CDC: History of Bioterrorism
Summary
TLDRThis script delves into the history and potential of bioterrorism, highlighting the evolution of biological warfare from ancient times to modern concerns. It discusses the use of diseases like anthrax, plague, and smallpox as weapons, the development of bioweapons by various nations, and the importance of public awareness and preparedness. The script emphasizes the lethal nature of biological agents and the need for vigilance against bioterrorism threats.
Takeaways
- π΅οΈ Terrorism has evolved to include bioterrorism, which utilizes dangerous pathogens as weapons.
- π‘ The immediate effects of chemical or radiation attacks differ from the delayed impact of bioterrorism, which can go unnoticed for hours or days.
- π The CDC categorizes diseases by their potential impact on bioterrorism into categories A, B, and C, with category A being the most severe.
- π The US government has implemented preparedness and response plans, which can be found on websites like wwr ad gov.
- 𧬠Historically, biological warfare has been conducted by various nations, including Japan's Unit 731 and the UK's anthrax trials on Gruinard Island.
- πΊπΈ The United States once had an offensive biological program, weaponizing several agents, but renounced the use of biological weapons under President Nixon in 1969.
- π€§ The Soviet Union maintained a large-scale, secret biological warfare program despite signing the Biological Warfare Convention.
- π¦ Iraq admitted to producing and weaponizing anthrax, highlighting the potential for state-sponsored bioterrorism.
- π¨ The anthrax attacks in the US in 2001 demonstrated the real-world danger of bioterrorism, with 22 people sickened and 5 deaths.
- π The threat of bioterrorism is increasing, with knowledge and preparedness being the best defense against such attacks.
- π The global nature of disease and the ease of travel increase the risk of bioterrorism, as seen with diseases like SARS and monkeypox.
Q & A
What is bioterrorism?
-Bioterrorism is a form of terrorism that involves the intentional use of biological agents, such as viruses, bacteria, or other germs, to cause illness or death in humans, animals, or plants.
How do the effects of a bioterrorism attack differ from those of a chemical or radiological attack?
-The effects of a chemical or radiological attack are typically immediate, necessitating a rapid response. In contrast, the effects of a bioterrorism attack may not be apparent for hours or even days, allowing the disease to spread undetected before it is recognized.
What are Category A diseases according to the CDC?
-Category A diseases are those that are considered the highest risk to national security because they can be easily disseminated or transmitted, result in high morbidity and mortality rates, and require specific public health response strategies. Examples include smallpox, anthrax, botulism, plague, tularemia, and viral hemorrhagic fevers.
Why were biological warfare research programs developed in the 1930s?
-Biological warfare research programs were developed in the 1930s due to the perceived military advantages of using disease as a weapon. Countries like Japan and the Soviet Union had active offensive bio warfare research programs, leading to the development of sophisticated and extensive capabilities.
What was the significance of the anthrax attacks in the United States in 2001?
-The anthrax attacks in 2001 were significant because they demonstrated the potential for bioterrorism to cause widespread fear and disruption. The attacks involved mailing anthrax spores, leading to 22 illnesses and 5 deaths, and highlighted the need for public health preparedness and response to bioterrorism.
Why did the United States renounce the use of biological weapons in 1969?
-The United States renounced the use of biological weapons in 1969 under President Richard Nixon as a part of a broader policy to promote international peace and security, and to set an example for other nations in the non-use of such weapons.
What is the role of the website ready.gov in the context of bioterrorism preparedness?
-The website ready.gov serves as a resource for preparedness information, providing detailed guidelines, facts, and recommendations on what individuals and communities can do to prepare for and respond to bioterrorism threats and other emergencies.
How did the use of plague as a biological weapon evolve over time?
-The use of plague as a biological weapon evolved from early attempts to infect fleas and drop them over cities, to more sophisticated methods such as the development of ceramic bombs loaded with infected fleas. Later, research focused on overcoming challenges like maintaining virulence in large quantities and controlling the spread of the disease.
What is the potential threat of botulinum toxin as a biological weapon?
-Botulinum toxin is the most lethal substance known to man, and its potential as a biological weapon lies in its ability to cause widespread illness and death with even a small amount. It can be used to contaminate food supplies or be dispersed in an aerosol form, though its effectiveness in open-air dissemination is limited.
How do viral hemorrhagic fevers, such as Ebola, pose a threat in the context of bioterrorism?
-Viral hemorrhagic fevers pose a significant threat in bioterrorism due to their high mortality rates, ease of transmission, and potential to cause panic and social disruption. An attack using these viruses could result in mass illness and many deaths, especially in densely populated areas.
What is the significance of tularemia as a potential biological weapon?
-Tularemia is significant as a potential biological weapon because it is highly infectious, can be spread through various means including air, food, and water, and does not require many organisms to infect a person. Its potential for causing large-scale illness and the difficulty in controlling its spread make it a concern for bioterrorism.
Outlines
π‘οΈ Bioterrorism and CDC Preparedness
This paragraph discusses the threat of bioterrorism, which involves the use of disease-causing germs like viruses and bacteria. It emphasizes the importance of vigilance and preparedness, referencing the CDC's categorization of diseases and the historical use of diseases as weapons. The paragraph also mentions the U.S. government's response to bioterrorism threats, including the development of preparedness and response plans available on government websites.
π§ͺ Historical Biowarfare and Its Consequences
The second paragraph delves into the history of biological warfare, highlighting the Japanese Unit 731's inhumane experiments and the development of biowarfare programs by the Allies and the Soviet Union. It discusses the British anthrax trials on Gruinard Island and the U.S. offensive biological program at Camp Detrick, which led to the weaponization of several agents. The paragraph concludes with President Nixon's renouncement of biological weapons and the subsequent dismantling of the U.S. biowarfare program.
π¦ The Perils of Plague as a Biological Weapon
This paragraph focuses on the use of plague as a biological weapon, from its historical deployment by the Tartar army to its study by the Japanese Imperial Unit 731 and the Soviet Union. It discusses the challenges of weaponizing plague due to its contagious nature and the potential for it to affect not only enemy forces but also friendly forces. The paragraph also touches on the concerns about the availability of plague cultures and the potential for its use by terrorists.
π€ Smallpox: A Weapon of the Past and Present
The fourth paragraph examines the history of smallpox as a biological weapon, from its use during the French and Indian War to the Soviet Union's development of smallpox as a weapon. It discusses the irony of smallpox's potential resurgence as a threat due to the cessation of vaccinations following its eradication. The paragraph also highlights the ease with which hemorrhagic fever viruses like Ebola can spread and the importance of preparedness against such diseases.
π· Tularemia: A Lesser-Known Bioterrorism Threat
This paragraph introduces tularemia, a disease that primarily affects small animals but has been studied as a potential biological weapon. It outlines the various ways in which humans can contract the disease and its potential use in bioterrorism due to its ability to contaminate food and water. The paragraph also mentions historical instances of tularemia use in biological warfare and the importance of early recognition and response to prevent a large-scale outbreak.
π¨ The Threat of Botulinum Toxin and Hemorrhagic Fevers
The final paragraph discusses the dangers of botulinum toxin, one of the most lethal substances known, and its potential use in bioterrorism. It also covers the threat posed by viral hemorrhagic fevers, such as Ebola, which can cause devastating outbreaks and have been developed as weapons. The paragraph emphasizes the importance of international cooperation and vigilance to prevent and respond to bioterrorism threats involving these agents.
Mindmap
Keywords
π‘Bioterrorism
π‘Category A Diseases
π‘Anthrax
π‘Biological Warfare
π‘Sverdlovsk Anthrax Leak
π‘Plague
π‘Smallpox
π‘Botulinum Toxin
π‘Viral Hemorrhagic Fevers
π‘Tularemia
Highlights
Terrorism has evolved to include bioterrorism, using dangerous disease-causing germs as weapons.
Bioterrorism can be silent, with the effects of a disease-causing germ attack potentially going unnoticed for hours or days.
The CDC categorizes diseases into categories A, B, and C based on their potential use in bioterrorism.
Category A diseases, such as smallpox and anthrax, are considered the most serious threats.
Historical use of disease as a weapon dates back to the Middle Ages, including the use of plague-infected corpses.
The Japanese Unit 731 conducted inhumane experiments using disease-causing agents during World War II.
The United States and the Soviet Union both had extensive biowarfare programs, despite signing the Biological Warfare Convention.
The accidental release of anthrax in Sverdlovsk in 1979 confirmed the dangers of bioterrorism.
Iraq admitted to producing and weaponizing anthrax, highlighting the potential for state-sponsored bioterrorism.
The 2001 anthrax attacks in the United States demonstrated the real-world impact of bioterrorism.
Botulinum toxin is recognized as the most lethal substance known to man, with potential use in bioterrorism.
Hemorrhagic fever viruses, such as Ebola, are of great concern due to their high mortality rate and potential for rapid spread.
Tularemia, a bacteria affecting small animals, has been studied as a potential biological weapon due to its infectivity.
The Soviet Union's bioweapon program was massive, employing thousands and maintaining large stockpiles of agents like plague.
Smallpox, eradicated in the 1970s, remains a potential bioterrorism threat due to the discontinuation of vaccinations.
The US government has implemented preparedness and response plans for bioterrorism, available on websites like ready.gov.
Knowledge and preparation are key defenses against bioterrorism, with resources available for public education.
Transcripts
terrorism never before in our history
has the need for watchfulness been so
great terrorism is not only an attack
using weapons of mass destruction or
chemicals but also includes weapons of
viruses bacteria and other germs this
form of terrorism is called bioterrorism
the effects of an attack using chemicals
or radiation would be immediate and
therefore need to be acted upon quickly
but many critical hours or even days
could silently go by before we might
know about the devastating effects of an
attack using a dangerous disease-causing
germs
the diseases that could be used by
terrorists are divided into different
categories a through C the videos you
will find on the CDC website describe
the category a diseases which include
smallpox anthrax botulism play tularemia
and viral hemorrhagic fevers if these
germs were used to intentionally infect
people they would cause the most illness
and death some of them can be spread
through air others can be spread through
water or food supplies diseases such as
plague and smallpox were long ago used
as weapons by mankind
more recently anthrax was intentionally
used in the United States leading to
several deaths and creating widespread
panic you do not need to live your life
in constant fear of bioterrorism attacks
remaining vigilant means being prepared
the United States government has taken
important measures to put into place
preparedness and response plans these
plans can be found on websites such as
wwr ad gov at the end of this
presentation you will find local and
national contact information on being
prepared as well as information about
bioterrorism
[Music]
[Music]
the idea of using disease as a weapon
gained a new level of sophistication in
the early 1930s as nationally funded
research programs on biological warfare
were developed the Japanese had a very
active offensive bio warfare research
program which included a battalion known
as 731 in their program the Japanese
conducted experiments on humans using 15
to 20 different disease-causing agents
with anthrax being one of their
favorites Allied prisoners of war and
innocent Manchurian civilians in nearby
villages provided an almost endless
supply of experimental subjects when
word of unit 731 leaked to the west
Allied forces began their own programs
concern that Japan and possibly Germany
would gain a military advantage in bio
warfare research on the third day Africa
so that the casualties begin dead sheep
can be seen further down the line it is
of course necessary to confirm that
they've died of anthrax in 1942 on
grannard island off the coast of
Scotland the British conducted their
first scientifically controlled bio
warfare field trials scientists exploded
anthrax bombs near immobilized sheep to
determine if the spores would survive an
explosion and retain the ability to
infect anyone nearby test results showed
that anthrax could in fact be
effectively dispersed by explosive
devices and could also remain viable in
the soil for decades this brought home
the realization that if an anthrax bomb
were dropped on a city like London the
results could have been catastrophic
granny Rhode Island was declared
off-limits until it was decontaminated
in the 1980s it's now safe for both
humans and animals
[Music]
like our allies the United States
responded to the perceived threats from
Germany and Japan in 1943 we began an
offensive biological program with a
modest research and development facility
at Camp Eric which is now Fort Detrick
Maryland by the end of the program we
had weaponized a total of seven
incapacitating or lethal human agents
including anthrax in 1969 Richard Nixon
renounced the use of biological weapons
for the United States I have decided
that the United States of America will
renounce the use of any form of deadly
biological weapons that either kill or
incapacitate President Nixon visited
Fort Detrick on the 25th of November
1969
I remember that date quite well because
following his announcement of taking
munitions and beating him to plow sheds
we all lost our job and that was a very
traumatic experience but following his
presidential announcement on the this
date the the entire United States
offensive program on biological warfare
came to a close within two years we
destroyed all of our seed stocks we
destroyed all of our production material
at Pine Bluff Arkansas and we completely
got out of the biological warfare
business even at its peak the u.s.
offensive program paled compared to the
Soviet Union's the Soviets had a massive
extensive sophisticated top-secret
program which employed tens of thousands
of scientists and engineers in numerous
research and production facilities the
Soviets signed the biological warfare
convention in the 1970s and yet their
program continued uninterrupted and in
fact intensified
our worst fears were confirmed in 1979
when an accidental release of anthrax
occurred at a biological research
facility in the town of Sverdlovsk much
of our recent knowledge about their
joint military and civilian program
comes from a Soviet defector dr. Ken Ali
Bek formerly known as dr. Kinison Ali
Bekoff he was the deputy director of bio
prepare a cover organization for the
civilian bio weapon and production
facilities although we had suspected for
years that they had continued their
offensive program some of the
information he provided was a real
wake-up call for the United States prior
to the Gulf War the intelligence
community suspected that the Iraqis had
done research on anthrax but they didn't
know just how extensive their program
was so as a precautionary measure during
the war about 150,000 US service members
were vaccinated against anthrax and more
would have been immunized if the war
hadn't ended so quickly after the war
the Iraqis admitted to producing and
weaponizing anthrax
although the weapons were never used
this past decade anthrax moved from
being an agent of concern for biological
warfare to the top of the threat list
for terrorism the armory qiyam truth
cult in Japan which released the nerve
agent sarin from the Tokyo subway in
1995 allegedly made multiple
unsuccessful attempts to infect people
with anthrax in October of 2001 the
United States experienced anthrax
attacks using powders sent through the
United States Postal Service 22 people
got sick and five people died from this
attack we learned just how dangerous
anthrax could be but there are things we
can do the best defense against the
bioterrorism attack is knowledge and
preparation the webpage ready.gov is a
good resource for preparedness
information it can be found at WWE gov
visit this webpage for detailed
guidelines facts and what you can do to
be ready in the event of
an emergency a small amount of time
spent becoming informed developing a
plan and preparing yourself against
terrorist threats now can prove to be
invaluable should the need arise don't
be afraid be ready
[Music]
man has used organisms found in nature
to kill or disable his enemies since the
Middle Ages one of the earlier examples
occurred in the 14th century when the
Tartar army laid siege to kapha a walled
city along the Black Sea when an
outbreak of bubonic plague began to
ravage the Tartars they decided to
catapult the plague-ridden corpses into
the city thereby helping to start an
outbreak within the walls shortly
thereafter the Genoese defenders within
the city were stricken with plague and
fled to Italy they carried this
infection with them to Europe beginning
the outbreak of a horrible black death
which decimated the European population
[Music]
with our current knowledge of the
epidemiology of plague
we know that fleas leave a body quickly
after it cools therefore it's most
likely that the outbreak was actually
spread in kapha
by flea infested rats which were already
within the city the Japanese Imperial
unit 731 operated in the 1930s and 40s
when Japan was mobilized and ready for
war general Shiro Ishii mastermind of
this terrible program had a mission to
turn illness into weapons of murder he
was particularly fascinated by play
because with plague a biological warfare
attack could present like a natural
epidemic person to person spread could
then produce disease out of proportion
to the original amount of agent used the
Japanese were unable to disseminate
plague by the aerosol or in the water
supply
so they used nature's vector for
spreading the disease the common flea
ceramic bombs loaded with infected fleas
were dropped over several cities in
mainland
causing large outbreaks among their
population plague is attractive as a
weapon because it generates fear it
spreads easily and it kills very quickly
the United States offensive program did
some research on play but it was never
fully weaponized in this country we
could not overcome the challenge of
maintaining virulence when it was grown
in large quantities it's it's a weapon
that you know it's a contagious agent
and we felt that in retrospect that we
had enough problems controlling an
aerosol under meteorological conditions
that can change without having an
organism that is so contagious so that
you know you don't you're not able to
control where that organism might end up
it might come back to bite you not only
bite your forces but some of your
friendly Allied forces also plague was
however a favorite organism in the
Soviet Arsenal because of its
communicability the Soviets overcame the
virulence problems experienced by the US
according to interviews with the Soviet
defector dr. Ally back they had 1500
metric tons of plague on hand at any
given time and kept it ready for use in
their intercontinental ballistic
missiles due to storage problems they
frequently recycled their stockpile of
plague with fresh agent we're very
concerned about terrorists use of plague
because the agent is found not only in
nature but also in numerous biological
supply houses throughout the world
[Music]
before the discovery of the smallpox
vaccine smallpox was in fact used as a
weapon one of the best documented
examples of this occurred during the
French and Indian War the British had
been defeated in their attempt to
conquer Fort carrion on Lake Champlain
so Sir Geoffrey Amherst commander the
British forces met with Indians who were
sympathetic to the French under the
pretense of friendship he deliberately
offered them blankets previously used by
smallpox victims the Indians who act
immunity to smallpox suffered a
devastating outbreak of the disease the
English were then able to successfully
attack the fort which by the way was
renamed Fort Ticonderoga military forces
have also been devastated by endemic
smallpox during the siege of Quebec
George Washington's troops suffered
massive losses from smallpox he
subsequently required all new recruits
to be inoculated against the virus I'd
like to comment for a few minutes on the
Soviet program and their development of
smallpox morale a major they first
worked with smallpox and imitated
chicken eggs and since a very small
amount of material is produced in the
egg you can imagine the large numbers of
eggs that were required to produce 100
metric tons of raw agent now as their
program advanced and are starting in the
early nineties they were using tissue
culture as a means of generating the
virus but 100 metric tons loaded into an
ICBM aimed at our major cities is cause
for worry it's incredibly ironic that
the great Public Health triumphs of
eradicating smallpox in the 1970
and the discontinuation of worldwide
vaccinations have opened the door for
this virus to be once again used as a
weapon
[Music]
[Music]
botulinum toxin is the most lethal
substance known to man so it's potential
as a weapon was appreciated early on
supporters of Pancho via may have used
botulinum against Mexican federales in
1910 while the details are unclear it's
been said that they left behind recipes
where they actually buried pork and
green beans for several days they then
dug up this horrible concoction and used
it to contaminate food and they also
smeared it on sharp instruments that
they used as weapons during the Second
World War intelligence reports indicated
that the Germans were developing
botulinum toxin as a cross English
Channel weapon to be used against
invasion forces in light of this it's
ironic that a hand grenade filled with
botulinum toxins may have been used by
Czech Patriots who were trained and
equipped by the British to assassinate
Reinhard Heydrich
head of the Nazi Gestapo in 1942
inconclusive reports suggested that he
died from the effects of the toxin
rather than injuries sustained from the
shrapnel the United States interest in
botulinum toxins may have grown in part
at our suspicions about the alleged
German program the Soviets studied
botulinum as well well the u.s. actually
developed botulinum is one of the lethal
agents in its arsenal but the United
States and the Soviets ultimately gave
botulinum a lower level of priority
botulinum usefulness for dissemination
over large areas was inferior to that of
other agents like anthrax in tularemia
botulinum appears to have been Saddam
Hussein's favorite biological weapon
according to United Nations documents
Iraq produced 19,000 liters of liquid
botulinum toxins and 8,500 litres of
liquid anthrax much of this was loaded
into bombs and Saddam was apparently
fully prepared to use these weapons
obtaining the bacterial cultures for
production of botulinum toxins was
unfortunately relatively uses of the
Iraqis the Iraqis got the culture that
they use for weaponization from a supply
house in the United States and they
selected the same culture that we
weaponized back in the 40s and early 50s
so we by getting this culture from the
supply house we saved them a lot of time
and energy and effort because they would
didn't they didn't have to go out and
search for a very strong toxin producer
botulinum toxins aren't great open-air
biological warfare weapons because of
their limited range and relative and
stability but terrorists could
potentially use the toxins effectively
in enclosed areas or to contaminate food
supplies
[Music]
Ebola strikes fear in the hearts of
people who hear the word movies have
been made about the dreadful outcome of
becoming infected with Ebola but it's
just one of several deadly hemorrhagic
fever viruses that can be used as a
weapon against mankind there are many
types of viruses in the world some more
deadly than others some viruses cause
mild colds while other viruses cause
severe illness and death the viral
hemorrhagic fever viruses are of great
concern these viruses cause internal and
external bleeding in people who get
infected viral hemorrhagic fever is
caused by four families of viruses you
can find more information about these
families and their viruses under
resources following this presentation
they include Ebola Marburg Lassa fever
yellow fever and a few others none of a
viral hemorrhagic fever viruses occur
naturally in the United States although
with travel becoming easier and more
common an outbreak of these viruses is a
growing possibility like we've seen with
SARS and monkey pox new viruses can
easily enter our country the way that
hemorrhagic fever viruses spread varies
according to the type of virus you can
get some of these viruses by being in
close contact with people or animals
that are infectious or by being bitten
by an infected insect
some of these viruses may have been
around for a long time
one-third of Athenians lost their lives
to a mysterious plague in 431 BC some
historians believe that Ebola may have
been the disease that was described as
the cause of all these deaths during war
in ancient Greece hemorrhagic fever
viruses are worrisome as possible
biological weapons because they spread
so easily infection can be transmitted
by direct contact with infectious body
fluids or by infectious droplets that
reach the mucous membranes of your nose
eyes or mouth Ebola has caused
devastating outbreaks in several parts
of Africa killing entire families as
well as nurses and doctors working in
hospitals a recent outbreak in the
Republic of Congo caused hundreds of
deaths and froze travel and commerce in
large parts of the country other
hemorrhagic fever viruses including the
ones that caused Lassa fever Rift Valley
fever in Congo comand hemorrhagic fever
have caused large outbreaks that killed
people and in some cases livestock
Marburg virus a close relative of Ebola
is already known to have been developed
as a weapon a terrorist attack using any
of these viruses in a populated area
could result in mass illness and many
deaths the Centers for Disease Control
and Prevention and other agencies are
staying alert to the possibility of
attacks using these hemorrhagic fever
viruses our partnership with health
departments and physicians is critical
to quickly identifying even a single
case of one of these diseases in the
u.s. we continue to be prepared to deal
with the possibility of a large outbreak
but it's always best to contain an
outbreak quickly before it grows out of
control
[Music]
first described as a plague-like illness
in the United States in 1911 a new
bacteria infecting ground squirrels was
discovered in Tulare County California
hence its name tularemia this disease
which affects mostly small animals is
frequently associated with sick rabbits
so it was described also as rabbit fever
there are several ways that people can
get infected being bitten by a blood
sucking insect such as a tick or deer
fly by handling meat and skins of
infected animals from food or water that
has been contaminated or by breathing in
the bacterial cases of tularemia
happened naturally in the environment
but cases have also happened in
laboratory settings where the disease
has been studied tularemia is not known
to spread from person to person but it
has been studied as a biological weapon
because it could be used to contaminate
food and water and because it does not
require many organisms to infect a
person as with the use of plague the
Japanese also used tool Aranea in their
biological warfare program general issue
used it in experiments against the
people of Manchuria before World War two
the goal was to create ways to infect as
many people as possible at one time
historians estimate that over 200,000
Chinese were killed in germ warfare
field experiments the World Health
Organization once estimated that 50
kilograms of tularemia spread through
the air over a city of five million
people would lead to 250,000 cases of
illness 19,000 of these sick people
would die illness from tularemia would
be expected to last for several weeks
however relapses can occur during the
following weeks and even months to
anemia is not a household name like
plague is however it is potentially a
dangerous disease that could be used as
a weapon to lavinia bacteria can be
mixed into food and water supplies and
then taken
by unsuspecting persons bacteria that is
sprayed into the air is also a concern
in 1994 it was removed from the list of
diseases that doctors are required to
report when they occur because of the
potential danger that tubing imposes to
mankind it was placed back on the
reportable list of diseases in 2002
Alenia is also classified as a category
a agent this means that it is one of the
critical agents of concern to us from a
bioterrorism perspective terenia was
included in the United States stockpile
of biological weapons in the late 1960s
dr. ken a Levesque is a Soviet Union
weapons defector who provided much
information about the biological weapons
programs in his country he has indicated
that his country and the United States
held similar studies trying to engineer
two arena strains that would be
resistant to antibiotics and vaccines
the United States ended its development
of such weapons in the early 1970s it's
important for doctors to recognize the
symptoms and how it spread this early
recognition would prevent a disaster if
this disease were introduced into our
food or water supply we're very
concerned about terrorists using
tularemia the disease agent is found not
only in nature but can also be purchased
from commercial sources for legitimate
scientific research although tularemia
may be obtained from other parts of the
world where its transfer is not well
regulated access to this bacteria is
under tight control in the United States
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