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09-91, NO. 2
Week ending 1 March 1991
AFMIC WEEKLY MEDICAL
IRAQ: Collateral Damage From Air Raid On
Chemical Warfare (CW) Plant
In an open source news release, an 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 and
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 unsucccssful and the infection was spreading in Baghdad."
Additionally, the physician said that disease incidence was
significantly increasing ("assuming a massive charactcr, to the
point of an epidemic") in cities where othcr 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 this 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. Furthermore, chemical warfare agents are not contagious.
An immediate onset of "disease" is consistent with a toxin agent.
We have assessed that Iraq has weaponizod botulinum toxin and
suspect that they have developed Staphyloccccal enterotoxin and
Clostridium perfringens toxin. A massive dose of a toxin such as
Staphylococcal enterotoxin B is somewhat consistent with the
general symptomology and cannot be ruled out as a possible cause
of the "disease." However, the extremely limited clinical
information ("injuries of the lungs, circulatory system and
intestinal systems") also could suggest an infectious agent such
as Bacillus anthracis if the "immediate" (meaning virtually 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 or agents.
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 strains of microorganisms that are resistant to
disinfectants and antibiotics, pose problems in all hospitals.
However, these infections are more difficult to control in less
developed countries, particularlly 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 would allow the government to
blame increases of endemic diseases (that are not biological
warfare candidates) on military conflict and potentially on
contamination by agents released as a result of damage inflicted
by coalition forccs 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 normal preventive medicine, waste
disposal, water purification and 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 anothcr
Because of the current worldwide attention associated with the
possibility of CBW agent use in the Gulf region, AFMIC believes
that significantly more detailed reporting would result if the
above scenario actually transpircd. This viewpoint is supported by
a recent DIA 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)(2) ][ (b)(6) ]
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