Report: Bioterrorists Could Poison Milk Supply With Botulism

The vulnerability of the U.S. milk supply makes it a tempting target for terrorists armed with botulinum toxin, a new study contends.

Contamination of the milk supply could easily make hundreds of thousands of people severely ill with botulism, a rare but serious paralytic illness caused by a nerve toxin produced by the bacterium Clostridium botulinum, the study authors suggest.

Their report appears in the June 28 early online edition of the Proceedings of the National Academy of Sciences.

To show the ease with which milk could be infected with botulism, study authors Lawrence M. Wein and Yifan Liu of Stanford University constructed a mathematical model that took into account the nine-stage "cows-to-consumers" supply chain. They limited their analysis to one milk-processing plant.

Using their model, Wein and Liu looked at the effects of a planned release of botulinum bacteria at points in the supply chain, including raw milk silos and tanker delivery trucks.

To deal with the problem, Wein and Liu recommend developing a 45-minute detection test that can identify contaminated milk. They believe that such a test could eliminate the botulism threat and cost only 1 cent per gallon of milk.

Before the paper was published, the U.S. Health and Human Services Assistant Secretary for Public Health Emergency Preparedness, Stewart Simonson, wrote to the science academy's president, Bruce Alberts, asking that the paper not be released. The paper "is a road map for terrorists and publication is not in the interests of the United States," Simonson wrote, according to CNN.

He went on to say that the paper has "very detailed information on vulnerability nodes" in the supply chain and "includes ... very precise information on the dosage of botulinum toxin needed to contaminate the milk supply to kill or injure large numbers of people. It seems clear on its face that publication of this manuscript could have very serious public health and national security consequences," he wrote.

HHS spokesman Marc Wolfson said Tuesday that while "Simonson respects the Academy's decision [to publish], he still doesn't agree with it, and the consequences could be dire. If there are dire consequences, it would be HHS and not the Academy that would have to deal with the consequences of the article being published."

Wein and Liu concluded their paper by saying, "The use of voluntary Food and Drug Administration guidelines is not commensurate with the severity of this threat, and the government needs to act much more decisively to safeguard its citizens from such an attack."

"Moreover, although the dairy industry is an obvious target, the government needs to force other food processing industries to quickly assess the impact of a deliberate botulinum release in their supply chains and to do what is necessary to prevent and mitigate such an event," they added.

Responding to Simonson's concerns, the academy's Alberts wrote in a journal editorial, "There is, therefore, everything to be gained by alerting the public and state governments to the dangers so that they can help the federal government in its ongoing, highly laudatory attempts to reach 100 percent compliance with its guidelines."

More information

The U.S. Food and Drug Administration can tell you more about food safety and terrorism.

Race Doesn't Affect Outpatient Care

June 28, 2005 08:41:08 PM PST

That doesn't mean the present level of outpatient care is perfect, however.

"We observed similar, though less-than-optimal, outpatient care across all racial and ethnic groups using visit-based, physician-provided nation data," study lead author Dr. Jun Ma, research associate at the Stanford University Prevention Research Center, said in a prepared statement.

The findings appear in the June 27 issue of Archives of Internal Medicine.

For this study, the researchers analyzed outpatient data from 1992 and 2002 and broke that data down by race and ethnicity. They used 23 quality measures to check for racial and ethnic disparities.

"When we set out to do the study, we expected to see these disparities. But our result was contrary to our hypothesis," Ma said.

Even though the study results indicated no racial or ethnic gaps in care, Ma said that doesn't mean they don't exist.

"A lack of statistical significance does not automatically mean there is a lack of clinical or political significance. It is a very complex issue," Ma said.

She also noted that the study has no information about initial access to health care and this may be an important factor in the findings.

"We speculate that racial and ethnic disparities may arise more from unequal healthcare access and utilization than from direct differences in treatment once a patient is in the system," Ma said.

More information

The U.S. Centers for Disease Control and Prevention has more about racial and ethnic health disparities.