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     09-91, NO. 2

Week ending 1 March 1991

                         AFMIC  WEEKLY  MEDICAL
                               INTELLIGENCE WIRE

              IRAQ:    Collateral Damage From Air Raid On
                         Chemical Warfare (CW) Plant

In a open source news release, a Egyptian physician claimed that 
100 guards at a CW plant in Baghdad became ill "immediately" 
following a coalition air raid on the facility. Reportedly, the
patients "sustained injuries of the lungs, the circulatory ad 
intestinal systems." The guards were brought to an undisclosed 
hospital, where half of them died despite medical efforts. The 
Egyptian physician stated that attempts to"disinfect the hospital 
were unsuccessful and the infection was spreading in Baghdad." 
Additionally, the physician said that disease incidence was 
significantly increasing ("assuming a massive character, to the 
point of a epidemic") in cities where other air raids had targeted 
chemical and biological warfare (CBW) facilities. 

Comment: The news release attempts to correlate both the sudden 
illness/deaths of the guards and the spread of disease among 
civilians with coalition targeting of CBW facilities. However,
until the report is independently confirmed, this incident should 
not be interpreted as a consequence of contamination resulting 
from coalition targeting of CBW facilities.

Although the facility is described as a CW plant, the symptoms 
described are not consistent with chemical warfare agents.  For 
example, chemical agents such as mustard produce severe injuries 
to the eyes and skin, and nerve gases produce obvious neurologic 
symptoms.  Furthmore, chemical warfare agents are not contagious.

   An immediate onset of "disease" is consistent with a toxin 
agent. We have assessed that Iraq has weaponized botulinurn toxin 
and suspect that they have developed Staphylococcal enterotoxin
and Clostridium Perfringens toxin. A massive dose of a toxin such 
as Staphylococcal enterotoxin B is somewhat consistent with the 
general symptomology ad cannot be ruled out as a possible cause
of the "disease." However, the extremely limited clinical 
information ("injuries of the lungs, culatory system and 
intestinal systems") also could suggest an infectious agent such 
as Bacillus athracis if the "immediate"  (meaning virtualiy no 
delay) onset of symptoms is analytically disregarded. The 
background information and general symptomology are not fully 
consistent with
any single biological warfare (BW) agent believed to be possessed 
by Iraq.   Efforts have been made to obtain further details of the 
alleged incident to determine the identity of the possible agent 

     09-91, NO. 2

Without further verification of the hospital and cause of 
illnesses in the facility, the reference to unsuccessful attempts 
to disinfect the hospital may reflect problems in controlling 
nosocomial infections. Nosocomial infections, which generally 
involve stt-ains of microorganisms that are resistant to 
disinfectants and antibiotics, pose problems in all hospitals. 
However, these infections are more diliilcult to control in less 
developed countries, particularly in hospitals with poor
sanitation and housekeeping practices.

Prior to 16 January 1991, the Iraqi government broadcast several 
public civil defense preparation statements. The language used in 
some of the public health statements wouuld allow the
government to blame increases of endemic diseases 
(that are not biological warfare candidates) on military conflict 
and potentially on contarination by agents released as a result of 
damage inflicted by coalition forces on CBW facilities. The 
reported increased incidence of diseases in cities where
CBW facilities were targeted most likely is due to increased 
occurrence of endemic diseases attributable to degradation of 
norinal preventive medicine, waste disposal, water purification 
distribution, electricity, and decreased ability to control 
disease outbreaks. It is unlikely that CBW  contamination of 
civilian casualties would "spread" throughout the community over a 
period of
time. BW casualties resulting from primary exposure generally are 
not contagious, and the agent infrequently would be secondarily 
transmitted to another person.

Because of the current worldwide attention associated with the 
possibility of CBW agent use in the Gulf region, ABC believes that 
significantly more detailed reporting would result if the above 
scenario actually transpired. This viewpoint is supported by a 
recent DlA assessment which concluded that there have been no 
confirmed reports of collateral contamination as a result of
coalition air strikes on biological and chemical research, 
production, or storage facilities.

     [   (b)(6)   ]




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