We may not realize until too late, Ken Alibek explains (in Biohazard), that we have become the victims of a biological attack:
It is not until days or weeks after such an attack has taken place—after the first wave of deaths—that we will most likely recognize its occurrence.
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A small amount of Marburg or Ebola released in the subway system of Washington, D.C., Boston, or New York, or in an airport, shopping mall, or financial center, could produce hundreds of thousands of victims.
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It is easier to make a biological weapon than to create an effective system of biological defense. Based on our current level of knowledge, at least seventy different types of bacteria, viruses, rickettsiae, and fungi can be weaponized. We can reliably treat no more than 20 to 30 percent of the diseases they cause.
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In a simulated attack staged in New York City in 1998, nearly all of the members of an emergency unit dispatched to the scene “died” because they were insufficiently protected. “They did all the right things,” a federal official who watched the exercise told The New York Times. “But the scenario utterly defeated them.” The emergency teams were hampered by their inability to identify which biological agents had been used.
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Most methods involve the exposure of vials or petri dishes containing laboratory-grown cultures to air samples from a suspected target area. This can be a laborious process. A field monitoring device used during the Gulf War took between thirteen and twenty-four hours to make a positive identification. For botulinum toxin, one of the staples of Iraq’s arsenal, this would already be too late.
Technology has improved since then. The Biological Integrated Detection System (BIDS) cut the time to only thirty minutes, but it can so far only determine the presence of anthrax, plague, botulinum toxin, and staphylococcus enterotoxin B.
In September 1998, he explains, Clinton and Yeltsin agreed in Moscow on a program of “accelerated negotiations” to strengthen the Biological Weapons Convention:
In America, the loudest protests have come from commercial biotechnology companies, who argue that open-ended inspections of their labs and production facilities will leave them vulnerable to industrial espionage. Biotechnology is a multi-million-dollar industry. Between 1989 and 1996 the number of firms in the United States developing new-generation drugs soared from 45 to 113.
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Nothing prevents a state from concealing a weapons program under the guise of protecting commercial secrets.
Arms treaties are important. They set standards of international behavior regarding the acquisition and use of weapons of mass destruction. But they are almost invariably ignored when countries believe their national security is at stake.
The American plan to stockpile and develop vaccines against known agents is the most comprehensive of its kind in the world, Alibek notes, but, as parts of that plan have been implemented, its limitations have become clear:
Mandatory immunization of troops has been official Pentagon policy since 1993. All 2.3 million American soldiers have begun to receive shots against anthrax, currently regarded as the principal threat because of its documented presence in Saddam Hussein’s arsenal. But no vaccines are contemplated against other agents believed to be in that arsenal, such as aflatoxin, botulinum, and smallpox. The extra cost would be enormous (the six-year anthrax vaccine program alone will cost the military an estimated $ 130 million) and vaccines are not without side effects. Injecting soldiers against dozens of diseases would not protect them from the agents we don’t know about, or from those for which there are no known vaccines.
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Vaccines made of live but weakened microorganisms are generally more effective than those made of nonliving cellular or subcellular components. Both types are usually benign, but in rare cases they can trigger significant changes in the blood and endocrine systems. Some have been known to affect the functioning of the heart, lungs, kidneys, and other organs. It is not medically advisable to combine too many different courses of vaccination.
There are currently no known vaccines for brucellosis, glanders, and melioidosis or for many viral diseases, such as Ebola and Marburg. The plague vaccine was found to be ineffective against aerosol dissemination in animal studies. The tularemia vaccine is difficult to culture and potentially dangerous. Of the four possible strains available for viral encephalitis, the first and most potent (a live vaccine) produces adverse reactions in 20 percent of all cases and is ineffective in 20 percent. The second is of restricted effectiveness (it only works against three subtypes of the disease), and the third and fourth are poorly immunogenic and require multiple immunizations. The smallpox vaccine, only available in the United States to lab workers and military personnel, can be administered either before or after infection. It requires periodic boosters and wears out after ten years, though revaccination is required after three years in case of infection. Skin testing is recommended for Q fever and botulinum toxin.
The anthrax vaccine used in the United States has to be administered six times before it becomes effective (three times in two-week intervals and three times in six-month intervals) with annual boosters thereafter.
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American experts maintain that annual boosters are safe—the live vaccine we used in Russia was associated with some risks—but scientists generally agree that excessive vaccination can create complications in the immune system, leading in rare cases to the formation of tumors.
Repeated vaccinations has been known to trigger or aggravate allergies. Thirty minutes after I received my last vaccination against anthrax in 1987, my face became swollen, and I developed a rash and had trouble breathing. I took Dimidrol, a powerful anti-allergy medication available in Russia (though not in the United States) and felt better again in a few hours. For the next ten days I received intravenous preparations at a hospital—a form of allergy treatment we called desensibilization therapy. Several colleagues had been forbidden from anthrax work after similar reactions.
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I received my first anthrax vaccination in 1979 and began a course of annual vaccinations in 1982. I was also vaccinated against smallpox once, twice against tularemia, and four times against plague. The chronic allergies I have suffered throughout my adult life are a direct consequence of repeated exposure to live vaccines, and to other biological substances I worked with.
Vaccines provide excellent protection against specific diseases, but the characteristic that makes them so effective—that specificity—is also the source of their limitations.
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Despite American efforts and expenditures, vaccines have limited value for the protection of civilians.

