is no subject to be taken lightly. The New York Times
has a tremendously well-researched article today
on the recent outbreaks of Norwalk virus aboard cruise ships. This article (excerpted below) highlights some major issues for American anti-terrorism planners in preventing/responding bioterrorist attacks on Americans at home and abroad.
Imagine for a second that these viruses were intentionally passed to the tourists aboard these ships. A terrorist group could have waited for these tourists to arrive in a vacation spot like Jamaica (not known for its anti-terrorism law enforcement efforts), procured a beat-up taxicab, and met the tourists as they disembarked for a port call. All the terrorist would have to do is spread some of the virus in the backseat and on the doors -- not hard to do with a fecal-oral virus like this. Biology would do the rest. The use of a non-lethal, relatively harmless bug this time was intentional. This is reconnaissance. In this hypothetical scenario, the terrorists are conducting reconnaissance to determine American respones times, quarantine procedures, scrubbing procedures, etc. However, the reconnaissance itself has somewhat of a disruptive effect, so it's not entirely harmless.
Now imagine for a second all of the potential means that bioterrorism vectors (aka humans) could enter this country. They could come in over land borders, e.g. through the U.S./Mexican port of entry at Tijuana. They could fly in on international flights. They could come in by sea. They could ferry in from Canada. The list goes on. Currently, the front line of defense for detecting sick people entering the U.S. is relatively weak. Unless you're hacking up phlegm on an airliner in quantities that a flight attendant would notice, you're not going to set off any alarms. It's entirely possible that you could enter the country through completely legal means carrying a virus or bacterial infection without anyone ever knowing.
Next, think of the viruses/bugs that could be used. One option is the sexy, deadly type of bug like Ebola or smallpox. But those may be too lethal, too hard to get through -- and too easily detectable. A more sophisticated terrorist might choose instead to use a strain of tuberculosis which is "multiple drug resistant", or MDR. Such strains of TB could then mutate in the U.S. and create tremendous secondary and tertiary difficulties for American medicine. And ultimately, these bugs could release a TB epidemic which American doctors are incapable of treating. The same can be done with strep, staph, and other bugs. The goal might not be to kill people outright, but to make a tremendous number of Americans sick. Terrorists don't always aim to kill -- sometimes they aim to disrupt.
Again, there's no current cause for alarm. This is all my speculation, based on my background and reading of several important books on the subject (including 'Germs'
by the NY Times reporters Judith Miller and William Broad; and 'The Coming Plague'
by Laurie Garrett). But if this is a new terrorist threat, we must act fast. The defenses in this area are thin, and we cannot afford to keep wasting money on airport/airliner/border security while leaving ourselves vulnerable to other, more clandestine threats.The New York Times
December 6, 2002Virus Rattles Cruise Industry and Health Officials
By DENISE GRADY
The reports from the Caribbean cruise ship Oceana began arriving at the Centers for Disease Control and Prevention late on Tuesday. By Wednesday night, the picture was disturbingly familiar: 117 on board were violently ill with vomiting and diarrhea, the same symptoms that had laid low passengers on three other ships in the last two months.
A common and highly contagious infection, caused by a germ known as a Norwalk-like virus, has been confirmed on two of the ships and is suspected on the other two. Since October, the virus has sickened at least 900 passengers and crew members on cruise ships.
The outbreaks are creating a mystery for federal health officials and are rattling passengers and cruise company executives. Norwalk-like viruses have hit ships before, but health officials said they did not know why the recent outbreaks were occurring, and they said the recent burst of cases appeared to be an increase over previous years.
The nature of the viruses — they are common, hardy, highly contagious and hard to track — raises the possibility that periodic outbreaks on ships may be inevitable, one more risk that the traveling public must factor into the calculation of whether to book tickets or stay home. The tight quarters of a ship provide ideal conditions for contagious germs like Norwalk viruses to multiply.