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Officials seek ways to protect Montana from bioterrorism

When it comes to international affairs—or even national affairs—Montana is usually out of the loop. Terrorist bombings, historical hatreds and heavily-armed lone wolves harboring deep-seated grudges are other people’s problems.

Or are they?

Consider this scenario: A Montana man loses his land to the bank when he can’t pay his debts. Consumed with rage, and fueled by an anti-government bias, he lets anthrax loose in the heating ducts at the county courthouse or the city hall or the county fairgrounds. The he leaves town on an already planned vacation. Days later, the workers in the targeted building begin to fall ill with flu-like symptoms. No one pays too much attention to this coincidence, until people start dying.

Though nothing like this has ever happened in Montana, state health officials are preparing for the day when it might.

About 18 months ago, the Centers for Disease Control and Prevention, concerned with the dangers of a domestic bioterrorism attack, began funding state public health departments to develop preparedness programs.

Bioterrorism is a 21st century word, defined as an attack on a targeted population, the weapon being a biological, disease-causing agent like anthrax or smallpox. Though the idea of a bioterrorism attack in Montana seems like a stretch, it may not be as science-fictionish as it sounds.

Lorrie Leighton-Boster, R.N., is the public health disaster coordinator for the Montana Department of Public Health and Human Services. She and state epidemiologist Todd Damrow have been developing a program to bring county public health agencies up to speed on the possibility of bioterrorism in Montana, and how to respond in the event such an attack ever occurs on our soil.

Leighton-Boster says the state’s bioterrorism preparedness program is an addition to the “big picture plan” the state already has in effect for more typical public health problems like an influenza epidemic or mass injuries following an earthquake.

And though preparing for a rogue agent armed with a vial of, say, tularemia, may be the sensible thing to do in this age of rapid transportation and anti-government sentiment, she also wants to make sure she’s not unduly alarming anyone.

“Yes, there is a plan,” she says. “We certainly don’t want to give anybody ideas about anything, but it is something we need to consider as something that could happen and be prepared for it.”

On the state health department’s list of “biological agents of highest concern” are some of the worst diseases ever to visit mankind, and frightening enough for a Stephen King novel: anthrax, plague, tularemia, botulism, viral hemorrhagic fevers, smallpox. Smallpox? How could smallpox be a threat when it’s been virtually eliminated from the world, its remnants relegated to two research labs, one in the U.S. and one in Russia?

The fear, Leighton-Boster says, is that political chaos in Russia has loosed the smallpox virus from its Russian lab by defectors or other scoundrels. “The potential is there,” she says.

The other bio-agents of concern occur naturally in animals and are easily obtained, if one knows how to go about such a thing. “If you had the knowledge to cultivate these, you could do it,” she says.

But who would cultivate such things as anthrax and plague, and why? And is Montana, relatively isolated and far removed from the slightly unreal world of political terrorism, at risk?

Leighton-Boster says that any spot on the globe is vulnerable to bioterrorism, either foreign or homegrown. “Anybody with a grudge to settle,” she says.

Although Montana is an unlikely target for Osama bin Laden, it does harbor, as all the world knows by now, its own brand of wing nuts: the Militia of Montana, the posse comitatus, self-styled patriots, white supremacists. “We do have some fringe groups,” Leighton-Boster says. “And it doesn’t have to be a group. It can be an individual who’s gone off the deep end, and unfortunately we have to prepare for something like this.”

To bolster her case that bioterrorism is indeed a threat, Leighton-Boster refers to Dr. Michael Osterholm, former Minnesota state epidemiologist and former advisor on bioterrorism to the late King Hussein of Jordan. Osterholm, with Washington Post science writer John Schwartz, penned Living Terrors: What America Needs to Know to Survive the Coming Bioterrorist Catastrophe. Osterholm, in a recent appearance on “60 Minutes,” quoted President Clinton as saying he believes a bioterrorism attack will occur in America sometime within the coming decade.

According to Osterholm and Schwartz, America’s public health agencies are in no way prepared to handle thousands—or millions—of cases of anthrax or smallpox. Nor has enough vaccine been stockpiled.

The state health department is preparing for “the epidemic from hell,” as the department puts it, by helping county health departments get ready. Among the programs the state is pushing to the counties is the establishment of a secure Internet connection—a “health alert network”—allowing county health officials to keep their colleagues around the state informed about “unusual symptoms” that appear in their counties.

State health officials also plan on a rapid investigation and containment of real or potential threats, quick lab diagnosis, and education and training for local health departments, among other goals.

Leighton-Boster estimates that Montana’s bioterrorism program will take years to develop. She and Damrow are currently presenting the program that has been developed thus far to any interested county health board or public health department. To date, they’ve talked to only two or three counties, but the presentations are relatively new, and she says she’s sensing interest among other counties. “A lot of this is kicking into gear right now,” she says.

Meanwhile, Leighton-Boster continues to help Montana prepare for the worst, in the hopes, of course, that the worst will never come.

“It’s not something we want to panic people about, but we want to be prepared,” she says. “The middle of a disaster is not the time [public health officials] want to be exchanging business cards.”

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