Public Health Coordinator Donald Henderson Waging War on Bioterror

Tuesday, January 01, 2002

Donald Henderson
Photograph courtesy of Johns Hopkins University
Donald Henderson was worrying about biological warfare long before anthrax started working its way through the postal system. As science adviser to George Bush and a senior health official in the Clinton administration, he heard firsthand about our country's vulnerabilities. In 1995, he continued his study of bioterror at Johns Hopkins University, where he headed the Center for Civilian Biodefense Studies. Now Henderson is director of the new federal Office of Public Health Preparedness, which will coordinate the national response to health emergencies. Sitting in his office at Hopkins, he shared his insights with Discover writer Rabiya S. Tuma.

What convinced you to focus on bioterrorism so early on?
Up until 1995, bioterrorism was considered improbable. Then three events happened. First, the Aum Shinrikyo released sarin gas in the Tokyo subway. It was discovered that they had been working with anthrax and botulinum toxin and had tried to aerosolize anthrax throughout downtown Tokyo. Around the same time, Saddam Hussein's son-in-law defected and brought with him papers showing that Iraq's germ warfare program was shockingly extensive. But the really serious event was the discovery of the magnitude of the biological weapons program in the Soviet Union. It was beyond anything we imagined, involving 60,000 people working in 50 different laboratories. It rivaled the size of their nuclear program.

Have we improved our readiness for a bioattack since then?
As late as 1998, the Centers for Disease Control and Prevention had nobody assigned to work in this area. Similarly at the National Institutes of Health there was no program, nobody assigned to it, and no money appropriated. Now the CDC does have a program for biological preparedness, and the NIH has a special research program. So we've improved, but we still have a long way to go.

Where are our weakest points?
We have a very weak point in our public health infrastructure. We depend on it being there 24 hours a day, seven days a week—just like the fire department—so if somebody calls up with something really strange, the public health authorities should be ready to move in and confirm, diagnose, detect other cases, and set up control measures. But we've allowed that infrastructure to deteriorate over the decades. And there are a lot of things we could do to speed up the research process so that when we see a biological agent, we are able to develop antibiotic or antiviral preparations or vaccines very rapidly. Such preparations would also be beneficial for dealing with natural infectious diseases, particularly emerging infections.

What makes a particularly effective bioweapon?
Clearly almost any agent that produces an infection could, in theory, be used as a weapon. But with ordinary influenza, for example, we have epidemics every two or three years; while a lot of people get sick and a number of them die, cities continue to function. We looked at agents that would be more disruptive than others, either as a result of the deaths that they caused or because of their ability to spread panic. We came up with six prime candidates: smallpox, anthrax, plague, botulinum toxin, tularemia (rabbit fever), and hemorrhagic fevers (a group of viral bleeding diseases that includes Ebola).

You fought to eradicate smallpox, yet people now list it as a potential weapon. How did this happen?
I am deeply, profoundly angry with the Soviets. The Soviet Union, in 1959, proposed to the World Health Assembly that the World Health Organization undertake the eradication of smallpox. During the program the Russian government provided 25 million doses of very high quality vaccine every year. They were extremely proud that they had played an important role in the eradication program. We finally declared the eradication of smallpox in 1980 at the assembly. We persuaded governments and laboratories to get rid of their stocks, and they did—to transfer them to one of two places, one in the United States and one in Russia. Then from 1994 to 1995, it became apparent what the Russians had been up to: They had been weaponizing smallpox. The people I worked with did not know about this; it was the military that was driving the weaponizing program.

How hard would it be for a terrorist to cause a widespread infection in a mall or a baseball stadium?
A number of our colleagues have expressed again and again how difficult it would be to identify a lethal agent, get a hold of it, grow it up, put it in the proper form, and disperse it. But I'd wager you could cause a lot of trouble and tens of thousands of casualties would not be out of the question. And who is to say a terror group couldn't purchase biological weapons material already prepared and ready for use? After all, those who flew the airplanes into the World Trade Center didn't need to know how to build airplanes.
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