AP, Mar. 25, 2003
Washington — Easy to find and easy to produce, botulinum toxin is the most poisonous natural substance on Earth. In the hands of a bioterrorist, a single gram – the weight of a paper clip – could kill more than one million people.
Federal officials in the United States fear the nation is both vulnerable to such an attack and ill prepared should one occur.
“We are making this the highest priority,” said Dr. Anthony Fauci of the National Institutes of Health, one of the federal government’s top bioterrorism officials. “We are really marshaling all available resources.”
The toxin easily poisons those who eat it, and experts fear terrorists could infect the nation’s food supply and sicken thousands, making the 2001 anthrax attacks-by-mail seem minor by comparison.
The government only has enough antitoxin available to treat victims of a small attack – one official put the inventory at more than 1,000 doses. And the special treatment needed for children is produced only by a California program now in jeopardy because of the state’s budget shortfall.
The issue takes on particular urgency as the United States wages war with Iraq. In 1995, Iraq told the United Nations that it had made more than 5,000 gallons of botulinum toxin and loaded much of it into bombs and warheads. Inspectors believe Saddam Hussein actually has materials capable of producing twice as much toxin – enough to kill the entire human population three times over.
Unlike smallpox, the most widely publicized bioterror threat, botulism is not contagious and, with medical treatment, the vast majority survive.
But while smallpox no longer exists in the wild, botulism is easily acquired. It’s found in soil and can contaminate poorly prepared food. About 120 Americans get botulism each year. Roughly three in four are infants, who can get it from trace amounts in honey.
Disseminating botulinum toxin would not be particularly difficult, though someone would need basic microbiology skills, experts say.
Heating food long enough at a high enough temperature will kill the organism, but foods like fruits and vegetables aren’t cooked. Milk and other dairy products aren’t heated long enough during processing to kill the toxin.
Botulism causes paralysis, starting at the head and moving down the body. Victims become limp, and at the beginning they can’t move their eyes, facial muscles or vocal cords. They have trouble swallowing. Eventually, the paralysis moves through the central nervous system, and patients must be put on ventilators or their lungs would stop pumping.
It’s the same paralysis that makes Botox (short for botulinum toxin) an effective tool for smoothing wrinkles. A tiny, purified amount is injected into people’s faces, temporarily paralyzing the muscles beneath the skin. Botox is also used to treat certain nerve disorders.
But in larger – though still tiny – quantities, it can be deadly.
Botulinum toxin has never been used successfully as a weapon, though the Japanese cult Aum Shinrikyo tried and failed to disperse it in aerosols at least three times in the early 1990s.
Still, experts fear both small- and large-scale attacks.
They cite, as an example of a small attack, cult followers spreading salmonella on salad bars at 10 Oregon restaurants in 1984, sickening about 750 people.
If even a few people were exposed, “that could cause panic and terror,” said Michael Doyle, director of the Center for Food Safety at the University of Georgia, who is advising federal officials on this issue.
Much more terrifying would be poisoning food or milk during processing.
“That would be something that could really bring the country to its knees,” Mr. Doyle said.
Milk represents a particular concern, according to experts in and outside the government. If botulinum toxin were present, it might not be killed during the processing stage. There’s also concern about the vulnerability of tankers transporting milk.
Milk producers have tried to plug certain security holes, sealing tankers after they’ve been cleaned and beefing up security checks in hiring workers, an industry spokesman said.
As they deal with the threat, federal officials also are trying to beef up the nation’s existing stockpile of antitoxins, made from the blood of vaccinated horses. Additional supplies won’t be ready until year’s end, at the earliest.
Researchers are also working on a new, genetically engineered antitoxin, which could be easily and quickly reproduced in large quantities, but that is still at least a few years away.
Federal officials are also considering taking over the California program that is the sole producer of antitoxin for children. Gov. Gray Davis has proposed eliminating the program because of California’s budget crisis.