Terrorism, War, or Disease? Unraveling the Use of Biological Weapons

RON BARRETT

In recent years, a number of studies have considered the possibility that plague bacillus (Yersinia pestis) might be used as a biological weapon. Several biosecurity exercises have simulated governmental responses to deliberate plague epidemics.¹ The U.S. Centers for Disease Control and Prevention (CDC) have listed Y.pestis among those pathogens posing the greatest risks to national security.² Although historical instances of intentionally caused plague outbreaks have demonstrated that they are of questionable military efficacy at best, this disease nevertheless poses several issues for concern.³ Y.pestis is relatively stable in diverse environments; it can be found in natural reservoirs (wild rodent populations) around the world; and it can develop much higher virulence in its pneumonic (respiratory) form.⁴ Even in its attenuated (milder) and more readily treatable bubonic (vector-borne) form, plague could still be an effective weapon for the generation of public fear. This fear is partly due to the history of pandemics such as the Black Death and the association of plague with dirt, rats, and poverty.⁵

All of these issues arose at various stages of the 1994 plague epidemic in Western India. With more than 5,000 suspected cases (238 “confirmed”) and 56 plague-related deaths, the epidemic comprised India’s first reported human plague infections in 28 years and its largest number of plague-specific casualties in more than six decades.⁶ Pneumonic plague cases were in unusually high pro

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