Precautions taken for bio-terrorism

By Rhonda Rowland
CNN Medical Correspondent

(CNN) -- The September 11 terrorist attacks in New York and Washington prompted federal agencies in the United States to brace for the possibility of an attack using biological or chemical weapons.

No such attack has been reported, but the Centers for Disease Control and Prevention in Atlanta, Georgia, put its network of public health officials on heightened alert.

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A chemical attack would cause symptoms like eye and lung irritation. The chemicals would not usually spread far beyond the area where they were released. But experts say biological weapons would be harder to detect.

"A biological event is very different," said Dr. Henry Siegelson of Disaster Planning International. "This is a delayed event. The patient may not even know that he's been exposed."

It would take an alert physician to notice the symptoms of a bio-terror attack. And some biological agents are contagious -- meaning victims might infect others before being quarantined.

One of those infections is smallpox, which was declared eradicated in 1980 after a worldwide public health campaign spearheaded by the World Health Organization. The virus is still kept alive at labs in the United States and Russia, and arguments about finally destroying the samples have balanced the benefit of further research into smallpox with some scientists' fears that it could be used as a biological weapon.

Experts say there are no national standards or guidelines for hospitals to respond to biological or chemical attacks. A recent survey of 186 hospitals in four northwestern states found fewer than 20 percent had response plans for bio-chemical incidents.

Fewer than one-third of respondents had enough antidote on hand to treat 50 patients exposed to chemicals; half had a two-day supply of antibiotics for a biological attack.

The national pharmaceutical stockpile program, overseen by the CDC, can rapidly deploy medications, antidotes, and equipment. But supplies of vaccines, such as that for smallpox, are limited.

"The U.S. government has recently let a contract to develop and then to manufacture a large quantity of smallpox vaccine and that's a very good step," said Samuel Watson with the Biomedical Security Institute.

The contract calls for creating 40 million more doses of smallpox vaccine, a powerful vaccine that can provide protection within hours. But the shipment won't be ready until 2004.

"For an attack by a terrorist using biological weapons, we're about halfway there," Watson said.

"We're very dependent on physicians in the emergency rooms to detect that something strange is happening," said Dr. D.A. Henderson, director of the Johns Hopkins Center for Civilian Biodefense Studies in Baltimore, Maryland.

Henderson, who directed the WHO program that wiped out smallpox, worries hospitals may not have the capacity to respond.

"Over the years we've managed to become more economically efficient in the hospitals. We closed down many hospitals...this means there are many fewer emergency rooms," he said.

Hospitals are slightly better prepared for chemical attacks. And, according to Siegelson, it wouldn't be hard to gear up for such attacks.

"We could do that today with minimal expenditures and a minimal amount of training, purchasing of the appropriate equipment and policies and procedures," Siegelson said.