Outside Smallpox, Plenty Else to Fear

American authorities are taking the prospect of bioterrorism more seriously these days — but even as they take care of one threat, plenty of others are lying in wait.

Last week, the Bush administration unveiled a plan to make the smallpox vaccine available to all 280 million Americans, in advance of any possible attack. Smallpox is probably the biological threat that causes the most concern among public health officials — because it is highly virulent, kills one-third of its victims, and can leave survivors scarred and seriously ill.

Smallpox may not be the biological threat that comes first to most Americans' minds. Anthrax remains a scare as authorities still do not know who sent anthrax through the mail last year, which killed five people.

And then there's West Nile, which was first discovered in the United States more than three years ago. Though spread primarily by mosquitos, at least one prominent lawmaker suggests the real cause of West Nile may be something more ominous — a planned bio-terror attack.

Plus, other potential biological threats exist that can be used to serve terror, scientists say.

"Theoretically, anything could be introduced," said Jacqueline Cattani, director of the Center for Biological Defense at the University of South Florida College of Public Health in Tampa.

Said Dr. John Clements, chair of microbiology and immunology at Tulane University in New Orleans: "We're going to see a lot of things we haven't seen before."

Ticking Time Bombs

Even before the clamor over smallpox's potential as a bio-terror weapon, scientists raised the alarm about the growing number of potent and easily transmittable diseases.

One of the most urgent growing threats is multi-drug resistant tuberculosis (MDR-TB), which is caused by an organism that is essentially the same as the one that causes regular TB — but has developed an immunity to the antibiotics usually used to treat it.

Scientists fear a sufferer of MDR-TB could be used as a sort of human germ bomb, a disease passed from one person to the next and the next. And it's not the only disease that could be used this way.

Victor Weedn, of the BioMedical Security Institute in Pittsburgh, cites the 1918 Spanish Flu pandemic — when a version of the virus unexpectedly emerged and killed 200,000 in the United States within a month.

"There are emerging diseases all the time," he said. And the modern world's ease of travel means that such diseases can have an even greater impact.

dMoreover, these highly virulent diseases don't necessarily need to use a human being as a host to have an impact, said Stephen Johnston of the University of Texas Southwestern Medical Center at Dallas. Examples include the foot-and-mouth disease that ravages livestock, or the crop disease known as rust.

Foot-and-mouth hasn't been seen in the United States since 1929, but when it struck Britain early last year, it shut down hundreds of that country's farms. According to official estimates, it cost the country's farming industry more than $12 million.

Fearing the Vector

Concern about West Nile grew significantly this year because of the big increase in fatalities. Last year, nine people died. This year, the death toll has reached at least 116.

And the disease has spread from the Northeast to most of the nation, prompting some to question just how West Nile came to be.

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