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INSIGHT: If the worst happens.

Article Excerpt
In the light of recent events in London, Professor Danny Burke describes in the first of two articles the chemical agents that could be used and their treatments

The Government's plans for dealing with chemical and biological attacks on the civilian population include pharmacists - not only hospital pharmacists but also community and primary care pharmacists as a crucial part of the NHS response, although without giving any details.1

The NPA, however, has reminded the Department of Health of the value of the community pharmacy network in coping with a bioterrorism attack.2 The release of chemical or biological warfare (CBW) agents among the civilian population by terrorists is viewed as a serious and imminent threat by governments in both Britain and the USA.3, 4 Nearly 70,000 tonnes of nerve gases and blistering agents (which is slightly over half the quantity that was used in World War I) are held by governments worldwide.5 The CBW agents most likely to be used by terrorists are: 6- 8 category A biological agents (anthrax, smallpox, plague, tularaemia and viral haemorrhagic fevers); botulinum, staphylococcal and ricin biotoxins; nerve gases.

For example, in 1979 an accidental release of anthrax spores from a government biological warfare plant into the atmosphere over Sverdlovsk (Yekaterinburg) killed up to 105 people,9 and the World Health Organization has estimated that 50kg of anthrax aerosol released over a city could kill hundreds of thousands.7 In 1995 members of the Japanese cult, Aum Shinrikyo, released sarin into the Tokyo underground railway system, killing 12 and injuring over 5,000,10 and ampoules containing sarin were reportedly found on...