Chemical - Biological Agents Update

This updates the Fact Sheet on Chemical-Biological Agents (CBA) issued by the Department of State in October 2001 to include information on smallpox and anthrax. There is no specific information to indicate that there is a likelihood of chemical and biological agent attacks in the immediate future. As always, the Department of State will promptly share with American citizens overseas any credible information about such threats to their safety. Americans overseas should stay informed and be prepared for any eventuality. This Fact Sheet provides the traveling American public with clear guidance on chemical and biological agents and is available on the State Department’s Internet website at http://travel.state.gov.

Events since September 11 have made clear the threat posed by terrorist use of non-conventional weapons, including chemical and biological agents. While conventional weapons such as explosive devices pose a more immediate threat in many areas overseas, use of chemical or biological agents cannot be excluded and must be considered a growing threat.

In 1999, the Department of Defense (DOD) announced its intention to commence the Family and Force Protection Initiative (FFPI) in order to provide enhanced protection against chemical and biological agents to the dependents of U.S. military service members and to civilian Department of Defense employees and their families. This program was first implemented for U.S. Forces Korea and the range of recipients has since been expanded. In December 2002 the Department of Defense announced plans to begin smallpox immunization of certain DOD personnel.

The Department of State has had a chemical and biological countermeasures program since 1998, when it began to deploy chemical antidotes and antibiotics to selected posts abroad. The Department expanded its countermeasures program in 2001, pre-positioning antibiotics at all overseas missions to protect employees in the event of a bio-terrorist attack. The 2001 anthrax attacks in the U.S. and the subsequent contamination of the Department’s mail and diplomatic pouch facility underlined the value of pre-positioning such antibiotics at our overseas missions. The State Department has provided emergency response chemical antidotes in mission health facilities worldwide.

Additionally, the Department of State plans to offer, on a voluntary basis, vaccination against anthrax and smallpox to U.S. government employees and their family members, and other mission critical employees at certain posts overseas who meet age and health requirements. The Department has no information to indicate that there is an immediate or specific threat to use biological agents against its personnel. While it is impossible to quantify the threat posed by such bio-weapons, the consequences of such use against U.S. personnel overseas could be very grave. In that context, offering the vaccine is a prudent step.

Exposures to CBA that occur outside U.S. Government facilities would require the involvement of local public health authorities who would provide information and, if necessary, protective antibiotics to the general public. Ciprofloxacin and other antibiotics effective against anthrax, including doxycycline and amoxicillin, are available with a prescription in most pharmacies throughout the world. Many countries, including the U.S., have maintained limited stocks of smallpox vaccine. Currently, the U.S. Government has access to enough vaccine to effectively respond to a smallpox outbreak in the United States.

The Centers for Disease Control and Prevention (CDC) is the lead government agency on prevention and control of infectious diseases, including biological agents. For detailed information on CBA, including anthrax and smallpox, inquirers are referred to the CDC Internet page at http://www.bt.cdc.gov. The CDC's international travelers hotline telephone number is 1-877-FYI-TRIP (1-877-394-8747); FAX: 1-888-CDC-FAXX (1-888-232-3299).

American citizens should regularly review their own personal security situations and take those precautions they deem appropriate to ensure their well-being.

Some general information on anthrax and smallpox follows:

There is an incubation period after exposure to biological agents. It is essential that you seek appropriate care for illnesses acquired while traveling abroad to assure prompt diagnosis and treatment.

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Anthrax
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One biological warfare agent is the spore-forming bacterium that causes anthrax, B.anthracis. Anthrax is contracted most commonly through inhalation of spores.

Anthrax is not contagious between people. Antibiotic treatment, if initiated at the time of exposure, is thought to be very effective. Antibiotic treatment initiated early on in the illness also appears to prevent death, based on experience in the United States.

An anthrax vaccine that confers protective immunity does exist, but is primarily given to military personnel. Vaccination is only recommended for persons at high risk, such as workers in research laboratories, who handle anthrax bacteria routinely.

Anthrax vaccination requires multiple boosters and annual revaccination to maintain its protective effect.

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Smallpox
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Another biological warfare-agent is a virus called variola, which causes smallpox. Smallpox is a serious, contagious, and sometimes fatal infectious disease. There is no proven treatment for smallpox, though it is possible antiviral agents might have a role in lessening the effects of smallpox infection. Smallpox virus would be difficult to transmit artificially as an aerosol agent; it is easily killed by a number of household disinfectants, and sunlight. As difficult as smallpox is to transmit however, once infection occurs it is highly lethal -— 30% mortality or more in selected populations. Smallpox is also contagious, being transmissible from person to person. Smallpox vaccination administered before exposure prevents smallpox infection for a minimum of three to five years. Vaccination is also effective in preventing most (90-95%) infections, or greatly reducing the severity of infections if given within 1 week of exposure. It is for this reason the U.S. has adopted a policy of vaccinating selected health care workers and first responders who would administer vaccinations in the event of an outbreak in the U.S. Unlike the anthrax vaccine, smallpox vaccine is a live-virus vaccine, and therefore has significant potential side effects, especially in those taking the vaccine who have contraindications. Complete information on the vaccine, its side effects and complications is available at the CDC website.

Smallpox can be prevented through use of the smallpox vaccine. The vaccine was successfully used to eradicate smallpox from the human population. Routine vaccination of the American public against smallpox stopped in 1972 after the disease was eradicated in the United States.

-- Until recently, the U.S. government provided the smallpox vaccine only to a few hundred scientists and medical professionals who work with smallpox and similar viruses in a research setting. After the events of September and October 2001, however, the U.S. government began working, in cooperation with state and local governments, to strengthen our preparedness for bioterror attacks by expanding the national stockpile of smallpox vaccine. The United States currently has sufficient quantities of the vaccine to vaccinate every single person in the country in an emergency.

-- The federal government is not recommending vaccination for the general public at this time. There may be some members of the general public who insist on being vaccinated now. Our public health agencies will work to accommodate them, but that is not our recommendation at this time.

CHEMICAL AGENTS

Chemical agents differ from biological weapons in the greater variety of means of exposure (breathing in vapors from a pin-head size quantity of some agents, skin contact to oily residues) and the shorter period in which symptoms of exposure begin to manifest (seconds to hours, compared to days or weeks with biological agents). Chemical agents are classified according to symptoms they cause (blistering, nerve agents, etc.). They also differ in whether they quickly lose potency (cyanide) or persist and require decontamination procedures (mustard and some nerve agents). Information on specific categories of agents, specific agents and methods of decontamination response is available at the CDC website and www.cia.gov, under “Publications” (“Chemical-Biological-Radiological Incident Handbook). You should also consult your health care provider or local health authority.