Disinformation and Epidemics: Anticipating the Next Phase of Biowarfare.

While biological warfare has classically been considered a threat requiring the presence of a distinct biological agent, we argue that in light of the rise of state-sponsored online disinformation campaigns we are approaching a fifth phase of biowarfare with a "cyber-bio" framing. By examining the rise of measles cases following disinformation campaigns connected to the US 2016 presidential elections, the rise of disinformation in the current novel coronavirus disease 2019 pandemic, and the impact of misinformation on public health interventions during the 2014-2016 West Africa and 2019-2020 Democratic Republic of the Congo Ebola outbreaks, we ask whether the potential impact of these campaigns-which includes the undermining of sociopolitical systems, the delegitimization of public health and scientific bodies, and the diversion of the public health response-can be characterized as analogous to the impacts of more traditional conceptions of biowarfare. In this paper, we look at these different impacts and the norms related to the use of biological weapons and cyber campaigns. By doing so, we anticipate the advent of a combined cyber and biological warfare. The latter is not dependent on the existence of a manufactured biological weapon; it manages to undermine sociopolitical systems and public health through the weaponization of naturally occurring outbreaks.

From biodefence to biosecurity: the Obama administration's strategy for countering biological threats.

The Seventh Review Conference of the Biological Weapons Convention (BWC), the first international treaty to outlaw an entire class of weapons, was held in Geneva in December 2011. On 7 December, Secretary of State Hillary Clinton became the highest-ranking US government official to address a BWC meeting. Secretary Clinton told the assembled delegation that 'we view the risk of bioweapons attack as both a serious national security challenge and a foreign policy priority'. At the same time, she warned that a large-scale disease outbreak 'could cripple an already fragile global economy'. Secretary Clinton's speech reflected a new understanding that the range of biological threats to international security has expanded from state-sponsored biological warfare programmes to include biological terrorism, dual-use research and naturally occurring infectious diseases such as pandemics. Recognizing these changes, President Barack Obama released a new national strategy for countering biological threats in 2009. This strategy represents a shift in thinking away from the George W. Bush administration's focus on biodefence, which emphasized preparing for and responding to biological weapon attacks, to the concept of biosecurity, which includes measures to prevent, prepare for and respond to naturally occurring and man-made biological threats. The Obama administration's biosecurity strategy seeks to reduce the global risk of naturally occurring and deliberate disease outbreaks through prevention, international cooperation, and maximizing synergies between health and security. The biosecurity strategy is closely aligned with the Obama administration's broader approach to foreign policy, which emphasizes the pragmatic use of smart power, multilateralism and engagement to further the national interest. This article describes the Obama administration's biosecurity strategy; highlights elements of continuity and change from the policies of the Bush administration; discusses how it fits into Obama's broader foreign policy agenda; and analyses critical issues that will have to be addressed in order to implement the strategy successfully.

The motivation for biological aggression is an inherent and common aspect of the human behavioural repertoire.

According to a widespread opinion shared by the vast majority of historians, instances of aggression using pathogen weapons constitute extremely rare events in human history. Similarly, students of human behaviour tend to believe that their science plays no role in explaining this phenomenon, which is held to be exceptional and abnormal. Contrary to this dominant view, I argue that Hamiltonian spite - like Hamiltonian altruism - is an inherent part of the human behavioural repertoire and it includes the use of pathogens for spiteful purposes. This paradigm is supported by the following observations. The use of pathogens as weapons emerged far before the scientific understanding of the nature of infections and epidemics, though it has been underrepresented in written history ever since. It is also present in our expectations concerning the likely behaviour of an enemy and it is also a frequent component of threats. Several languages appear to bear linguistic references to our motivation for biological aggression in profanity. Finally, given that wartime epidemics kill people at a rate comparable to (or exceeding) that of mechanical weapons, all wars fought in recorded history incorporated an element of aggression through biological means. On the basis of these arguments, I claim that the motivation for biological aggression is an inherent and common aspect of past and present human behaviour.

Why people believe they were exposed to biological or chemical warfare: a survey of Gulf War veterans.

The study sought to understand better how people come to believe they have been exposed to biological and chemical warfare. We conducted telephone interviews with 1,009 American veterans (65% response rate) deployed and not deployed to the Gulf War, a conflict during which there were credible threats that such warfare could be used. Only 6% of non-Gulf War veterans reported exposure to biological or chemical warfare, but most of Gulf War veterans reported exposure (64%). The majority of these were unsure whether the exposure was chemical or biological in nature. The most commonly reported exposure indicators were receiving an alert from the military and having physical symptoms. Veterans who were certain of the type of exposure (biological or chemical) were more likely to recall having been told by the military and to recall physical symptoms. Future communications with soldiers and the general public about biological and chemical warfare may need to emphasize the uncertain nature of such risk information. Evaluations of exposure diagnostic technologies should take into account the problem of people initially believing, but not later discounting, false positive results.

The psychological dimension of chemical, biological, radiological and nuclear (CBRN) terrorism.

Terrorism is an increasing feature of the World Scene. In the UK, our perspective has changed from a largely Ireland focused one to a more international view. The United States of America are, for the first time, seen as major terrorist targets. We are now "at war with terrorism". The medical aspects of terrorism have been extensively discussed in this journal and elsewhere, this article specifically addresses the psychological consequences of the use of terror weapons.

Reactions of psychiatric inpatients to the threat of biological and chemical warfare in Israel.

In the months before the Second Gulf War, the threat of biological and chemical warfare led many Israelis to experience significant stress and mood changes. In this study, we investigated whether this threat affected the subjective mood and behavior of inpatients with schizophrenia and compared the results with effects noted in their clinical staff. Subjects were evaluated at two points in time-2 months before the war and on day 1 of the war-with a specially designed questionnaire and with the Spielberger Scale for Trait Anxiety. Although the responses of the two groups did not differ radically before the war, on the first day of war, significant differences were noted, with patients demonstrating increases in anxiety and level of concern. Both groups reported similar effects on their mood. Patients were more concerned about the potential for the outbreak of World War III, whereas staff were more concerned about economic effects. Female subjects in both groups demonstrated greater anxiety and mood changes after the outbreak of war compared with before the war. Effects observed on the patients may be related to the decreased coping threshold resulting from their illness, which renders psychotic patients more vulnerable to any acute stressor; however, effects on the staff members should not be ignored.

The impact of anthrax attacks on the American public.

CONTEXT: Incidents involving anthrax (Bacillus anthracis) through the mail in 4 metropolitan areas have raised concerns about the public's response nationally and locally. OBJECTIVE: To examine public response to these incidents and what it reveals about the demand placed on health professionals and public health officials nationally, in affected areas, and by affected people. DESIGN: Random-digit-dialed telephone surveys of samples of households nationally and in 3 specific metropolitan areas where cases of anthrax were reported: the District of Columbia; Trenton/Princeton, New Jersey; and Boca Raton, Florida. OUTCOME MEASURE: Respondents were asked a series of questions measuring their level of concern and their behavior in response to threats of anthrax and potential bioterrorist acts. RESULTS: The lives of a large share of people were affected in 3 metropolitan areas where anthrax incidents occurred. Residents of those 3 areas and people there who were affected by the incidents expressed a higher level of concern and took more precautions handling their mail. However, these incidents did not lead to great demands on the health system. CONCLUSIONS: The incidents of anthrax created anxieties, especially in areas where incidents occurred. There was some increased demand on the health system, but the demands were not large-scale. In the event of a major outbreak of disease, most Americans will rely heavily on their own physician for advice. Both national and local systems of population-based information gathering about the public's response to bioterrorist attacks are needed.

[Contemporary control of biological warfare]. / Wspólczesne zagrozenie bronia biologiczna.

Biological pathogens actually are in the focus of interest as a potential biological weapon in bioterrorist's disposition. In the study the main pathogens and their activity spectrum have been presented. The special attention has been paid upon aerosol way of transmission and its consequences. The possibilities of prevention and treatment of diseases caused by biological pathogens have been also discussed.

Psychosocial responses to biological and chemical terrorist threats and events. Implications for the workplace.

1. Both biological and chemical weapons (BCW) could potentially be used in future terrorist attacks on U.S. workplaces and communities. 2. Threats of BCW terrorism may lead to anxiety, adverse health effects, and the exacerbation of psychiatric symptoms and syndromes in workers and managers. 3. Actual BCW attacks will likely cause both acute and chronic mental disorders in a significant number of surviving victims who may also be employees or employers. 4. Occupational health nurses can help prevent or remediate maladaptive psychological responses by educating themselves and their work forces, assisting in a risk assessment of the workplace, understanding disaster planning, and assisting management in policy formulation and psychosocial triage.

Weapons of mass destruction: biological.

Humans are susceptible to microbial infections from many sources. Biological warfare is the use of microbial forms of life to diminish the capabilities, disrupt the organization, and terrorize the noncombatant population of an adversary. This form of warfare has been used throughout history and has gained renewed interest with the current use of asymmetrical warfare. The civilized world has condemned its use by the implementation of treaties specifically against it. This is a brief review of some of the more easily used biological agents such as anthrax, plague, tularemia, Q fever, and smallpox. Each agent's biology, infectious route, and disease course will be discussed. Possible delivery systems and signs of outbreak will also be reviewed. There are few real neurosurgery-related implications in biological warfare. Neurosurgeons, as members and leaders of the healthcare community, must have the ability to recognize and initiate treatment when biological agents have been deployed. If there is widespread use of these inhumane agents, the neurosurgical community will not be able to practice the surgical art for which we have trained. New knowledge must be acquired so that we can best serve our patients and communities during times of extreme need.

Sitting it out in the sealed room: the Israeli response in the 1991 Gulf War.

The response of the Israeli civilian population to the Scud missile attacks and the possibility of chemical and biological warfare during the 1991 Gulf War have been monitored in various contexts. The present article reviews the findings and their implications for civilian defence planning in the event of a reprise. In 1991 the most controversial policy was the insistence that Israeli families prepare a sealed room in which to sit out the Iraqi attacks. The evidence suggests that in some instances this may have been counterproductive, even during relatively short periods of immurement.