SAN FRANCISCO - David Hose is a bioterrorism casualty.
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Little wonder, then, that his confidence in U.S. readiness for another such attack is about as low as his energy and as weak as his still-battered immune system, lingering after-effects of the anthrax he accidentally inhaled handling a letter addressed to Sen. Pat Leahy three years ago.
"I was worried before the attacks," said Hose, 60, who spent more than two weeks in the hospital with the anthrax infection and will never fully recover. "Now, I'm convinced it will happen again and I don't think we're doing enough to address that."
Hose, a government employee, is not alone. Biological weapons experts, including the scientist who played a big role in eradicating smallpox from the globe, have similar concerns.
While the experts laud the increased spending government lavished on combatting biological threats in 2004, they sense momentum slowing as public attention and political will wane. The unsolved anthrax attacks that killed five and sickened Hose and 16 others three years ago are but faint background noise in the national security debate of today.
The fact that U.S. forces in Iraq have yet to find any biological weapons also factors into the public's fading attention, experts say.
"There is a certain element of complacency setting in," said Dr. D.A. Henderson of the University of Pittsburgh's Center for Biosecurity. "Anthrax still keeps me up at night."
Henderson said anthrax remains atop his list of diseases that have the potential to be used as weapons. That's because there's been little accounting of what became of the former Soviet Union's vast biological weapons program.
"The Russians kept 30 metric tons of anthrax in dry storage. The amount used in the U.S. attacks was 10 grams," Henderson said. "There were 60,000 Russians working on this, we don't know where most of them are today."
Henderson, who led the global smallpox eradication campaign in the 1960s and served as a bioterrorism consultant to President Bush, said the federal government made significant progress in 2004 in combatting the threat, including earmarking a record amount of money to address the problem.
Federal spending has increased from $414 million in fiscal year 2001 to a proposed $7.6 billion for this year, according to a Pitt study. Since Sept. 11, 2001, the federal government has awarded contracts worth a combined $1.5 billion to biotech companies to beef up the nation's smallpox and anthrax vaccine stockpiles.
Further, Henderson said, previously nonexistent communication links among federal agencies and local emergency officials have dramatically improved, though room for additional advances remain. Public health officials, for instance, now monitor pharmacies for spikes in sales of fever reducers, rash ointments and other indications that a biological attack is underway.
Nonetheless, the United States remains woefully unprepared for another attack, Henderson and other experts say.
The threat from biological weapons has outstripped that from chemical and nuclear arms because of the "riotous" progress of biotechnology, according to a British Medical Association report released in October.
Carelessness in the stewardship of biotechnology advances could be exploited by terrorists to target specific ethnic groups and recreate devastating diseases such as the 1918 Spanish flu, the report says.
Another study, compiled by a panel of experts convened by the CIA in 2003 and titled "The Darker Bioweapons Future," warned that advances in biotechnology could lead to a generation of biological weapons far more dangerous than those currently known.
"The effects of some of these engineered biological agents could be worse than any disease known to man," the panel told the CIA. "The same science that may cure some of our worst diseases could be used to create the world's most frightening weapons."
In November, an influential committee of the World Health Organization recommended that researchers be permitted to conduct genetic-engineering experiments with the smallpox virus. Some bioterrorism experts, Henderson among them, consider such tinkering more hazardous than the problem it aims to combat. Henderson advocates destroying the the two known stocks of smallpox in the United States and in the former Soviet Union.
Meanwhile, public health experts say that one glaring weakness is that most cash-strapped U.S. hospitals would be unable to handle the crush of people who will either be sickened or panicked by a bioattack.
"We have an incredibly under-trained public health officials and the numbers are getting worse," said Dr. Shelley Hearne, executive director of the Trust for America's Health in Washington D.C. 'We've had a series of some really scary wake-up calls over how seriously unprepared we are in the case of a serious disease outbreak."
Another major vulnerability is the nation's antiquated vaccine manufacturing system and the reluctance of big pharmaceutical companies to enter a low-profit, high-risk market.
Hearne pointed to Emeryville, Calif.-based Chiron Corp.'s failure to deliver half the nation's expected flu vaccine supply this year and the administration's bungled program in 2003 to inoculate 500,000 front-line health care workers with the smallpox vaccine.
Only about 40,000 workers ultimately received injections because of apathy or health concerns over the effectiveness of the smallpox vaccine.
"We need a credible bioterrorism game plan that everybody buys into," Hearne said. "We don't have that."
On the Net:
University of Pittsburgh's Center for Biosecurity:
http://www.upmc-biosecurity.org
WHO: http://www.who.int/csr/disease/smallpox/en
Trust for America's Health: http://healthyamericans.org
