The United States Government has identified the potential of chemical, biological, radiological and/or nuclear (termed CBRN) terrorism, especially after the September 11 attacks. They have been concerned ever since Sarin was used in a Tokyo subway (Aum Shinrikyo in 1995) and the anthrax case (in November 2001). The chances of terrorists resorting to these agents in warfare are pretty high considering their advantages over conventional methods. Most organizations fighting terrorism are not equipped well enough to detect such chemicals. A closed container can help most of them escape discovery. The low cost involved in their production increases the dangers manifold. Since most of the above agents affect the human body directly, they are essentially more efficient than conventional warfare.
Chemical weapons have four major classifications. Choking agents are aimed at being fatal and are easily accessible. Phosgene is one such industrial chemical agent. Blister agents are meant to leave its victims incapacitated rather than dead. Mustard gas and lewisite are just two examples used in the World War I. Most Blood agents are cyanide based (such as Hydrogen Cyanide) and are directed towards individuals rather than a large number of people. The last category, Nerve agents include chemicals such as Sarin, Tabun and Soman, and are considered significantly more potent than the others. They can easily inflict damage over a large group of people. Biological weapons involve infectious agents such as bacteria (Inhalation Anthrax, Tularemia, Pneumonic Plague and Q-fever), viruses (Smallpox, Marburg fever and Venet Equine Enzephalitis) and toxins (Botulism, Ricin and SEB intoxication).
Knowing all of the above, the United States must comprehend the consequences of potential future attacks and take steps to prepare and be the first to take action against the new and unconventional terrorist. The advent of the 21st century has upgraded the nature of terrorism from the traditional wars and bombs, which makes chemical and biological weaponry some of the most potent options available for use in future attacks."
However, to properly foresee such consequences and to adequately implement successful preventative security measures, the inherent disparities between chemical and biological terrorism must be properly identified and accounted for. For the most part, the difference in these two forms of attack can be found in the conspicuousness of their effects. Chemical terrorism is largely overt in nature, meaning that its effects can readily be seen without a prolonged incubation period. Typical homeland security measures have usually focused on such covert attacks, since the effects of the absorption of chemical agents through the skin, through inhalation, or through mucous membranes are readily apparent and either fatal or incapacitating within a brief amount of time. Such attacks usually call for the expedient mobilization of law enforcement authorities and emergency medical personnel, in addition to both public and private healthcare officials.
Nevertheless, the more insidious (and potentially more effective) manner of terrorist attacks by far are those of the covert variety. The vast majority of biological warfare can be stratified as covert measures of warfare, for the simple fact that there is typically a significant period of incubation between the launch of a biological offensive and the manifestation of its effects. Subsequently, there is a large likelihood that the initial determinants of a biological terrorist attack will be found by primary healthcare providers such as physicians, who ideally will be trained to notice patterns of unusual symptoms or diseases. The propensity for this possibility explains why disease surveillance measures must be enforced at a local, statewide level, so that epidemiologists and other physicians will be aware of shared symptoms which indicate a covert biological attack.
The following quotation emphasizes the importance of healthcare providers in the identification and containment of covert, biological warfare. "…in the event of the covert release of the contagious variola virus, patients will appear in doctors' offices, clinics, and emergency rooms during the first or second week, complaining of fever, back pain, headache, nausea, and other symptoms…By the time the rash becomes pustular and patents begin to die, the terrorists would be far away and the disease disseminated through the population by person-to-person contact (Khan, Levitt, Sage, 2000, p.7) ." The role of physicians as the first line of defense against such an attack is readily apparent, since it would be left to their authority to determine the pattern in the symptoms of patients, recognize the progression of their afflictions, and ideally quarantine them and prevent this disease from spreading further. There will be a relatively brief amount of time between the initial attack and successive waves of victims reporting such symptoms for healthcare providers to implement measures of diagnosis and act accordingly. Prevention strategies would could include "mass vaccination or prophylactic treatment (Khan, Levitt, Sage, 2000, p. 7)," among other methods, and could possibly mean the difference between an isolated incident and a sweeping series of fatalities with nation or global wide effects.
However, it should be noted that although most chemical methods of warfare are overt, it is possible to launch covert offensives through the use of chemical agents as well. Chemical poisoning of food and water supplies are one such example of covert applications of this form of terrorism, and may take several months to be detected during which time large quantities of population are exposed to its noxious effects. Again, the most solid defensive mechanism against such an occurrence would be the recognizing of a similarity of symptoms in patients by health care providers, and in this case, an examination of the possible sources that could present such an effect as well as the quarantining methods outlined above.
Despite the difference in the nature of chemical and biological attacks, the methods of vigilance and response to such warfare are largely identical. Early detection is the integral component for effectively counteracting such offensives, which requires adequate preparation at municipal and state levels, as well as a fair amount of coordination of activity at the federal level. One of the primary purposes of the U.S. public health surveillance and response system is to defend the interest of the public against the event of any unusual public health crisis (Nsubuga, Nwanyanwu, Nkengasong, Mukanga, Trostle, 2010, p. 1). As such, the most prudent initial measure of preparation for these attacks is to bolster the level of epidemiologic identification and response biological and chemical attacks, which may be done the most effectively by the purveyance of "diagnostic reagent to state and local public health agencies (Khan, Levitt, Sage, p.9)." The usage of diagnostic exams for biological and chemical agents can provide a method of surveillance, as well as a degree of awareness of the diseases prone to manifest as a result from these harmful substances.
Similarly, adequate preparation will involve the generation of a list of the most likely and most devastating of chemical and biological elements to be used against the United States in a terrorist attack. Such lists are currently existent, and are generally stratified by past popularity as well as by the level of vulnerability the general population has against them. Such lists must be frequently updated to include the latest biological and chemical developments, and also need to be altered to account for the variance of specific population capacities and the resources of a local area to treat those capacities. Of particular importance in the prioritization of substances on these lists is their ability to be disseminated, "especially agents that are highly contagious or that can be engineered for widespread dissemination via small-particle aerosols (Khan, Levitt, Sage, p.8).
Of equal importance to the generation of lists of the most dangerous and widespread biological and chemical means of warfare is the degree of education and awareness that must be provided to the proper authorities who will have to deal with such potential outbreaks. Such personnel include law enforcement employees in police and fire departments as well as in various military branches. Healthcare officials of various designations including physicians, nurses, and technicians must also be kept abreast of developments in biological and chemical warfare fronts, all for the purpose of aiding the imminent detection of any potential offensive.
Measures of preparation more specific to healthcare professionals include the procurement of a number of vaccines and antidotes that may be of use during a particular outbreak. The prioritization of these curative measures correlates with the hierarchy of potential offenses found in the previously mentioned list of biological and chemical terrorist means. Additionally, specially prepared laboratories have been created to investigate the presence of these substances, particularly those which are not indigenous to the United States. The United States Centers for Disease Control has proposed a network of multilevel laboratories that will "link clinical labs to public health care agencies in all states, districts, territories and selected cities and counties and to state-of-the-art facilities that can analyze biological agents. (Khan, Levitt, Sage, 2000, p. 13)." These laboratories will be able to transfer technology and results to one another, exchange information about these crucial agents which are of…