Citizens have been warned to look out for suspicious packages or envelopes possibly containing the deadly substance, which has already claimed one life in the United States.
The BBC's Jacky Rowland in Afghanistan
The BBC's Tim Franks in Washington
Neil Bennett, the BBC's Health correspondent
Dr Joanna Spear, of King's College Department of War Studies
Transcript:
Bridget Kendall:
Welcome to News Online's Global Forum. I'm Bridget Kendall and today we're going to spend much of the programme talking about the anthrax threat. I'm joined by Joanna Spear, a weapons proliferation expert at King's College, London, from Northern Afghanistan by the BBC's Jacky Rowland, Tim Franks in Washington and here in the studio Neil Bennett, the BBC's health correspondent.
This week has seen the closure of parts of the US Congress because of fears of contamination from anthrax, as well as countless scares in the United States and other parts of the world. The number of cases of anthrax infection appears to be extremely small but the fear of attacks still seems to be growing.
But first of all let's go to Jacky Rowland who's in Northern Afghanistan and before we get to this whole question about anthrax catch up on the latest news events.
Jacky our first question comes from Peter in Uganda and the reports that we've had in the news today that US and possibly British ground troops are in Afghanistan and he wants to know where you are, near the Northern Alliance, how they have reacted to that news.
Jacky Rowland:
Well they're welcoming any cooperation, any help that they can have from the Americans but they have quite a clear objective here and they have an ulterior motive and that is that the Northern Alliance really wants to become the American's best friend here in Afghanistan, they want to be seen to be cooperting, sharing intelligence, even getting involved in some kind of joint operations. And that's because as and when the Taleban are defeated the Northern Alliance wants to dominate any government that may be set up in a post Taleban era.
Bridget Kendall:
So Mark who's in Birmingham, Alabama in the United States wants to know: "Do these fighters in the Northern Alliance expect to be fighting alongside British and American ground troops?"
Jacky Rowland:
I don't know that we'd actually see any kind of joint military operations, just simply because they're operating in two different - completely different - spheres of warfare, you could almost say that they're fighting in different centuries from a military point of view. When you think about the kind of precision weapons that the United States has been using and when you look at the kind of antiquated desert warfare that's going on on the ground they really aren't compatible and I don't think that the Americans or British would find it desirable either. Really what we have seen going on in recent days and weeks has been the Northern Alliance up here in the north of the country in many ways carrying on its battle on the ground, almost independently of the air strikes. Many military commanders have privately expressed a certain amount of disgruntlement that the United States has not been making its work easier by removing Taleban positions, of bombing frontline positions. So they've really been getting on with the business of fighting the Taleban which they have been doing for the last five years now. And we have been particularly seeing movement just to the west of where I am now, around the key Taleban held city of Mazar-e Sharif, with territory changing hands really quite quickly there on a fluid battlefield in recent days.
Bridget Kendall:
Have you, Jacky, yourself, seen any evidence or heard any credible reports of special forces around where you are with the Northern Alliance?
Jacky Rowland:
Well what we've heard is from a military commander with the Northern Alliance near Mazar-e Sharif, he says he has eight US military personnel with him at the moment, they're there essentially to gather intelligence, now we haven't had that confirmed from Washington but the Pentagon has acknowledged that yes there are a small amount of elite special commandos on the ground at the moment. The Americans have made it clear that we're talking about a very small number but they've hinted that this in fact could be built upon and there could possibly be more special forces in the future who might even get involved in more wider scale operations such as, for example, reconnaissance and even identifying targets for bombings. However, we have had quite a clear hint, or at least the people of Afghanistan have had clear messages now - broadcast on local radio frequencies by American planes flying over Afghanistan, messages warning them that US troops will soon be passing through the region and urging people to stay at home where they'll be safest and in particular recommending that they shouldn't travel on major roads or use bridges or anything that could possibly be a target of US military operations.
Bridget Kendall:
Now another thing the United States has been doing is organising food drops and Nicholas Smith in Wellingborough here in Britain asks that he's had - he says he's heard mixed comments about that and wonders if you can tell him what effect, if any, they have had?
Jacky Rowland:
To be honest Bridget I don't think they've really had a material effect at all. International aid agencies also have been quite sceptical about them. America is not in the good books of the aid community at the moment, they've already been calling for a pause in the bombing to allow them to move badly needed food, medicine, blankets into the country before winter sets in and they've said that this business about dropping humanitarian daily rations, as they're called, into Afghanistan, is basically a publicity stunt. I mean we have seen, there have been some of these distinctive yellow plastic packages that have landed not far from where I am at the moment, they're mainly collected by young fit people, people who've got vehicles, to collect them and transport them and we've seen them, mostly for sale, on the marketplace and certainly they've been quite conspicuous by their absence in the local refugee camp which is obviously where they would really be needed.
Bridget Kendall:
And finally Jacky this question of fears of an anthrax outbreak. Louise here in Britain says: "Have you seen or heard anything that would link this to Osama bin Laden? Has there ever been any use of bioweaponry in Afghanistan's civil war?" she asks. Indeed is anyone paying any attention to this whole anthrax story where you are Jacky?
Jacky Rowland:
I think really for the people of Afghanistan it's too far away and too obscure, they have very day-to-day mundane concerns like having enough to eat and the kind of diseases they'd be more worried about would be malaria and dysentery. In terms of any evidence to link Osama bin Laden to the anthrax outbreaks in the West, I mean it's very difficult, when you already think of trying to link Osama bin Laden sitting in his cave to aircraft crashing into the World Trade Center, already we have seen a number of Muslim and Arab countries asking exactly what the evidence is, that's not to say that the evidence doesn't exist but it is quite difficult to draw these links and even more difficult to try to construct some kind of chain of cause and effect between Osama bin Laden here in this very rugged, almost prehistoric, environment and hi-tech biological warfare in the West. But that's not to say that there isn't some kind of link and we must remember that Osama bin Laden has all manner of friends and co-conspirators in other Arab countries and in other countries in the West as well where they do have access to this kind of hi-technology. So I'm afraid Bridget that from the ground here in Afghanistan I'm not really able to provide further enlightenment into any links between Osama bin Laden and the current anthrax scare.
Bridget Kendall:
Jacky Rowland thank you very much for joining us.
And now to get some more fundamental answers about some of the questions about anthrax we have here in the studio our health correspondent Neil Bennett. Neil first question comes from Jubin Kurien here in Southampton and quite simply he'd like you to explain what anthrax is, what are the symptoms and what are the effects they have on the human body.
Neil Bennett:
Anthrax is a bacterial infection, it's caused by an organism which is carried in grass eating animals - cows mainly. It exists in the form of tiny spores. Now these have hard outer shells and they can survive in the environment for many, many years, they can exist in the soil, for example, for up to 40 years. Now the effects on the body are threefold, depending on which type of anthrax contamination you're suffering from. First of all if you have skin infection, cutaneous anthrax as it's called, that's if you've come into contact with one of these anthrax spores. Now if they've got into a cut they can cause lesions, small lesions on the body, most commonly on the head, on the forearm or on the hands. These are characterised by ulcers which have swellings around them which are generally painless but they have a black centre to the ulcers, this is what's - this is the most characteristic aspect of anthrax contamination via the skin. That's by far the most common form of contamination - 95 per cent of cases. There are two other much rarer types of anthrax infection. First of all if you breathe in the anthrax spores but that's rare because it's very hard for anthrax to exist in this aerosol type form. Now if that is undetected and goes on to its second phase that can be fatal. The third type is if you ingest, if you eat, a piece of contaminated meat then you have a gastrointestinal infection with anthrax, that's the rarest of all three.
Bridget Kendall:
We haven't seen that have we?
Neil Bennett:
We haven't seen that and that is also very commonly fatal. No we have not seen that, we've only seen mostly the skin contamination, one case of the lung infection.
Bridget Kendall:
And Alex Martinez who's in Miami wants to know: "How long can the bacteria, these spores, continue to infect people once they've been exposed to them - how long is the incubation period?"
Neil Bennett:
Well the incubation period is usually between one and six days but there has been a case of up to 60 days after contamination that the symptoms have started to appear - that's very unusual, usually between one and six days, so within a week.
Bridget Kendall:
Tom in London has another question carrying on from that about modern antibiotics, he says: "There seems to be a lot of conflicting information about anthrax and its treatment, how effective are these antibiotics, especially if administered soon after the bacteria has been detected?"
Neil Bennett:
That's the key point. If the infection has been picked up quickly and it is often quite difficult to pick up the infection quickly because the symptoms can be confused with other things, particularly the lung infection. The skin lesions are rather more characteristic of anthrax rather than anything else. But if they're picked up quickly then treatment with antibiotics is very effective.
Bridget Kendall:
Thank you very much for the moment Neil, we'll come back to you. We're now going to go over to Washington and our correspondent there Tim Franks. Tim you've been watching this anthrax story from much closer to the heart of it and Daniel, here in the United Kingdom, wants to ask: "If there any indication that the US population really is as worried about anthrax as the media coverage would seem to suggest?"
Tim Franks:
Well to be very candid Bridget no. I have to say, and one only goes on anecdotal evidence - people you speak to, people you see around about you in the streets here in the capital Washington - people aren't that concerned to the extent that they're not panic stricken, they're not gripped by fear. I think that they do have some level of anxiety about this because it seems that at the moment the investigating authorities don't have that much of a clue, at least they're not sharing it publicly with where the source of this is and where the next target is going to be. But the parallel I've been drawing is with London in perhaps the 1970s and 1980s when there's been a letter bomb campaign going on, for the time that that happens people are taking more precautions, they are more careful about their mail, they are a bit worried about things that they see that they're not quite used to - that aren't part of the normal routine - but people get on with their lives and those that I've talked to have said, you know, we could stay at home twitching the curtains but we're relatively fatalistic about it and in fact they also draw parallels with the situation in Western Europe where there has been sporadic terrorist activity over many years and they say - Well people there get on with their lives so should we here. I think that the shock here though is that once upon time, and it probably is just before 11th September, Americans really felt impregnable, they felt invulnerable and there wasn't any sense, despite the occasional attack - we had the World Trade Center bomb in '93 which killed six people - the idea of a big terrorist threat was simply not on people's radars. And that's been the shock here. But as I say it's more of a sort of social shock rather than any psychological panic.
Bridget Kendall:
But there has been a big run on these antibiotics hasn't there? At least that's what's been reported.
Tim Franks:
In some cases yes, people have gone out and bought antibiotics and indeed, you know, in the wake of the 11th September when people were speculating about the possibility of biological attack there was a run on gas masks as well. But it doesn't take that many people, in a sense, to create a run on certain products and that I think gets a little bit inflated, perhaps wrongly by us in the media and I think perhaps also, if I may say so, in some of the British newspapers that I've seen over here - they have talked about panic and people teetering on the edge of paralysis by fear. That simply isn't the case, the vast majority of people are just getting on with their lives and they're just thinking that, you know, the authorities are doing all that they can and also, to be utterly frank, that despite the very unfortunate death of one man - the photo editor in Florida - everybody else since then who has been tested and is undergoing treatment seems to be absolutely fine and the five other people who we definitely know have contracted anthrax - dozens more have tested positive for exposure to anthrax - but the five more that we know have actually contracted the disease all seem to be having a very good prognosis - they all look as if they're going to make a full recovery. That again is reassuring people.
Bridget Kendall:
Tim, thanks for that. Stay with us. But now we can go to Jo Spear who's an expert on this subject at King's College in London. And Jo we've had a lot of quite detailed questions about this. Dr Desmond Ling, for example, in Dorchester here in Britain says: "Since anthrax spores can survive for decades what can you do in buildings in which they've been found, how long can it be before they can be declared safe to enter?"
Jo Spear:
Well they can do a number of different techniques to really sweep the building clean using like massive vacuum cleaners but what we know from the British experience on a Scottish island is that if it gets into soil it's very difficult to remove the contamination and then it can take decades to decontaminate. Now that's not true of a building but because the spores can exist naturally in soil and things like that it can be a problem for the longer term.
Bridget Kendall:
Mary Reynolds who's in San Antonio, Texas wants to know about postal mail, "Since Anthrax is such a highly infective agent," she said, "and spore laden mail must get mixed up with normal mail and runs through postal machines wouldn't that mean that much of the general mail could get contaminated from it?"
Jo Spear:
In order to get contamination from anthrax you need between 8,000 and 50,000 spores and the chances of that many being released from an envelope would mean that it wasn't working at all. So I think although there may be one or two tiny spores in the general mail it wouldn't be enough to infect anybody.
Bridget Kendall:
We've had another question, this from Brussels in Belgium and goes on to a slightly different subject, from Noris Kern about the likelihood of other diseases, other biological weapons, being used like smallpox or indeed diseases for which there's no vaccination available. What's your assessment about that?
Jo Spear:
Well it's certainly the case from what we know about the situation in Iraq, discovered by the UNSCOM inspections which took place after the Gulf War in 1991, we know that Iraq had an extensive biological weapons programme which dealt with things like plague, Q fever, botulinum, Clostridium - so a number of nasty things. But the thing is it didn't only look at diseases that would affect humans, it also looked at animal diseases and diseases that would affect crops as well. So we do know that there is the potential for lots of different things to be weaponised.
Bridget Kendall:
You mentioned Iraq, is it Iraq where most attention is focused outside the possibility of an Osama bin Laden threat or actually is there a much larger pool of places where this could come from?
Jo Spear:
It has been the case that the Pentagon has been hinting that there is an Iraqi involvement but I think that link is not yet proven and we might be a little bit hasty in pointing the finger here. It is the case that Russia also had a very extensive biological weapons programme and that parts of that are now in the states of the former Soviet Union - it's kind of split up around. And we do know that some of the diseases themselves were available on the open market for some time, particularly at the beginning of the new period after the end of the Soviet Union. So there is some potential for those to have been purchased and taken elsewhere. So it's not just that everything points to Iraq.
Bridget Kendall:
Let's go back to Tim Franks in the United States on that. Tim, Chris here in Britain asks whether the authorities in the United States are investigating anyone else, apart from Osama bin Laden. And actually who he was thinking was whether they're still holding the possibility that it might be some far-right militia types, for example?
Tim Franks:
I spoke recently to Bob Graham, a couple of days ago, he's the senator who chairs the Senate Intelligence Committee, so as close to those investigating authorities and those senior intelligence sources as you can get and he was saying, well at the moment nothing is being ruled out. The investigators don't definitely know what the source of the anthrax is, where it's coming from, who's going to be targeted next. It could be a home-grown terrorist, in the parlance that's used here, and it could indeed be somebody with a grudge, for example, against abortion clinics - several have, around the country, many many indeed, have received threats - they are going to be next on the list. Although the clues that investigators do have so far do suggest some sort of Middle Eastern, Near Eastern link because there has been included anti-American, anti-Israel language and messages. And for that reason a lot of people, we're all sort of home-made sleuths in our own way, are drawing the conclusion that the likelihood is that there is some sort of connection, even if not directly, to Osama bin Laden and the al-Qaeda network, some sort of connection to that brand of terrorist activity. But the truth is that the authorities also are having to deal with a vast number of hoaxes which they are taking more and more seriously because of their nuisance value - hundreds upon hundreds of hoaxes have been made and that's stretching the law enforcement agencies very much here and it's exercising people like John Ashcroft, the Attorney General, the equivalent of the Home Secretary in Britain, who's saying that really the law enforcement agencies simply don't have the resources either to analyse all these dubious white powders that are being sent through the post or indeed to try and track down these hoaxters to imprison them and stop them wasting everybody's time.
Bridget Kendall:
What about other potential threats to life Tim? We've had an e-mail from Hong Kong saying: "Is the US now wondering about whether it needs to protect things like possibly poisoned drinking water?" Have you had any indication of that?
Tim Franks:
Yes they have decided to step up the security around reservoirs, in the same way that they've done that around nuclear facilities and indeed every other sort of large institution, utility company, banks and so on that you can think of. However, the bio-terrorism experts say that it would be very, very difficult to poison the water supply, you would need an absolutely huge amount of toxin in order to do that. What they are concerned about though it's not so much necessarily poisoning the drinking supply, it's what you were discussing just a little earlier, which are the other toxins - botulinum, smallpox - these sorts of things - no one really knows, as I say, what the source of these attacks are, who is behind them and because of that no one really knows what the next threat may be and that is causing some concern and for that reason Tommy Thompson, the health secretary here, announced at the weekend that they're planning to buy up millions upon millions of more smallpox vaccines in a sort of prophylactic preventative move. But that - even doing that I don't think is necessarily going to calm people's concerns. As I said earlier on there isn't panic here but there is a level of concern about anthrax and about these other potential threats.
Bridget Kendall:
Tim Franks thanks for joining us. Coming back to you, Neil, in the studio, if you do open this Pandora's box of fears about biological weapons really there is no end to what might be potential I suppose and it really is very easy to terrify yourself. We've had an e-mail from Matt Sledmore in Oxford and he says: "Surely anthrax is seen by many as a psychological weapon rather than one of mass destruction and do you think that the purpose of this outbreak might, in fact, be to cause chaos and disruption above everything else?"
Neil Bennett:
Yes I'm sure it is. It's a very common terrorist tactic, we saw it with the IRA during the '80s and the '90s and one of their means of spreading fear and a general sense of unease and distress and disruption was the hoax bomb warning. We know very well that they were certainly capable of carrying out bomb attacks, they then followed it up with a campaign of hoaxes which thoroughly disrupted people's everyday lives, going to and from work, and made them thoroughly miserable and this is an extremely effective terrorist tactic. You only have to send one parcel contaminated with anthrax, you only to have to make - to send one parcel bomb then the threat of more is what really is your follow-up weapon, as it were, it spreads unease and it spreads distress and that's exactly what we've seen with anthrax - a number of hoax calls following it up as well, people pretending to send anthrax in the post. This is also extremely damaging psychologically but you have to keep these things in perspective - anthrax is extremely difficult to make, it's extremely difficult to distribute and in this country well we've only had 14 reported cases of anthrax contamination since 1981, we've only had one death since 1974. So you really do have to keep these things in perspective. But of course when people don't keep things in perspective then that's exactly what the terrorists intention is.
Bridget Kendall:
And out of interest what were those contaminations from?
Neil Bennett:
They were from, I believe, people who were working in tanneries - they're the people at risk, people who work with animal skins and animal carcasses.
Bridget Kendall:
But these fears are not just in Britain and the United States are they, I mean everyday now we hear about buildings being closed down or airports partly evacuated - Australia, Brazil, Germany, other places in Europe. If - and we've had one case in Kenya where someone has tested positive, so if this were a worldwide crisis of anthrax would there be enough antibiotics available to everyone who might be made vulnerable by it?
Neil Bennett:
It would seem so yes at this stage. Because generally speaking a genuine anthrax attack is targeted at an individual - a parcel has to be sent to an individual. Talking about a worldwide crisis I think perhaps is a bit farfetched at this stage and certainly it seems as though the manufacturer of the main antibiotic, which is a drug called Cipro, Bayer, the German company, manufacture this, they are going to treble their manufacturing capability by the beginning of next month, so I don't think anybody is concerned about running out of antibiotics.
Bridget Kendall:
Neil Bennett thank you very much for that answer to a question which was in fact from K. Olé.
And let's go back to Jo Spear now. Jo we've had a question from Duncan Calder, who's here in Edinburgh, and he asks does the fact that some very virulent strains of anthrax, sent through the US postal service, make it more likely that terrorists would now have the capability of launching a large-scale anthrax attack?
Jo Spear:
I'd actually say the opposite. The fact that they've used such a low-tech method, that they haven't actually used a more sophisticated means to disseminate it - to actually make it a mass scale attack - actually indicates the difficulties of weaponisation which some of your colleagues have just pointed to. And this is the thing with all the potential biological weapons that we're talking about that what we're not convinced that terrorists, or even state sponsored terrorists, know how to do effectively is to weaponise. So they can do something quite unsophisticated like put it in an envelope in the post but it's not clear that they could do the more dramatic types of attacks which would have mass casualties. So I think in a way it's actually a little bit reassuring in these tricky times to actually know that they did have to use the postal service.
Bridget Kendall:
Although there have been reports from Washington DC, from the US Senate I think, that this might be what's being called "weapons grade" anthrax?
Jo Spear:
Yes what that would really mean is that the spore size is small enough to remain in the air. Because one of the things is that traditionally the anthrax spore is too heavy to stay in the air and falls to the ground and there is an indication that this anthrax may have been milled down to make it light enough to stay in the air and therefore be more effective. So I do agree that that would mean it was slightly more sophisticated but nevertheless the means by which they've got it into the building is very unsophisticated.
Bridget Kendall:
So finally Jo, a question from Matthew in Lytham St. Annes here in Britain: "Do you think the media has exaggerated fears on this story?"
Jo Spear:
I think this is one of the problems of having a global village where we can all see what goes on somewhere else, so that people who are actually a long way from where the action is at the moment because they can see things on their television and hear it on the news and read it in the newspapers are thinking it affects them when it really doesn't necessarily. So it's not necessarily what the news is saying, it's the fact that we get to find out about it so quickly and it seems so immediate because for many of us it's in our front rooms. So I think it's that rather than the actual content of the media per se which is kind of exaggerating to us the nearness of the problem.
Bridget Kendall:
Jo Spear thank you very much. And that's all we have time for today. Thank you for your questions and thank you to to Neil Bennett here in the studio, Joanna Spear of King's College London, Tim Franks who was in Washington and Jacky Rowland who was in Northern Afghanistan. I'm Bridget Kendall and for now goodbye.
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