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Skip to 0 minutes and 6 seconds PROFESSOR RAINA MACINTYRE: Welcome to the course. I’m Professor Raina MacIntyre. And what I’m going to do is take you through the changing landscape of bioterrorism and get you thinking about some important new changes, so that you can consider this context as you go through the material in the course. What is bioterrorism? There are many different definitions, but the one I like the base is this one. A bioterrorism attack is a deliberate release of viruses, bacteria, or other germs used to cause illness or death in people, animals, or plants. Some other important concepts include biological warfare.

Skip to 0 minutes and 45 seconds Biological agents used as weapons may be used against an individual in the same way that a gun may be used, or against a population as a bomb may be used. The only difference between physical weapons and biological weapons is that a bioweapon used against one person could spark an epidemic in a whole population, simply because these are contagious agents. That’s the difference. You shoot a person with a gun, you will only kill that one person. That effect is not going to spread to others. You use a bomb, it’s going to kill the people in the vicinity of that bomb. And it’s not going to have further impact.

Skip to 1 minute and 25 seconds But an infectious agent, a biological weapon that’s very highly infectious, only needs to infect one or a few people to affect the whole population. This is a key concept. So infectious diseases are unique, because they do have the capacity to be transmitted from person to person. And people exist in mutually exclusive states of being susceptible to an infection, infected with it, or immune to it. And it does have this potential for epidemics, because it’s contagious. And emerging infectious diseases actually increasing in the last decade or so. Infectious epidemics have a unique capacity to cause major, almost instant, economic disruption. They may even be associated with natural disasters, because of loss of proper water supplies or infrastructure.

Skip to 2 minutes and 18 seconds You can see epidemics occurring after, say, an earthquake or a flood. During the SARS epidemic in 2003, there was near bankruptcy of travel related industries. The US anthrax letter bombs in 2001 shut down the entire US Postal system, which had massive domino effects on the economy. In the Ebola epidemic in 2014, we saw issues of law and order and public demand that became quite disruptive to society’s critical infrastructure. Power, gas, banking, finance, and so on can also become affected in a major pandemic. And this is why governments around the world make major investment in planning for the health, economic, and societal impacts of pandemics, regardless of the cause.

Skip to 3 minutes and 6 seconds Whether the pandemic is caused by a natural cause or an unnatural cause, the impact on society is similar. This is a study which was published in the New England Journal of Medicine in 2016. And what it shows you is a timeline of serious emerging infections. And you can see, the SARS epidemic at the beginning in 2003 in the pink. And then, this clustering over time, more and more serious infections occurring. And so many occurring simultaneously, just in the last few years. This is a study that we’ve done at UNSW that has looked at avian influenza viruses that have been infecting human beings.

Skip to 3 minutes and 48 seconds And again, you can see this clustering over time with a huge increase in the number of avian viruses, different avian viruses that are infecting human beings in recent years.

Skip to 4 minutes and 1 second So another concept with bioterrorism is it doesn’t always cause mass harm. And it can be a one hit attack or it can cause an ongoing epidemic. An example of a one hit attack would be anthrax, which is not transmissible from person to person, or a point source food outbreak or water outbreak where a water supply or a food supply is contaminated. You’ll get a big outbreak and then no further spread after the initial attack.

Skip to 4 minutes and 30 seconds If however, an agent is transmissible from person to person– and when I say agent, I mean the bacteria or the virus– and if it’s got a high R-zero, or reproductive number, which reflects how infectious it is, a single or a few releases will result in an epidemic or a pandemic affecting the whole population. So distinguishing natural from unnatural pandemics is actually quite difficult for a highly infectious agent, because once the epidemics been initiated, whether it was initiated naturally or unnaturally, it’s going to look the same.

Skip to 5 minutes and 4 seconds If the R-zero is low, for example, meaning that the number of cases occurring from one infectious case is low, then if it was used as a biological weapon, the perpetrator mightn’t require multiple ongoing releases to simulate a natural epidemic. And there you might see a pattern that’s quite aberrant. So distinguishing natural from unnatural epidemics is generally absent in public health training practice and discourse. We tend to assume that every epidemic is natural.

Skip to 5 minutes and 40 seconds So the key differences between terrorism and bioterrorism. In the case of terrorism, the weapon is visible and macroscopic, such as a gun or bomb. In bioterrorism, it’s an invisible weapon. The attack itself is recognisable as unnatural in terrorism. But it may appear natural in bioterrorism. The element of terror is present in terrorism but it may be absent in bioterrorism if it’s not recognised as an attack. And the motive actually may not be to incite terror. The target in the case of terrorism is often many people. With bioterrorism, it may be many people or it may be one person or a few people. But one infected person can infect others and result in an epidemic.

Skip to 6 minutes and 24 seconds Which raises the question, is bioterrorism a misnomer. I’m not going to go into the history of bioterrorism, but it dates back to at least 300 BC. There are just numerous examples in history. And you don’t need to do this course to read about those. You can just search for them on Google and you’ll find them. All you need to know is that, where there are methods to harm human beings that are available, those who wish to harm people will use those methods. And biological warfare is just another tool in the armoury of people who wish to harm others.

Skip to 7 minutes and 2 seconds There were in fact documented bioweapons programs in many countries, including the United States, the former Soviet Union, the United Kingdom, and South Africa, and also documented use by various terrorist groups around the world. There’s also a question about what happened to the stocks of bioweapons following the breakup of the Soviet Union. And finally, there’s been a real acceleration of science and some quantum changes in science, which I’ll go over, which have changed the whole landscape since the Cold War. We do have a Biological Weapons Convention, which was reviewed for the eighth time in 2016. What’s been written about it so far suggests that there was not a lot of consensus in this last review.

Skip to 7 minutes and 48 seconds It’s the first multilateral disarmament treaty banning an entire category of weapons. And it’s a supplement to the 1925 Geneva Protocol. It’s been ratified by 22 countries, including the US and the former Soviet Union. But it’s not enforceable or auditable. And it also assumes the major threat is from nation states, which clearly is not the only possible perpetrator of biological weapons. Now, the real game changer in bioterrorism is genetic engineering. There are methods publicly available for engineering deadly superviruses. And the question again, if methods for harm are available on the internet, will terrorists use them. If an engineered outbreak occurs, how do we know it’s unnatural? Most bioterrorism agents actually occur naturally as well.

Skip to 8 minutes and 44 seconds So it is hard to tell if you see an outbreak of a disease, whether its origin is natural or unnatural. In fact, the motive for bioterrorism may be to simulate nature. It’s kind of a stealth attack. Terror may be absent if bioterrorism is not recognised. And the incitement of terror may not be the motive for a biological attack. In fact, if you look back historically at many of the attacks that have been well studied, the motive hasn’t been terror, it’s been to disable an enemy. In the era of genetic engineering, really, any epidemic could be unnatural. And unless you ask the question and look, you’ll never find it.

Introduction to bioterrorism and biosecurity

In this step Professor MacIntyre will introduce you to the basic concepts and definitions of bioterrorism and biosecurity and how they differ. Some examples of the differences between bioterrorism incidents and biosecurity incidents will be given, and the importance of both is highlighted.

After watching this video, discuss the answer to this question in the comments section below:

Reflect on the examples of biosecurity and bioterrorism incidents given. How these might be relevant to your local community?

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This video is from the free online course:

Biosecurity and Bioterrorism: Public Health Dimensions

UNSW Sydney