Medical Aspects of Chemical and Biological Warfare
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INTRODUCTION
Biological and chemical warfare has long con-cerned military planners, strategists, and tacticians.Experiences in the Persian Gulf War (1990–1991),the rising concern over terrorist groups and theirinterest in weapons of mass destruction, and thecontinuing difficulties with curbing the prolifera-tion of traditional chemical and biological weaponshave resulted in continuing modifications in poli-cies that would be employed in future scenarios.The use of such agents against the United States orits allies or both, including military and civilianpopulations, remains a distinct and perhaps increas-ing possibility.Recent events in the world, including the terror-ist attack with the nerve agent sarin in a subway inTokyo, Japan, in March 1995, have demonstratedboth the willingness of extremist organizationsto use these agents and the ready availability of deadly agents. Biological organisms continue to bereadily available throughout the world, obtainablein nature or through biological supply houses ormedical laboratories. Dangerous chemicals alreadyexist in local communities and in hardware and gar-dening shops.The current threat posed by weapons of biologi-cal and chemical origin has been discussed exten-sively in previous chapters of this textbook. Thischapter discusses three issues that will likely havea significant effect on chemical and biological de-fense in the next century:•the global proliferation of biological weapons;•the advances in technology, particularlybiotechnology, that will affect the develop-ment of weapons and their countermea-sures; and•possible changes in the future use
of chemi-cal and biological weapons by the enemythat will make delivery of medical care evenmore challenging.Efforts at counterproliferation will not be dis-cussed in this chapter. This should not be construedas a reflection of its reduced importance, for limit-ing the proliferation of weapons of mass destruc-tion continues to be a large effort of the UnitedStates government. Instead, emphasis is placed hereon the issue of biotechnology, for this is the areawhere medical personnel will find the greatest con-troversy and conflict. For the interested reader whodesires a more in-depth review of the subject of fu-ture prospects of biological weapons and prolifera-tion, we refer you to two excellent sources:
Biologi-cal Weapons: Weapons of the Future?
and
Director’sSeries on Proliferation
(see Recommended Readingat the end of this chapter).The potential exists for both (
a
) misuse of the bio-technology for refinement of current biologicalweapons and (
b
) development of new agents withadded potency. The profound impact that biotech-nology will continue to have on biological weap-ons and their countermeasures is of particular con-cern when put in the context of the worldwidedeployability of military forces, the potential useof genetic engineering for both peaceful and sinis-ter purposes, and continued attractiveness of bio-logical warfare as an option by adversaries in fu-ture conflicts.
PROLIFERATION OF BIOLOGICAL WEAPONS
The limitation and eventual elimination of bothchemical and biological weapons are two of thegreatest challenges facing the international commu-nity. Unfortunately, proliferation of such weaponsis continuing despite the best efforts of manynations, including the United States, to preventproliferation.
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Biological weaponry is the most wor-risome issue because of the relative ease in devel-oping and mass-producing potent agents, thecontinuing difficulties in identifying enemy capa-bilities and limiting their development, and thepotential ability for adversaries to bioengineer anddeliver new organisms using the latest advances intechnology.On 23 February 1993, following the Persian Gulf War and the breakup of the Soviet Union, a panelof the U.S. House of Representatives Committee onArmed Services submitted a special report,
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Special Inquiry of the House Armed Services Committee Intothe Chemical and Biological Weapons Threat
. This re-port concluded that despite the decrease in abso-lute quantities of chemical weapons, the potentialdiversity and the frequency with which such weap-ons could be encountered were increasing. Thethreat had shifted to Third World scenarios, withdeployed U.S. military forces facing new threatsfrom chemical and biological weapons. Technologi-cal advances have increased the diversity of poten-
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