Medical Countermeasures

Medical Countermeasures

The UN’s International Atomic Energy Agency records show a dramatic rise in the level of smuggled radiological materials. The illicit international trafficking of radiological materials is brisk and the threat is growing. The UN’s International Atomic Energy Agency (IAEA) records show a dramatic rise in the level of radiological materials smuggling activity: In 2005, there were over 100 documented cases of attempts to smuggle radiological materials across international borders. According to the IAEA, Cesium-137 has been the second most frequently intercepted radiological material in recent years.

The Threat: Cesium-137

Cesium-137 is a readily available radioactive material: it is used in a variety of devices in the field of medicine, as well as in factories, construction sites, hospitals, and food processing plants. Cesium-137 would be particularly useful as a dirty bomb component because its most common form is an easily dispersed light powder (cesium chloride) and because it has a long half-life of 30 years. Internal contamination with Cesium-137 can occur through ingestion, inhalation, or absorption into the bloodstream through wounds, and can cause serious illness or death. At lower doses, radiation exposure has been associated with the development of cancer. The only effective method of reducing these risks is removal of the radioactive contaminants from the body. Early recognition of internal contamination provides the greatest opportunity for radiocontaminant removal.

A New Twist on a Conventional Design

Terrorists intent on using radiological materials as weapons do not need to rely on cross-border smuggling, but instead might obtain the materials from sources in the U.S., such as hospitals, research laboratories, or factories. A dirty bomb requires only conventional explosives and radioactive material, such as Cesium-137. Dirty bombs are designed to maximize panic and terror by dispersing radioactive materials over as wide an area as possible to maximize human casualties and render contaminated areas unusable. On July 7, 2005, terrorists detonated four conventional bombs simultaneously in three separate London subway lines and on a bus at the height of rush hour, killing 52 commuters, injuring 700 others, and disrupting transportation and communications throughout the city for days. On March 11, 2004, terrorists detonated 10 conventional bombs simultaneously on four commuter trains in Madrid, killing 191 commuters and injuring 1,800 others. If each of these attacks had involved bombs containing radiological material such as Cesium-137, the devastation and resulting panic undoubtedly would have been greatly magnified.

An Essential Tool for Response to Radiological Attacks

The threat of attacks like these has grown since September 11, 2001, requiring first responders to consider adopting procedures for responding to such possibilities. Although Radiogardase® (Prussian blue insoluble capsules) is included in the Strategic National Stockpile maintained by the Centers for Disease Control and Prevention (CDC), it is unclear how quickly the CDC’s stockpile will be made available, and in what quantities, to first responders on the ground handling the aftermath of Cesium-137 dirty bomb attacks. Terrorists seek to create physical and psychological insecurities. Stocking adequate supplies of Prussian blue at the state and local levels can help alleviate these fears by assuring citizens that a vital treatment option will be immediately available, if and when needed.