Infectious Disease, Threats to Security
█ BRIAN HOYLE
Infectious diseases are those diseases that are caused by microorganisms such as bacteria and viruses, many of which are spread from person to person. An intermittent host, or vector, aids the spread of some infectious diseases. One example is the transmission of the viral agent of Yellow Fever to humans via the bite of a mosquito. Other infectious diseases are spread directly from one person to another via infected body fluids or contaminated droplets in the air, as from a sneeze. Examples include influenza (aerosolized droplets) and hemorrhagic fevers such as Ebola (body fluids).
The scope of infectious diseases. Of the estimated 54 million deaths that occurred worldwide in 1998, approximately one-fourth to one-third (i.e., 13.5 to 18 million) were the result of an infectious disease. The bulk of these deaths occurred in the developing world and many involved children.
Infectious diseases have been part of human history for thousands of years. For example, descriptions of a disease with symptoms like those of anthrax, which is caused by the bacterium Bacillus anthracis , appear in the Old Testament Book of Exodus; anthrax is also thought to be the "burning wind of plague" mentioned in Homer's epic poem Iliad. Another example of an ancient infectious disease is bubonic plague. A huge epidemic of bubonic plague during the Middle Ages was called the Black Death, because of the characteristic skin discoloration produced by the bacterial infection.
The increasing ease of global travel and prevalence of antimicrobial treatments (i.e., antibiotics) in the twentieth
century produced an increase in the spread of infectious diseases, as well as the emergence of new or newly recognized diseases. One example is Acquired Immunodeficiency Syndrome (AIDS). Recognized in the 1980s, AIDS is now a world-wide epidemic affecting millions of people. Tuberculosis, which is caused by the bacterium Mycobacterium tuberculosis has reemerged as a health threat. More than 30 new infectious diseases have emerged since 1975.
Infectious disease and security: Disease as a weapon. Throughout most of recorded history, the suffering and huge loss of life produced by infectious diseases like anthrax and bubonic plague has mostly been accidental. Nonetheless, biological warfare is also ancient. For example, hundreds of years ago, the bodies of cattle were dumped into wells to poison the drinking water, and the bodies of human victims of anthrax were catapulted into fortified cities to spread the disease to the enemy.
In the twentieth century, the use of infectious disease as a weapon and security threat became an accepted strategy of war. Anthrax weaponry was researched in World Wars I and II. During World War II, Britain produced millions of anthrax packages that were planned for air dropping in Germany to infect the population as well as the food chain. The ancient infections of anthrax and plague, along with smallpox, were explored as biological weapons by the former Soviet Union. Soviet scientists considered these microbes as strategic weapons, potentially capable of destroying entire populations.
In the last few decades of the twentieth century, the use of infectious disease became part of the arsenal of terrorist organizations. For example the Japanese cult Aum Shinrikyo, which released poison gas into the Tokyo subway system in 1995, killing 12 people and hospitalizing thousands, was also developing weapons to disperse the Ebola virus and anthrax spores.
The mass illness and death caused by the deliberate release of an infectious microorganism is a threat to the security of a country. The microorganisms can be easily disguised and transported virtually anywhere people can travel. As well, various microbes can be spread by insects, the wind, and in water. Thus, traditional security measures that have secured borders from other threats are ineffective against the deliberate use of microorganisms.
The consequences of the deliberate use of infectious agents are potentially catastrophic. For example, it has been estimated that the release of 100 kilograms of powdered anthrax upwind of a city as compact and populated as Washington, D.C. could kill up to 300,000 people and cripple the operation of the city.
Part of the appeal of the use of infectious disease as a weapon is the economic hardship that can be caused. A 1997 report from the United States Centers for Disease Control and Prevention conservatively estimated that the costs of dealing with the aftermath of an anthrax outbreak in a major urban center would be approximately $26.2 billion (U.S.) per 100,000 people. In a city such as New York, the tally could be in the thousands of billions of dollars. Several such attacks might bankrupt a country.
This economic drain would be on top of the already excessive economic burden that countries face in dealing with natural disease outbreaks. The cost of dealing with a long-lasting disease such as tuberculosis can be thousands of dollars per person. And, hospitalization is frequently required, which strains a nation's health care infrastructure.
Infectious disease and security: The spread of infection. The main security threat from infectious diseases remains the spread of a disease through the population. For example, in 2000, 1,128 cases of malaria were imported into the United Kingdom by arriving travelers. Once in a country, an infection can spread rapidly. This has happened in the United States and Canada with West Nile fever. From a handful of cases in New York City in 1999, the virus has spread to most of the continental U.S. and Canada, and has sickened or killed thousands of people.
This ease of disease spread has produced unexpected outbreaks of disease all over the world. A few examples include legionellosis and leptospirosis in Australia, yellow fever and Creutzfeld-Jacob disease in Europe, and West Nile fever, hantavirus pulmonary syndrome, cryptococcosis and Escherichia coli O157:H7 in North America.
Another aspect of infectious disease that is a threat to security is the emergence of bacteria that have acquired resistance to the treatments used against them. A well-known example is the increasing resistance of bacteria to antibiotics. The microorganisms that cause infectious diseases such as AIDS, tuberculosis, malaria, and hospital-acquired infections are becoming more prevalent.
The development of resistance is a natural process, as a microbe seeks to adapt to the stress imposed by the antimicrobial agent. However, the refinement of genetic engineering technologies has made possible the tailoring of bacteria and viruses so as to be more lethal.
Current security issues. In June 1996, U.S. President Bill Clinton initiated a process to develop a national policy concerning infectious diseases. A part of this policy concerned the influence of infectious diseases on the country's internal and international security. A report issued in 2000 by the National Security Council warned that the economic downturn and political destabilization caused by epidemics of infectious disease, primarily in underdeveloped countries, could constitute a security threat to the United States in the twenty-first century. In the underdeveloped world, the majority of deaths due to infectious diseases involve children. Thus, the next generation of some countries has been decimated. U.S. reliance on the natural resources of the affected countries, and the hostility towards the West that could develop in the underdeveloped world, could put the U.S. and other developed nations at risk.
In 2002, the principal government-sponsored security threat for biological weapon use came from Iraq. The government of Saddam Hussein had previously sanctioned a biological weapons development program. The Iraqi government acknowledged past production and testing of thousands of liters of anthrax-contaminated material for use as weapons. This threat was one of the primary reasons for the 2003 war that toppled the Hussein government.
As more states and groups develop the capacity for biological warfare or terrorism, the security threat against military and civilian personnel grows. For example, in the aftermath of the September 11, 2001 terrorist attacks in the U.S., several incidents of deliberate dispersal of anthrax bacterial spores occurred. These incidents highlighted the ease by which the biological agents could be delivered to their target in something as nondescript as a letter.
█ FURTHER READING:
Inglesby, Thomas V. "Bioterrorist Threats: What the Infectious Disease Community Should Know about Anthrax and Plague," in Emerging Infections 5. Washington, DC: American Society for Microbiology Press, 2001.
Kaufmann, A.F., M.I. Meltzer, and G.P. Schmid."The Economic Impact of a Bioterrorist Attack: Are Prevention and Postattack Intervention Program Justifiable?" Emerging Infectious Diseases no. 3 (1997): 83–94.
Central Intelligence Agency. "The Global Infectious Disease Threat and Its Implications for the United States." January 2000 < http://www.cia.gov/cia/publications/nie/report/nie99–17d.html > (22 November 2002).
World Health Organization. "Strengthening Global Preparedness for Defense against Infectious Disease Threats." Statement to the United States Senate Committee on Foreign Relations—Hearing on The Threat of Bioterrorism and the Spread of Infectious Diseases. 5 September 2001 < http://www.who.int/emc/pdfs/Senate_hearing.pdf >(24 November 2002).