The document is a research paper on anthrax as a bioterrorism threat to Malaysia's national security. It discusses anthrax as a biological weapon, describes the 2001 anthrax attacks in the US, and analyzes the threat posed by anthrax to Malaysia. It also examines strategies for preventing and responding to anthrax outbreaks, including vaccination programs and decontamination procedures. The paper aims to evaluate Malaysia's preparedness for a bioterrorism event and provide recommendations to strengthen defenses against anthrax and other biological threats.

1. BIOTERRORISM THE EMERGENCE THREAT
TO MALAYSIA’S NATIONALSECURITY:
A CASE STUDY ON ANTHRAX
MEJ MOHAMMAD BIN HARUN
(AFB 100057)
Research Paper Submitted in partial fulfillment to the
University of Malaya to obtain the
Diploma in Strategic and Defence Studies
FACULTY OF ARTS AND SOCIAL SCIENCES
UNIVERSITY MALAYA
2011
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2. DECLARATION
This is to confirm that :
i) I understand that plagiarism is an offense as stated in ‘Prohibition against
Plagiarism’, UM-MTAT, Diploma Strategic and Defence Studies, Handbook No.14,
2008.
ii) I also understand that if I commit plagiarism disciplinary action can be
instituted against me based on the provisions in the Universities Colleges Act 1971
(Tatatertib Pelajar-pelajar 1999) Section V (Tatacara Tatatertib).
iii) I have been given explanations on plagiarism and other forms of academic
cheating during lectures and tutorials.
iv) I declare that this research paper is the result of my own research except the
material as cited in reference, and
v) I declare that this research paper has not been submitted and submitted to
obtain other academic qualification.
…………………………………………………
MEJ MOHAMMAD BIN HARUN (AFB 100057)
FACULTY OF ARTS AND SOCIAL SCIENCES
UNIVERSITY OF MALAYA
2010
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3. ACKNOWLEDGEMENT
I would like to take this opportunity to thank number of people and institution that
have assisted my research through this course. My gratitude to Dr Mohd Rashid bin
Mohd Saad, my supervisor, for his constant guidance, supervising and advice in my
research paper. My greatly indebted to Lt Col Clark Smith as my Directing Staff at
MAFSC for the encouragement and guidance that he had given to me in completing
this course.
I am also want to thankful to the Faculty Arts and Social Sciences Dean and lectures,
Prof. Dr. Mohammad Redzuan bin Othman, Dr Azharuddin bin Md Dali, Dr
Muhamad Asri bin Mohd Ali, Mr K.S Balakrishnan, Dr Sufian Mansur, Madam
Salina binti Zainol, Ms Geetha a/p Govindasamy, MAFSC Faculty members and all
my fellow course participants.
My gratitude to Lieutenant General Dato’ (Dr) Abd Razak bin Md Yusoff, Director
General of Malaysian Armed Forces Health Services Division and Lt Kol Fauzi bin
Mamat for allowing me to attend this course. I am also grateful to Mej Rozalina binti
Omar for her support and advice before attending this course.
Finally, I would like to thank my parents, Harun bin Hj Yum and Fatimahwati binti
Ahmad for giving me moral and spiritual support to concentrate on my research and
complete my assignment.
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4. ABSTRACT
Biological agents may appeal to the new terrorist groups because they affect
people indiscriminately and unnoticed, thereby sowing panic. The Bioterrorist attack
on October 2001 in the United States by deliberate dissemination of potentially lethal
anthrax spores in letters sent through the United States Postal Service is the recent use
of anthrax as biological weapon to the realities of life in the 21 st century. This anthrax
attack caused massive disruption of postal services in many countries around the
world and huge economic, public health and security consequences. In addition to
biological agents as weapons of war, there is also increasing concern over the
possibility of terrorist use of biological agents to threaten civilian populations.
Anthrax was considered by United States Army Medical Research Institutes of
Infectious Disease (USAMRIID) as the most likely bioterrorist agent and was the first
lethal bioterrorist agent used in United States. It is particularly suitable because it can
cause widespread illness and death an eventually cripple a city or region. Inhalational
or pulmonary anthrax results most commonly from inhalation of anthrax spore
containing dust and is highly fatal with nearly 100% mortality. A lethal dose of
anthrax is reported to result from inhalation of about 10,000 - 20,000 of spores.
Patients with anthrax inhalational cases characterized by fever, dyspnoea, stridor,
hypoxia and hypotension leading to death within 24 hours. This disease can rarely be
treated, even if caught in early stages of infection.
The exposure to naturally occurring or resulted from the deliberate use of
pathogens as biological weapons by the bioterrorist poses a global risk to Malaysia’s
national security. As public health histories record, infectious diseases outbreak
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5. whether causes naturally occurring or intentionally release by terrorist have had a
devastating impact on the quality of life of individuals in most nations. The possible
emergence of the biological threats to Malaysia will effected many aspects such as the
human security, economic and global trade security, social security and delivery of
health security. All of these aspects will become the agenda that will threaten of
individual, communities, tourist, traders and governments.
The continuous efforts of improving the systems for surveillance, monitoring
health risks detection and improvement on the management of health services,
emergency rapid reaction and decontamination units for preparedness in outbreak
should be our country agenda towards the preparedness against bioterrorism.
Vaccination has been the single most cost effective public health intervention and
have recognized as the military value of vaccines against biological threats to protect
service members from hostile use of a biological agent. The current anthrax vaccine
was known as “Anthrax Vaccine Adsorbed” (AVA) is effective against inhalational
anthrax and may help prevent onset of disease post exposure if given with appropriate
antibiotics.
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6. CONTENTS
TITLE PAGE.................................................................................................................i
DECLARATION..........................................................................................................ii
ACKNOWLEDGEMENT..........................................................................................iii
ABSTRACT..................................................................................................................i
v
CONTENTS.................................................................................................................vi
ABBREVIATION.......................................................................................................ix
CHAPTER 1 INTRODUCTION
Bioterrorism - An Overview...............................................................................1
Global Incident of Bioterrorism..........................................................................3
Overview of Anthrax Outbreak..........................................................................4
Problem Statement..............................................................................................6
Research Important.............................................................................................8
Literature Review...............................................................................................9
Research Objectives..........................................................................................13
Research Hypotheses........................................................................................14
Research Methodology.....................................................................................14
Limitations of Study.........................................................................................15
Chapterization...................................................................................................15
CHAPTER 2 BIOTERRORISM RELATED ANTHRAX
Background of Biological Warfare and Bioterrorism.......................................18
Anthrax Bacterium as Biological Weapons and Bioterrorism..........................20
The Current Threat of Anthrax to Human Population......................................23
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7. The Emergence Threat to Malaysia’s National Security..................................26
Management of Bioterrorism from Malaysian Perspective..............................33
CHAPTER 3 CLINICAL PRESENTATION AND MANIFESTATION
OF ANTHRAX INFECTION
Background.......................................................................................................35
Clinical Characteristics of the Anthrax Bacterium...........................................37
Clinical and Epidemiologic Features................................................................38
Mode of Infection and Symptoms....................................................................40
Vaccination of Anthrax Infection.....................................................................42
Treatment and Prevention of Anthrax Infection...............................................44
Decontamination of Site in Anthrax Infection..................................................46
CHAPTER 4 ANALYSIS OF PREVENTION STRATEGY FROM
ANTHRAX INFECTION
Strategy of Prevention......................................................................................49
United States Experience and Response to Anthrax Incidents of 2001............49
Training for Preparedness and Response..........................................................51
Strategic Plan for Bioterrorism Preparedness and Response - Centres For
Diseases Control and Prevention (CDC’s), Atlanta USA.................................54
World Health Organisation (WHO) Guidance of Public Health Response to
Biological and Chemical Weapons...................................................................57
Application of the Selected Strategies to Malaysia and Malaysian Armed
Forces towards the Preparedness of Bioterrorism............................................63
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8. CHAPTER 5 CONCLUSIONS
Conclusions.......................................................................................................71
BIBLIOGRAPHY.......................................................................................................75
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9. ABBREVIATION
U.S. - United States
BWC - Biological Weapons Convention
BTWC - Biological and Toxin Weapons Convention
SARS - Severe Acute Respiratory Syndrome
MOH - Ministry of Health
MAF - Malaysian Armed Forces
H1N1 - Influenza A Virus
MAFHS - Malaysian Armed Forces Health Services
FBI - Federal Bureau of Investigation (United States)
CDC - Centers for Diseases Control and Prevention
WHO - World Health Organisation
PPB(MAL) 15- Publikasi Perkhidmatan Bersama (Malaysia) 15
USAMRIID - United States Army Medical Research Institutes
of Infectious Diseases
GDP - Gross Domestic Product
MAS - Malaysian Airlines System Bhd
MOSTE - Ministry of Science, Technology and
Environment
AVA - Anthrax Vaccine Adsorbed
AMI - American Media Incorporated
EPA - Environmental Protection Agency
WMD - Weapon Mass Destruction
EMS - Emergency Medical Services
RRAT - Rapid Response and Advanced Technology
LRNB - Laboratory Response Network for Bioterrorism
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10. PDD 39 - Presidential Decision Directive 39
NSC - National Security Council
NBC - Nuclear Biological and Chemical
NBCD - Nuclear Biological and Chemical Defence
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