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U.S. Unprepared Despite Progress, Experts Say

The government "is on a wartime footing," said Anthony S. Fauci, the NIH official who heads biodefense research. "People who say we haven't made progress are not well informed about what it takes to make vaccine," he said, citing steps to develop vaccine for the ebola virus since 2001. "This is light speed. . . . Usually vaccines can take many years or decades."

The government also has launched other initiatives. One gives officials early warning of a biological attack by correlating pharmacy data about, for example, cough medicine sales with spikes in symptoms such as high fever and rashes observed at medical clinics. Another plan calls on mail carriers to deliver drugs after an attack.

Chris Schmidt, an emerging infectious disease fellow in the poxvirus section of the Centers for Disease Control in Atlanta, shows the use of a biohazard suit. (Ric Feld -- AP)

_____Rising Spending_____
Charts: Federal spending on biodefense grew rapidly after 2001, with large portions going to NIH and Bioshield program. Also, smallpox vaccination efforts fall well short of goal.
_____From This Series_____
Impervious Shield Elusive Against Drive-By Terrorists (The Washington Post, Aug 8, 2004)
U.S. Eyes Money Trails of Saudi-Backed Charities (The Washington Post, Aug 19, 2004)
In Search Of Friends Among The Foes (The Washington Post, Sep 11, 2004)
From a Virtual Shadow, Messages of Terror (The Washington Post, Oct 2, 2004)
Moroccans Gain Prominence in Terror Groups (The Washington Post, Oct 14, 2004)
About This Series

Three years after the Sept. 11, 2001, attacks, the U.S. government has undertaken extensive efforts to root out Islamic terrorists around the world and to defend the U.S. homeland. These articles are part of a series that considers the elusive nature of the threat and the problems authorities confront in battling it. Today's stories examine the difficulty of devising defenses and responses to bioterrorism. Previous parts of this series can be found at www.washingtonpost.com/nation.

_____Biotech Headlines_____
Helping Kids Cope In Parent's Illness (The Washington Post, Nov 9, 2004)
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Va. Tech, Research Group to Team Up (The Washington Post, Nov 8, 2004)
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Administration officials say most gaps in U.S. biological defenses result from the sheer vastness of the task ahead -- radically transforming entire sectors of society to mount defenses. They cite the need to induce an intensely skeptical drug industry to invest in biowarfare research, and the challenge of redirecting cash-starved hospitals and local health agencies into the unfamiliar field of mass casualty response.

In this age of bioterrorism dangers, long-tolerated weaknesses in the U.S. health care system have become serious national security vulnerabilities.

Daunting Array of Bioagents

The list of biological agents available to terrorists is daunting: smallpox, plague, tularemia, botulism and viral hemorrhagic fever, to name a few. Experts believe the most likely biological attack would be small, like the anthrax attacks that killed five people three years ago. But as that incident showed, even a few grams of microbes can cause widespread disruption.

Anthrax bacteria remain among the easiest microbes to manufacture and weaponize. The government has little in the way of defenses, primarily a few million doses of an old vaccine that requires six injections to confer immunity weeks later. A planned newer vaccine requires several inoculations. In the event of an attack, health officials foresee being swamped not only by crowds demanding inoculation, but also by paperwork on who has been treated.

Deepening their alarm is the prospect of new genetically engineered pathogens that could be both more deadly and more difficult to detect and treat. A 2003 CIA study described the effects of these genetically altered strains as potentially "worse than any disease known to man."

Because of "explosive growth" in biotechnology, the skills needed to make microbes resistant to antibiotics and vaccines are widely available, the CIA report said. Unlike nuclear weapons research, which is more detectable and can generally be conducted only by large government labs, bioweapons can be made by individuals in secret.

"The diversity of new BW agents could enable such a broad range of attack scenarios that it would be virtually impossible to anticipate and defend against," the CIA review said.

Although many in the scientific community are skeptical about the prospect of genetically altered superbugs, barriers to the creation of new pathogens have been falling rapidly. "We are at a transformative moment in science," said Tara O'Toole, director of the University of Pittsburgh Center for Biosecurity.

Terrorism experts believe the capacity to produce sophisticated bioweapons is still beyond the grasp of terrorist groups such as al Qaeda but easily within the reach of states such as Iran, as well as microbiologists in countries where extremist sympathies run deep. And terrorists need little expertise to mount a potentially devastating attack on livestock or crops, experts note.

"You don't need to manipulate genetics to spread foot-and-mouth disease in cattle," said David Franz, who headed the military's top biodefense research lab at Fort Detrick, Md. "You can see economic damage that adds up not to millions, but to tens of billions of dollars."

Drill Led to Breakdown

In a May 2003 exercise, the victims of a mock bioterrorism attack began to trickle into Chicago's emergency rooms complaining of fever and chills -- first in twos and threes, then by the dozens and hundreds. Soon it was thousands, and people were dying of respiratory failure all over the Midwest. But at least physicians were able to diagnose the microbe afflicting the actors in the drill : the plague.

Over the next several days, the telephone networks crashed at some Chicago hospitals and at government offices taking part in the "Topoff 2" exercise, and one was forced to use ham radios. Hospitals ran out of beds, equipment and nurses. Civic leaders gave conflicting advice on what to do. Three days later, Chicago's health system was close to collapse. Thousands of untreated people were on the streets infecting others, and 47,000 were dead or dying.

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