Letters to the future: what the 2001 Anthrax attacks tell us about emergency preparedness and response

A little over twenty years ago, a biological attack triggered worldwide alarm after deadly anthrax spores were sent via mail to media and government organisations across the United States of America (USA), infecting 22 people, five of which died. The so-called “Amerithrax” case, which sparked a multi-agency investigation, is remembered by the Federal Bureau of Investigation (FBI) as the most complex in the history of law enforcement to date. Although the world had been no stranger to bioterrorist attacks, this episode was bound to resonate widely and shape how communities and institutions worldwide prepare for unexpected threats.  

Anthrax is a zoonotic disease that causes high mortality in animals and can infect humans. Bacillus anthracis – the pathogen behind the disease – can enter the body of animals when they ingest or inhale bacterial spores present in the soil where they are feeding. Because the spores can easily contaminate feed and water, anthrax poses a serious threat to animal health. 

The disease can damage livestock production and cause significant shortfalls in animal food sources, thus impacting the livelihoods of farmers and more broadly those of entire communities. The potential impact on public health is equally devastating. Humans can be exposed to the pathogen through direct or indirect contact and, although more rarely, by eating meat from infected animals.   

A lesson learnt in emergency response 

The bioterrorist attacks in the United States of America have left a profound legacy behind. Among the first instances in recent history, a pathogen able to cause an infectious disease in animals and humans had emerged as a biological agent that can be weaponised in imaginative ways, including inhaling anthrax spores sent via mail. The events also heightened public fear of bioterrorism. In the aftermath of the attacks, any unidentified white powder was treated as a potential biological threat, leading to thousands of emergency responses, most of which turned out to be false alarms or hoaxes but still caused major disruption and high costs. 

Andy Weber, Senior Fellow at the Council on Strategic Risks and former Assistant Secretary of Defence for Nuclear, Chemical & Biological Defence Programs, believes that the events in the country struck a chord with the rest of the world. “Five people were killed, but the quality and quantity [the perpetrator used] could have caused much heavier consequences,” he says. 

We need to be aware of animal pathogens around the world and that also livestock can be an easy target for the introduction of animal pathogens, even more so in densely populated farms. The economic impact on agriculture could be staggering, too. Because it is hard for them to get caught, terrorist groups may also launch multiple attacks in different locations around the world with potential catastrophic ripple effects.

Andy Weber, Senior Fellow at the Council on Strategic Risks and former Assistant Secretary of Defence for Nuclear, Chemical & Biological Defence Programs.

There is an important lesson for the future to learn from the events. The law enforcement sector played an undeniably central role in 2001. Yet, for the sake of preparedness to biothreats – whether targeted to humans or to livestock – there are further linkages that need to be explored: representatives of the human, veterinary and public health community are all professional figures whose insights are key to responding to a biothreat with a zoonotic agent. Animal health professionals are uniquely positioned to assess whether the cause of an outbreak is natural or human made. In case of doubts or suspicions, they can warn law enforcement authorities who will evaluate whether the case is worth of criminal investigation. In turn, Law Enforcement officials can collect evidence about criminal activities and provide an early warning to Veterinary Services, who then shall intervene to contain the disease outbreak.  

Animal health emergencies represent a multi-faceted challenge that calls for a multisectoral approach. No single agency or sector, in fact, has enough expertise to tackle an emergency or mitigate its impacts. In some contexts, the expertise of other stakeholders such as the ones in security – whose priorities are not always targeted to health – is achingly needed. Only by combining the insights of both Law Enforcement agencies and Veterinary Services can effectively and timely respond to biothreats originating in animals – whether naturally occurring or deliberately released.  

Taking control over the next threats to health security

The complexity of today’s world only enhances the likelihood of error or inadequate response to a global health emergency. With changing weather patterns and temperatures on the rise, anthrax is indeed more likely to naturally occur. Droughts, for instance, can contribute to concentrating people and animals around water sources. At the same time, the fact that it’s inexpensive, alongside its widespread availability and flexible nature, make this biological agent a weapon of choice for individuals aiming to use science for malicious purposes, whether for financial gain or with the goal of bringing disruption.  

However, anthrax is not the only infectious agent that can pose a large-scale threat. Other animal pathogens and toxins can be used as weapons of biological warfare and/or biological terrorism, targeting livestock to cause famine and harm livelihoods.  

Andy Weber recalls that, back in the days, a large programme was developed to use contagious animal diseases such as African swine fever and rinderpest as weapons targeting cows, swine, sheep and other animals, alongside plants and crops. Additionally, because most biological weapons developed against humans are zoonotic, animal health laboratories need to be very careful their materials not being made available to potential terrorists.  

Towards a more resilient world 

Over the past 20 years, technological advances – such as synthetic biology – along with the widespread availability of these technologies, global instability, failures in international cooperation and the erosion of non-proliferation treaties, have contributed to a rising risk of biothreats. 

The anthrax experience revived the conversation around bioterrorism and sharpened the world’s focus on the need for preparedness. Uncertainty looms large in a world where animal, human and environmental health have grown dramatically interconnected. To mitigate or prevent animal health threats, The World Organisation for Animal Health is hosting a Global Conference on Biological Threat Reduction this fall. The event stems from the need to improve global health security, spurring action through multisectoral collaborations to advance prevention, preparedness and response capabilities across the world.  

A little over twenty years after the world was shaken to the core by an act of bioterrorism, it is important to remember that only together can the animal health and the security sectors handle potential threats of this sort. The lack of preparedness may make the two systems vulnerable. However, with preparation, collaboration and mutual understanding among key actors, we can make sure that no animal health emergency is mismanaged or left unanswered. A far-sighted, inclusive preparedness strategy is the antidote to the unforeseeable events we are likely to face in the years to come: if we are prepared today, we will save human and animal lives tomorrow. 

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