" An attack on the United States with biological weapons could threaten vital national security interests. Massive civilian casualties, breakdown in essential institutions, violation of democratic processes, civil disorder, loss of confidence in government and reduced US strategic flexibility abroad are among the ways a biological attack might compromise US security.

2) Current organizational structures and capabilities are not well suited for the management of a BW attack. Major “fault lines” exist between different levels of government (federal, state, and local), between government and the private sector, among different institutions and agencies, and within the public and private sector. These “disconnects” could impede situational awareness and compromise the ability to limit loss of life, suffering, and economic damage.

3) There is no surge capability in the US health care and public health systems, or the pharmaceutical and vaccine industries. This institutionally limited surge capacity could result in hospitals being overwhelmed and becoming inoperable; could impede public health agencies’ analysis of the scope, source and progress of the epidemic, the ability to educate and reassure the public, and the capacity to limit causalities and the spread of disease.

4) Dealing with the media will be a major, immediate challenge for all levels of government. Information management and communication (e.g., dealing with the press effectively, communication with citizens, maintaining the information flows necessary for command and control at all institutional levels) will be a critical element in crisis/consequence management.

5) Should a contagious bioweapon pathogen be used, containing the spread of disease will present significant ethical, political, cultural, operational and legal challenges.

SMALLPOX, because of its high case-fatality rates and transmissibility, represents one of the most serious biological warfare threats to the civilian population. In 1980, the World Health Assembly announced that smallpox had been eradicated and recommended that all countries cease vaccination. Although labs in two countries still officially store smallpox samples (US and Russia), its re-appearance would almost certainly indicate an intentional outbreak.

Aerosol release of smallpox virus disseminated among a relatively small population could result in a significant epidemic. Evidence suggests the infectious dose is very small. Several factors are cause for concern: the disease has historically been feared as one of the most serious of all pestilential diseases; it is physically disfiguring; it bears a 30 percent case-fatality rate; there is no treatment; it is communicable from person to person. Vaccination ceased in this country in 1972, and vaccination immunity acquired before that time has undoubtedly waned. Prior to eradication, data on smallpox outbreaks in Europe indicated that victims had the potential to infect 10 to 20 others. However, there has never been a smallpox outbreak in such a densely populated, highly mobile, unvaccinated population such as exists today.

In 1947, in response to a single case of smallpox in New York City, 6,350,000 people were immunized (500,000 in one day), including President Harry Truman. In 1972, after disappearing from Yugoslavia for four decades, a single case of smallpox emerged. There are two ways to control a smallpox epidemic – vaccine and isolation. Yugoslavia’s Communist leader, Josip Tito, used both. He instituted a nation-wide quarantine, and immunized the entire country of 20 million people using vaccine supplied by the World Health Organization.

Estimates of the current US supply of smallpox vaccine range from seven to twelve million doses. This stock cannot be immediately replenished, since all vaccine production facilities were dismantled after 1980, and renewed vaccine production is estimated to require at least 24-36 months. The Centers for Disease Control and Prevention recently contracted with Acambis Inc. of Cambridge MA to produce 40 million doses of new vaccine. "

“DARK WINTER”was developed and produced by:

The Center for Strategic and International Studies www.csis.org Contact: Dr. John Hamre, President & CEO (202) 775-3227

http://www.house.gov/reform/ns/web_resources/briefing_memo_july_23.htm

-- steven valdiserri (valsteve11@home.com), October 05, 2001