The Health bulletin [serial] - University of North Carolina at Chapel Hill

April, 1951 The Health Bulletin 13This would tax medical, health and ecoinomic facilities to a great degree. As anillustration, he cited industrial plants inwhich effectiveness would fall off sharplyif even less than 20 per cent of theemployees failed to report for work andthe serious handicaps which would resultif key individuals died or could notreport for work."Whatever the direct damage in termsof sickness, death, decreased efficiencyand confusion, there would also be apsychological reaction on the part ofthe attacked population. Fear of theunusual or the unknown has panicpotentialities, and this aspect of theproblem would require serious consideration;undoubtedly an enemy wouldmake every effort to exploit it."One of the principal routes whichwould be used to spread germs, in Dr.Haas' opinion, would be the air, althoughdrinking water, milk and otherfoods, drugs, cosmetics, money or papersare also possible methods of dissemination.Our physical senses alone wouldnot tell us that germs are present asthey would probably be odorless, tastelessand colorless, he said.None of the present methods of testingwater, milk and food products andof sampling air are immediately applicablefor detection of biologic warfareagents, Dr. Haas said."While these limitations must be faced,they do not justify a policy of inactionor delay. Some of the simpleroperations of sampling and identificationshould be put into effect, and itmay be anticipated that experience andresearch will ultimately overcose manyof the initial difficulties, while otherscan be minimized by efficient organization."He advised "more knowledge and betterequipment ... to permit developmentof defense against biologic warfareto the extent that would permit maximumprotection of personnel subject toattack."The nine specific research projects henamed as necessary to strengthen ourdefense are: 1, development of airsampling devices capable of detecting awide variety of agents than currentlypossible; 2, more rapid methods forisolation and identification of diseaseagents; 3, methods for active immunizationafter exposure; 4, antigens capableof immunizing against whole classes oforganisms rather than individual speciesor strains; 5, mass immunization procedurewhich would permit immunizationby inhalation of antigens by largenumbers of people simultaneously; 6,procedures for sterilization of large airmasses; 7, information on optimal dosageof disease agents and on infectionrates after exposure to know dosages;8, measures for arresting infections duringthe incubation period by adequateyet economical treatment; 9, specifictreatment for diseases caused by smallerviruses.Once an attack has occurred, civil defensemust be directed toward minimizingthe effects of an attack, he said."This would include limiting the numberof casualties; shortening the periodof morbidity; reducing or preventingfatalities, and preventing developmentof secondary cases (spread of the diseasethrough personal contact)."One of the first steps in control of diseaseis the ability to recognize its presence.This ability, according to Dr.Haas, "can be developed to a greaterstate of efficiency than is usually considerednecessary for peacetime communicabledisease control."For example, influenza, typhus, Qfever, typhoid and cholera are a few ofthe germs believed to be possible biologicwarfare agents. The doctor, by knowingwhat constitutes the usual incidence ofcertain diseases in a particular localityat various seasons, can quickly recognizeany unusual illnesses or familiar illnessesoccurring in unexpected numbers.Any suspicious circumstances should beimmediately investigated to determinewhether or not the outbreak occurredas a result of biologic attack.Absenteeism from schools or certainindustries, overloading of hospitals andclinics—evidence of outbreaks of communicabledisease in peacetime—shouldalert authorities that an attack mighthave taken place."Adequate preparation in advance and