What is bioterrorism?
Bioterrorism is typically defined as the use—or threatened use—of biological agents to spread fear or intimidation for religious, political, ideological, financial, or personal purposes. These biological agents (with the exception of the smallpox virus) occur naturally in various parts of the world. However, their construction can be enhanced or changed for use in weapons, making these agents more resistant to vaccines and antibiotics.
Bioterrorism agents may be spread in different ways, most often as a gas or a contaminant for food and water supplies.
Terrorists choose to use biological weapons because bioterrorism gives the biggest "bang" for the buck. Such weapons are relatively inexpensive to prepare and easy to hide, allowing terrorists the opportunity to quietly stage an attack that may take several days before signs of illness are detected.
How has DHEC been preparing for the possibility of a bioterrorist attack in South Carolina?
DHEC's Office of Public Health Preparedness (OPHP) is charged with leading the agency's efforts to prepare for a potential terrorist attack, which would endanger the public health. These attacks could include the use of biological, chemical, and nuclear weapons. In order to prepare, OPHP has been actively involved in numerous activities to protect the health of South Carolinians. These activities including:
- planning vaccinations for healthcare workers and other emergency responders against the spread of smallpox by terrorists. Although smallpox has been eradicated since the ‘70s, it is reported that certain terrorist countries and organizations have sought to obtain the virus for weapons;
- coordinating the emergency distribution of medicines and supplies from the national stockpile, if needed. DHEC's OPHP has a pharmacist who plans and directs that distribution;
- assisting in the coordination of emergency drills to test the readiness of the agency's ability to respond to a public health crisis; and
- ensuring that, in the event of a public health emergency in South Carolina, accurate and adequate information is provided to the public in a timely manner.
On December 13, 2002, President George W. Bush announced the Smallpox Vaccination Program, the first step in the effort to protect the country from a possible biological attack using smallpox. Although there was no credible information or imminent threat of a biological attack, state and local governments formed volunteer Smallpox Response Teams capable of providing critical services in the event of an intentional smallpox release. DHEC received 7,800 doses of the vaccine and has been coordinating South Carolina’s team development.
In the event of an attack on the U.S., will there be enough vaccine for everyone?
Yes. The Department of Homeland Security established and monitors the Strategic National Stockpile (SNS), formerly known as the National Pharmaceutical Stockpile (NPS), in anticipation of an attack on our country.
The mission of the stockpile program is to ensure the rapid availability of life-saving medicines, supplies, and equipment necessary to protect citizens against nerve, biological, and chemical agents. The program stands ready to respond to a terrorist attack using a biological or chemical agent—anywhere in the United States.
How can I Protect my Family or Myself?
Protecting yourself and your family is of great importance during any emergency situation – natural or man-made. Therefore, it’s good advice to prepare and be ready to respond. The American Red Cross offers sensible recommendations (pdf) based on the national threat level.
How can my child’s school prepare itself for a potential bioterrorist attack?
Many school districts across the country have initiated educational programs to help children cope with the threat of attack, as well as to help children contribute to their families overall level of preparedness. The American Red Cross provides an informative program for educators to help children understand the issues with its “Facing Fear: Helping Young People Deal with Terrorism and Other Tragic Events” program. The National School Safety and Security Services offers additional information that can help greatly.
Should South Carolina residents have their own supply of antibiotics to protect themselves against bioterrorism?
It is important to remember that antibiotics only kill bacteria, not viruses. For this reason, many bioterrorists employ viral agents such as smallpox. The best way to protect yourself and your family against viruses is through an effective inoculation campaign.
The state of South Carolina is also supported by the Strategic National Stockpile, which maintains a sufficient supply of medicines and medical supplies to combat a bioterrorist attack.
For bacterial agents, including anthrax, antibiotics are most effective. However, they can also create problems if administered improperly. The national Centers for Disease Control and Prevention and the U.S. Health and Human Services Department are able to answer additional questions you may have.
Is the state water supply safe from bioterrorism?
DHEC and its partners across the state are taking action to ensure the safety of our water supply and respond effectively in the event of an emergency. Among other things, DHEC helps:
- Provide technical assistance to public drinking water systems regarding emergency response issues and bioterrorism
- Provide support for water systems in preparing risk and vulnerability assessments
- Provide assistance to water systems in preparing emergency response plans, and
- Coordinate its findings with DHEC's Division of Acute Disease Epidemiology.
For additional information on what is being done by specific states, review information provided by the Environmental Protection Agency.
What is anthrax?
The Centers for Disease Control and Prevention defines anthrax as an acute infectious disease caused by the spore-forming bacterium Bacillus anthracis. Anthrax most commonly occurs in wild and domestic animals such as cattle, sheep, goats, camels, and antelopes, but it can also occur in humans when they are exposed to infected animals or tissue from infected animals.
Anthrax infection can occur three ways:
- Cutaneous infection occurs when anthrax enters a cut or abrasion on the skin. At first, the infected area may resemble an insect bite, later developing pus-filled sores.
- Inhalation infection is the most serious, resulting in death in approximately 95% of all cases. Although initial symptoms resemble a common cold, this form of anthrax quickly escalates to create severe breathing problems and shock in its victims.
- Gastrointestinal infection may follow the consumption of contaminated meat. Initial signs of nausea, loss of appetite, vomiting, fever are followed by abdominal pain, vomiting of blood, and severe diarrhea.
Certain anthrax spores can live in the soil for many years, and humans can become infected with anthrax by handling products from infected animals or by inhaling anthrax spores from contaminated animal products. Eating undercooked meat from infected animals can also spread anthrax. However, it is rare to find infected animals in the United States.
For more detailed information about anthrax and bioterrorism, visit DHEC’s anthrax page.
Is anthrax contagious?
Direct person-to-person spread of anthrax is extremely unlikely to occur.
In countries where anthrax is common and vaccination levels of animal herds are low, persons should avoid contact with livestock and animal products and avoid eating meat that has not been properly slaughtered and cooked. Also, an anthrax vaccine has been licensed for use in humans. The vaccine is reported to be 93% effective in protecting against anthrax. This vaccine is commonly used in the U.S. military.
Can I be vaccinated against anthrax?
Anthrax vaccinations are only recommended for the following groups:
- Persons who work directly with the organism in the laboratory
- Persons who work with imported animal hides or furs in areas where standards are insufficient to prevent exposure to anthrax spores
- Persons who handle potentially infected animal products in high-incidence areas (Incidence is low in the United States, but veterinarians who travel to work in other countries where incidence is higher should consider being vaccinated.)
- Military personnel deployed to areas with high risk for exposure to the organism (as when it is used as a biological warfare weapon).
At this time, the anthrax vaccine is not recommended for the general public.
What is smallpox?
Smallpox is a serious, contagious, and sometimes fatal infectious disease. The variola virus that emerged in human populations thousands of years ago causes smallpox. There is no specific treatment for smallpox disease, and the only prevention is through vaccination.
Smallpox outbreaks have occurred from time to time for thousands of years, but the disease is now eradicated after a successful worldwide vaccination program. The last case of smallpox in the United States was in 1949. The last naturally occurring case in the world was in Somalia in 1977. After the disease was eliminated from the world, routine vaccination against smallpox was stopped because it was no longer necessary for prevention.
Except for laboratory stockpiles, the variola virus has been eliminated. However, in the aftermath of the events of September and October, 2001, there is heightened concern that the variola virus might be used as an agent of bioterrorism. For this reason, the U.S. government is taking precautions for dealing with a smallpox outbreak.
For more information about smallpox and bioterrorism, please visit our smallpox page.
Is smallpox contagious?
Generally, direct and fairly prolonged face-to-face contact is required to spread smallpox from one person to another. Smallpox also can be spread through direct contact with infected bodily fluids or contaminated objects such as bedding or clothing. Rarely, smallpox has been spread by virus carried in the air in enclosed settings such as buildings, buses, and trains. Humans are the only natural hosts of the smallpox-causing variola virus. Smallpox is not known to be transmitted by insects or animals.
A person with smallpox is sometimes contagious with onset of fever, but the person becomes most contagious with the onset of rash. At this stage, the infected person is usually very sick and bed-ridden, and the infected person is contagious until the last smallpox scab falls off.
Can I be vaccinated against smallpox?
In February 2003, DHEC began its smallpox vaccination program to increase the overall level of public health preparedness in South Carolina. Public health workers and other emergency caregivers—police, firefighters, emergency medical technicians, and others—are the first to receive the vaccinations to heighten their immunity in the event of a bioterrorist attack using smallpox. However, this program is only a precaution. At this time, no smallpox threat has been identified and vaccinations are not being offered to the public.
If an attack occurs and widespread vaccinations become necessary, DHEC will work in conjunction with the Centers for Disease Control and Prevention to provide vaccinations for every citizen requesting it.
If I was vaccinated against smallpox before 1980, can I still get smallpox?
Yes. Generally, the smallpox vaccination remains effective for up to ten years. The vaccination was required for most persons entering school prior to the mid-1970s, and persons receiving the vaccination in the past typically respond most effectively to a re-vaccination.
For more information, see DHEC's Smallpox Preparedness Program.
Is there anything specific that South Carolinian's can do to prepare for a possible bioterrorist attack?
The United States Department of Homeland Security offers three simple pieces of advice:
- Make a kit of emergency supplies - When preparing for a possible emergency situation, it's best to think first about the basics of survival: fresh water, food, clean air and warmth.
- Make a plan for what you will do in the event of an emergency – Be prepared to assess the situation, use common sense and whatever you have on hand to take care of yourself and your loved ones.
- Be aware of what might happen - Knowing what to do during an emergency is an important part of being prepared and can make a big difference when seconds count.