Officials fear toxic ingredient in Botox could become terrorist tool

By Joby Warrick
Washington Post Staff Writer
Monday, January 25, 2010; A01

In early 2006, a mysterious cosmetics trader named Rakhman began showing up at salons in St. Petersburg, Russia, hawking a popular anti-aging drug at suspiciously low prices. He flashed a briefcase filled with vials and promised he could deliver more -- "as many as you want," he told buyers -- from a supplier somewhere in Chechnya.

Rakhman's "Botox" was found to be a potent clone of the real thing, but investigators soon turned to a far bigger worry: the prospect of an illegal factory in Chechnya churning out raw botulinum toxin, the key ingredient in the beauty drug and one of world's deadliest poisons. A speck of toxin smaller than a grain of sand can kill a 150-pound adult.

No Chechen factory has been found, but a search for the maker of the highly lethal toxin in Rakhman's vials continues across a widening swath of Eastern Europe, the Middle East and Asia. U.S. officials and security experts say they know the lab exists, and probably dozens of other such labs, judging from the surging black market for the drug.

Al-Qaeda is known to have sought botulinum toxin. The Lebanese Hezbollah movement, which the United States has designated a terrorist organization, and other groups have bought and sold counterfeit drugs to raise cash. Now, with the emergence of a global black market for fake Botox, terrorism experts see an opportunity for a deadly convergence.

"It is the only profit-making venture for terrorists that can also potentially yield a weapon of mass destruction," said Kenneth Coleman, a physician and biodefense expert.

Last year, Coleman and fellow researcher Raymond Zilinskas set out to test whether militant groups could easily exploit the counterfeit Botox network to obtain materials for a bioterrorism attack. In a project sponsored by the James Martin Center for Nonproliferation Studies, two scientists found that a biologist with a master's degree and $2,000 worth of equipment could easily make a gram of pure toxin, an amount equal to the weight of a small paper clip but enough, in theory, to kill thousands of people.

Obtaining the most lethal strain of the bacterium might have posed a significant hurdle for would-be terrorists in the recent past. But today, the prospect of tapping into the multibillion-dollar market for anti-wrinkle drugs has spawned an underground network of suppliers and distributors who do most of their transactions online, the researchers found. Customers don't need prescriptions or identification, other than a shipping address.

"We assume that illicit producers are willing to sell their products to anyone with cash," Zilinskas said.

Lethal weapon

Botox -- the trade name for the most common commercial formulation of the drug botulinum toxin Type A -- is not a weapon. It has been used for decades to cure medical ailments including migraine headaches and facial tics, and more recently as a wildly popular treatment for the wrinkles of aging. Eight companies worldwide are licensed to make variations of the drug, and in the United States it is sold only by prescription, under the oversight of the Food and Drug Administration.

Each vial contains a minuscule amount of the actual toxin, a naturally occurring nerve agent secreted by a kind of bacterium called Clostridium botulinum. The amount of poison in a prescribed dose is so small that a determined terrorist would have to obtain hundreds of vials at $400 each to kill even a single person, bioterrorism experts say.

Pure toxin is another matter. At full strength, it is the most toxic substance known to exist.

So lethal is the undiluted toxin that at least three countries -- the United States, the then-intact Soviet Union and Iraq -- explored its possible use as a possible biological or chemical weapon. All three gave up on the idea, partly because botulinum toxin degrades quickly when exposed to heat, making it poorly suited for delivery by missile or bomb.

Terrorists, on the other hand, have long been drawn to the toxin as a way to inflict widespread casualties through contamination of food or water supplies. The Japanese doomsday cult Aum Shinrikyo experimented with a botulinum weapon in the early 1990s. An al-Qaeda training manual discovered in 2001 advocated the use of botulinum toxin in terrorist attacks.

None of the previous efforts succeeded. Aum Shinrikyo managed to cultivate a lethal strain of the toxin-producing bacterium, but stumbled when it tried to convert the poison into an aerosol form. Al-Qaeda's known bioweapons efforts were hampered by rudimentary lab equipment and limited access to lethal strains.

All of those problems can now be bypassed at a time when illicit networks are making the toxin for profit, said Coleman, the co-author of the study.

"There are no major obstacles," he said. "It's not that hard to acquire the bacterial strains. But you don't even have to make it. You can buy it from existing manufacturers. And you can buy it in sufficient quantity to cause widespread harm."

Tracking the sources

The case of the Russian counterfeiter offers a glimpse into an illegal network of fake Botox suppliers that operates largely in the shadows.

Anti-wrinkle drugs are exceptionally popular in Russia and Eastern Europe, where less stringent consumer laws allow their distribution by non-physicians, including operators of beauty salons. But commercial botulinum toxin is costly, and many users have flocked to vendors who offer cheaper substitutes, said Marina Voronova, until recently a Russia-based bioweapons expert who has investigated counterfeit networks in the former Soviet Union.

Voronova, who now works for the nonprofit environmental group Global Green, said the Rakhman case came to light because of the man's success in undercutting licensed suppliers in St. Petersburg's salon circuit -- and also because he was among a very few vendors to make personal sales calls in an industry that mostly operates in cyberspace. Rakhman built up a brisk trade simply by walking into upscale shops and offering to sell Botox at a deep discount, she said.

"He was coming to St. Petersburg with a suitcase full of vials," said Voronova, who learned details of Rakhman's sales pitch in interviews with local officials. Rakhman took regular flights from Chechnya and seemed to have unlimited supply. When an undercover investigator asked how many doses he could deliver, he replied: "As many as you want," Voronova said, citing an account given to her by a Russian investigator.

Rakhman abruptly halted his St. Petersburg trips when local authorities began closing in, and Russian investigators were never able to determine where his counterfeit Botox was manufactured. Zilinskas and Coleman, in their study, concluded that much of the fake Botox sold over the Internet originated in China, a country with a history of producing knockoff versions of drugs and cosmetic products sold under patent in the West. But they noted that the toxin could be made in a garage-size laboratory almost anywhere, including Chechnya, notorious for black-market smuggling and a home-grown Islamic insurgency.

China recently acknowledged the seriousness of Botox counterfeiting domestically when it announced it was shutting down a factory in Shanxi province accused of making a copycat version of the drug. That crackdown came several months after Allergan, the chief U.S. manufacturer of commercial Botox, formally complained to Beijing that Chinese manufacturers were violating Allergan's patent protections.

Allergan officials say they are continuing to work with China to identify bogus manufacturers, but they also acknowledge that some producers are outlaws who hide from Chinese authorities by frequently changing their names and business addresses.

"There are organized criminal networks, and they act as registered agents for one another," said Allergan spokeswoman Caroline Van Hove.

Indeed, Internet hawkers of discount Botox -- sold under names such as Beauteous -- often list legitimate-sounding Chinese addresses that turn out to be fictional. The Washington Post recently sought to locate three Chinese firms that offered cut-rate Botox over the Web, only to find empty lots and dead ends.

The manufacturer of Beauteous gave a manufacturing address that turned out to be an upscale corner of Beijing where many foreign embassies are located. The street number listed on the Web site does not exist.

Home-grown threats?

No laboratories for fake Botox have turned up in the United States, but there have been prominent examples of doctors and vendors who obtained cheap, unlicensed botulinum toxin to sell to unsuspecting patients and customers, sometimes with lethal results.

In 2004, U.S. Justice Department officials raided a string of clinics in five states after uncovering a supply network that substituted industrial-grade botulinum toxin for commercial Botox. The inferior toxin, which was made legally for laboratory research and not licensed for human use, paralyzed four patients.

But U.S. investigators acknowledge that they know less about the volume of trade in Botox-like drugs over the Internet. The counterfeits are part of a booming trade in fake pharmaceuticals ranging from cancer-treating medicines to knockoff Viagra. One U.S. investigator called the problem "out of control."

"We don't know how much is getting through," said the investigator, who insisted on anonymity because of his involvement in ongoing criminal probes. The fact that one of the hottest commodities happens to be a lethal poison elevates the risk to whole new level, he said.

"We know al-Qaeda has talked about going after food supplies in the United States," the official said. "There are new reasons to be concerned about what they're going to target next."

Correspondents Ariana Eunjung Cha in Beijing and Rama Lakshmi in New Delhi contributed to this report.

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