Germ Warfare

by MAJOR GENERAL RAYMOND W. BLISS, USA (Ret.)

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RECENT repeated allegations that the United Nations has been using germs of disease as a weapon of warfare against man have brought the subject of biological warfare into prominence. This is one form of warfare which has not yet been thoroughly accepted or tried.We have not employed it and probably never will. It is extremely doubtful if it could be used with any success except in a localized and isolated area, and then with a very minor degree of effectiveness.

Why not use germs as an additional war weapon? Morality aside — and little consideration is given to any aspect of morality in war — bacterial agents would not be any more dangerous than the conventional methods of warfare. Probably they would be less so. There are few usable effective protective measures against such weapons as bombs, fire, and bullets. Not enough thought is given to developing protective measures against them. Any form of peacetime killing is considered a crime and the safeguard is generally confined to the social punishment of the criminal. On the other hand, protection against disease is a constant aim of all peoples and has been the subject of endless study. Disease is disease and whether acquired naturally or produced artificially is controlled and controllable by identical means. Since the beginning of modern civilization man has been learning how to protect himself diseasewise. Barrier after barrier of superstition and ignorance has been exposed and removed. This has been a progressively successful battle. One has only to look at the constantly increasing span of life expectancy to know that this is a fact. Fear of disease, which was so prevalent even as late as a generation ago, is becoming a thing of the past. Good health — both mental and physical — is the fashion.

Many qualified scientists seriously question the possibility of widespread dissemination of disease by the methods of germ warfare. For the introduction or production of a disease, the germs must be made to reach intended victims, gain access to their bodies, infect some, and be able to multiply and spread in epidemic form. The agent used must, among other things, be virulent enough to cause disease or death in order to be able to infect more than a very few people in a purely localized effort. Further, it must retain its virulence under the trying conditions of temperature changes, drying, and various degrees of sunlight. The quantity of material necessary to infect will vary as the degree of immunity which individuals possess varies.

Experimental data have proved little about the definite amount of infective material required for the artificial induction of disease. Some work along these lines was attempted by certain German physicians during World War II but their brutal experiments were cut short by the end of the war and the physicians involved were hanged as war criminals. At any rate, the quantity necessary must be large enough to break through and overcome all of the combined immunities, natural or acquired, which may be present. Lower dosages will stimulate body mechanisms and create greater resistance to the particular disease, rather than cause the disease. As all of the above-mentioned conditions must exist, the accomplishment of disease induction seems most questionable.

One compelling reason in questioning the effectiveness of biological warfare is the status of available preventive and curative measures. Man has learned about his body with its protective mechanisms which are present at birth in the form of natural immunities. In addition to natural protection, immunity may be acquired either by contracting or exposure to a disease or by vaccination. All of these increase the individual’s resistance. A lasting immunity is generally acquired as a result of having a contagious disease. Seldom does a person contract such a disease a second time. For this reason all populations have a very distinct resistance to communicable disease. This resistance will be in varying degrees. The expanding use of antibiotics, if persisted in for a long period of time, might conceivably reduce the immunity of the population by increasing its susceptibility. Public health scientists are familiar with the varying susceptibility levels of peoples in different parts of the world to all of the infectious diseases peculiar to man. The induction of active protection through such measures as immunization by vaccination is commonplace and is becoming more and more effective as our knowledge is expanded through medical research.

A great many disease agents are of unquestioned value when artificially introduced into the body. Inoculations or vaccination against smallpox, yellow fever, typhoid fever, typhus fever, diphtheria, and tetanus are protective under most conditions. Other immunizing vaccines are being carefully studied and developed and many are in use. They increase materially in value as biological research proceeds. These are available for utilization against practically all of the biological warfare agents which might be employed. It is well known that vaccination alone cannot be relied upon for complete protection, as absolute immunity is seldom produced in this manner. However, the disease, if contracted, will be modified and will usually be much milder than in unvaccinated individuals.

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ASIDE from the relative safety which exists because of natural and acquired immunity there is today the health security brought about by constantly improving public health standards. Sanitary measures not even thought of a generation ago are now widely in effect and in most countries taken for granted. Pure water, safe food supplies, and protection against disease carried by insects and rodents are a part of the accepted health laws of most nations. Individuals have an increasing knowledge of these advancements, for they have learned how to apply proper hygienic and sanitary measures, how to avoid disease, and how to keep “fit.”

Preventive disease knowledge has never been more advanced. And so the present time is the least propitious of all in history for any nation to attempt germ warfare. In spite of this it is only in recent times that nations have given serious consideration to disease dissemination as an aggressive measure.

It is interesting to examine the results of intelligent application of preventive measures where large numbers of people are suddenly exposed to all manner of disease. This sudden exposure has existed with our troops in Korea. In that country all loathsome diseases are constantly present. Never have troops in war been more violently exposed to as many diseases. In Korea, contaminated water has been made entirely safe by chlorination, boiling, and other methods. This safety has been made evident on a large scale by a lack of water-borne diseases, and this is more remarkable because no water in all that area was potable except that which was made so by our military. Food contamination has been proved to be fully controllable. Insects, rodents, and similar conveyors of vectors of disease need not be greatly feared when simple methods are instituted to curb them. Our health record has been excellent — in fact, no field army at any time has been in better health. The disease incidence among our troops in Korea is not materially different from that of our forces in the United States, which is excellent.

All manner of germs and germ agents occur in abundance permanently in Korea; that is, the diseases which they cause are endemic. No more serious health hazards than already exist could have been created had germ warfare been waged against our troops. Our defense against those diseases has been a combination of the natural immunity of the individual, induced immunity in the form of various inoculations and vaccinations, the application of improved and constantly improving measures of sanitation, and most of all a reasoning knowledge by individuals who know and appreciate the value of a constant practice of personal hygienic procedures. Our methods of disease control are not secret. They are public knowledge and available to all who will use them; they may be counted on to be successful against either neighborly or belligerent germs.

Of course the living standards of communities and nations and the habits of the people comprising them have a real bearing on their susceptibility to disease and on those other factors related to biological warfare. In this country, for example, very high public health standards exist. The peoples in those parts of the world where a similar sanitary code is nonexistent and where frequent close contact with animals and disease reservoirs is the mode of life have a high degree of natural immunity to many of the infectious agents to which the average American is rarely exposed. Yet the peoples of these nonsanitary-minded countries are not ignorant of disease; indeed, they have learned by living with it for centuries. They know a great deal about plague, for example, which typifies diseases it is alleged we are intentionally spreading.

Some years ago scientists in Manchuria and China published a rather complete and most interesting manual about the history of plague in those regions. They stated that the native hunters knew plague as a disease of the tarbagans, the Siberian marmots. These rodents are extensively hunted and caught for their fur. Disease among them is as old as the hills. This is proved by old legends dealing with the tarbagans and their mysterious sickness, as passed from generation to generation and recorded in the old Tibetan sacred books. Further, it took many generations to work out an adequate code of precautions against this plague infection. Tarabagans had and have true plague, which is transmitted to humans by the fleas these animals harbor. The natives generally know how to guard against infected rodents and localities. Even when human rases arose, they remained isolated because of the drastic measures adopted by relatives and neighbors, who as a rule left the victims to their fate and hurriedly shifted camp. These and other protective measures were learned by hard and sad experience, without benefit of scientific research. The natives acquired a certain amount of immunity and now all modern methods of prevention are available to these peoples and are increasingly used. In the specific instance of plague, very satisfactory vaccines have been developed in recent years and constant research seeks to develop a more potent vaccine than the present one. All of our personnel in the Far East are immunized against plague, and presumably Russian medical scientists have advised similar measures for the Chinese and Koreans.

Plague is constantly present in Madagascar, and we have expanded our knowledge of it from recent careful studies. The French scientists there have contributed, in a remarkable measure, to broader knowledge of plague; and our workers from the Walter Reed Army Research School in Washington,

D.C., have just returned from Madagascar with original and experimental data. Both the bubonic and pneumonic types of plague, if diagnosed early, can be very successfully treated with the newer antibiotic drugs. These studies have also shown that the mere presence of virulent plague organisms does not mean that human beings are going to contract the disease. Parallel examples with similar findings exist for all other diseases which might be induced by biological warfare methods.

It probably would be impossible to introduce artificially and spread by epidemic any disease among populations where modern sanitation is much below desirable standards. This follows from the intimate knowledge of disease and its consequences possessed by the natives and from the widespread natural immunity among such peoples. No new disease agents would be brought into these places since all of the loathsome forms are present and have been for centuries. Infant mortality in these areas is excessive but these deaths occur before development of sufficient protective immunity has taken place.

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IT would be interesting if those governments and other groups who are using every propaganda device to establish their claim that germ warfare is being used in the present war would elaborate on the local success of this alleged method of warfare. From the information available it would appear that communicable disease in North Korea and Manchuria is at about the normal level for those areas. It is perfectly true that some diseases which, in our country, have been conquered by the application of modern hygienic measures are very prevalent in parts of the Far East. Smallpox, typhus, and typhoid fever were noticeably present at the lime germ warfare charges were instigated. It is natural to blame others for one’s misfortunes, and the germ warfare propaganda could very well have been used as an escape measure in attempting to justify poor and substandard public health measures.

Naturally the aim of germ warfare would be to produce widespread disease with a high mortality. Great epidemics have occurred and have been recorded in history — some involving around SO per cent of the exposed population. However, epidemics of this magnitude have been rare and took place in periods of relative ignorance when environmental conditions were present which no longer exist in any modern society. The influenza epidemic of 1917—18 was severe and its causation is still not thoroughly known. Today such an epidemic would be more controllable because of existing world-wide listening posts which are always on the alert for the early recognition of influenza and other epidemic diseases. Furthermore, because of the knowledge and increasing effectiveness of antibiotic drugs the mortality rate would be comparatively negligible.

With the exposure of generation after generation to all the diseases known to man, the human race has developed resistance to them. Too, knowledge is not as circumscribed as in the past. With a continuing increase in learning there has been a corresponding global interchange of ideas among medical scientists in recent years. Former outposts of the world have been brought into close association with metropolitan areas, particularly by the airplane and radio, and are no longer isolated. The diseases of all the earth are known. Although the exotic diseases of the tropics might be spread in individual instances to other sections of the world, they and their causative agents are known and are being studied in the laboratories of the northern countries as well as in their native habitats.

Today when an epidemic disease of man occurs under the conditions most favorable for its spread, there is seldom more than 20 to 25 per cent of the exposed population sick and the death rate among those taken with the disease is usually not more than from 3 to 5 per cent. The instigation of an epidemic of this limited magnitude — even if remotely possible — would not be worth the effort spent on its production, and the germs might turn around and bite the hand that raised them.

Neither new diseases nor germs for new diseases can be produced at will. They are not manufacturable like airplanes or bombs, nor can they be trained like bloodhounds. Even if new forms of infective agents are experimentally developed, measures for their defense, both individual and populationwise, will simultaneously advance.

Would a biological warfare attack combined with saturation bombing by conventional weapons be unduly hazardous from a disease standpoint ? It might be reasonable to suppose that epidemics would start if the mode of a community’s life was thrown into complete chaos. No doubt there would be sickness — probably more than under normal conditions, It is notable, however, that no epidemics of infectious diseases or intestinal diseases followed atomic bombing of Hiroshima or Nagasaki. The incidence of communicable disease did not increase in the cities of Great Britain or Germany during World War II, notwithstanding frequent severe and prolonged bombing. In both cases the possibility of devastating disease was constantly borne in mind and careful studies were made 1o determine the presence of virulent organisms of disease. These were found to be present in the peoples involved — but significant outbreaks of disease did not occur, despite the drastic disruption of normal living conditions. It can be reasonably assumed that there need be no untoward fear of disease from this combined method of warfare.

Were germ warfare to be attempted, the psychological effect on the exposed peoples might very well equal or exceed the material damage. That might well be the one rational argument for its use. Even if a large and serious community infection could be established it would not compare in importance or number of deaths with the lethal destruction wrought by atomic or other types of bombing. Possibly small and localized sabotage activities might cause a certain amount of hysteria, and this might conceivably be to the advantage of an enemy if any diversion from the main war effort was effected. Various psychological fear reactions might be expected in some populations. It is conceivable that were germ warfare to be attempted in the Far East there would be little psychological effect. It may well be that the very nature of their governments over a considerable period of time has rendered communistic peoples more or less immune against fear.

Fear among our own people would be in inverse ratio to their knowledge and understanding of the methods at hand to diagnose and control communicable disease. However, we do not have to speculate concerning the effect upon modern society of a sudden and perhaps unknown variety of disease.

The previously mentioned influenza epidemic was catastrophic. It was an entirely new experience, yet there was no panic. Modern society is highly disciplined in such matters. The reaction of the British and German populations to bombing furnishes further evidence of the futility of trying to disable a people by mass fear. Unquestionably, the use of biological warfare as a sabotage tool in future wars could be effective on a very small scale; but when it is recognized and control measures are applied, the effects are inconsequential. The successful methods of modern health services in the prevention, control, and treatment of disease should reduce to insignificance the effects of any attempt at biological warfare.

The combined efforts of both the military and civilian defense organizations will be brought into play in the event of any attempted germ warfare attack against this country. The control of communicable diseases and epidemics is accomplished through the practicing physician and city, state, and federal health services. The operation of these agencies conforms to a known and long-tried pattern and depends basically on the recognition and prompt reporting of infectious diseases by practicing physicians. There is every reason to believe that this reporting system will be even more carefully followed in wartime than it is in normal peacetime. The various community organizations, the newspapers, and the radio will assist in the initial recognition of an unusual incidence of disease. It goes without saying that it is most unlikely that a disease could become established and spread to any serious degree without its being detected.

Regardless of the degree of importance attributed to bacterial warfare, the general principles of the management and control of communicable disease remain the same whether the outbreak occurs spontaneously or as a result of enemy action. The measures and procedures of preventive medicine available today, if properly applied, will limit the effectiveness and bring under early and complete control an artificially produced disease just as they control the naturally occurring types. Therefore, it is important to maintain, apply, and improve our presently established public health measures as protections in the event of unusual disease incidence of any type. There is every justification in believing that we shall continue to improve these methods of control and treatment. The early dissemination of completely truthful reports by responsible authorities will be of the greatest importance. These prompt reports to the community should be accompanied by advice as to the specific preventive and control measures necessary for individual protection.

The basis of our defense against biological warfare is our highly developed scientific medical and health resources comprising personnel and matériel. The research potential of this country justifies the hope that there will be continual progress in our understanding of and our defense against communicable disease and against any eventuality arising from biological warfare.