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Overview/ Perspective on Bioterrorism

Since September 11th, we have entered into a new era, which includes not only conventional terrorist events (World Trade Center, Pentagon), but the use of biological agents against a civilian population in a way that has not occurred previously in our lifetimes. However, despite the powerful psychological impact that anthrax has produced, the actual numbers of deaths and serious illnesses has remained much smaller. This paradox preserves one of the central dichotomies in bioterrorism: the contrast between its efficacy in producing a psychological impact in large numbers of individuals and the relatively small numbers of individuals who have died or become seriously ill.

As we have struggled to come to grips with these rapidly evolving events, one of our first conclusions was that one of the important ways in which a university can contribute is to make information available. The information provided here is the first step in that process. We sincerely hope that it will be useful, and encourage comments from those who have the time to do so. Questions and comments on this WEB Site and its contents, as well as suggestions, should be directed to the Center for Infectious Diseases (center.infecdis@tulane.edu).

Questions about this WEB Site and its contents should be directed to Dr. Don Krogstad (krogstad@tulane.edu) Questions about the basic biology of anthrax should be directed to Dr. John Clements (jclemen@tulane.edu). Questions about the municipal water supply and the safety of the food supply should be directed to Dr. William Hartley (hartley@tulane.edu), and questions about air-borne spread should be directed to Roy Rando (rando@tulane.edu). Questions about interactions between the community and the city and state health departments should be directed to Dr. Rebecca Meriwether (rmeriwe@tulane.edu), whereas clinical questions should be directed to Dr. Susan McLellan (smclell@tulane.edu).

Selected Links to Websites on the Internet with Bioterrorism Information

Tulane University School of Public Health and Tropical Medicine
Louisiana State Department of Health
CDC Web Site
Johns Hopkins Web Site
Department of Health and Human Services
US Department of State
US Army Medical Research Institute of Infectious Diseases
US Army Medical Research and Material Command

Books:

[1] Regis D: The Biology of Doom: the history of America’s secret germ warfare project. Henry Holt and Company, New York, 1999. Short (236 page), very readable overview of the U.S. program in biological warfare highly focused on individuals.

[2] Miller J, Engelberg S, Broad W: Germs: biological weapons and America’s secret war. Simon and Schuster, New York, 2001. Likewise an overview, but a more comprehensive perspective, which began as an assignment for The New York Times and is not limited to the U.S. military’s efforts.

[3] Falkenrath RA, Newman RD, Thayer BA: America’s Achilles Heel: nuclear, biological and chemical terrorism and covert attack. MIT Press, Cambridge, MA, 1998. This book is based on work in preparation for a Senate-convened conference on nuclear, biological and chemical threats in 1996, which expanded from a primary initial focus on nuclear threats.


[4] Siegrist DW, Graham JM: Countering Biological Terrorism in the US: an understanding of issues and status. Oceana Publications, Dobbs Ferry, NY, 1999. This is a carefully documented historical work, produced by the Potomac Institute for Policy Studies, with the perspective of a think tank on the issue.


[5] Tucker, JB: Scourge: the once and future threat of smallpox. Atlantic Monthly Press, New York, 2001. Focused entirely on a pathogen that had been eradicated, but now threatens to reappear as a biological agent. Its perspective will continue to resonate, whether or not smallpox is used in the near future.


[6] Fenner F, Henderson DA, Arita L, Jezek Z, Ladnyi ID: Smallpox and its eradication. World Health Organization, Geneva, 1988. Encyclopedic compendium describing the virus, its clinical consequences and the campaign for eradication, with some comments about the potential for bioterrorism.

Journal Articles:

[1] Bioterrorism Symposium, DA Henderson, ed. Emerging Infect Dis 1999; 5: 491-590.

[2] Henderson DA: Bioterrorism as a public health threat. Emerging Infect Dis 1998; 4: 488-492.

[3] McDade JE, Franz J: Bioterrorism as a public health threat. Emerging Infect Dis 4: 493-494.

[4] Bellamy RJ, Freedman AR: Bioterrorism. Quarterly J Med 2001; 94: 227-234.

[5] Russell PK: Vaccines in civilian defense against bioterrorism. Emerging Infect Dis 1999; 5: 531-533.

[6] Henderson DA: The looming threat of bioterrorism. Science 1999; 283: 1279-1282.

[7] Henderson DA, Inglesby TV, Bartlett JG, Ascher MS, Eitzen E, Jahrling PB, Hauer J, Layton M, McDade JE, Osterholm MT, O’Toole T, Parker G, Perl T, Russell PK, Tonat K: Smallpox as a biological weapon: medical and public health management. Working Group on Civilian Biodefense – Consensus Development Conference. JAMA 1999; 281: 2127-2137.

[8] Franz DR, Jahrling PB, Friedlander AM, McClain DJ, Hoover DL, Byrne WR, Pavlin JA, Christopher GW, Eitzen EM: Clinical recognition and management of patients exposed to biological warfare agents. JAMA 1997; 278: 399-411.

[9] Gelfand HM, Posch J: The recent outbreak of smallpox in Meschede, West Germany. Am J Epidemiol 1971; 93: 234-237.

[10] Wetter DC, Daniell WE, Treser CD: Hospital preparedness for victims of chemical or biological terrorism. Am J Publ Hlth 2001; 91: 710-716.

[11] CDC: Bioterrorism: alleging use of anthrax and interim guidelines for management – United States, 1998. JAMA 1999; 281: 787-789 (also Morbid Mortal Wkly Rep 1990; 48: 69-74).

[12] McGowan JE: Nosocomial tuberculosis: new progress in control and prevention. Clin Infect Dis 1995; 21: 489-505.

[13] Fennelly KP, Nardell EA: The relative efficacy of respirators and room ventilation in preventing occupational tuberculosis. Infect Control Hosp Epidemiol 1998; 19: 754-759.


Tulane Center for Infectious Diseases

1430 Tulane Avenue, SL-71 | New Orleans, LA 70112-2699 | Phone: (504) 584-2663
Fax (504) 988-6686 | Email: center.infecdis@tulane.edu