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Terrorism has been a hot topic throughout the emergency response community for the past several years. Acts of terrorism occurring within the United States are a very real possibility. Bombings have been the weapons of choice in the past; however, biological weapons present a credible threat for the future.
Anthrax, in particular, is a likely choice of the terrorist for a number of reasons. It is highly lethal with a mortality rate of 80% to 90% from inhalation exposure. Deadly concentrations are much less than for chemical nerve agents. Anthrax is relatively easy to produce and occurs naturally in many parts of the world, including the United States. It is also easy to deliver in its most deadly form, aerosol.
Photo by Robert Burke
Responders to a reported anthrax incident will need Level B protection at a minimum for packaging the suspected agent and decontaminating victims.
Anthrax weapons can be produced at a fraction of the cost of other weapons of mass destruction, with equal effectiveness. One kilogram (2.2 pounds) of anthrax can be produced for less than $50 and if properly aerosolized, under appropriate weather conditions, could kill hundreds of thousands of people in a metropolitan area.
Within the past 10 months, terrorism in the United States has taken on a new twist, the "anthrax hoax." Threats boasting the release of anthrax or the exposure of individuals have occurred in at least 17 states and continues to spread. The FBI reports it investigates new anthrax hoaxes on a daily basis. Targets have included abortion and family-planning clinics, federal and state buildings, churches, courthouses, public schools, dance clubs and office buildings. Threat mechanisms have included mailed letters with a white powder inside boasting "you've just been exposed to anthrax," threatening letters, notes written on walls in buildings, telephoned threats and materials left in buildings. These incidents are much like bomb threats. The potential for an anthrax incident is very real, but all of the events that have occurred so far have been hoaxes.
Each time an anthrax threat occurs, though, it must be taken seriously. Response to these types of incidents causes much the same response from fire, police and EMS as would a real anthrax release. Response resources are tied up for hours, building activities are disrupted, as is traffic around the buildings and neighborhoods. Thousands of dollars are lost from business disruptions and the cost of emergency responses.
Media coverage plays into the attention the responsible persons are trying to obtain and encourages copycats to create similar hoaxes in other locations. With the type of response the emergency community is giving to these hoax events, a terrorist wouldn't need to have anthrax or for that matter any other biological material to create an act of terrorism - the threat alone serves the purpose.
Photo by Robert Burke
Separate decontamination lines must be set up for non-ambulatory victims of an anthrax release.
On Oct. 30, 1998, abortion clinics in Indiana, Kentucky and Tennessee received letters claiming to contain anthrax. The letters carried postmarks from Cincinnati. In Indiana 31 people, including a mail carrier, were thought to have been exposed and so they were decontaminated with chlorine bleach. They were then transported to hospitals, decontaminated again and given antibiotics. Hospital workers who treated the "victims" were also given antibiotics.
In Los Angeles 91 people were quarantined for more than eight hours after a report that anthrax had been released into the air-handling system of a federal building. Once again, antibiotics were administered to those thought to be exposed. A state office building in Wichita, KS, was evacuated after an envelope was found in a stairwell with a white powder and note claiming it was anthrax. Between 20 and 25 people were believed to have been contaminated. Fifteen were decontaminated as a precaution.