Experts warn of cracks in European response to bioterrorism threats

The bioterrorism threat gripping North America didn't take long to reach across the Atlantic.

At the Robert Koch Institute (RKI) in Berlin, an Information Centre for Biological Attack Substances has been launched and is collating information on the availability of vaccines, laboratories and hospital beds throughout Germany. It also provides a hotline. “We received more than 100 calls a day over the first 3 weeks,” says Susanne Glasmacher, the institute spokesperson. The RKI has also posted information for physicians on the Internet. The government has already purchased 12 vehicles equipped with oxygen tanks, gas masks and devices for taking and analyzing samples to meet the threat of radioactive, chemical or biological contamination in the Berlin area. Another 340 vehicles will be acquired by year's end for the rest of Germany.

In France, the country's facilities for decontamination and for monitoring attacks that use airborne or waterborne bioterrorism agents will be upgraded under a new program called Biotox. The government has also contracted with Aventis to manufacture 3 million doses of smallpox vaccine and will spend 150 million Euros buying ciprofloxacin.

In the UK, existing stocks of antidotes and antibiotics have been taken out of storage for distribution to doctors and hospitals, and the Public Health Laboratory Service (PHLS) has issued guidelines on responding to the anthrax threat. “Over the last 3 weeks we have been very active in giving information on anthrax, plague, smallpox and botulism to the public, together with guidance on how to deal with suspicious packages,” says Brian Duerden, the medical director. However, the British Medical Association has warned that the secrecy surrounding contingency plans for countering bioterrorism may prove counterproductive if health professionals aren't given key roles.

The piecemeal nature of the national responses reveals the lack of Europe-wide criteria for dealing with bioterrorism. Systemic failures in response capacity have been identified by Wolfgang Beyer, an anthrax expert from the Veterinary Institute at the University of Hohenheim, Germany. “As far as Northern Europe is concerned, preparations against bioterrorism have been neglected over recent years,” said Beyer. “Basic channels of information are missing — for instance, people who have to deal with catastrophes do not know where to send samples for analysis. ... Meanwhile, laboratories with the capability to analyze samples are short of equipment and financial support.”

A recent study in the British Medical Journal said these facts could be symptomatic of deficiencies in the general management of infectious disease across the European Union (EU). Weak points include the identification and reporting of cases involving more than one country and networking in order to share information and lessons on communicable disease outbreaks (BMJ 323: 861-3).

Mike Catchpole, deputy director of the Communicable Disease Surveillance Centre, PHLS, and Lyle R. Peterson, deputy director, Division of Vector-borne Infectious Disease, US National Center for Infectious Diseases, have proposed a surveillance centre for infectious diseases within the EU (BMJ 323: 818-9).

“Europe needs an effective surveillance system for infectious diseases,” says Catchpole. “For many diseases we have effective networks, but there is still room for improvement. Such improvement would strengthen Europe's capacity to respond to communicable disease threats of any sort, including bioterrorism.”

In an attempt to coordinate protection planning, officials from EU member states and candidate countries have met twice over the last 3 weeks and agreed to establish centralized databanks on vaccines, antibiotics and hospital beds, and to create a team of on-call specialists.