Vector

Author’s note

Unfortunately, much of what the characters in Vector say about bioweapons and bioterrorism is true. This holds most notably for Detective Lou Soldano’s comment concerning the potential for a major bioterrorism attack in the United States or Europe: it is not a question of whether one will occur, but rather, when. Indeed, there have already been several minor bioterrorist events in the United States.

In 1984, there was an intentional contamination of restaurant salad bars in Oregon, causing an outbreak of salmonellosis in 751 people. In 1996, there was an intentional contamination of muffins and donuts in a hospital laboratory in Texas, causing an outbreak of Shigella dysenteriae in forty-five people.

The threat of bioterrorism has risen progressively in the world, particularly over the last decade. Consider the example of Aum Shinrikyo, the apocalyptic sect that released sarin gas in the Tokyo subway in March 1995. At the same time the cult unleashed its chemical attack, it was engaged in an active bioweapons program involving both anthrax and botulinum toxin, just like Yuri Davydov was in the novel. They’d even gone so far as to send a delegation to Zaire to explore the possibility of obtaining the Ebola virus for weaponization.

The Soviet Union had maintained an enormous covert bioweapons program prior to its dissolution in 1989, despite being a signatory to the 1972 Biological and Toxin Weapons Convention (BWC) strictly forbidding such activity. At its height, the program employed more than fifty thousand scientists and technicians in research and production facilities. It was administered under the aegis of Biopreparat, which was under the Ministry of Defense. The program purportedly has been dismantled by the Yeltsin government (although many experts fear not completely), resulting in a diaspora of tens of thousands of highly trained bioweapon personnel. Considering Russia’s current economic dislocations, the question invariably arises: where are these people now and what are they doing? Some, perhaps, are driving taxis in New York City like Yuri Davydov, the disaffected émigré in Vector, and meeting up with equally disaffected members of the violent far right.

Rogue nations like Iraq, Iran, Libya, and North Korea have added to the rising threat of bioweapons. In the aftermath of the Gulf War, the United States and its allies were shocked to learn the size of Iraq’s stockpile of bioweapons and production facilities, whose existence had entirely eluded intelligence operations. This revelation served as a sharp wake-up call to the various allied governments. Regrettably, at the same time, the discovery captured the attention of terrorist groups and individuals worldwide who suddenly became intensely interested in bioweapons. The attraction is simple: bioweapons are inexpensive to make; require materials, equipment, and expertise that are easy to procure (some of the information is even on the Internet); and, for the most part, involve biological agents that are readily available. As an added feature, bioweapons are the best weapons of mass destruction for covert use. The effects of their release take many hours or even days to materialize, giving the perpetrators time to escape.

Adding to this unfortunate circumstance of the rising threat of bioweapons is the current social, economic, and political reality of the world. With mounting religious fundamentalism in some countries, thwarted nationalistic goals in others, economic deprivation in many, and, in the industrialized west, the increased desperation of violent far-right groups whose agenda has stalled in an era of increased globalization, there has been a worldwide rise of terrorism in general. The combination of this increase with a heightened appreciation of the evil attractiveness of bioweapons is what makes the current situation so critical.

In Vector, medical examiners were the first to confront an occurrence of bioterrorism in the form of a single case of anthrax. Lamentably, since there was a simple but unverified explanation for the case in the story, the doctors’ index of suspicion of bioterrorism was not adequate for them to insist on proper follow-up. If they had, the event as it unfolded could possibly have been prevented. This is an important lesson. Leaving fiction for the real world, there is a high probability that the medical profession would be the first group of professionals to interface with a bioterrorism event, and that distinct possibility must be part of medical thinking these days. This is particularly true involving illnesses caused by agents known to have bioweapon potential.

Yet the medical profession’s responsibility with regard to bioterrorism goes beyond detecting an episode and treating its victims. The medical profession has an ethical duty to continue to institutionalize the opprobrium currently associated with the use of bioweapons. Members of the medical profession of all countries must insist on investigating any suspicious disease incidents within their borders and report such circumstances to the world forum. If that had happened in Sverdlovsk in 1979 following the anthrax leak from a Biopreparat bioweapon facility, the Soviet medical profession would have done the world a service. It would have exposed the illegal Soviet offensive bioweapon program. Instead, the world was treated to elaborate KGB disinformation, and Biopreparat continued its illegal and ethically repulsive secret work for another ten years.

Another reason the medical profession has an ethical role to play in relation to bioweapons is that this technology represents the ultimate perversion of biomedical research. Indeed, with the help of the burgeoning field of bioengineering, the possibility exists of constructing new doomsday organisms. Experts shudder at the thought of combining the contagiousness of the common cold or even smallpox with the pathogenicity of Ebola.

As is the case with the nuclear threat, the public feels it can do little to thwart the development or deployment of bioweapons. But that is not entirely true. The public can play a role in this worsening biological nightmare by being cognizant of the threat bioweapons pose. Counterintelligence is the only way to actually prevent occurrences, and the public should be suspicious and vigilant. Since it is true that small labs and production facilities can be made in private locations like basements or spare rooms, it is important to be on the alert for tip-offs, like fermenting odors or the sound of constant, circulating fans. These should be reported to the authorities. Any unexpected traffic or theft involving microorganisms, microbiological equipment, microbrewery fermenters, biocontainment gear, or pest control spraying devices should also be brought to the attention of law enforcement.

With everything else there is to worry about these days between AIDS, famine, economic woes, civil war, ethnic cleansing, and global warming, it seems there is hardly room for the specter of bioterrorism. Yet few threats have the capability of killing so many so fast. For years we lived under the fear of nuclear winter annihilating the human race. Now there is a similar threat from biology.

Finally, on a more positive note, governments and local authorities, particularly in the United States, have started to consider seriously the menace of bioterrorism and have begun to act. Money has been appropriated. The Department of Defense and the FBI have formed specialized response units. Major cities like New York have tasked their emergency management organizations with the problem. There have been efforts at training on the local level and exercises to mimic real events. Still, the results to date are equivocal. It may take an actual bioterrorist strike to harden government initiative, but by then, for many, it will be too late. Much needs to be done, and we all have to contribute. Let’s not wait for an incident like the planned one in Vector to solidify our resolve.

Robin Cook, M.D.

Naples, Florida

December 1998