ne of the great social benefits of science fiction is to prepare us for the future. The future has a habit of becoming the present, often suddenly and unpleasantly. The danger of plagues and bioterrorism are no exception: from John Christopher's No Blade of Grass to Michael Crichton's The Andromeda Strain to Richard Preston's The Cobra Event, books and movies have long discussed the possible modes of biological offense and defense.
Fortunately, the world's first biological attack has been much milder than any of these cinematic scenarios; for a literature built on hope for the future, SF can be surprisingly pessimistic. Still, writers have poured decades of thought into the subject, and their observations have been noted by high-ranking officials, up to and including U.S. presidents. The Centers for Disease Control and Prevention (CDC), which include research laboratories, mobile field hospitals and vast stockpiles of antibiotics and vaccines, probably owe their existence in part to the warnings of science fiction.
So what lessons have we learned? First of all, the easiest protection against biological agents is for nobody to have any. Unfortunately, all of these diseases occur in nature, which means determined humans can always get their hands on some. It also means the diseases will sometimes break out randomly, with no assistance at all. For the moment, a disease-free world is more the stuff of fantasy than of science fiction.
The first practical line of defense is to avoid contact with the disease. This is most visibly accomplished with bulky space suits, although in most cases gloves and masks and goggles work nearly as well. The one proviso here is that the pore size of the mask has got to be smaller than the the organisms it's blocking—ordinary gas masks will not do the trick. There are also sterilizing agents, such as Lysol, which can kill bacteria and viruses in the air and on surfaces. Obviously, though, we can't live our lives this way: walking around in space suits and spraying disinfectant on everything. Too often neglected (by writers and officials alike) is one of the simplest protections of all: washing our hands, and keeping our fingers away from our mouths, noses and eyes. Even among predominantly airborne bugs such as cold viruses, this has been shown to reduce exposure and transmission significantly. That and, uh, don't sniff your mail.
Antibiotics for anti-terrorism
Detecting the release of bioweapons is also important. Sadly, at present our detection relies on human beings—when they start getting sick, we know something is wrong. Unfortunately, by the time symptoms appear, it may be too late to help the first round of victims. However, we have already developed several types of bioelectronic detectors which can sense and identify specific organisms.
This is more difficult than simply identifying a particular chemical (e.g., nerve gas), since in most cases it involves reading DNA or RNA sequences and matching them against a library of stored patterns. At present, these detectors are truck-sized, expensive, and operate rather slowly, but there are several major initiatives aimed at miniaturizing the technology. Within a few years, there will be hand-held detectors for use by soldiers and health officials, and also permanent detectors installed in major urban areas and government centers. When a release occurs, we will quickly know what and where and when, with enough precision to alert everyone who might have been exposed.
The defense we've been hearing the most about lately is antibiotics, which neutralize invading bacteria. Unfortunately, many organisms, including anthrax and botulism, cause disease not only through infection, but also by producing toxins. Curing the infection does not eliminate these toxins, so patients who are treated in time often have long recovery periods, while their bodies rebuild and their immune systems track down and eliminate each molecule of the offending substance.
This is where 21st-century molecular medicine comes in: the CDC has used horse antibodies to develop a botulism antitoxin, which can inactivate the toxin and halt the nerve damage it produces. Nerves already damaged by the toxin are then replaced by the body over a period of weeks. This drug is stockpiled exclusively by the CDC, although it is made available to hospitals when needed for food poisoning outbreaks and such. Similarly, researchers at Harvard Medical School have designed a protein which binds to a key portion of the anthrax toxin, neutralizing it. So far, it has only been tested in rats, but some of those rats have survived 10 times the exposure to anthrax which would normally be lethal. Under the circumstances, human trials are likely to be highly accelerated, hastening the day when even inhalation anthrax is considered a nuisance infection, like strep throat. (Let's not forget what a scourge strep throat once was, before the discovery of penicillin, when it was still known as scarlet fever!)
Another problem with antibiotics is that they can't cure viral infections. However, a treatment known as immune globulin therapy—featured in the movie Outbreak—harvests antibodies from infected animals or people who've recovered from the disease. This therapy is specific to a particular virus, but is widely used to treat exposure to diseases like hepatitis and rabies. More encouragingly, a number of antiviral drugs—drugs which directly interfere with the viral machinery—are already on the market today, and have proven effective against HIV, herpes, chicken pox, influenza and other human viruses. One of these—Cidofovir—has even been identified by the U.S. Army Medical Research Institute for Infectious Diseases (USAMRIID) as a probable smallpox fighter, after it cured the related disease of monkeypox in laboratory animals.
Science fiction to the rescue
The preferred method for dealing with viruses, though, is to immunize against them. Most people in Western societies have received vaccines against polio, measles, diphtheria, pertussis and other major illnesses. This sometimes includes smallpox, although widespread immunization against that disease halted in 1972, after the virus was declared extinct. However, since at least two stockpiles of frozen virus are known to exist, and since the virus may remain viable in the tombs and graves of the millions who died from it, the CDC stockpiles millions of doses of smallpox vaccine. In fact, it will soon be purchasing enough to immunize every man, woman and child in the United States if the need should ever arise.
Notably, you can also vaccinate people against bacteria and even toxins. The present anthrax vaccine has something of a bad reputation, owing mainly to health code violations by its only producer, but there are alternate sources in other countries, notably Britain, which may soon be tapped for at least a few million doses. There's a botulism vaccine as well, which is routinely given to American military personnel.
There is of course the risk of mutant or genetically modified strains of disease organisms, which may be drug-resistant and/or immune to existing vaccines. Thus the dream of a universal vaccine or universal medicine which prevents/cures all diseases. In science fiction, this mythical drug has been tagged with names like "panphage," "boosterspice" and "nanites," but it's still the same dream that has been around since the classical Greeks gave their own name to it: panacea. This is, of course, well beyond the reach of contemporary medicine. Still, a near-term equivalent does exist in all of us: the human immune system.
Signaling molecules such as interferon can be used to rally the body's natural defenses, dramatically improving its response against many diseases. More recently, researchers at the Food and Drug Administration (FDA) and National Institutes of Health (NIH) have experimented with bits of injectable DNA called "CpG sequences," which resemble the DNA of bacteria, but not of humans or animals. When the body detects CpG sequences, it immediately mounts a massive and generalized immune response which sweeps up bacteria and viruses alike—even engineered or drug-resistant ones. This classifies it as a protective agent or prophylactic, rather than a treatment or immunization. Early testing has shown that mice, given a short-term CpG dose, are completely protected against a long list of pathogens, including both the anthrax bacillus and the Ebola virus—two of the world's deadliest diseases. "These things are almost ready for prime time," assures NIH scientist Robert Seder.
In the end, the threat of bioterrorism may be like the Y2K bug: catastrophic only when ignored. Fortunately, America has been primed by the warnings of countless books and movies, and so has been preparing itself for decades. Within hours of a major disease outbreak, the CDC will be out in force, setting up quarantines, immunizing the people who might have been exposed and caring for the sick with a huge and sophisticated arsenal of 21st-century medicines. We do have an unfortunate shortage of hospital beds—house calls and tent cities might come back into vogue at least temporarily—but even so I think we can reasonably hope for a quick containment and a low body count. In fact, harming the U.S. with bioweapons will soon be so difficult that even the most desperate and evil groups may find it not worth the effort—and the inevitable reprisal. So by preparing us for the worst, science fiction may very well have saved the world. Again.
Wil McCarthy is a rocket guidance engineer, robot designer, science fiction author and occasional aquanaut. He has contributed to three interplanetary spacecraft, five communication and weather satellites, a line of landmine-clearing robots, and some other "really cool stuff" he can't tell us about. His short fiction has graced the pages of Analog, Asimov's, Science Fiction Age and other major publications, and his novel-length works include Aggressor Six, the New York Times notable Bloom, and The Collapsium.
