Medical After Action Report

File: doc04_08.txt
Page: 08
Total Pages: 23
                                                                      j;)


                            S   CRET

                                                     March 12, 1991


                        AFTER ACTIO~ REPORT

                      MEDICAL DEFE~SE AGAINST
                        BIOLOGICAL WARFARE


     The United States Army Medical Department was ill prepared for
medical  defense  against  biological  warfare   (BW) agents.    The
insufficient supply and production capability for vaccines against
known BW agents resulted in the requirement for prioritization of
assets based on assumptions that may have been incorrect.       This
requirement would not have been necessary if planning for available
countermeasures had taken place.     The threat and countermeasures
were well known long before Desert Shield/Desert Storm.

     The Armed   Forces Medical  Intelligence    Center provided  an
intelligence assessment of Iraq's BW capability before the Kuwait
invasion and reiterated this threat to deployed Marine support
elements as early as 9 August 1990.   Concern for the possibility of
covert  BW   attacks   was  emphasized   by    the 30  August   1990
investigation of a large number of dead sheep on the Saudi - Kuwait
border area.   Although the determination that numerous dead sheep
in the desert was a natural phenomenon based on Bedouin failure to
employ available government veterinary programs,     the finding of
dead sheep by deployed forces continued to be a cause of alarm as
late as 24 February 1991.

     On  30  August   1990  the  Armed  Forces   Epidemiology  Board
recommended pre-exposure vaccination against Anthrax and Botulinum
Toxin  be  instituted  as  soon as  possible.    This recommendation
resulted in a    4 September 1990 recommendation by the Assistant
Secretary of Defense for Health Affairs (ASD-HA) to the Chairman of
the Joint Chiefs of Staff that vaccination against both Anthrax and
Botulinum Toxin be instituted.  This recommendation represented the
consensus  of  the  three  Surgeons  General   and the Armed  Forces
Epidemiology Board.   on 27 September 1990 the Commander in Chief of
the U.S. Central Command (CINC USCENTCOM) was briefed on the threat
and  the recommendation    for vaccination  with  prioriti~ation  of
limited vaccine   assets to be determined by CINC USCENTCOM.       A
request for an intelligence assessment as to the population at risk
was made.  On 17 October 1990 the Director of Medical Readiness,
Joint  Chiefs  of   Staff, requested  the   USCENTCOM plan  for  the
vaccination program.    A 24 October 1990 message provided the US
CENTCOM Surgeon's prioritization but implementation was delayed due
to the lack of a supporting intelligence assess~ent.

     Preliminary    findings of a   primate  study on post-exposure
treatment   of   inhalation  anthrax  with   either  antibiotics  or