1. The Biological War Threat Anthrax, Black Plague, and Bird Flu, Oh, My! Kimothy L. Smith, DVM PhD

2. Nevada Counties with Cases of Anthrax

3. Played in Las Vegas at the House of Blues in Feb 2012

4. Overview A Brief Bit of History Biological Warfare Programs Bio-Terrorism and Biodefense Emerging Infectious Diseases Summary and Discussion

5. A Brief Bit of History The Siege of Caffa European Settlement of America George Washington

6. Locator Map of Caffa Present Day Feodosija, Ukraine. Establish in 1266

7. Siege of Caffa The year 1346 First known use of Biological Warfare Responsible for spreading the Black Death from Crimea to Europe

8. European Settlement of America In 1763 Lord Jeffrey Amherst purposely distributed Smallpox virus contaminated blankets to American Indians In the mid-1800’s at least four different major epidemics struck the Plains tribes

9. George Washington Personal physician recorded in his journal that Washington had Anthrax Surgically removed the lesion from his thigh Kept very secret

10. Recommended Reading

11. Biological Warfare Programs Country Program Status and Sverdlovsk Biological Weapons Convention Military vs. Civilian and Agricultural Threats

12. Program StatusKey Probable Possible Research Former

13. Sverdlovsk Anthrax Incident 1979

14. Military housing south of Compound 19 Sverdlosvk 1979 Between 120 and 400 persons sick At least 75 died Initial report blamed contaminated meat Later linked to release from bio-weapons facility Multiple fragment sizes for vrrA loci

15. Biological and Toxin Weapons Convention The 1925 Geneva Protocol prohibited use of Biological Weapons The BTWC was opened for signature in 1972 and entered into force in 1975 The Convention bans the development, production, stockpiling, acquisition and retention of microbial or other biological agents or toxins, in types and in quantities that have no justification for prophylactic, protective or other peaceful purposes.

16. Sec. of State Clinton at BWC Review Conference 7 “The nature of the problem is evolving. The advances in science and technology make it possible to both prevent and cure more diseases, but also easier for states and non-state actors to develop biological weapons. A crude, but effective, terrorist weapon can be made by using a small sample of any number of widely available pathogens, inexpensive equipment, and college-level chemistry and biology. Even as it becomes easier to develop these weapons, it remains extremely difficult…to detect them, because almost any biological research can serve dual purposes. The same equipment and technical knowledge used for legitimate research to save lives can also be used to manufacture deadly diseases.”

17. Military vs. Civilian and Agricultural Threat On the battlefield the threat of BW may be as effective (or more!) as actual use Is the enemy objective to kill or hinder (incapacitating agents) or consume resources? Control of BW agent after release may be difficult or impossible due to drift, etc., or use of infectious agent

18. Military vs. Civilian and Agricultural Threat Military use of BW agent on a civilian population? Biological Warfare or Bio- Terrorism? Attack on agricultural targets could be potentially more devastating, at least economically Accomplished by State or Non-state actors

19. Bioterrorism and Biodefense Aum Shinrikyo and Amerithrax Biodefense Spending vs. Readiness DIY Bio and Synthetic Biology “The Birds are Already Doing That…”

20. Aum Shinrikyo Anthrax Attack 1993 Aum leader Chizuo Matsumoto aka Shoko Asahara

22. SterneLivestockVaccineStrain Kameido (Aum Shinrikyo) Isolate vrrB 1 vrrA vrrC 1 vrrC 2 vrrB 2 CG3 pXO1-AAT -Both isolates lack pXO2 plasmid -Fragment sizes match for 7 loci

24. Sept. 18, 2001 Trenton Mailing of anthrax letters to NBC and NY Post and probably to the National Enquirer. Sept. 20St. Petersburg Mailing of hoax letters to NBC and probably to NY Post [and National Enquirer?] Sept. 21place? Mailing of accusatory letter to Quantico Marine Base accusing Dr. Asaad, former USAMRIID scientist, as terrorist. Sept. 19- 25 NYC NBC received and opened ANTHRAX letter (brown granular sandy); not recognized as dangerous, and not reported by media. Sept. 25NYC NBC received and opened HOAX letter postmarked 20 Sept; notified FBI but incident not reported by media. Oct. 1DCWashington Times article quoting SH (reprint from 11 Aug 97). Oct. 2Boca RatonStevens (AMI) checked into hospital, near death, undiagnosed. Oct. 4Boca RatonFirst report of anthrax case, 5pm (Stevens, AMI). Oct. 5Boca RatonDeath of first anthrax victim (Stevens, inhalation anthrax). Oct. 5St. Petersburg Mailing of hoax letters hoax letters to J. Miller at NY Times and H. Troxler at St. Petersburg Times. Oct. 5-8US mediaSuspicion of possible bioterrorism is increasing but mail not implicated. Oct. 6-7Boca RatonAt AMI, spores found in 2nd worker and on Stevens' computer keyboard. Oct. 8Boca Raton 2nd worker (Blanco, mailroom worker) at AMI sick, nasal spores detected; FBI takes over investigation, seals AMI office. Blanco later confirmed to have inhalation anthrax. Oct. 9US mediaLooks like bioterrorism (letters not yet recognized as source). Oct. 9St. PetersburgTroxler (St. P Times) opened hoax letter. Oct. 9TrentonMailing of anthrax letters to Daschle and Leahy. Oct. 10Boca Raton 3rd AMI worker (2nd in mailroom) tests positive for anthrax. FBI now conducting criminal investigation. Anthrax strain appears to be Ames. Oct. 10-12US media First suspicion that source of anthrax at AMI might be a letter (not found), since two of those affected work in mailroom. Oct. 12NYCMiller at NYT opened hoax letter. Oct. 12-13US mediaFirst reports of any anthrax of hoax letters to media. Oct. 12NYC NBC cutaneous anthrax case reported (Brokaw's Assistant). First symptom was 25 Sept. CSF smear Thoracic radiograph

26. Bruce Ivins

27. Amerithrax The total cost of Amerithrax is incalculable 5 deaths and 24 infected person (known) Did the U.S. reaction cause this to be a “Black Swan” event?

28. Biodefense Spending Federal Agency Biodefense Funding, FY2010-FY2011 Biosecurity and Bioterrorism: Volume 8, Number 2, 2010

29. Civilian Biodefense Funding by Agency, FY2011 (in $millions) Federal Agency Biodefense Funding, FY2010-FY2011 Biosecurity and Bioterrorism: Volume 8, Number 2, 2010

30. Bio-Response Report Card The Bipartisan WMD Terrorism Research Center’s Bio-Response Report Card October 2011, WMD Center Wash., DC wmdcenter.org

31. Do-it-yourself: Cathal Garvey, 26, poses in the biology laboratory he created in his mother's spare bedroom. – MIT Technology Review 2/13/12 DIY Bio

32. The Cat’s Out of the Bag

33. “The Birds are Already Doing That…” National Institutes of Health funded study to genetically modify H5N1 Influenza virus (Bird Flu) to be more easily transmitted between humans The research prompted the National Science Advisory Board for Biosecurity (NSABB), which advises the Department of Health and Human Services (HHS), to recommend that Science and Nature redact key information prior to publication Both NSABB and HHS expressed concerns that published details about the papers' methodology and results could become a blueprint for bioterrorism.

34. Emerging Infectious Diseases West Nile Virus Severe Acute Respiratory Syndrome (SARS) Avian Flu Swine Flu Ebola Reston Virus XDR TB

35. Summary and Discussion BW Threat of yesterday likely doesn’t exist today Bioterrorism and EID’s are “Black Swan” events Balanced approach between Biodefense and building Public Health Capability and Capacity is the most sound approach Despite fears of DIY Bio and Synthetic Biology openness of research keeps us safer

36. Questions or Comments?