ER staff nurse Dianne Vandiver and medical technologist Brent Butler take a blood sample from an emergency room patient at a Los Alamos public hospital, one of three New Mexico hospitals participating in the hepatitis C project. The Centers for Disease Control estimates that 3.9 million Americans are chronically infected with hepatitis C. Yet very little is known about hepatitis C risk factors -- behaviors that increase the probability that a person will contract the disease.
The primary goal of the international project, though, is to show how monitoring unusual outbreaks of disease can serve as a worldwide early-warning system for covert biological weapons development. Sandia scientists have proposed setting up an online health information exchange that would rely on thousands of doctors worldwide sharing disease information about their patients. Called the Cooperative Disease Monitoring Project, the effort is being coordinated by Sandia with funding from the Department of Energy's Chemical and Biological Weapons Nonproliferation Program. When an outbreak of a rodent-borne disease now known as the hantavirus killed more than a dozen people in the southwestern United States in spring 1993, the U.S.
A similar outbreak in 1979 in the Russian province of Sverdlovsk, near Chelyabinsk-70, turned out not to be so innocent.
More than 150 nations have agreed to an outright ban on biological weapons research as part of the BWC, ratified by most participants by the mid 1970s.
Developing a practical compliance regime for the BWC has been difficult, partly because all biological agents have peaceful uses. In the early 1990s a multinational BWC Verification Experts Group (VEREX for short) considered a set of 21 confidence-building "transparency" measures for the BWC, including on-site inspections, remote sensing, and voluntary data exchanges between participating countries. Now the BWC nations are considering including the disease-tracking approach as a way to strengthen the final verification regime, says Zelicoff, who was a member of the U.S. A combination of vigilant disease monitoring and follow-up pathological studies would help accomplish that, Zelicoff says.
What about rogue nations that might interfere with doctors' abilities to share epidemiological information over the Internet?
Sandia initially is cooperating with Chelyabinsk-70 partly because hepatitis C is a potentially serious worldwide problem, and partly because the virus is clearly not related to military applications -- "it's an apolitical disease," Zelicoff says. On June 1, hospitals in Snezhinsk, Russia, began taking 1cc blood samples from randomly selected emergency room visitors who agree to the tests. In all 2,000 patients in Snezhinsk and 2,000 in New Mexico will be tested for hepatitis C over the next four or five months.


Sandia provided additional emergency room equipment as well as the video conference and computer hardware necessary for the hospitals involved to coordinate their work over the Internet.
In the end, Zelicoff hopes, doctors will know a lot more about hepatitis C than before and will be more equipped to stem its spread. Some 30 percent of those who contract hepatitis C have no identifiable history of exposure to the virus, according to the Hepatitis Foundation International. Results of the study will be submitted for publication in an internationally recognized journal.
In the long term, Zelicoff hopes, BWC signatories will set up and maintain an Internet-based information-sharing network based on the hepatitis C model and provide investigative support when new disease outbreaks are identified.
Sandia is a multiprogram Department of Energy laboratory operated by Lockheed Martin Corporation. Steam key will be sent to your email address and can be redeemed to download the full game.
You must have JavaScript enabled in your browser to utilize the functionality of this website. New Mexico health officials believe up to 2 percent of the state's population has the disease. The hope is that by sharing information about who gets the virus and how it is transmitted, physicians can better understand how to prevent its spread. By keeping an eye on unusual outbreaks, and by asking nations that censor the sharing of health information to explain themselves, the scientists believe an effective "transparency regime" can be created for international treaties such as the Biological Weapons Convention (BWC), which forbids experimentation or acquisition of biological agents or toxins for military purposes. Also participating are the New Mexico Department of Public Health, the University of New Mexico School of Medicine, Los Alamos National Laboratory, and the former Soviet nuclear weapons lab Chelyabinsk-70. Foreign physicians attending a conference there became disturbed by local doctors' accounts of a pulmonary illness that caused 64 deaths in a two-week period.
But after more than 20 years, the world community still hasn't agreed on the best ways to verify that all party nations are complying with the treaty. Even botulism, which was discovered in the early 1980s to be effective in treating an eye-muscle disorder called blepharospasm, now has more than 50 FDA-approved uses. Once a mysterious outbreak is identified, the tools of modern epidemiology would be sufficient to determine its origin, he says. Also, both New Mexico and the region surrounding Chelyabinsk-70 have unusually high incidences of hepatitis C.


Meanwhile the main hospitals in three small New Mexico cities -- Los Alamos, Silver City, and Alamogordo, selected for their demographic similarities with Snezhinsk -- are collecting samples from randomly selected volunteers.
Statistically about 2 percent, or 40 to 50 people at each site, are expected to be infected. Sandia also helped design the patient questionnaire and postulate its questions along with hepatitis C experts at the New Mexico Department of Public Health and the UNM School of Medicine. A worldwide community of physicians would report the outbreaks, obtain information about new viruses, and make the information available to all BWC parties. Since January 1998, in fact, the World Health Organization has monitored some 20 separate outbreaks worldwide.
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The outbreak was sudden, it was often fatal, and it was confined to a region where military research takes place.
On further study, pathologists found the victims had been infected with several strains of anthrax.
In the hantavirus case, it took pathologists only a few weeks to isolate the virus and determine it was transmitted through the excrement of field mice. Each volunteer is asked to fill out a 150-item questionnaire intended to isolate behaviors that could be risk factors for contracting the disease. The Soviet government first blamed the outbreak on contaminated meat, but a 1994 study published in Science suggested that a release of windborne anthrax from a Sverdlovsk biological weapons factory probably caused the infections. Then tip the palm tree to open the huge skull gate, recover the stolen treasure and sail the scalawags to the nearest dungeon!
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