Looking Ahead in a New World
OAM examines the issues of a post-September 11 world.

As 2001 drew to a close, Afghan women were shedding their veils and returning to work. The Taliban’s last stronghold was on the verge of ruin, and the outline of a new power-sharing government was nearing completion. In the aftermath of September 11, OAM found Oberlin connections in key policy and health positions. Some are framing our future; others are preventing past mistakes.

Viruses: Conquerors of the Planet
When the first supply of smallpox vaccines arrives early this year, thank D.A. Henderson for pushing the issue
by Doug McInnes ’70

Daily reports of anthrax infection last fall revived a dormant fear in Americans about the deadliness of nature’s own biological agents. Smallpox is perhaps mankind’s most lethal disease; it killed more than 300 million people in the last century alone. Eradicated in 1979 after a 12-year campaign orchestrated by the World Health Organization (WHO), the virus survives today only in laboratories—in theory.

The campaign was stunningly successful, but former WHO leader D.A. Henderson ’50 has maintained for years that smallpox and other infectious diseases could reemerge as weapons of mass destruction. In 1998, he helped to found the Center for Civilian Biodefense Studies at Johns Hopkins University, which embarked upon a lonely campaign to convince a disinterested and resistant government of the grim possibilities.

Despite periodic talk of bioterrorist attacks, few authorities considered them a real threat. But, here and there, Henderson made inroads—attracting the attention of infectious disease specialists, the CIA, the Department of Defense, and some well-placed officials at the Department of Health and Human Services. Then the World Trade Center fell.

“People started asking what the terrorists might do next,” Henderson says. “By the following weekend, it began to dawn on us that one of their avenues could be the use of bioweapons.” The Bush administration and media reached the same conclusion, and suddenly the country wanted to hear what Henderson and his tiny biodefense center had to say. His quotes dotted pages of the The New York Times and The Washington Post, and he was interviewed at length by “60 Minutes’” host Mike Wallace. He was called in for frequent consultations with Health and Human Services Secretary Tommy Thompson and his staff.

On October 5, the first anthrax case was reported. Consultations became more frequent and the pace of activity more frantic. At the end of the month, Thompson appointed Henderson director of the new Center for Public Health Preparedness.

“The bottom line is that there’s not much expertise on bioterrorism matters in either the medical community or public health institutions,” Henderson says. He and his colleagues have tried to fill the vacuum. “We are a small group, but we do have a lot of expertise. Unfortunately, in all of this there has been a lack of information forthcoming from our government.”

A New Routine

Henderson rises each day at 5:30 a.m., often to travel from his Baltimore home to Washington, where he may confer with Thompson or other high-ranking Bush staff members. He arrives home between 6 and 9 p.m., greeted by 150 email messages. He’ll reply to 30, handing the rest off to someone else. Then there are the phone calls. Henderson typically works until after midnight, beginning his daily cycle less than six hours later. A glass of wine offers an occasional respite. Before September 11, he exercised to unwind. Now there is no time.

Henderson’s warning, delivered in a calm voice bordering on monotone, is straightforward: terrorists have at their disposal ancient deadly organisms, including smallpox, anthrax, botulism, and plague. Among these, two stand out: the smallpox virus because it is contagious, and anthrax bacteria because it is accessible, stable, transportable, and easy to release.

Just 100 kilograms of anthrax released upwind of a large American city would kill between 130,000 and 3 million people, depending on the weather and other variables, Henderson estimates. He gave that assessment to the Senate Foreign Relations Committee on September 5, just weeks before anthrax-laced letters were unleashed within the mail.

Henderson says smallpox is more difficult to transport or release into the air, “but if a smallpox epidemic were to start, it would be a disaster.”

Smallpox acts like a chain letter; each victim is expected to pass it on. To stop its spread, health officials must remove the next round of potential hosts by vaccinating those who have been exposed or who could be. Simple, in theory; a mammoth task in practice.

In 1947, a Mexican traveler carried smallpox into New York City, where, to prevent a pandemic, health officials vaccinated 6.5 million people. Smallpox released into today’s mobile population would spread more widely and rapidly than 50 years ago. Routine vaccination for Americans ceased in 1972, and those vaccinated before then have most likely lost immunity. Moreover, eradication efforts were so successful that large supplies of vaccine were deemed unnecessary. As of September 11, there were 15 million doses on hand.

Fortunately, Henderson’s campaign for larger stockpiles caught the attention of mid-level officials within the Clinton administration. The government’s first order—40 million doses—was placed in the year 2000 and will arrive early this year. In the aftermath of the attack, the Bush administration increased the order—enough for all Americans. That supply will arrive later.

“Biological weapons have been little used over the past century with the exception of several incidents in China during the second world war,” says Henderson. “Some people have asserted that there was a moral bar below which people would not go. Others believed it extremely difficult for any terrorist group to produce biological weapons and make them useable. Many people had the feeling that since this was something we hadn’t witnessed, it was therefore unlikely.”

But smallpox has existed in the laboratories of several nations, including the former Soviet Union, which had continued a massive bioweapons program long after signing an international agreement to stop. The Soviets were also suspected of creating mechanisms to deliver the virus via warheads of intercontinental ballistic missiles.

Who else might have or want bioterrorist weapons? In a report to Congress, Henderson said at least a dozen countries have or are seeking offensive biological weapons capabilities. The New Yorker listed 10 such countries two years ago: Russia, China, India, Pakistan, Israel, North Korea, Iraq, Iran, Cuba, and Serbia. Potential suppliers abound, and U.S. officials fear that former Soviet bioweapons experts are up for hire.

Because bioweapons are far easier to create than nuclear bombs, terrorists find them appealing. Producing one kilogram of plutonium requires 100 tons of uranium ore and an array of large, specialized equipment. Bioweapons can be developed in a two-car garage with equipment that can be ordered off the shelf from biotechnology supply houses. And while a sizable plutonium operation could be spotted aerially, a bioweapons facility can operate in anonymity. Once production is completed, the facility can be disinfected within a day. No traces would remain. Furthermore, agents are easily released in an aerosol spray form, odorless and invisible. Only later, perhaps weeks later, would people fall sick.

Dealing with such threats requires new technology and public health strategies. Henderson suggests that microchip sensors be developed to identify diseases quickly by decoding their genetic signature. He also urges a speedy development of new antibiotics and antiviral drugs and new ways to enhance human immune response.

Lorain County Medical Examiner Paul Matus ’72 is leading efforts to improve preparations for a bioterrorism attack in Ohio. “If smallpox hit the county tomorrow, we would be in very deep trouble,” he says. “We have no vaccines here. We would have to scramble to get people vaccinated—if we could get the vaccines.”

History illustrates what to expect if we fail to prepare. Smallpox ravaged ancient Egypt in the time of the Pharaohs. The plague killed one-third of Europe’s population in the 14th century, yellow fever 10 percent of Philadelphia’s citizenry in the 18th century. Ninety percent of Native Americans died in the 100 years following their first contact with Europeans—smallpox was the primary culprit.

As perilous as the situation appears, it is likely to get worse. Some of the world’s regions are fertile zones for the emergence of new diseases, like the ebola virus. “In the tropics and subtropics, we have people living in very poor conditions in a milieu of organisms that are constantly mutating,” Henderson says. “Some of them can be quite lethal. We also have more travel than ever before. We’ve got people going into rain forests where people have never penetrated before. They can bring diseases out with them—we’re seeing it now.”

Threats also come from the vast, emerging biotechnology industry that is working to unravel the genomes of people, plants, and animals. The ease of DNA swapping adds to the risk. “There are all sorts of people taking a gene from one organism and putting it into another,” Henderson says. “One laboratory took a gene from ebola and put it into HIV. It is possible for a pathogen to escape or to be turned into a weapon. We’ve got to be much more concerned with biological organisms in the 21st century than we were in the 20th century.”

To put our battle against biology into perspective, Henderson turned to a quote from Nobel laureate Joshua Lederberg. “Man’s only competitor for dominance of the planet is the viruses, and the ultimate outcome is not foreordained.”

Doug McInnes is a freelance science writer in Casper, Wyoming.

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