Biological terrorism and public health

Survival

Volumn 43, Issue 1, 2001, Pages 93-106

  Chyba, Christopher F ^a  

^a NONE

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EID: 0012925144     PISSN: 00396338     EISSN: None     Source Type: Journal    
DOI: 10.1093/survival/43.1.93     Document Type: Article

References (77)

1. Incubation times for many potential biological agents are given in D.R. Franz et al., 'Clinical recognition and management of patients exposed to biological warfare agents', Journal of the American Medical Association, vol. 278, 1997, pp. 399-411.
2. C.F. Chyba, Biological Terrorism, Emerging Diseases, and National Security, (New York: Rockefeller Brothers Fund Project on World Security, 1998), http://206.135.15.24/ pws/Chyba_Bioterrorism.pdf.
3. Institute of Medicine, Emerging Infections: Microbial Threats to Health in the United States (Washington DC: National Academy of Sciences, 1992); Centers for Disease Control and Prevention, Addressing Emerging Infectious Disease Threats: A Prevention Strategy for the United States (Atlanta, GA: CDC, 1994); Committee on International Science, Engineering, and Technology, National Science and Technology Council, Infectious Disease - A Global Health Threat (Washington DC: US Government Printing Office 1995); J.R. Davis and J. Lederberg (eds.), Public Health Systems and Emerging Infections, Institute of Medicine (Washington DC: National Academy Press, 2000); National Intelligence Estimate, The Global Infectious Disease Threat and its Implications for the United States, NIE 99-17D, January 2000, http:// www.odci.gov/cia/publications/nie/ report/nie99-17d.html. The most important new WHO activities are those of its Communicable Disease Surveillance and Response (CSR), http://www.who.int/emc.
4. Institute of Medicine, Emerging Infections: Microbial Threats to Health in the United States (Washington DC: National Academy of Sciences, 1992); Centers for Disease Control and Prevention, Addressing Emerging Infectious Disease Threats: A Prevention Strategy for the United States (Atlanta, GA: CDC, 1994); Committee on International Science, Engineering, and Technology, National Science and Technology Council, Infectious Disease - A Global Health Threat (Washington DC: US Government Printing Office 1995); J.R. Davis and J. Lederberg (eds.), Public Health Systems and Emerging Infections, Institute of Medicine (Washington DC: National Academy Press, 2000); National Intelligence Estimate, The Global Infectious Disease Threat and its Implications for the United States, NIE 99-17D, January 2000, http:// www.odci.gov/cia/publications/nie/ report/nie99-17d.html. The most important new WHO activities are those of its Communicable Disease Surveillance and Response (CSR), http://www.who.int/emc.
5. Institute of Medicine, Emerging Infections: Microbial Threats to Health in the United States (Washington DC: National Academy of Sciences, 1992); Centers for Disease Control and Prevention, Addressing Emerging Infectious Disease Threats: A Prevention Strategy for the United States (Atlanta, GA: CDC, 1994); Committee on International Science, Engineering, and Technology, National Science and Technology Council, Infectious Disease - A Global Health Threat (Washington DC: US Government Printing Office 1995); J.R. Davis and J. Lederberg (eds.), Public Health Systems and Emerging Infections, Institute of Medicine (Washington DC: National Academy Press, 2000); National Intelligence Estimate, The Global Infectious Disease Threat and its Implications for the United States, NIE 99-17D, January 2000, http:// www.odci.gov/cia/publications/nie/ report/nie99-17d.html. The most important new WHO activities are those of its Communicable Disease Surveillance and Response (CSR), http://www.who.int/emc.
6. Institute of Medicine, Emerging Infections: Microbial Threats to Health in the United States (Washington DC: National Academy of Sciences, 1992); Centers for Disease Control and Prevention, Addressing Emerging Infectious Disease Threats: A Prevention Strategy for the United States (Atlanta, GA: CDC, 1994); Committee on International Science, Engineering, and Technology, National Science and Technology Council, Infectious Disease - A Global Health Threat (Washington DC: US Government Printing Office 1995); J.R. Davis and J. Lederberg (eds.), Public Health Systems and Emerging Infections, Institute of Medicine (Washington DC: National Academy Press, 2000); National Intelligence Estimate, The Global Infectious Disease Threat and its Implications for the United States, NIE 99-17D, January 2000, http:// www.odci.gov/cia/publications/nie/ report/nie99-17d.html. The most important new WHO activities are those of its Communicable Disease Surveillance and Response (CSR), http://www.who.int/emc.
7. Institute of Medicine, Emerging Infections: Microbial Threats to Health in the United States (Washington DC: National Academy of Sciences, 1992); Centers for Disease Control and Prevention, Addressing Emerging Infectious Disease Threats: A Prevention Strategy for the United States (Atlanta, GA: CDC, 1994); Committee on International Science, Engineering, and Technology, National Science and Technology Council, Infectious Disease - A Global Health Threat (Washington DC: US Government Printing Office 1995); J.R. Davis and J. Lederberg (eds.), Public Health Systems and Emerging Infections, Institute of Medicine (Washington DC: National Academy Press, 2000); National Intelligence Estimate, The Global Infectious Disease Threat and its Implications for the United States, NIE 99-17D, January 2000, http:// www.odci.gov/cia/publications/nie/ report/nie99-17d.html. The most important new WHO activities are those of its Communicable Disease Surveillance and Response (CSR), http://www.who.int/emc.
8. W. Laqueur, 'Postmodern Terrorism', Foreign Affairs, vol. 75, no. 5, 1996, pp. 24-36; J.F. Sopko, 'The Changing Proliferation Threat', Foreign Policy, vol. 105, Winter 1996-1997, pp. 3-20; R. Betts, 'The New Threat of Mass Destruction', Foreign Affairs, vol. 77, no. 1, 1998, pp. 26-41; A. Carter, J. Deutch, and P. Zelikow, 'Catastrophic Terrorism: Tackling the New Danger', Foreign Affairs, vol. 77, no. 6, pp. 80-94; R.A. Falkenrath, R.D. Newman, and B.A. Thayer, America's Achilles' Heel: Nuclear, Biological, and Chemical Terrorism and Covert Attack (Cambridge, MA: Belfer Center for Science and International Affairs, 1998); S. Simon and D. Benjamin, 'America and the New Terrorism', Survival, vol. 42, no. 1, Spring 2000, pp. 59-75; O. Roy, B. Hoffman, R. Paz, S. Simon and D. Benjamin, 'America and the New Terrorism: An Exchange', Survival, vol. 42, no. 2, Summer 2000, pp. 156-172.
9. W. Laqueur, 'Postmodern Terrorism', Foreign Affairs, vol. 75, no. 5, 1996, pp. 24-36; J.F. Sopko, 'The Changing Proliferation Threat', Foreign Policy, vol. 105, Winter 1996-1997, pp. 3-20; R. Betts, 'The New Threat of Mass Destruction', Foreign Affairs, vol. 77, no. 1, 1998, pp. 26-41; A. Carter, J. Deutch, and P. Zelikow, 'Catastrophic Terrorism: Tackling the New Danger', Foreign Affairs, vol. 77, no. 6, pp. 80-94; R.A. Falkenrath, R.D. Newman, and B.A. Thayer, America's Achilles' Heel: Nuclear, Biological, and Chemical Terrorism and Covert Attack (Cambridge, MA: Belfer Center for Science and International Affairs, 1998); S. Simon and D. Benjamin, 'America and the New Terrorism', Survival, vol. 42, no. 1, Spring 2000, pp. 59-75; O. Roy, B. Hoffman, R. Paz, S. Simon and D. Benjamin, 'America and the New Terrorism: An Exchange', Survival, vol. 42, no. 2, Summer 2000, pp. 156-172.
10. W. Laqueur, 'Postmodern Terrorism', Foreign Affairs, vol. 75, no. 5, 1996, pp. 24-36; J.F. Sopko, 'The Changing Proliferation Threat', Foreign Policy, vol. 105, Winter 1996-1997, pp. 3-20; R. Betts, 'The New Threat of Mass Destruction', Foreign Affairs, vol. 77, no. 1, 1998, pp. 26-41; A. Carter, J. Deutch, and P. Zelikow, 'Catastrophic Terrorism: Tackling the New Danger', Foreign Affairs, vol. 77, no. 6, pp. 80-94; R.A. Falkenrath, R.D. Newman, and B.A. Thayer, America's Achilles' Heel: Nuclear, Biological, and Chemical Terrorism and Covert Attack (Cambridge, MA: Belfer Center for Science and International Affairs, 1998); S. Simon and D. Benjamin, 'America and the New Terrorism', Survival, vol. 42, no. 1, Spring 2000, pp. 59-75; O. Roy, B. Hoffman, R. Paz, S. Simon and D. Benjamin, 'America and the New Terrorism: An Exchange', Survival, vol. 42, no. 2, Summer 2000, pp. 156-172.
11. W. Laqueur, 'Postmodern Terrorism', Foreign Affairs, vol. 75, no. 5, 1996, pp. 24-36; J.F. Sopko, 'The Changing Proliferation Threat', Foreign Policy, vol. 105, Winter 1996-1997, pp. 3-20; R. Betts, 'The New Threat of Mass Destruction', Foreign Affairs, vol. 77, no. 1, 1998, pp. 26-41; A. Carter, J. Deutch, and P. Zelikow, 'Catastrophic Terrorism: Tackling the New Danger', Foreign Affairs, vol. 77, no. 6, pp. 80-94; R.A. Falkenrath, R.D. Newman, and B.A. Thayer, America's Achilles' Heel: Nuclear, Biological, and Chemical Terrorism and Covert Attack (Cambridge, MA: Belfer Center for Science and International Affairs, 1998); S. Simon and D. Benjamin, 'America and the New Terrorism', Survival, vol. 42, no. 1, Spring 2000, pp. 59-75; O. Roy, B. Hoffman, R. Paz, S. Simon and D. Benjamin, 'America and the New Terrorism: An Exchange', Survival, vol. 42, no. 2, Summer 2000, pp. 156-172.
12. W. Laqueur, 'Postmodern Terrorism', Foreign Affairs, vol. 75, no. 5, 1996, pp. 24-36; J.F. Sopko, 'The Changing Proliferation Threat', Foreign Policy, vol. 105, Winter 1996-1997, pp. 3-20; R. Betts, 'The New Threat of Mass Destruction', Foreign Affairs, vol. 77, no. 1, 1998, pp. 26-41; A. Carter, J. Deutch, and P. Zelikow, 'Catastrophic Terrorism: Tackling the New Danger', Foreign Affairs, vol. 77, no. 6, pp. 80-94; R.A. Falkenrath, R.D. Newman, and B.A. Thayer, America's Achilles' Heel: Nuclear, Biological, and Chemical Terrorism and Covert Attack (Cambridge, MA: Belfer Center for Science and International Affairs, 1998); S. Simon and D. Benjamin, 'America and the New Terrorism', Survival, vol. 42, no. 1, Spring 2000, pp. 59-75; O. Roy, B. Hoffman, R. Paz, S. Simon and D. Benjamin, 'America and the New Terrorism: An Exchange', Survival, vol. 42, no. 2, Summer 2000, pp. 156-172.
13. W. Laqueur, 'Postmodern Terrorism', Foreign Affairs, vol. 75, no. 5, 1996, pp. 24-36; J.F. Sopko, 'The Changing Proliferation Threat', Foreign Policy, vol. 105, Winter 1996-1997, pp. 3-20; R. Betts, 'The New Threat of Mass Destruction', Foreign Affairs, vol. 77, no. 1, 1998, pp. 26-41; A. Carter, J. Deutch, and P. Zelikow, 'Catastrophic Terrorism: Tackling the New Danger', Foreign Affairs, vol. 77, no. 6, pp. 80-94; R.A. Falkenrath, R.D. Newman, and B.A. Thayer, America's Achilles' Heel: Nuclear, Biological, and Chemical Terrorism and Covert Attack (Cambridge, MA: Belfer Center for Science and International Affairs, 1998); S. Simon and D. Benjamin, 'America and the New Terrorism', Survival, vol. 42, no. 1, Spring 2000, pp. 59-75; O. Roy, B. Hoffman, R. Paz, S. Simon and D. Benjamin, 'America and the New Terrorism: An Exchange', Survival, vol. 42, no. 2, Summer 2000, pp. 156-172.
14. W. Laqueur, 'Postmodern Terrorism', Foreign Affairs, vol. 75, no. 5, 1996, pp. 24-36; J.F. Sopko, 'The Changing Proliferation Threat', Foreign Policy, vol. 105, Winter 1996-1997, pp. 3-20; R. Betts, 'The New Threat of Mass Destruction', Foreign Affairs, vol. 77, no. 1, 1998, pp. 26-41; A. Carter, J. Deutch, and P. Zelikow, 'Catastrophic Terrorism: Tackling the New Danger', Foreign Affairs, vol. 77, no. 6, pp. 80-94; R.A. Falkenrath, R.D. Newman, and B.A. Thayer, America's Achilles' Heel: Nuclear, Biological, and Chemical Terrorism and Covert Attack (Cambridge, MA: Belfer Center for Science and International Affairs, 1998); S. Simon and D. Benjamin, 'America and the New Terrorism', Survival, vol. 42, no. 1, Spring 2000, pp. 59-75; O. Roy, B. Hoffman, R. Paz, S. Simon and D. Benjamin, 'America and the New Terrorism: An Exchange', Survival, vol. 42, no. 2, Summer 2000, pp. 156-172.
15. 'Terrorists want a lot of people watching and a lot of people listening, and not a lot of people dead.' B.M. Jenkins, 'International Terrorism: A New Mode of Conflict', in International Terrorism and World Security, D. Carlton and C. Schaerf (eds.), (London: Croom Helm, 1975), p. 15. See also B. Hoffman, Inside Terrorism (New York: Columbia University Press, 1998).
16. 'Terrorists want a lot of people watching and a lot of people listening, and not a lot of people dead.' B.M. Jenkins, 'International Terrorism: A New Mode of Conflict', in International Terrorism and World Security, D. Carlton and C. Schaerf (eds.), (London: Croom Helm, 1975), p. 15. See also B. Hoffman, Inside Terrorism (New York: Columbia University Press, 1998).
17. A carefully documented account of the Aum's biological and other attacks is given by D.E. Kaplan, 'Aum Shinrikyo (1995)', in J.B. Tucker, ed., Toxic Terror: Assessing Terrorist Use of Chemical and Biological Weapons, MIT Press, Cambridge, MA, 2000, pp. 207-226. See also M. Leitenberg, 'The Experience of the Japanese Aum Shinrikyo Group and Biological Agents', in B. Roberts (ed.), Hype or Reality: The 'New Terrorism' and Mass Casualty Attacks (Alexandria, VA: CBACI, 2000) pp. 159-172.
18. A carefully documented account of the Aum's biological and other attacks is given by D.E. Kaplan, 'Aum Shinrikyo (1995)', in J.B. Tucker, ed., Toxic Terror: Assessing Terrorist Use of Chemical and Biological Weapons, MIT Press, Cambridge, MA, 2000, pp. 207-226. See also M. Leitenberg, 'The Experience of the Japanese Aum Shinrikyo Group and Biological Agents', in B. Roberts (ed.), Hype or Reality: The 'New Terrorism' and Mass Casualty Attacks (Alexandria, VA: CBACI, 2000) pp. 159-172.
19. W.J. Broad, S. Wu Dunn, and J. Miller, 'How Japan Germ Terror Alerted World', New York Times, 26 May 1998, p. A1.
20. The initial exaggeration of Aum's biological-weapons capabilities has been emphasised by M. Leitenberg, 'The Experience of the Japanese Aum Shinrikyo Group and Biological Agents', in B. Roberts (ed.), Hype or Reality: The 'New Terrorism' and Mass Casualty Attacks (Alexandria, VA: CBACI, 2000), pp. 159-172; see also A.E. Smithson and L. Levy, Ataxia: The Chemical and Biological Terrorism Threat and the US Response, Stimson Center Report no. 35, pp. 75-80, http://www.stimson.org/cwc/ ataxia.htm.
21. The initial exaggeration of Aum's biological-weapons capabilities has been emphasised by M. Leitenberg, 'The Experience of the Japanese Aum Shinrikyo Group and Biological Agents', in B. Roberts (ed.), Hype or Reality: The 'New Terrorism' and Mass Casualty Attacks (Alexandria, VA: CBACI, 2000), pp. 159-172; see also A.E. Smithson and L. Levy, Ataxia: The Chemical and Biological Terrorism Threat and the US Response, Stimson Center Report no. 35, pp. 75-80, http://www.stimson.org/cwc/ ataxia.htm.
22. For a near-contemporary account, see T. Rosebury, Peace or Pestilence: Biological Warfare and How to Avoid it (New York: McGraw-Hill, 1949).
23. Office of Technology Assessment, Technologies Underlying Weapons of Mass Destruction, OTA-BP-ISC-115, December 1993 (Washington DC: US Government Printing Office, 1993).
24. K. Alibek, Biohazard: The Chilling True Story of the Largest Covert Biological Weapons Program in the World - Told from Inside by the Man Who Ran It, (New York: Random House, 1999); A.E. Smithson, Toxic Archipelago: Preventing Proliferation from the Former Soviet Chemical and Biological Weapons Complexes, Stimson Center Report no. 32, http://www.stimson.org/cwc/ toxic.htm.
25. K. Alibek, Biohazard: The Chilling True Story of the Largest Covert Biological Weapons Program in the World - Told from Inside by the Man Who Ran It, (New York: Random House, 1999); A.E. Smithson, Toxic Archipelago: Preventing Proliferation from the Former Soviet Chemical and Biological Weapons Complexes, Stimson Center Report no. 32, http://www.stimson.org/cwc/ toxic.htm.
26. D. McClain, 'Smallpox', in Textbook of Military Medicine, Part I: Medical Aspects of Chemical and Biological Warfare, Office of the Surgeon General, Department of the Army, 1997, pp. 539-559. The CDC awarded a contract in 2000 to Ora Vax of Cambridge, Massachusetts, to produce smallpox vaccine; approximately 40 million doses will be produced initially with anticipated delivery of the first full -scale production lots in 2004. The contract allows for increased production of the vaccine should the need arise. See J. Koplan, 'CDC's Strategic Plan for Bioterrorism', presentation to 'Bioterrorism: Public Health Emergency and National Security Threat', Washington DC, November 28-29, 2000, http://www.hopkins-biodefense.org/sympcast/ transcripts/trans_kopl.html.
27. D. McClain, 'Smallpox', in Textbook of Military Medicine, Part I: Medical Aspects of Chemical and Biological Warfare, Office of the Surgeon General, Department of the Army, 1997, pp. 539-559. The CDC awarded a contract in 2000 to Ora Vax of Cambridge, Massachusetts, to produce smallpox vaccine; approximately 40 million doses will be produced initially with anticipated delivery of the first full -scale production lots in 2004. The contract allows for increased production of the vaccine should the need arise. See J. Koplan, 'CDC's Strategic Plan for Bioterrorism', presentation to 'Bioterrorism: Public Health Emergency and National Security Threat', Washington DC, November 28-29, 2000, http://www.hopkins-biodefense.org/sympcast/ transcripts/trans_kopl.html.
28. L.K. Altman, 'Protection Urged for Possible Smallpox Attack', New York Times, 11 March 1998, p. A16.
29. The Soviet defector Ken Alibek envisions this type of attack in his article, 'Russia's Deadly Expertise', New York Times, 27 March 1998, p. A19.
30. J.J. Fialka, 'CIA Says North Korea Appears Active in Biological, Nuclear Arms', Wall Street Journal, 25 February 1993, p.16; D.R. Franz et al., 'Clinical recognition and management of patients exposed to biological warfare agents', Journal of the American Medical Association, vol. 278, 1997, pp. 399-411; R.F. Knouss, 'The Federal Role in Protection and Response', in S.D. Drell, A.D. Sofaer, and G.D. Wilson, eds., The New Terror: Facing the Threat of Biological and Chemical Weapons, (Stanford: Hoover Institution Press, 1999), pp. 348-359.
31. J.J. Fialka, 'CIA Says North Korea Appears Active in Biological, Nuclear Arms', Wall Street Journal, 25 February 1993, p.16; D.R. Franz et al., 'Clinical recognition and management of patients exposed to biological warfare agents', Journal of the American Medical Association, vol. 278, 1997, pp. 399-411; R.F. Knouss, 'The Federal Role in Protection and Response', in S.D. Drell, A.D. Sofaer, and G.D. Wilson, eds., The New Terror: Facing the Threat of Biological and Chemical Weapons, (Stanford: Hoover Institution Press, 1999), pp. 348-359.
32. J.J. Fialka, 'CIA Says North Korea Appears Active in Biological, Nuclear Arms', Wall Street Journal, 25 February 1993, p.16; D.R. Franz et al., 'Clinical recognition and management of patients exposed to biological warfare agents', Journal of the American Medical Association, vol. 278, 1997, pp. 399-411; R.F. Knouss, 'The Federal Role in Protection and Response', in S.D. Drell, A.D. Sofaer, and G.D. Wilson, eds., The New Terror: Facing the Threat of Biological and Chemical Weapons, (Stanford: Hoover Institution Press, 1999), pp. 348-359.
33. Assessment of Future Scientific Needs for Live Variola Virus, Institute of Medicine (Washington DC: National Academy Press, 1999).
34. A thorough summary of the West Nile outbreak in New York is given by M. Schock-Spana, 'A West Nile Virus Post-Mortem', Biodefense Quarterly, vol. 1, no. 3, December 1999, http://www.hopkins-biodefense.org/pages/news/ quarter1_3.html#Anchor-cdc.
35. R. Preston, 'West Nile Mystery', New Yorker, October 18 and 25, 1999, pp. 90-108.
36. J. Steinhauer and J. Miller, 'In New York Outbreak, Glimpse of Gaps in Biological Defence', New York Times, 11 October 1999, p. Al; L.K. Altman, 'Officials Working to Contain West Nile Virus', New York Times, 26 April 2000.
37. J. Steinhauer and J. Miller, 'In New York Outbreak, Glimpse of Gaps in Biological Defence', New York Times, 11 October 1999, p. Al; L.K. Altman, 'Officials Working to Contain West Nile Virus', New York Times, 26 April 2000.
38. T.J. Török et al., 'A Large Community Outbreak of Salmonellosis Caused by Intentional Contamination of Restaurant Salad Bars', Journal of the American Medical Association, vol. 278, no. 5, 1997, pp. 389-395; W.S. Carus, 'The Rajneeshees (1984)', in J.B. Tucker (ed.), Toxic Terror: Assessing Terrorist Use of Chemical and Biological Weapons (Cambridge, MA: MIT Press, 2000), pp. 115-138.
39. T.J. Török et al., 'A Large Community Outbreak of Salmonellosis Caused by Intentional Contamination of Restaurant Salad Bars', Journal of the American Medical Association, vol. 278, no. 5, 1997, pp. 389-395; W.S. Carus, 'The Rajneeshees (1984)', in J.B. Tucker (ed.), Toxic Terror: Assessing Terrorist Use of Chemical and Biological Weapons (Cambridge, MA: MIT Press, 2000), pp. 115-138.
40. D.R. Franz et al., 'Clinical recognition and management of patients exposed to biological warfare agents', Journal of the American Medical Association, vol. 278, 1997, pp. 399-411; F.R. Sidell, E.T. Takafuji, and D.R. Franz (eds), Medical Aspects of Chemical and Biological Warfare (Washington DC: Office of the Surgeon General, 1997).
41. D.R. Franz et al., 'Clinical recognition and management of patients exposed to biological warfare agents', Journal of the American Medical Association, vol. 278, 1997, pp. 399-411; F.R. Sidell, E.T. Takafuji, and D.R. Franz (eds), Medical Aspects of Chemical and Biological Warfare (Washington DC: Office of the Surgeon General, 1997).
42. C.F. Chyba, Biological Terrorism, Emerging Diseases, and National Security, Rockefeller Brothers Fund Project on World Security, New York, 1998, http://206.135.15.24/pws/ Chyba_Bioterrorism.pdf.
43. Birds had been dying from the West Nile virus for at least a month prior to the first recognised human cases. The connection between the bird deaths and a threat to humans was not made until after human illnesses began. See M. Schock-Spana, 'A West Nile Virus Post-Mortem', Biodefense Quarterly, vol. 1, no. 3, December 1999, http:// www.hopkins-biodefense.org/pages/ news/quarter1_3.html#Anchor-cdc; and J. Steinhauer and J. Miller, 'In New York Outbreak, Glimpse of Gaps in Biological Defenses', New York Times, 11 October 1999, p. A1.
44. Birds had been dying from the West Nile virus for at least a month prior to the first recognised human cases. The connection between the bird deaths and a threat to humans was not made until after human illnesses began. See M. Schock-Spana, 'A West Nile Virus Post-Mortem', Biodefense Quarterly, vol. 1, no. 3, December 1999, http:// www.hopkins-biodefense.org/pages/ news/quarter1_3.html#Anchor-cdc; and J. Steinhauer and J. Miller, 'In New York Outbreak, Glimpse of Gaps in Biological Defenses', New York Times, 11 October 1999, p. A1.
45. Time Almanac 2001, (Boston: Family Education Company, 2000), p. 213.
46. J. Gerth and T. Weiner, 'Imports Swamp US Food-Safety Efforts.' New York Times, 29 September 1997, p. A1; R.L. Berkelman et al., 'Infectious Disease Surveillance: A Crumbling Foundation', Science 264, 1994, pp. 368-370.
47. J. Gerth and T. Weiner, 'Imports Swamp US Food-Safety Efforts.' New York Times, 29 September 1997, p. A1; R.L. Berkelman et al., 'Infectious Disease Surveillance: A Crumbling Foundation', Science 264, 1994, pp. 368-370.
48. R.M. Krause, The Origin of Plagues: Old and New', Science 257, 1992, pp. 1073-1078; S.S. Morse, 'Factors in the Emergence of Infectious Diseases', Emerging Infectious Diseases, vol. 1, no. 1, 1995, pp. 7-15.
49. R.M. Krause, The Origin of Plagues: Old and New', Science 257, 1992, pp. 1073-1078; S.S. Morse, 'Factors in the Emergence of Infectious Diseases', Emerging Infectious Diseases, vol. 1, no. 1, 1995, pp. 7-15.
50. D. R. Burton and P.H.I. Parren, 'Fighting the Ebola Virus', Science 408, 2000, pp. 527-528.
51. S. Sternberg, 'Tracking a Mysterious Killer Virus in the Southwest', Washington Post Health, 14 June 1994, p.10-13.
52. Institute of Medicine, Emerging Infections: Microbial Threats to Health in the United States (Washington DC: National Academy of Sciences, 1992).
53. J. Maurice, 'Russian Chaos Breeds Diphtheria Outbreak', Science 267, pp. 1416-1417.
54. See UNAIDS, 'AIDS Epidemic Update: December 2000', http:// www.unaids.org/wac/2000/wad00/ files/WAD_epidemic_report.htm.
55. National Intelligence Estimate, The Global Infectious Disease Threat and its Implications for the United States, NIE 99-17D, January 2000, http:// www.odci.gov/cia/publications/nie/ report/nie99-17d.html.
56. The outbreak initially struck members of the Navajo nation, leading some officials and media to dub the illness 'Navajo flu', and contributing to some anti-Indian reactions. S. Sternberg, 'Tracking a Mysterious Killer Virus in the Southwest', Washington Post Health, 14 June 1994, pp.10-13; L. Garrett, The Coming Plague: Newly Emerging Diseases in a World Out of Balance (New York: Farrar, Straus and Giroux, 1994), pp. 528-549.
57. The outbreak initially struck members of the Navajo nation, leading some officials and media to dub the illness 'Navajo flu', and contributing to some anti-Indian reactions. S. Sternberg, 'Tracking a Mysterious Killer Virus in the Southwest', Washington Post Health, 14 June 1994, pp.10-13; L. Garrett, The Coming Plague: Newly Emerging Diseases in a World Out of Balance (New York: Farrar, Straus and Giroux, 1994), pp. 528-549.
58. A succinct history of the 1995 ebola outbreak in Zaire is given in the report by the Committee on International Science, Engineering, and Technology, National Science and Technology Council, Infectious Disease - A Global Health Threat (Washington DC: US Government Printing Office, 1995).
59. An overview of infectious disease monitoring in the United States may be found in J. Lederberg, R.E. Shope, and S.C. Oaks, eds., Emerging Infections: Microbial Threats to Health in the United States, Institute of Medicine (Washington DC: National Academy Press, 1992), Chapter 3.
60. B.A. Perkins et al., 'Unexplained Deaths Due to Possibly Infectious Causes in the United States: Defining the Problem and Designing Surveillance and Laboratory Approaches', Emerging Infectious Diseases, vol. 2, no. 1, 1996, pp. 47-53.
61. A.E. Smithson and L. Levy, Ataxia: The Chemical and Biological Terrorism Threat and the US Response, Stimson Center Report no. 35, pp. 122-132, http://www.stimson.org/cwc/ ataxia.htm.
62. CDC FY2000 Budget Summary, http:// cdc.gov/2000bdg/cdcbud/pdf
63. R. Prasannan, 'Military Microbe', The Week, 23 July 1995, pp. 30-37.
64. WHO Budget, http://www.who.int/ aboutwho/en/qa6.htm.
65. The WHO'S international health surveillance networks and their geographic coverage is described in 'EMC Annual Report 1997', World Health Organisation, http:// www.who.int/emc-documents/emc/ docs/whoemc982.pdf.
66. GPHIN is described at http:// www.hc-sc.gc.ca/hpb/transitn/ gphin_e.pdf.
67. S.S. Morse et al., 'Controlling Emerging Infectious Diseases', 1997, http://www.fas.org/promed/ papers/morse.htm; B.H. Rosenberg and J. Woodall, 'Sentinel Centres for Global Health Security', The Lancet, vol. 349, 1997; Centers for Disease Control and Prevention, Addressing Emerging Infectious Disease Threats: A Prevention Strategy for the United States (Atlanta, GA: CDC, 1994).
68. S.S. Morse et al., 'Controlling Emerging Infectious Diseases', 1997, http://www.fas.org/promed/ papers/morse.htm; B.H. Rosenberg and J. Woodall, 'Sentinel Centres for Global Health Security', The Lancet, vol. 349, 1997; Centers for Disease Control and Prevention, Addressing Emerging Infectious Disease Threats: A Prevention Strategy for the United States (Atlanta, GA: CDC, 1994).
69. S.S. Morse et al., 'Controlling Emerging Infectious Diseases', 1997, http://www.fas.org/promed/ papers/morse.htm; B.H. Rosenberg and J. Woodall, 'Sentinel Centres for Global Health Security', The Lancet, vol. 349, 1997; Centers for Disease Control and Prevention, Addressing Emerging Infectious Disease Threats: A Prevention Strategy for the United States (Atlanta, GA: CDC, 1994).
70. J.B. Tucker, 'Introduction', in Toxic Terror: Assessing Terrorist Use of Chemical and Biological Weapons, (Cambridge, MA: MIT Press, 2000), pp. 1-14.
71. G. Cameron, J. Pate, D. McCauley, and L. DeFazio, '1999 WMD Terrorism Chronology: Incidents Involving Sub-National Actors and Chemical, Biological, Radiological, and Nuclear Materials', The Nonproliferation Review, vol. 7, no. 2, Summer 2000, pp. 157-174.
72. For example, in 2000 there were reports of outbreaks of anthrax in Ethiopia and tularemia in Kosovo. See the WHO's 'Disease Outbreak News' at http://www.who.int/disease-outbreak-news/.
73. A.F. Kaufmann et al., The Economic Impact of a Bioterrorist Attack: Are Prevention and Postattack Intervention Programs Justifiable?', Emerging Infectious Diseases 3, 1997, pp. 83-94.
74. D.A. Henderson, 'Surveillance Systems and Intergovernmental Cooperation', in S.S. Morse (ed.), Emerging Viruses, (Oxford: Oxford University Press, 1993) pp. 283-289.
75. R.P. Kadlec, et al., 'Biological Weapons Control: Prospects and Implications for the Future', Journal of the American Medical Association, vol. 278, 1997, pp. 351-356; J.B. Tucker (ed.), Procedures for Investigating Suspcious Outbreaks of Infectious Disease in a Noncooperative Environment (Springfield, VA: National Technical Information Service, 1998); M Wheelis, 'Investigating Disease Outbreaks under a Protocol to the Biological and Toxic Weapons Convention', Emerging Infectious Diseases 6, 2000, pp. 595-600.
76. R.P. Kadlec, et al., 'Biological Weapons Control: Prospects and Implications for the Future', Journal of the American Medical Association, vol. 278, 1997, pp. 351-356; J.B. Tucker (ed.), Procedures for Investigating Suspcious Outbreaks of Infectious Disease in a Noncooperative Environment (Springfield, VA: National Technical Information Service, 1998); M Wheelis, 'Investigating Disease Outbreaks under a Protocol to the Biological and Toxic Weapons Convention', Emerging Infectious Diseases 6, 2000, pp. 595-600.
77. R.P. Kadlec, et al., 'Biological Weapons Control: Prospects and Implications for the Future', Journal of the American Medical Association, vol. 278, 1997, pp. 351-356; J.B. Tucker (ed.), Procedures for Investigating Suspcious Outbreaks of Infectious Disease in a Noncooperative Environment (Springfield, VA: National Technical Information Service, 1998); M Wheelis, 'Investigating Disease Outbreaks under a Protocol to the Biological and Toxic Weapons Convention', Emerging Infectious Diseases 6, 2000, pp. 595-600.