Wiley Handbook of Science and Technology for Homeland Security, 4 Volume Set

CHALLENGES TO MEDICAL COUNTERMEASURES AGAINST CHEMICAL, BIOLOGICAL, RADIOLOGICAL, AND NUCLEAR (CBRN) AGENTS

ANDREA MEYERHOFF

GexGroup Inc, Washington, D.C., and Division of Clinical Pharmacology,Johns Hopkins University School of Medicine, Baltimore, Maryland

1 BACKGROUND

The public health threat of biological and chemical agents has persisted for centuries; that of radiation-emitting and nuclear agents for more than a half-century. But it is only in the past decade that the pace of efforts to address these threats has accelerated to the point where we might now take a step back and evaluate what has been accomplished and, based on what we have learned, how we might proceed. This article first recognizes the unique challenges presented by the need for medical countermeasures against chemical, biological, radiological, and nuclear (CBRN) agents and then examines early twenty-first century efforts to develop them. Because of both the 2001 occurrence of an anthrax release in the United States and the subsequent robust investment in medical countermeasures for this and other biothreat agents, a focus on biodefense will provide useful examples. Nonetheless the issues raised, with necessary modifications, pertain equally to other threat agents as well. The subsequent discussion of future directions for CBRN drugs and vaccine research is based on unanswered questions regarding countermeasure safety and efficacy.

2 THREATS, CHALLENGES, SOLUTIONS

In 1998, the US Centers for Disease Control ...