NEW ORLEANS, Sep 12,2000
(Reuters Health)

The leader of the Irish Republican Army said it best, when he said 'you guys need to be lucky all the time I only need to be lucky once.'

"Terrorists have yet to put together all the pieces of the puzzle," but they "are learning from their mistakes," Dr. Ted Cieslak, of the US Army Medical Research Institute, Fort Detrick, Maryland, told participants at the 38th annual meeting of the Infectious Diseases Society of America last weekend. Every week, he said, there is more and more information on the Internet on how to do this right. "I think," he continued, that "it is only a matter of time before somebody does get this right in a big way."

Many biological agents are simple and inexpensive to produce and easy to distribute, Dr. Cieslak explained. Since "we are not going to know if we have been hit until people start getting sick, it's a big, big problem for us." "My agent of choice is anthrax," he said. "Nothing else comes anywhere near the projected kill ratio of anthrax except smallpox, which would have at least as great if not greater destructive capacity." The reasons we have not yet seen large-scale bioterrorist attacks, according to Dr. Cieslak, is "first of all, we have been lucky." But, he noted that "we are seeing more events, which for obvious reasons we don't want to publicize."

There have been a number of anthrax hoaxes of which a couple of dozen have been reported over the last couple of years, he added. "But," Dr. Cieslak said, "for every one you have read about in the press, there are dozens that you have never heard about. In fact, there were well over 300 of these anthrax hoaxes perpetrated last year. And the reason you don't hear about them is that we keep them quiet." To date every one of these has been a "lame" hoax, easily identified by the FBI, he noted. "So far," Dr. Cieslak added, "our intelligence community and our law enforcement community have done a phenomenal job at keeping abreast of this threat." Speaking of smallpox, Dr. Cieslak told Reuters Health that the fear is that smallpox is already out. "Allegations have been made by two high level Soviet defectors that other nations have the virus. The allegation is that those other countries spirited it away during the days when smallpox was still endemic and never declared it to the World Health Organization," he said. "But a more pressing problem, I think, is that the entire genetic sequence of smallpox is known and published. And someday the technology will exist to take the virulent genes of smallpox and create them from scratch, and then splice those genes into cowpox or monkey pox," Dr. Cieslak said. That would be a global health threat of the highest magnitude, he added, "I think that would be much more problematic even than anthrax."

Our best defense right now, he noted, is training and just being aware of the threat. "But I also think, Dr. Cieslak concluded, "that somebody, someday, somewhere will get lucky and we will have a problem on a large scale. The leader of the Irish Republican Army said it best, when he said 'you guys need to be lucky all the time I only need to be lucky once.'