, critics say, has largely failed to deliver.

So far, only a fraction of the anticipated remedies are available.

Drug companies have waited months, if not years, for government agencies to decide which treatments they want and in what quantities.

Unable to attract large pharmaceutical corporations to join the endeavor, the government is instead relying on small start-up companies that often have no proven track record.

The troubles have been most acute with the highest priority of all: a $900 million push to add a new anthrax vaccine to the stockpile. What had begun as an effort to test and manufacture a safer, faster-acting vaccine has turned into an ugly battle between two biotech businesses. Each has hired Washington lobbyists to attack its rival's product and try to win over lawmakers and administration officials. Delivery of the new vaccine is far behind schedule, and a dispute between the Department of Health and Human Services and VaxGen, the company chosen to make the vaccine, could even end the deal. The only doses that have been added to the stockpile are of a decades-old vaccine that has generated complaints of serious side effects.

From the start, officials in Washington knew that Project BioShield would be a risky venture - for the government, the companies involved and even ordinary Americans, who might be asked to take relatively untested treatments in an emergency. Officials hoped $5.6 billion in federal money would entice companies to develop new drugs and vaccines for anthrax, smallpox, botulism, Ebola and other deadly diseases.

Because of the perceived urgency of the threat, the project suspends some traditional standards. It allows new vaccines or drugs to be used in emergencies before completing the lengthy Food and Drug Administration approval process. Full testing on humans is also not required because it is too dangerous...

British scientists have helped to develop a new malaria treatment which they hope could save many thousands of young lives in Africa. Imperial College in London collaborated with experts in Kenya to develop a technique based on fluid replacement for children ill with malaria.

They estimate it could save the lives of 80% of the million African children who die each year due to malaria.

In one trial of 88 children with malaria, 98% survived after treatment.

The treatment was developed in an eight-year collaborative study between the London college and the Wellcome Trust Kenya Medical Research Institute Centre, and is featured in the journal PLOS Clinical Trials. Using intensive care methods usually only available on paediatric intensive care units in developed countries, they showed that fluid depletion was key to the development of severe symptoms among Kenyan children with malaria.

In the past children with severe malaria have been denied additional fluids for fear they might exacerbate brain swelling associated with the disease.

The new treatment avoids this problem by including albumin - a molecule which holds water inside blood vessels - in resuscitation fluids given to children.

It is absolutely essential that the results are reproduced in larger studies before we advise on any change in practice

In two preliminary studies less than 5% of children who received albumin died - compared to up to 40% who die after receiving conventional treatments.

And in a new trial of 88 children, just 2% of children receiving albumin died, compared to 16% receiving a cheaper synthetic solution.

Researcher Dr Kathryn Maitland said: "The observation that treating very sick children with severe malaria with albumin infusion can reduce the mortality rate by over 80%, represents a major breakthrough towards improved treatment of this devastating illness.

"However, administration of fluid to children critically ill with malaria is contrary to prevailing practice, and albumin is currently not available in most African hospitals...

On the grounds of a military base an hour's drive from the capital, the Bush administration is building a massive biodefense laboratory unlike any seen since biological weapons were banned 34 years ago.

The heart of the lab is a cluster of sealed chambers built to contain the world's deadliest bacteria and viruses. There, scientists will spend their days simulating the unthinkable: bioterrorism attacks in the form of lethal anthrax spores rendered as wispy powders that can drift for miles on a summer breeze, or common viruses turned into deadly superbugs that ordinary drugs and vaccines cannot stop.

Managers of the National Biodefense Analysis and Countermeasures Center say it will explore the consequences of biological attacks, at times by simulating or creating small amounts of biological agents to study how to defend against them. Some research priorities suggested in government documents:

* "Weaponized" pathogens: Microbes, such as anthrax spores, pictured above, that have been converted into a fine powder or other form that can be easily spread.

* Novel delivery systems: Modern techniques and devices that can disperse viruses and bacteria over a wide area.

* Genetically engineered threats: Pathogens that have been genetically altered to make them more virulent or harder to defeat.

The work at this new lab, at Fort Detrick, Md., could someday save thousands of lives -- or, some fear, create new risks and place the United States in violation of international treaties. In either case, much of what transpires at the National Biodefense Analysis and Countermeasures Center (NBACC) may never be publicly known, because the Bush administration intends to operate the facility largely in secret.

In an unusual arrangement, the building itself will be classified as highly restricted space, from the reception desk to the lab benches to the cages where animals are kept. Few federal facilities, including nuclear labs, operate with such stealth. It is this opacity that some arms-control experts say has become a defining characteristic of U.S. biodefense policy as carried out by the Department of Homeland Security, NBACC's creator...

World health officials last night put out an unprecedented warning that deadly new strains of tuberculosis, virtually untreatable using the drugs currently available, appear to be spreading across the globe.

The new strains are known as extreme drug-resistant TB, or XDR-TB. They have been identified and have killed people in several countries, including the United States and eastern Europe, and they have recently been found in Africa, where they could swiftly put an end to all hope of containing the Aids pandemic through treatment.

Yesterday Paul Nunn, who heads the World Health Organisation's TB resistance team, said the situation was very serious. There are 9m cases of TB in the world and the WHO estimates that 2% of them - or 180,000 - could be XDR-TB. "This is raising the spectre of something that we have been worried might happen for a decade - the possibility of virtually untreatable TB," said Dr Nunn.

Even in the United States, which has the best medicines available, a third of those who have been diagnosed with XDR-TB have died. In March, the Centres for Disease Control in the US registered that there had been 64 cases of XDR-TB; 21 of those ended in death.

Significant numbers of cases have been confirmed in Latvia and Russia, but in many parts of the world, XDR-TB could be rife but unrecognised. One of the reasons the WHO is concerned is that tuberculosis spreads easily in confined places, such as aircraft. Multi-drug resistant TB strains - those that are resistant to the two basic, first-line drugs used to treat the disease - have spread everywhere, including to the UK. Multi-drug resistant TB is increasingly common and is difficult and expensive to treat. The patient must be given four out of the six existing second-line drugs.

But the XDR-TB strains now appearing are a medical nightmare because at least three out of those six second-line drugs have no effect. There are no third-line drugs.

The spectre of a new untreatable plague has concentrated minds because of the identification of a cluster of cases in KwaZulu Natal, in South Africa. Scientists ran tests on people with tuberculosis in a rural part of the region. They studied 544 patients and found that 221 had TB strains against which the two common drugs, rifampicin and isoniazid, had no effect.

Finding such a high rate of multi-drug resistant TB was serious enough. But they also discovered that 53 of the patients had XDR-TB - and 52 of them died within an average of 25 days....