April 1, 2003
by Erik Alsgaard

WASHINGTON - When church disaster-response officials gathered recently to review emergency preparedness plans, they also began a task that was a grim sign of the times: developing a resource for congregations on biochemical terrorism.

Representatives from the Baltimore-Washington Conference Disaster Response Committee met March 28 to review plans already in place for natural disaster assistance.

Dr. Chet Clarke, a biochemical expert and member of Bethany United Methodist Church in Ellicott City, Md., attended the meeting. He brought news that was at times chilling, at times encouraging.

"My greatest fear is a lack of education," he said. "Churches need to know what the six major biochemical agents are. We need to know what are contagious and which are not. Panic in an uneducated populace can be used as a weapon; it can kill."

Clarke, an expert in researching the incubation period of pneumonic plague and smallpox, told the group about substances that could be involved in a bioterrorist attack.

Smallpox - "Very contagious and very lethal," Clarke said. According to the Centers for Disease Control in Atlanta, "Smallpox is a serious, contagious and sometimes fatal infectious disease. There is no specific treatment for smallpox disease, and the only prevention is vaccination." The CDC describes two clinical forms of smallpox: "Variola major is the severe and most common form of smallpox, with a more extensive rash and higher fever. Variola minor is a less common presentation of smallpox, and a much less severe disease, with death rates historically of 1 percent or less."

Anthrax - According to the CDC, "anthrax is an acute infectious disease caused by the bacterium Bacillus anthracis. Anthrax most commonly occurs in hoofed mammals and can also infect humans. Symptoms of disease vary depending on how the disease was contracted, but usually occur within seven days after exposure. The serious forms of human anthrax are inhalation anthrax, cutaneous anthrax and intestinal anthrax. Inhalation anthrax is often fatal. Direct person-to-person spread of anthrax is extremely unlikely, if it occurs at all. Therefore, there is no need to immunize or treat contacts of persons ill with anthrax, such as household contacts, friends, or coworkers, unless they also were also exposed to the same source of infection."

Pneumonic plague - "Very contagious," Clarke said. The first signs of illness are fever, headache, weakness and rapidly developing pneumonia with shortness of breath, chest pain, cough and a bloody cough, he said. Without early treatment, patients may die, according to the CDC. "To reduce the chance of death, antibiotics must be given within 24 hours of first symptoms," according to the CDC. A plague vaccine is not currently available for use in the United States.

Tularemia - "This is a bacteria that is very virulent," Clarke said. "It's very infectious but not contagious." According to the CDC, a small number of Francisella tularensis (10-50 organisms) can cause disease. If used as a bioweapon, "the bacteria would likely be made airborne for exposure by inhalation," but "manufacturing an effective aerosol weapon would require considerable sophistication," the CDC says. People have not been known to transmit the infection to others so infected persons do not need to be isolated.

Botulinum toxins - These pose a major bioweapons threat, said Clarke, because of their potency and lethality. According to the Center for Civilian Biodefense Strategies, part of Johns Hopkins University in Baltimore, the toxin "is the single most poisonous substance known." The toxin "does not penetrate intact skin," according to the center, and natural cases of botulism are rare. "A deliberate aerosol or food-borne release of botulinum toxin could be detected by several features including: a large number of cases presenting all at once; cases involving an uncommon toxin type; patients with a common geographic factor but without a common dietary exposure; and multiple simultaneous outbreaks without a common source."

Hemorhagic fevers - Examples include yellow fever and ebola. "Viral hemorrhagic fevers (VHFs) refer to a group of illnesses that are caused by several distinct families of viruses," according to the CDC. "Characteristically, the overall vascular system is damaged, and the body's ability to regulate itself is impaired. These symptoms are often accompanied by hemorrhage (bleeding); however, the bleeding is itself rarely life-threatening. While some types of hemorrhagic fever viruses can cause relatively mild illnesses, many of these viruses cause severe, life-threatening disease."

Mustard gas is another possibility for terrorist use, Clarke said. "A potentially deadly chemical agent that attacks the skin and eyes - and one of the best known and most potent chemical weapons, mustard gas causes severe blisters and, if inhaled, can also damage the lungs and other organs," according to the Web site, www.terrorismanswers.com, produced by the Council on Foreign Relations.

Clarke noted that mustard gas is usually disabling but not fatal. Unlike the symptoms of exposure to other chemical agents, which usually appear immediately, he said, the symptoms of exposure to mustard gas appear later. "This makes mustard gas especially insidious, since victims can suffer damage before they even realize they need treatment."

Mustard gas has nothing to do with mustard, according to the Council on Foreign Relations Web site. "In some forms it is yellowish and reputedly smells like mustard, but its aroma has also been likened to the smell of horseradish, garlic and apples. At room temperature, it's actually a liquid rather than a gas, but the name 'mustard gas' has stuck since it was used in notorious gas attacks during World War I."

Mustard gas is a blister agent and is less likely to kill large numbers of people than such nerve agents as sarin and VX, the Web site reports.

Sandy Ferguson, associate council director in the Baltimore-Washington Conference, said that working on a packet of resources for both natural and manmade disasters places the conference ahead of the curve. "The Baltimore-Washington Conference is being proactive in resourcing local churches," she said. "This resource will be comprehensive but not exhaustive."

The packet, she said, should be ready by June.

Clarke applauded the committee's work on this issue, and said local churches play a vital role in responding to disaster.

"Right now, people don't know where to go" in the event of a biochemical attack, he said. "That's a big problem. Churches could help get the word out and assist the community in being places people could go to get help."

More information is available from the Centers for Disease Control, www.bt.cdc.gov, the National Center for Infectious Diseases, www.cdc.gov/ncidod/, and the Council on Foreign Relations, www.terrorismanswers.com/home/.

United Methodist News Service
Erik Alsgaard is managing editor of the UMConnection newspaper and co-director of communications for the Baltimore-Washington Conference.