Anthrax bioterror in Europe

The Obama administration has declared its intention to respond faster and more effectively to bioterrorism. But at least two bizarre incidents among drug abusers in Europe force us to question whether experiments with biological weapons might be under way already. In recent weeks, we have heard mystifying reports of the outbreak of anthrax infections among heroin users in Scotland and Germany. More than two dozen users in Scotland and London have been diagnosed, 12 of whom have died. At least one case has been reported in Germany.

Might this be a peculiar anomaly, or does it portend something far more sinister? As Scottish public health and criminal investigators search for the source of the contamination, we are left to ponder the probabilities. There are two principal sources of contamination in illegal drugs. The most obvious is the additives used to «cut» the drug to increase the quantity for street sale. While experts will attest to an amazing array of substances used, Bacillus anthracis hardly falls within that category. Using large amounts of a pathogen that would place the producer at risk makes no sense.

The other source of contamination is exposure during production. If the source of the heroin is within a region where anthrax is endemic, there is a possibility that cross contamination can occur from tents, containers or utensils made from animal hides. This leads to subsequent questions: How much of a concentration has to be present to result in a significant contamination at the far end of the supply chain? Why have none of the distributors been affected? Why has the contamination been so localized?

This leads to a third, more ominous possibility: that the anthrax contamination of heroin is an act of bioterrorism. When we first suggested this prospect, colleagues asked, «But why target heroin users?» Granted, drug abusers exist at the margins of society and often are viewed as lost to the mainstream. Yet they also represent the essence of a society viewed as decadent and evil, especially to a fundamentalist zealot. What better way to accomplish a divine mission than by the very means of the immorality? As a tactical terrorist strike, this offers multiple benefits. The first is a secure and highly efficient delivery channel. By its very nature, the trafficking of illegal drugs avoids detection by customs, law enforcement and health officials. This ensures delivery of the biological weapon, most likely to large population centers.

The primary victims would be those who use drugs and, to a lesser extent, those who distribute the drugs – the «pushers» – violators of Shariah law who can be punished by death. Secondary victims would include law enforcement personnel, health care workers and other public servants such as trash collectors – all symbols and instrumentalities of the system of government you wish to take down. There also is a possibility that chance victims will succumb to incidental exposure, as happened during the 2001 postal anthrax attacks. The randomness of casualties would lead eventually to widespread fear and apprehension, a primary goal of the terrorist.

Absent specific facts, it is impossible to say whether this is a plausible explanation or simply a bizarre coincidence. What is certain is that this event is a symptom of our continuing state of unpreparedness for a well-planned and -executed bioterror attack. The wake-up calls have been many. Al Qaeda has stated its intent to obtain and employ biological weapons. The national intelligence leadership’s Feb. 2 statement that an attempted attack on the United States is a certainty within the next six months is a second alarm. Can the danger be any clearer? The call for immediate and definitive action is dead right. Failure in this regard could be dead wrong, with the emphasis on «dead.»

Donald A. Donahue Jr., executive director of the Center for Health Policy & Preparedness at the Potomac Institute for Policy Studies and Dr. Stephen Cunnion, the center’s medical director.