Yersinia Pestis

You will die quickly. That is the good news. The bad news is how many could die before the CDC identifies the agent and stops the spread of a biological attack. Mandated quarantine and other measures will kick in to safeguard the greater public. But for the families of the ones who die and for the nation at large it will be a time of sorrow. This news was brought home to me again with the story of wildlife biologist Eric York, who was found dead a mere three days after performing a necropsy on a mountain lion that later tested positive for plague. Forty-nine people who had contact with Mr. York received antibiotics as a precautionary measure.

Attempting to sicken the public by introduction of a pathogen is nothing new. In the olden days of warfare a favorite trick was to poison wells. It worked well enough. (No pun intended! smile) Some theorize the death of cattle during during Moses’ day was merely the lowly Anthrax spore. The Soviet Union killed a few of their own two-legged creatures when Anthrax was accidently released from a biological weapons factory to then float into the lungs of the unsuspecting local population. While the government tried to cover up their blunder claiming the population had suffered from tainted meat sources the truth later emerged. Yep, inhalation anthrax pure and simple. Here is a good link.

But let’s discuss plague as a bioterror weapon. Yersinia Pestis is the critter that causes plague. It is a bacterium carried by rodents and the disease is transmitted by fleas. From the 14th through the 18 century besieged cities were at times the recipients of catapulted bodies of the victims of plague. Nothing like having a rotting 180 pound inbound projectile loaded with disease landing on your street. The Japanese military certainly had no qualms about furthering the tradition of using Y. Pestis in the 1930’s. They happily dropped plague-ridden fleas off aircraft over portions of China. The former USSR had active bioweapons programs in the 1990’s which also included experimentation with aerosolized plague. The city of Surat, India and surrounding areas experienced a frightening outbreak of plague in 1994. Shortly after the rats started dying, people began to die too. It didn't take long for the government of India to figure it out.

Our government and the CDC have done much work to understand the kinetics of an outbreak of plague if an aerosolized form of the bacterium is released into a high density urban population. Should this ever occur our healthcare infrastructure would be temporarily stressed and the eventual economic downturn of such an attack could run in the billions of dollars.

But what about panic? How to manage panic is another issue. When we had an Anthrax attack in the U.S. a few years ago I distinctly remember one thing. There was a low-grade sense of panic among my own medical community. The panic increased when a baby was found to have contracted cutaneous anthrax. I know doctors who stocked up on antibiotics for their families and took masks and gloves home to open their personal mail.

The death of Eric York from Yersinia Pestis is a remote event. The potential for a large-scale biological attack against a targeted population within our borders is also hopefully a remote event. But we need to remember that the world in which we live has greater danger. Assuredly, better technology and medical surveillance to track these events in their infancy will aid our fight.

Tammy