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Ever since the dawn of biotechnology, the world had to face a new dilemma: bioterrorism. Using biological agents such as bacteria, viruses, fungi, etc., bioterrorism attack aims to cause illness of death in people, animals, or plants as a method of warfare. Used throughout history, biological weapon serves as a pivotal role in disarming an army.
Botulism toxin, known for the most toxic substance in the biological world, has been used throughout history as a biological weapon. The bacteria Clostridium Botulinum causes botulism disease, which is a serious paralytic illness that strikes all age groups. The clinical forms of botulism include food-borne botulism, infant botulism, and wound botulism. Botulism, if left untreated, is fatal; however, even treatment with antiserum cannot provide full recovery.
Botulism is rare a disease. Therefore, if anyone is diagnosed with food-borne botulism, investigation of food supply must be carried out promptly; for investigation of the botulism-diagnosed-individual's surrounding is the only method of detecting a potential bioterrorism attack.
With the continuous advancements in biomedicine follows a continuous proliferation of bioterrorism, which uses biological agents for malicious purposes (Anderson, 2). More specifically, bioterrorism is a method of terrorism that intentionally releases or disseminates biological weapons that may be in natural occurring or human-modified form (Botulism- Definition). Although bioterrorism is considered a recent dilemma, the use of biological weapon predates recorded history, during the ancient times where biological toxins were extracted from plants and animals and applied on darts and arrows to kill human enemies. Evidence of bioterrorism was also evident during the Medieval Wars, the earliest times of recorded history. The dead bodies that carried highly contagious diseases, such as smallpox and bubonic plague, were catapulted into besieged towns, where they quickly spread to civilians within the town walls (Hurlbert, 4).
Usage of biological weapon reached its height during the 19th century world wars, as agents were used in all criminal, terrorist, or state-sponsored events (Anderson, 20). Sprouted from the world wars, biological research programs for both offensive and defensive strategies have been developed by the United States, Britain, the former Soviet Union, Canada, and several other nations (Fong, 7). However, attention has not been focused on the potential threats of biological warfare and bioterrorism until the terrorist attack on September 11th, 2001 and the anthrax crisis in Florida and New York City (Fong, 7). Throughout history, biological warfare has played a significant role, as biological weapons, deliberately or inadvertently, in restricted and assisted armies over the centuries.
Advantages of biological weapons are that they are effective in spreading the disease, highly toxic, inexpensive, and cultivated in a short period of time. Due to the detrimental effects of biological weapon, the army faced with these weapons would be easily disarmed. However, biological weapons prove difficult to store and deliver without unintentionally releasing them (Hurlbert, 6). Therefore, innocent workers and civilians are vulnerable to be contaminated by the biological weapon being cultured.
When successfully grown, these cultured biological agents are released to cause illness or death in people, animals, or plants. These agents may be viruses, bacteria, or other germs that are typically found in nature, but are usually altered to increase ability to cause disease and drug-resistant (CDC, 1). Bioterrorism agents are separated into three categories: Cat-A, Cat-B, and Cat-C, depending on their toxic and priority levels. Category-A agents pose highest risk to the public and national security due to their easy transmission, high death rates, pubic panic, and special public health preparedness (Knobler, 276). Category-B agents exhibits less severe criteria than that of category-A; and category-C agents include pathogens that can spread and produce easily (Knobler, 227). In terms of fatality, category-C agents induce incapacitating symptoms, but not lethal.
A category-A agent, Clostridium botulinum bacteria produce nerve toxins that cause serious paralytic illness called botulism, also known as â€œbotoxâ€Â (CDC,1). Clostridium botulinum are straight to slightly curved, gram positive, rod-shaped, with oval, sub-terminal spores (Shapiro, 5). There are seven types of Clostridium botulinum that are distinguished by the antigenic characteristics of the neurotoxins they produce. Human botulism is caused by strains of Clostridium botulinum that produce toxin types A, B, E and rarely F. Type C and D are almost exclusively confined to animals (Fong, 194).
There are three main types of botulism: food-borne botulism, infant botulism, and wound botulism (Fong, 144). Food-borne botulism occurs when a person ingests pre-formed toxin that leads to illness within a few hours to days. Infant botulism occurs in susceptible infants who harbor Clostridium botulinum in their intestinal tract. Finally, wound botulism occurs when wounds are contaminated with this bacterium (CDC, Fact).
In nature, Clostridium botulinum can be found in the soil and aquatic habitats in the world (Shapiro, 5). When infected with botulism, symptoms begin anywhere from 6 hours to 2 weeks (Hurlbert, 18). Symptoms include double vision, blurred vision, slurred speech, difficulty swallowing, dry mouth, muscle weakness, vomiting, and eventually respiratory failure (CDC, Fact). Botulism is not contagious and affects all age groups. Once the symptoms appear, the damage is irreversible; the only treatment involves passive antibody shots against all botox strains. Often, the damage is already done even before victims realize what has occurred (Hurlbert, 18).
Due to their detrimental effects, Clostridium botulinum is an effective weapon. When the bacteria is widely spread with bioterrorism attack, the amount of antiserum required to treat hundreds thousands of exposed people would lack significantly. As mentioned previously, even the antiserum treated individuals would never fully recover from the damage. In addition, the effects of antitoxin would prove futile in some cases, as many people would have surpassed the severity limit of the disease (Hurlbert, 18).
Contrary to the triumph that the bacteria perform within the body, Clostridium botulinum is unstable in air. When exposed to sunlight, dry conditions and brief boiling, Clostridium botulinum is easily destroyed (Hurlbert, 18). Also, the anaerobic nature makes the toxin difficult to grow. Large quantities of this pathogen are necessary in order to contaminate the water supply to reach to a lethal concentration (Shapiro, 5).
Historically, the intentional use of the botulism toxin date to the 20th century. The Japanese first bean developing this toxin as a weapon within the notorious Japanese biological unit in Manchuria. (Williams and Wallace). A couple years later, during World War II, the United States also developed methods for the large-scale production of the botulism toxin. To keep this work anonymous, scientists referred to the toxin as agent X. The United States also produced the toxin in large quantities in order to use them for vaccination. Because the United States feared that the Axis powers would use the botulism toxin during their planned Normandy invasion, the United States vaccinated the troops involved in the invasion so that they would develop immunity to them. Contrary to what was predicted, Germany was too fearful of the Allied powerâ€™s retaliation of biological weapons. Other countries, including the former Soviet Union, experimented with this toxin as well (Fong, 194).
Iraq conducted the largest known military botulism toxin programs, producing 19,000 liters of concentrated toxin loaded into missiles and shells. Ironically, the seed cultures were legally obtained from American Microbiological Supply House. To prepare for potential exposure to this toxin, approximately 8,000 American service personnel were vaccinated in 1991 (Fong, 195).
In the event of bioterrorism, immediate detection is difficult, as the symptoms would not arise for over one day. Vaccination after exposure, as mentioned previously, would be ineffective, as botulism is not a contagious disease, and the immunity would develop in 12 days, and by that time, the toxin would have already taken full effect (Fong, 201).
To detect the large-scale detection of this toxin, a series of correct diagnosis is necessary. If one is diagnosed with botulism that is not wound botulism, infant botulism, or confirmed food-borne botulism, immediate epidemiology investigation is necessary. It is possible that the toxin was aerosolized, or was ingested along with food (Missouri Department of Health and Senior Services).
A new dilemma for the coming century, bioterrorism is an essential topic that must be looked upon. As the field of molecular biology develops, the potential of this science for creating even more effective and horrific biological weapon must be considered. Also, the recent war and the current threat of further United States military involvement with Iraq has reportedly raised the prospect of the use of biological weapons both on the battlefield and in terrorist attacks on civilian populations anywhere in the world (Hurlbert, 2).