To view this site you need Adobe Flash Player and your browser must allow javaScripts. Go here to get the latest Flash Player. FRONT LINES Facing the flu effectively By DANIEL M. GERSTEIN NOT LONG AGO,WE ACHIEVED A MAJOR MILESTONE IN THE STRUGGLE TO MITIGATE THE EFFECTS OF , AND PERHAPS EVEN PREVENT, A BIOLOGICAL WARFARE ATTACK. Despite this important development, most Americans probably did not see the recent announcement about the possibility of a broad-spectrum vaccine for the prevention of seasonal influenza as a significant biodefense development. If such reinforcement was needed for some, the recent Swine Flu pandemic, which was discovered in April 2009 and has killed over 100 in Mexico and sickened thousands around the globe, serves as yet another example of the importance of such a vaccine. The potential for such a vaccine should serve as both a cause for optimism and a harbinger of the dangerous window of vulnerability that we face. As concluded in the recent Commission on the Prevention ofWMD Proliferation and Terrorism report, World at Risk (http:// www.preventwmd.gov/report/), released in November 2008, the United States can expect a terrorist attack using nuclear—or, more likely, biological—weapons before 2013. This puts us in a race that pits wellintentioned doctors and scientists against those who would use this technology to develop biological weapons. By some accounts, biotechnology is experiencing annual growth rates of over 400 percent. This growth can be measured by the development of a broad-spectrum influenza vaccine or the ability to rapidly decode the genomes of everything from humans to viruses. It can also be measured by the number of articles that provide detailed information—almost recipes—for altering the basic forms of life. In the same week that the potential for the influenza vaccine was announced, both houses of Congress introduced biosecurity measures designed to enhance the current Select Agent Program (SAP) that seeks to limit the proliferation of the most deadly pathogens and to improve security at our nation’s laboratories. These measures are necessary, but not sufficient in light of the growing threat that we face from the proliferation of the deadly elements of a biological warfare attack. Other important measures that we must incorporate into our biodefense activities include improved cooperation within the international community, the development of a real time biosurveillance capability and training, education and exercises for those responsible for protecting populations in the event of an attack. Global cooperation While closing proliferation windows by strengthening the SAP in the United States is important, gaining international acceptance of these limits and improving cooperation and collaboration across the globe is essential. The reticence of some nations to share information about the state of avian influenza transgenic shift and the continued secrecy surrounding Severe Acute Respiratory Syndrome (SARS) even after several years have passed demonstrate that more needs to be done in this regard. The patient privacy. Some want to allow for cities, counties and states to develop these systems. Others worry about cost. Still, it seems that we have the equivalent of the “canary in the coal mine,” if we could only harness the information in a real time, productive biosurveillance system. Foundations of preparedness In the event of a biological warfare attack or even a natural disease outbreak, training, education and exercises are the foundational elements of preparedness. Government leaders and public health officials need to understand their roles in the crisis, making the right decisions immediately and getting the proper information out to the public.What measures must be taken to prevent additional infections? Do we need to quarantine? How should precious drugs and vaccines be allocated? In this regard, it is instructive to look at the history of smallpox eradication to understand that the way we fight disease may appear counterintuitive, but it is nonetheless essential to limiting the spread of infection. Experience taught us that bringing smallpox victims to a hospital actually magnified the effects of the epidemic.We discovered that a more appropriate strategy was to have infected individuals remain at home and limit their exposure to others; this guidance is being followed today in an effort to contain the spread of the Swine Flu. We are in a race that we must win. It is imperative that we invest in a broad campaign plan to reduce the threats we face from the various biological proliferation windows. Legislation concerning improving SAP and biosecurity is a start, but we owe it to the American people to do more. HST Daniel M. Gerstein, PhD, is a vice president within the L-3 Services Group, where he works on strategic security issues. He has written several books and articles about national security. EAL TIME R BIOSURVEILLANCE MUST BE SEEN AS AN ESSENTIAL COMPONENT OF THE NECESSARY IMPROVEMENTS FOR OUR BIODEFENSE POSTURE. recent willingness to share information about the Swine Influenza should give us some hope and certainly reinforces that disease is a global issue that does not respect the artificial boundaries that define national borders. Real time biosurveillance must be seen as an essential component of the necessary improvements for our biodefense posture. Much of our effort to date has focused on deployment of sensors for detecting a release of chemical or biological material in key cities and locations. Considerably less effort has gone into developing a comprehensive system linking all of the treatment facilities, emergency rooms and clinics into an electronic web providing immediate notification of disease anomalies. The question is: Why not? The answer is that many people are concerned about Register online today for exclusive online content and eNewsletters Homeland Security Today Magazine | June 2009 7