Committee on Science Needs Microbial Forensics: Developing an Initial International Roadmap, Board on Life Sciences, Division of Earth and Life Sciences, National Research Council of the National Academies.

Today we find ourselves with a complex infrastructure of government agencies, Select Agent registries, regulated research, environmental monitoring in designated cities, federal and state regulations—all resulting from one more or less successful biological attack on the United States. The Amerithrax attack with highly refined material produced by a knowledgeable expert (presumably in a U.S. bioweapons laboratory) resulted in 22 illnesses and 5 deaths. Approximately 4 g of material were used in the Amerithrax attack. At that time, the United States planned and prepared as best it could for an attack involving 50 kg of weaponized anthrax spores released on a city with a population of 500,000, anticipating 125,000 casualties. However, it is unlikely that a nonstate entity would be able to produce that quality or quantity of material undetected. Moreover, aside from B. anthracis, there are few (if any) biological agents that can be grown in quantity, viably maintained, stabilized, processed to the appropriate size, and delivered in an aerosolizable form except by a few specialized bioweapons facilities and certainly not by terrorists in a garage or cave. Most exotic microorganisms are just too difficult to grow and keep alive, even in the most sophisticated facility. In addition, the technology involved in weaponizing biological materials is complex, demanding, and requires substantial expertise. The more likely scenario is someone having access to a small amount of unrefined material that he/she uses to make a few individuals ill (causing perhaps a few deaths), the consequence of which will be a nation paralyzed with fear, not illness.

In that context, microbial forensics becomes more important than ever. How does one differentiate a natural outbreak from an accidental release from a legitimate laboratory, or the use of biological material to commit a crime, bioterrorism, and all-out biological warfare? How can this be accomplished quickly enough to inform law enforcement, the intelligence community, policy makers, and the public in a timely fashion? The traditional clinical laboratory sciences of culture identification, serology, etc. are inadequate for these purposes. It was with this background that the workshop in Zagreb, Croatia, was held in October 2013 with the intent to identify the scientific challenges that must be met to improve the capability of microbial forensics to investigate suspected outbreaks and to provide evidence of sufficient quality to support responses, legal proceedings, and the development of government policies. The workshop also was designed to increase awareness of microbial forensics among the members of the larger international scientific communities and to engage these communities in the development of a plan on how to address scientific challenges.

One of the more important concepts discussed during the workshop was that the techniques of microbial forensics could aid not only law enforcement and policy makers, but also public health workers, in trying to identify the existence and source of natural outbreaks. Indeed, as we saw in the Amerithrax attack, the public health system will likely be the first to encounter and the first line of defense against a biological attack. Most infectious diseases develop gradually, with individual patients seeking medical care through their local health care providers. People vary in their susceptibility to infectious diseases, and subtle clues may signal an attack, such as an increase in frequency of a naturally occurring infectious disease, unusual seasonality, unexpected resistance to antimicrobials, or unusual age distribution. These features are likely to be recognized first in the public health arena, and the more common the tools and techniques are between law enforcement and public health, the more likely that a true attack will be identified early, perhaps in time to administer prophylactic antibiotics or vaccines or prevent a second release. Moreover, the further we get from an actual attack, the less inclined policy makers are to provide financial support for continuing the research necessary to prepare for an attack. As noted in the 2013 President’s Report for the Global Partnership Against the Spread of Weapons and Materials of Mass Destruction (U.K. Foreign and Commonwealth Office, 2013):

Many of the capabilities required for detecting and responding to the whole spectrum of natural, intentional, and man-made events are essentially the same. Systems and networks that might be created for rare events will atrophy through lack of use, whereas systems created for addressing natural, man-made and accidental outbreaks of infectious disease are likely to be used frequently. Relying on tools and systems that are compatible with both rare and common occurrences means that in an instance of a rare event, detection and response will not be delayed by lack of familiarity with the tools or systems of reporting.

This article is an excerpt from Science Needs for Microbial Forensics: Developing Initial International Research Priorities, published by the National Research Council of the National Academies. The full report can be viewed at the following link: http://www.nap.edu/catalog.php?record_id=18737