British Response:  MPs Call for Stricter Controls on Research

Potential terrorists could easily obtain lethal pathogens just by signing up for certain research courses at British universities, members of the British House of Commons said today.

The current voluntary system for screening students from overseas needs to be strengthened, the Commons Foreign Affairs Committee said, urging the government to create a central authority to control all of the country’s dangerous biological materials (see GSN, Dec. 4).

“Our anxiety is that a fully qualified research scientist, who unknown to the authorities was a supporter of a terrorist group, could be admitted to a postgraduate or other research institution within the U.K. to pursue an approved program of research,” the committee said.

“Such a scientist could thus gain unhindered access to the dangerous materials or pathogens,” it added.

Officials do not believe that any terrorist groups that currently threaten the United Kingdom have obtained biological weapons, according to the Press Association.  A recent report from the Foreign Office, however, estimates that terrorists could possibly kill up to 3 million people by releasing 100 kilograms of anthrax from a tall building, the Press Association reported (Gavin Cordon, Press Association, Dec. 11).

For further information, see:

Biological Weapons Green Paper (British Foreign Affairs Committee)

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Smallpox I:  Israeli Inoculations Run Smoothly

Israeli officials have inoculated 15,000 emergency personnel, health workers and soldiers against smallpox, with almost no severe reactions to the vaccine, the New York Times reported today (see GSN, Oct. 24).

Israel is now poised to immunize its entire population in four days if a case of smallpox appears anywhere in the world, the Times reported.  The Israeli effort stemmed from discussion on the threat of smallpox in the United States, but the Jewish state has now “jumped far ahead” of U.S. efforts, according to Boaz Lev, director general of the Israeli Health Ministry.

“After Sept. 11, there was a profound change in our psychology,” Lev said.  “Although there was no new information on which to base our vaccination decision, the potential terrorist threat increased dramatically, especially in the minds of doctors,” he added.

Potential medical fallout from the vaccine has not surfaced even though a handful of every million people vaccinated would probably suffer severe side effects, and one or two of those people would probably die, according to health statisticians.

In the current batch of Israeli inoculations, only 5 percent of those immunized reported side effects that included headaches, muscle pain, fatigue and general weakness.  One woman who was not immunized was infected by her husband’s vaccine, but she responded quickly to treatment and recovered.

The vaccine that Israel uses, which is called Lister, is probably responsible for the lack of complications to date, Lev said.  The Lister vaccine is less dangerous than the U.S. vaccine, he said.  Extensive screening before vaccinations has also helped eliminate potential complications, he added.

Initially, up to half the Israeli candidates for immunization balked because of the vaccine’s potential dangers, the Times reported.  A public education program and doctors who set an example by being vaccinated reportedly increased immunization rates greatly.

Some medical professionals in Israel have protested the vaccination program for being too limited.  Upset that his recommendation to vaccinate the entire country was rejected, Aryeh Eldad this summer resigned his position as the head of a Health Ministry advisory team on immunization (see GSN, Aug. 14).  Israel is now considering widening the scope of its immunizations, Lev said.

The results of the Israeli vaccination campaign have fueled the drive of U.S. officials who support widespread smallpox immunizations in the near future, according to the Times.  U.S. President George W. Bush is expected soon to reveal his smallpox immunization plan, which might recommend immunizing as many as 500,000 emergency health workers and 500,000 military personnel (see GSN, Nov. 25).

“The United States has much to learn from Israel’s experience,” wrote Leonard Marcus, director of the health care negotiation and conflict resolution program at the Harvard School of Public Health in Massachusetts, in a recent report on Israel’s response to the threat of biological terrorism (Judith Miller, New York Times, Dec. 10).

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Smallpox II:  Vaccination Plans Vary Widely Among U.S. States

Most U.S. states have submitted smallpox vaccination plans to federal officials by this week’s deadline, the Associated Press reported today.

State’s vaccine requests vary greatly, from Georgia’s plans to inoculate up to 500 people to California’s request for 70,000 doses of the vaccine, AP reported.  Strategies on vaccination are also greatly varied.  Michigan, for example, has requested 5,000 to 7,000 doses to offer at roughly 30 hospitals.

“We don’t necessarily need it in every corner or at every hospital,” said Geralyn Lasher of the Michigan Department of Community Health.

North Dakota, however, plans to have at least 15 immunized workers at each of its 46 hospitals.

“We really believe that it’s likely that smallpox patients could present themselves at any of our hospitals,” said Tim Wiedrich, biological terrorism coordinator for the North Dakota Health Department.

The widespread nature of the requests was expected, according to at least one U.S. health official.

“We wanted to give them that flexibility,” said Jerome Hauer, the chief biological terrorism official at the U.S. Department of Health and Human Services.

U.S. officials plan to begin a public education campaign on the smallpox vaccine to coincide with the immunizations, which would begin after the Bush administration issues orders to state officials.  Once vaccinations are underway, states would be required to carefully monitor reactions and report twice a week to the Centers for Disease Control and Prevention.

Officials have said that fewer than 500,000 people will probably receive the shots because not all of those selected will agree to be vaccinated, and some will have conditions that put them at risk of side effects.

The effort will be “one of the most complicated logistic activities any state and local agency will have to undergo,” said Michael Osterholm, a University of Minnesota bioterrorism expert (Laura Meckler, Associated Press, Dec. 10).

Meanwhile, Arizona and a several other states missed the Monday deadline to submit smallpox vaccination plans, according to the Associated Press (see GSN, Nov. 22).

Arizona health officials said they expect Governor Jane Hull to approve their plan this week.  U.S. officials would receive the plan thereafter, but a state official said that immunizations are not imminent.

“We will not be giving any smallpox vaccinations until liability and compensation issues are cleared up,” said David Engelthaler, bioterrorism coordinator for the Arizona Department of Health Services (see GSN, Nov. 15).

The state’s plan includes phased vaccinations over six weeks, allowing medical personnel to learn more about side effects (Associated Press, Dec. 10).

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U.S. Response:  NIH Seeks to Sustain Increased Biological Defense Funding

By David Ruppe
Global Security Newswire

WASHINGTON — U.S. health officials are hoping to sustain unprecedented funding for bioterrorism defense-related research in the coming years, following a sizable increase by Congress this fiscal year (see GSN, Feb. 6).

That goal may be hard to achieve, however, in the face of a tough fiscal climate and the stated determination by the White House budget office to scrutinize new research funding requests closely for “high payoff” and “maximum efficiency and effectiveness.”

The National Institutes of Heath in fiscal 2003 was awarded $1.75 billion for biological defense-related work, an increase of nearly $1.5 billion over the previous year.  The fiscal 2003 funding will be distributed roughly in thirds for drug and vaccine development and testing, for basic and clinical research, and for constructing four regional biological defense research centers, each with Biosafety Level-3 or -4 biological containment facilities.

NIH forecasts a $421 million decrease in required funding for such facilities from fiscal 2003 to fiscal 2006 as up to 10 are built, but is hoping to see a corresponding $497 million increase for research funding including at the new centers, according to long-range budget data provided by National Institute of Allergy and Infectious Diseases Director Anthony Fauci in a presentation last week (see GSN, Aug. 16).

Fauci, speaking at a conference on biological defense funding here, seemed optimistic, saying, “I think we’re going to get reasonable increases from one year to another.”

Fauci spokesman Gregory Folkers said the overall funding level would basically remain the same according to the NIH plan, but struck a note of caution about the outcome.

“Of course, we can’t predict future budget levels, and numerous external factors may impact future funding.  Thus, the numbers Dr. Fauci discussed are possible scenarios, based on assumptions that may or may not come true,” he said.

Folkers said the biological defense funding plan was based on a careful assessment of what would be needed.

“The plan is designed to carefully balance and orchestrate the complex yet delicate interplay needed to successfully engage the best elements of academic and private sector research, to build and sustain research momentum, to identify and exploit research opportunities, to build and use critical research tools and infrastructure, and to make the optimum use of biodefense funds,” he said.

Fauci, Folkers and other experts jointly wrote in an American Society of Microbiology News article in August, “There is a dearth of investigators involved in research on some of the most important pathogens that could potentially be used in a bioterrorist attack.”

“Much of the 500 percent increase in funding will be wasted on research that lacks scientific merit, and thus has been unable to compete successfully for funding under previous standards for proposal review,” Richard Ebright, a chemistry professor at Rutgers University, wrote in an e-mail.

“Worse, the 500 percent increase will significantly increase the number of institutions and persons with access to, and training in handling of, BW agents, and thus will increase the probability of future accidental or deliberate releases of BW agents,” he said.

Biological Defense Given High Priority

In the wake of the Sept. 11 attacks and subsequent anthrax attacks last year, the Bush administration has declared bioterrorism defense a high priority.  Congress this year approved administration requests for approximately $600 million for Pentagon biological warfare defense research and $1.1 billion to strengthen state and local first response capabilities.

NIH says its biological defense research funds will be spent on expanding existing research on potential bioterrorist agents, developing new vaccines, therapeutic drugs and diagnostic tests, and expanding clinical research on newly discovered and developed products.

The new research facilities, called “regional centers of excellence for biodefense and emerging infectious diseases research,” will “enable biomedical research efforts on pathogenic microbes, including potential bioterrorism agents,” according to an NIH release describing its plan.

The centers also will be on hand to provide expert assistance to first responders in the event of a biological incident.

Tight Fiscal Climate

While the amount of money appropriated for biological defense research is dwarfed by the $400 billion national military budget this year, White House willingness to increase funding for biological defense research appears to remain an open question.

In two prominent documents, White House officials gave indications that additional funding requests for research and development in general in fiscal 2004 may be hard to come by.

In a May memo, Office of Science and Technology Policy Director John Marburger and Office of Management and Budget Director Mitchell Daniels encouraged agencies to “fund new, high priority activities by reallocating resources from lower-priority or recently completed activities.”

The memo said requests for additional funding would require “a compelling rationale that the activity is important …  and that funds from lower priority or recently completed programs cannot be substituted within the agency’s guidance level.”

Also, the administration’s budget document for fiscal 2003 said the overall $2.4 billion requested for biological defense research work at various agencies was intended for “jump-starting” research and development.

Federal finances currently are tight particularly in light of the struggling economy, expected ramping up of the administration’s 10-year tax reduction program, and significant funding increases for defense.

Fauci said he has had a number of discussions with senior administration officials, including Bush, inquiring into how the current level of funding would be spent.

Fauci said the message he took from those meetings is that research must be driven by defined goals and he said as a result greater emphasis will be placed within his institute on making basic research, the institute’s “classic” work, applicable to specific challenges.

When how research money would be spent in the future, he said, “We’re not going to skip over the basic research, but we are going to be very attentive to the basic research getting spelled out in definable endpoints.”

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Anthrax:  Postal Officials Hid Contamination, Watchdog Group Says

By Mike Nartker
Global Security Newswire

WASHINGTON — Judicial Watch, a nonprofit watchdog organization, announced Friday that it has requested a federal investigation into the U.S. Postal Service’s handling of last year’s anthrax contamination at a Washington postal facility (see GSN, Oct. 25).

In a Dec. 6 complaint to the U.S. Attorney’s Office for the District of Columbia, Judicial Watch alleged that the Postal Service knew by Oct. 18 last year that the Brentwood Road postal facility had become contaminated with anthrax.  Officials even knew specifically which mail-sorting machine had handled the contaminated letter, according to the complaint.

Despite written emergency regulations for the Postal Service, however, officials waited to close the facility until four days later, when the anthrax-related deaths of two Brentwood employees were announced, Judicial Watch said in a press statement.  The delay was caused, in part, by the Postal Service’s desire to avoid an estimated cost of $500,000 per day to close the facility, according to Judicial Watch.

As a result of the Postal Service’s delay, Brentwood employees were prevented from obtaining tests for anthrax exposure and preventive antibiotics in a timely manner, Judicial Watch said (see GSN, March 8).  The group has called on federal prosecutors to investigate whether to charge postal officials with any crimes, possibly including involuntary manslaughter, conspiracy, and obstruction of justice.

The organization has filed the complaint on behalf of hundreds of postal employees and a postal employee support group called Brentwood Exposed.  Judicial Watch has based its complaint on documents obtained from the Postal Service through a court order, including a log kept by a senior Brentwood official, according to the Judicial Watch statement.

“The criminal act of terrorism perpetrated by a still unidentified person or persons, by the transmission of anthrax pathogen through the U.S. mail, has been exponentially compounded by crimes of commission and omission at Brentwood by [the U.S. Postal Service] and/or U.S. government officials,” Judicial Watch said in the complaint.

The Postal Service considers the allegations to be “without merit,” a spokeswoman said, according to an Associated Press report Saturday.

Judicial Watch has also filed a complaint with the Equal Employment Opportunity Commission for an investigation into whether the Postal Service’s actions violated the civil rights of Brentwood employees, the Judicial Watch said in the press statement.  While the Postal Service delayed action at Brentwood, where employees are 97 percent African-American, the predominately white staff members in the offices of Senators Tom Daschle (D-S.D.) and Patrick Leahy (D-Vt.), which also received anthrax-tainted letters, received more timely care, Judicial Watch alleged.

For further information, see:

GSN Anthrax Attack Chronology (Dec. 12, 2001)

Journal of the American Medical Association Background on Anthrax

CDC Frequently Asked Questions About Anthrax

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Smallpox:  WHO Plans to Increase Vaccine Stocks

World health officials have agreed to increase global stocks of smallpox vaccine, Reuters reported Friday (see GSN, Dec. 3).

Health officials from Mexico, the World Health Organization and the Group of Seven industrialized countries — who met Dec. 6 in Mexico City for the Ministerial Meeting on Health Security and Bioterrorism — have agreed to increase funding for the WHO’s smallpox vaccine stocks, according to Reuters (see GSN, Dec. 3).

“We don’t want to alarm our people,” British Health Minister Alan Milburn said.  “And yet we’d be failing in our obligation if we didn’t prepare for the worst,” he added (Richard Jacobsen, Reuters, Dec. 6).

Meanwhile, five groups that represent emergency health workers in the United States have formed a smallpox task force to weigh in on the inoculation debate, the Baltimore Sun reported today.  U.S. President George W. Bush is reportedly considering a voluntary plan to immunize 500,000 health care workers and 500,000 military personnel against smallpox.

The worker organizations acted because “no one has asked our advice,” said Robert McNamara, chair of emergency medicine at Temple University Hospital in Pennsylvania.

Emergency workers might not want to be inoculated, according to the Sun.  For example, half of the participants in a recent survey of 80 nurses were unwilling or unsure whether they would want to be immunized, according to William Chiang, an emergency specialist at Bellevue Hospital in New York who conducted the survey.  Those who said they would refuse to take the vaccine totaled 11 percent, according to the Sun, and 39 percent said they had not yet decided.

“Unfortunately, there hasn’t been a lot of outreach from the government to the people who are going to be asked to be immunized,” McNamara said (Knight Ridder/Baltimore Sun, Dec. 8).

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U.S. Response:  CDC Issues New Laboratory Guidelines

The U.S. Centers for Disease Control and Prevention issued new guidelines yesterday to increase security at laboratories that handle dangerous biological pathogens (see GSN, Dec. 4).

The recommendations — which call on laboratories to limit access to sensitive areas, to keep pathogens secure and to monitor areas where they are stored — are meant to aid facilities in developing soon-to-be required security plans, the Associated Press reported.  Previous information on such plans was a “fairly scampy” two pages, said Steve Ostroff, deputy director of the CDC National Center for Infectious Diseases.

The CDC is expected to require all laboratories to develop a biological security plan when it publishes new regulations next week to help improve security of dangerous pathogens.  The regulations also are expected to order tighter security at laboratories that handle “select agents,” which consist of more than 40 of the most dangerous pathogens such as anthrax and Ebola, AP reported.  The regulations will require personnel who work with select agents to undergo background checks, and they will require every facility that possesses a select agent to register with federal regulators and submit to inspections, according to AP.  Previously, only laboratories that transferred or received samples of select agents were required to register (Laura Meckler, Associated Press/Baltimore Sun, Dec. 6).

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Smallpox I:  U.S. Test Subjects Suffering From Aches, Pains, Fevers

U.S. trials of smallpox vaccine are revealing a variety of annoying — but not life threatening — side effects, the Washington Post reported today (see GSN, Nov. 25).

Immunization tests of healthy young men and women at a half dozen universities and clinics have resulted in fevers, aches, swelling, itching, rashes and a general unpleasantness, all considered routine responses to the receiving the smallpox vaccine.

“I just wanted to go to bed for a day or two,” said Alison Francis, a New York University graduate student who was recently inoculated.  “I thought, ‘Can you just chop off my arm?’” she added.

None of the 1,500 volunteers who have been tested in the last year have died, the Post reported, but in one government study of 200 young adults, 75 registered high fevers and several were put on antibiotics.  In a study at the University of Rochester Medical Center in New York, 5 percent of participants developed rashes that spread over their bodies, researcher John Treanor said.  Some test subjects developed significant swelling, he said.

Experts have said that a lack of recent smallpox inoculations has left the U.S. population unprepared for the vaccine’s effects, triggered by exposing vaccinees to a live virus.

“The reactions we are seeing are totally out of line with today’s vaccine experience and absolutely in line with historical experience,” said Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases.  “In the 30 years since we had routine vaccination, the public’s tolerance level has gone way down,” he added.

Even some professionals have been taken aback by the immunization reactions because most U.S. health care workers have never administered the vaccine or treated its side effects.

“I can read all day about it, but seeing it is quite impressive,” said Kathy Edwards, a Vanderbilt University physician who oversaw a smallpox trial at Baylor University in Texas.  “The reactions we saw were really quite remarkable,” she added.

Studies have shown that a previous smallpox immunization can prevent much suffering and annoyance.  For those who were not inoculated — or born — when routine smallpox immunizations ceased in the United States, however, the experience can be “pretty miserable,” said Meg Gifford, a University of Maryland junior who took part in a study.

“You can’t scratch it — it’s all bandaged up.  All I could do was smack it,” she said (Ceci Connolly, Washington Post, Dec. 5).

Meanwhile, the largest U.S. union representing health care workers has demanded better protections for those who probably would be the first to receive the vaccine in an expected national inoculation plan, the Atlanta Journal-Constitution reported today.

Officials from the Service Employees International Union and the Bush administration met yesterday to discuss whether workers sickened by the vaccine would be allowed to take leave and whether officials would screen workers properly before immunizing them.  The union represents 710,000 health care professionals.

“Without better protections, the proposed plan could put hospital patients, caregivers and the public at risk,” the union said in a statement (Associated Press/Atlanta Journal-Constitution, Dec. 5).

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Smallpox II:  Vaccine Promoter Is No Maverick, Sheriff’s Office Says

By David McGlinchey
Global Security Newswire

A Florida sheriff who was inoculated against smallpox Tuesday and encouraged his deputies to do the same is not trying to act ahead of U.S. leaders planning a national vaccination strategy, an official from his office said yesterday (see GSN, Dec. 4).

Orange County Sheriff Kevin Beary, is promoting an effort to produce vaccinia immune globulin, which is used to treat adverse reactions to smallpox vaccine, said Chief Steve Jones of the sheriff’s office.

The globulin — known as VIG — is produced from blood plasma extracted from people who have recently been immunized against smallpox.  U.S. officials have contracted with several companies to produce VIG, which would be needed if the United States conducts large-scale immunizations (see GSN, Nov. 12).  Experts have estimated that for every 1 million people who are inoculated against smallpox, fewer than 50 would become seriously ill from side effects of the vaccine, and one or two would probably die.

It had been reported that Beary was seeking to protect his force from smallpox even though U.S. President George W. Bush, who is reportedly considering inoculating 500,000 emergency workers and 500,000 military personnel, has not yet announced national plans.

Although immunity to smallpox is a benefit of inoculation, Beary is primarily advocating producing VIG for the national stockpile, Jones said.

The sheriff’s office received calls from news organizations across the country when the VIG drive was announced, but Jones said he had not expected that Beary would be depicted as maverick local official.

“Before it gets to the end, it’s all twisted around,” Jones said.

The sheriff’s “primary goal” is to encourage voluntary participation in the VIG drive and to assuage fears, Jones said.  Health officials have said that a thorough screening process, which the Florida program has in place, should drastically reduce the chances of complications from the vaccine.

“He’s basically trying to tell people, ‘I did it.  I had no reaction to it,’” Jones said.

Beary is encouraging his law enforcement agency to follow his lead, and the program so far has enrolled about 10 of his 1,400 deputies, including Jones, who said he has felt “absolutely no ill effects.”

The office supports the drive but is not pushing it, Jones said.  Beary is not paying deputies “on our time” to be vaccinated, he added.

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