[Paleopsych] NYT: Op-Ed: Got Toxic Milk?
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Mon May 30 22:12:59 UTC 2005
Got Toxic Milk?
New York Times Op-Ed, 5.5.30
By LAWRENCE M. WEIN
WHILE the anthrax scare at Washington post offices this year proved to
be a false alarm, it was a reminder of how vulnerable Americans are to
biological terrorism. In general, two threats are viewed as the most
dangerous: anthrax, which is as durable as it is deadly, and smallpox,
which is transmitted very easily and kills 30 percent of its victims.
But there is a third possibility that, while it seems far more
mundane, could be just as deadly: terrorists spreading a toxin that
causes botulism throughout the nation's milk supply.
Why milk? In addition to its symbolic value as a target - a glass of
milk is an icon of purity and healthfulness - Americans drink more
than 6 billion gallons of it a year. And because it is stored in large
quantities at centralized processing plants and then shipped across
country for rapid consumption, it is a uniquely valuable medium for a
For the last year, a graduate student, Yifan Liu, and I have been
studying how such an attack might play out, and here is the situation
we consider most likely: a terrorist, using a 28-page manual called
"Preparation of Botulism Toxin" that has been published on several
jihadist Web sites and buying toxin from an overseas black-market
laboratory, fills a one-gallon jug with a sludgy substance containing
a few grams of botulin. He then sneaks onto a dairy farm and pours its
contents into an unlocked milk tank, or he dumps it into the tank on a
milk truck while the driver is eating breakfast at a truck stop.
This tainted milk is eventually piped into a raw-milk silo at a
dairy-processing factory, where it is thoroughly mixed with other
milk. Because milk continually flows in and out of silos,
approximately 100,000 gallons of contaminated milk go through the silo
before it is emptied and cleaned (the factories are required to do
this only every 72 hours). While the majority of the toxin is rendered
harmless by heat pasteurization, some will survive. These 100,000
gallons of milk are put in cartons and trucked to distributors and
retailers, and they eventually wind up in refrigerators across the
country, where they are consumed by hundreds of thousands of
It might seem hard to believe that just a few grams of toxin, much of
it inactivated by pasteurization, could harm so many people. But that,
in the eye of the terrorists, is the beauty of botulism: just one
one-millionth of a gram may be enough to poison and eventually kill an
adult. It is likely that more than half the people who drink the
contaminated milk would succumb.
The other worrisome factor is that it takes a while for botulism to
take effect: usually there are no symptoms for 48 hours. So, based on
studies of consumption, even if such an attack were promptly detected
and the government warned us to stop drinking milk within 24 hours of
the first reports of poisonings, it is likely that a third of the
tainted milk would have been consumed. Worse, children would be hit
hardest: they drink significantly more milk on average than adults,
less of the toxin would be needed to poison them and they drink milk
sooner after its release from dairy processors because it is shipped
directly to schools.
And what will happen to the victims? First they will experience
gastrointestinal pain, which is followed by neurological symptoms.
They will have difficulty seeing, speaking and walking as paralysis
sets in. Most of those who reach a hospital and get antitoxins and
ventilators to aid breathing would recover, albeit after months of
intensive and expensive treatment. But our hospitals simply don't have
enough antitoxins and ventilators to deal with such a widespread
attack, and it seems likely that up to half of those poisoned would
As scary as this possibility is, we have actually been conservative in
some of our assumptions. The concentration of toxin in the terrorists'
initial gallon is based on 1980's technology and it's possible they
could mix up a more potent brew; there are silos up to four times as
large as the one we based our model on, and some feed into several
different processing lines that would contaminate more milk; and the
assumption that the nationwide alarm could go out within 24 hours of
the first reported symptoms is very optimistic (two major salmonella
outbreaks in the dairy industry, in 1985 and 1994, went undetected for
weeks and sickened 200,000 people).
What can we do to avoid such a horror? First, we must invest in
prevention. The Food and Drug Administration has some guidelines -
tanks and trucks holding milk are supposed to have locks, two people
are supposed to be present when milk is transferred - but they are
voluntary. Let's face it: in the hands of a terrorist, a dairy is just
as dangerous as a chemical factory or nuclear plant, and voluntary
guidelines are not commensurate with the severity of the threat. We
need strict laws - or at least more stringent rules similar to those
set by the International Organization for Standardization in Geneva
and used in many countries - to ensure that our milk supply is
vigilantly guarded, from cow to consumer.
Second, the dairy industry should improve pasteurization so that it is
far more potent at eliminating toxins. Finally, and most important,
tanks should be tested for toxins as milk trucks line up to unload
into the silo. The trucks have to stop to be tested for antibiotic
residue at this point anyway, and there is a test that can detect all
four types of toxin associated with human botulism that takes less
than 15 minutes. Yes, to perform the test four times, once for each
toxin, on each truck would cost several cents per gallon. But in the
end it comes down to a simple question: isn't the elimination of this
terrifying threat worth a 1 percent increase in the cost of a carton
One other concern: although milk may be the obvious target, it is by
no means the only food product capable of generating tens of thousands
of deaths. The government needs to persuade other food-processing
industries - soft drinks, fruit juices, vegetable juices,
processed-tomato products - to study the potential impact of a
deliberate botulin release in their supply chains and take steps to
prevent and mitigate such an event.
Americans are blessed with perhaps the most efficient food
distribution network in history, but we must ensure that the system
that makes it so easy to cook a good dinner doesn't also make it easy
for terrorists to kill us in our homes.
Lawrence M. Wein is a professor of management science at Stanford
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