1. Aum Shinrikyo and Bioterrorism By Paul Rega MD

2. The First Attempt at Anthrax Bioterrorism 1993 1993 Kameido, Tokyo Kameido, Tokyo

3. June 29, 1993 Five residents in Kameido (eastern zone of Tokyo) report foul odor in neighborhood Five residents in Kameido (eastern zone of Tokyo) report foul odor in neighborhood Public health investigators discover originating from 8-storey headquarters of the Aum Shinrikyo Public health investigators discover originating from 8-storey headquarters of the Aum Shinrikyo

4. June 30, 1993 41 complaints about the foul odor causing 41 complaints about the foul odor causing Loss of appetite Loss of appetite Nausea Nausea Vomiting Vomiting Investigators ask to check headquarters Investigators ask to check headquarters Admittance refused Admittance refused Air and ground samples collected Air and ground samples collected Building’s activity monitored Building’s activity monitored Determined that odor posed no real threat to human health Determined that odor posed no real threat to human health

5. July 1, 1993 Neighbors complain of loud noises and intermittent mist emanating from the headquarters' cooling tower. Neighbors complain of loud noises and intermittent mist emanating from the headquarters' cooling tower. 118 complaints of foul odors 118 complaints of foul odors Mist fluid described as “gelatin-like, oily, gray-to-black” Mist fluid described as “gelatin-like, oily, gray-to-black” Samples collected; no bacteriologic studies performed Samples collected; no bacteriologic studies performed

6. July 2, 1993 After intermittent misting continues, persistent complaints by neighbors to authorities force Shoko Asahara, the Aum Shinrikyo founder, to cease activities on the rooftop and to vacate building. After intermittent misting continues, persistent complaints by neighbors to authorities force Shoko Asahara, the Aum Shinrikyo founder, to cease activities on the rooftop and to vacate building.

7. July 16, 1993 Officials inspect vacated building. Officials inspect vacated building. Nothing found except black stains on wall Nothing found except black stains on wall Incident forgotten until 1996. Incident forgotten until 1996.

8. March, 1995 Aum Shinrikyo launch sarin attack on Tokyo subway system Aum Shinrikyo launch sarin attack on Tokyo subway system The results The results 12 dead 12 dead Approximately 1,000 hospitalized Approximately 1,000 hospitalized 5,500 sought medical care 5,500 sought medical care 10% of first responders injured 10% of first responders injured

9. May 23, 1996 During arraignment of Asahara, cult members testify that the 1993 Kameido incident was their attempt to aerosolize Bacillus anthracis to create an inhalational anthrax epidemic During arraignment of Asahara, cult members testify that the 1993 Kameido incident was their attempt to aerosolize Bacillus anthracis to create an inhalational anthrax epidemic The foul odor and the blackish mist was the result The foul odor and the blackish mist was the result The purpose for an epidemic: Trigger a world war making way for Asahara to rule the world! The purpose for an epidemic: Trigger a world war making way for Asahara to rule the world!

10. November, 1999 One 1993 fluid sample finally allowed to be tested for pathogens One 1993 fluid sample finally allowed to be tested for pathogens Test tube of 2.6 mL of gray-black fluid tested at Northern Arizona University, Flagstaff, AZ Test tube of 2.6 mL of gray-black fluid tested at Northern Arizona University, Flagstaff, AZ Found: 4 x 10³ colony-forming units of B. anthracis/mL Found: 4 x 10³ colony-forming units of B. anthracis/mL B. anthracis is genotypically identical to a commercial strain used in Japan to vaccinate animals against anthrax B. anthracis is genotypically identical to a commercial strain used in Japan to vaccinate animals against anthrax

11. 1999-2000 Retrospective case-detection survey conducted to identify any 1993 anthrax victims Retrospective case-detection survey conducted to identify any 1993 anthrax victims Physicians at 39 health care facilities in the high-risk area surrounding the cult’s headquarters were asked telephonically about any anthrax cases in 1993. Physicians at 39 health care facilities in the high-risk area surrounding the cult’s headquarters were asked telephonically about any anthrax cases in 1993. No one reported any cases resembling inhalational anthrax whether respiratory or meningitis No one reported any cases resembling inhalational anthrax whether respiratory or meningitis

12. Why Unsuccessful? The anthrax strain used could not produce a protective capsule and is regarded as nonpathogenic for immunocompetent people The anthrax strain used could not produce a protective capsule and is regarded as nonpathogenic for immunocompetent people The spore concentration at 10/mL is much less than what is considered optimal for a liquid- based biologic weapon The spore concentration at 10/mL is much less than what is considered optimal for a liquid- based biologic weapon The liquid suspension too viscous The liquid suspension too viscous Droplets too large (>5μm in diameter) to be inhaled into lungs Droplets too large (>5μm in diameter) to be inhaled into lungs Effectiveness of spray system questionable Effectiveness of spray system questionable Solar radiation decreases survivability of spores Solar radiation decreases survivability of spores

13. Reference Takahashi H, Keim P, et al. Bacillus anthracis Incident, Kameido, Tokyo, 1993. www.cdc.gov/ncidod/EID/vol10no1/03- 0238.htm. Accessed 1/11/04. Takahashi H, Keim P, et al. Bacillus anthracis Incident, Kameido, Tokyo, 1993. www.cdc.gov/ncidod/EID/vol10no1/03- 0238.htm. Accessed 1/11/04. www.cdc.gov/ncidod/EID/vol10no1/03- 0238.htm www.cdc.gov/ncidod/EID/vol10no1/03- 0238.htm