Germs, Spores, and Borders
Protecting the U.S. Homeland from Biological Threats Requires a Holistic Approach
By Steve Melito
Last December, the Centers for Disease Control (CDC) reviewed its leading health challenges of 2013. “Our biggest successes,” said CDC director Tom Frieden, MD, MPH, “may be the bad things that did not happen.” This included stopping the outbreak of a smallpox-like virus in the Eurasian Republic of Georgia, and preventing other infectious diseases from reaching the U.S. “Global health and protecting our country go hand in hand,” Dr. Frieden explained.
The CDC isn’t part of the Department of Homeland Security (DHS), but DHS works in concert with the nation’s health protection agency. The DHS Office of Health Affairs (OHA) also coordinates efforts with the U.S. Department of State to share information both across the U.S. federal government and with Canada and Mexico. As part of OHA, the National Biosurveillance Center (NBIC) integrates biomonitoring activities to provide a common operating picture.
Protecting the Northern Border
In an age when weapons of mass destruction (WMD) and infectious diseases can travel at the speed of an airliner, early detection of biological risks is critical. Today, NBIC tracks information from more than 12 federal agencies as well as state and local governments, private stakeholders, and international sources. To provide early warning of a possible biological attack or pandemic, NBIC analyzes data about human, animal, plant, and environmental health.
According to NBIC’s strategic plan, OHA will leverage federal government efforts under the Beyond the Border initiative, a U.S.-Canada effort to promote perimeter security and protect binational trade and travel. The Action Plan commits the United States and Canada to establishing working groups for improved CBRNE defense and greater interoperability in emergency management communications.
Biological attacks are not the only epidemiological risks to homeland security, however. As a Joint Border Threat Assessment from 2010 explained, “high traveler volumes” between the United States and Canada create an “inherent risk” that communicable diseases could be introduced into Canada from the U.S., or vice versa. With an estimated 75 percent of Canadians living within 100 miles of the U.S. border, the spread of infectious disease could degrade the security, economics, and health delivery systems of both countries.
The Severe Acute Respiratory Syndrome (SARS) epidemic of 2002-2003 underscores the importance of early warnings and international cooperation. Outside of Asia, Canada had the highest rate of SARS, with 251 cumulative cases and 38 deaths. Although the epidemic began in southern China, Canada’s Global Public Health Intelligence Network (GPHIN) provided initial warning to North America. GPHIN is part of the World Health Organization’s Global Outbreak and Alert Response Network (GOARN).
Beyond Border Security
For the United States, surveillance of potential biological threats is also a part of border security with Mexico. The Border Infectious Disease Surveillance (BIDS) program is a regional effort with federal, state, academic, and international partners. BIDS gathers and exchanges epidemiologic data, promotes binational communications, and strengthens cross-border public health infrastructure. Operations span a 100-km zone on both sides of the border from Texas in the east to California in the west.
In Arizona, the BIDS project is housed in the Arizona Department of Health Services (ADHS) Office of Border Health. Recent achievements include the establishment of a network of sentinel clinic and hospital sites with enhanced epidemiology and laboratory diagnostic capabilities. Multiple surveillance sites for Severe Acute Respiratory Infections (SARI) and Influenza-Like Illness (ILI) now operate at acute care facilities in the Arizona border region.
The spread of infectious diseases such as influenza is of particular concern after the 2009 H1N1 pandemic, which was so severe in Mexico that the government closed schools to prevent contagion. Acting on information from Mexican authorities, the CDC issued a travel health warning that advised U.S. citizens to postpone all non-essential travel to Mexico. CDC also worked with the Food and Drug Administration to ramp-up the Strategic National Stockpile of anti-influenza medications.
As a Joint Border Threat Assessment from 2010 explained, “high traveler volumes” between the United States and Canada create an “inherent risk” that communicable diseases could be introduced into Canada from the U.S., or vice versa.
H1N1 was a combination of influenza virus genes never previously identified in either animals or people, yet international media attention focused on a Mexican hog farm owned by the largest U.S. pork producer and processor. Virginia-based Smithfield Farms denied accusations that “swine flu” originated at its Veracruz facility, but the risk of animal-to-human disease transmission remains a concern worldwide. Last year, for example, Chinese authorities killed more than 200,000 birds after an outbreak of H7N9 avian flu in Shanghai.
North American efforts to combat the spread of SARS and H1N1 were largely successful, but the United States has still upgraded its international protocols. In April 2012, the U.S. joined Canada and Mexico in signing the North American Plan for Animal and Pandemic Influenza (NAPAPI). This comprehensive health security framework outlines how all three nations will assist each other and provide a rapid, coordinated response to outbreaks of animal and/or human influenza.
Biowatch Against Bioterrorism
Pandemics are not the only proof that biological threats pose a danger to homeland security. Since 9/11, releases of anthrax and ricin have been used in acts of bioterrorism on U.S. soil. The 2001 anthrax attacks and the 2003 and 2013 ricin letter all used powdered forms of toxins that shut down mailrooms and, in the case of the anthrax letters, claimed lives. Ricin, a highly-toxic protein obtained from pressed castor bean seeds, is of special concern because no known antidote exists.
Although state-of-the art biodetection technologies are available, the basic principles and problems of air sampling remain. As Charles D. Yaffee, M.S., a leading American industrial hygienist explained to a National Safety Congress and Exposition in Chicago nearly 60 years ago, “The preferred instrument is one which gives an on-the spot answer.” Today, responders can choose portable products such as the ACD-200 Bobcat dry filter unit (DFU) air collector with rapid filter elution system.
Made by InnovaPrep, Inc. of Drexel, MO, this lightweight unit is designed specifically for tactical use and exceeds requirements from the U.S. military’s Joint Program Executive Office for Chemical and Biological Defense. The air sampler has a dry filter made of electrically-charged fibers and can collect particles smaller than the size of the weaves. Responders can address a range of air sampling requirements, including the collection of bioaerosols, and then transport samples to a lab.
In some U.S. cities, biosecurity efforts are backed by BioWatch, a DHS program that’s designed to detect the release of airborne pathogens. Biowatch uses a network of air collectors and filters that are co-located with Environmental Protection Agency air quality monitors. Based on technologies developed at Lawrence Livermore and Los Alamos National Laboratories, the DHS system collects airborne particles onto the filters, which are then transported to CDC laboratories for analysis.
Recently, PositiveID of Delray Beach, FL, announced that its BioWatch “lab in a box” can eliminate the trip to the lab altogether. The company’s Microfluidic Bio-agent Autonomous Networked Detector (M-BAND) collects and detects airborne pathogens in a self-contained unit, and then transmits the results to smartphones or other devices every three hours. PositiveID received $30 million from DHS to develop the system.
Current BioWatch technology has generated false alarms, however, and critics claim that the program cannot detect underground and indoor releases. Dr. Philippe Le Goff, an international expert in risk-oriented computational fluid dynamics (roCFD), sees a greater role for three-dimensional modeling and simulation. “By modeling the potential of an anthrax attack at an airport, for example, we can predict how airborne anthrax spores will be dispersed—and who might be affected.”
Predictive modeling and simulation can also help to protect against airborne contamination in both current and future critical infrastructure. Applications for roCFD include the design and protection of government buildings, military installations, and biological laboratories, as well as hospitals and pharmaceutical manufacturing facilities. By simulating and modeling biological threat scenarios, agencies can adopt a more pro-active approach.
Argon Electronics, a U.K. supplier of CBRN and HazMat training simulators, is working with leading detector manufacturers to offer responders a different type of simulator. Argon’s CBRN PlumeSIM product is not designed for biological releases, but simulates plumes, deposition, and hot spots for chemical and radiological training exercises. This technology echoes Le Goff’s methodology, and highlights the importance of both software-based modeling and responder training for biosecurity.
Cooperation: A Force Multiplier
Current and emerging technologies are essential, but defense against biological threats still involves communication, collaboration, and cooperation. The whole of department, whole of government, and whole of international community model that agencies within and beyond DHS have implemented is one that the Department of Defense (DoD) shares.
“Harnessing the power of the international community to reduce biological risks can only be done by building bridges between the security and public health sectors,” said Rebecca K.C. Hersman, Deputy Assistant Secretary of Defense for Countering Weapons of Mass Destruction on 1 April 2014 during testimony before the Senate Armed Services Committee. “DoD recognizes that addressing biological threats requires global prevention, detection, and response.”
A former Senior Research Fellow at National Defense University, Hersman is responsible for formulating policies to help protect U.S. and Allied warfighters against CBRN attacks. The Deputy Assistant Secretary for Defense is also charged with providing guidance about CBRN defense of American interests abroad. “Cooperation is a force multiplier,” she explained in her recent Senate testimony, “enabling swift and comprehensive action” against a spectrum of threats “in these times of fiscal austerity.”
In an age when agencies are being asked to do more with less, this collaborative approach also applies to biodetection. Cooperation and coordination with Canada and Mexico are essential, and responders must be ready for a range of scenarios. H1N1 never rivaled the Great Influenza Pandemic of 1918-1919, but the World Health Organization (WHO) noted in 2013 that “the world is ill-prepared to respond to a severe influenza pandemic or any similarly global, sustained, and threatening public-health emergency.”
Communicable disease are not the only biological threats to the U.S. homeland, however. International and domestic terrorist groups, as well as lone-wolf actors, remain a concern even as popular memories of the ricin and anthrax letter attacks fade. Providing affordable, integrated biodetection systems that the public can trust and responders can rely upon is one of the great public health and national security challenges of the 21st century.
Top picture caption: Train passengers in Mexico City wear masks to prevent the spread of H1N1. (Wikimedia Commons)
This article originally appeared in the Spring 2014 issue of Security & Border Protection magazine.