Monday, January 25, 2010

AL QAEDA WANTS THE BOTOX -- Another WaPo bioterror scare story

Today reporter Joby Warrick and the Washington Post place the whoopie cushion on the chair for another story about how easy it is to make the most poisonous thing in the world -- botulinum toxin -- and how al Qaeda wants it and might be able to buy it from counterfeiters. In places like ... China!

"The Washington Post recently sought to locate three Chinese firms that offered cut-rate Botox over the Web, only to find empty lots and dead ends," the newspaper reported glumly here.

Oh, rats! The Chinese did not make teh botox that could be bought by al Qaeda!

"We know al-Qaeda has talked about going after food supplies in the United States," [an anonymous official source] told the Post. "There are new reasons to be concerned about what they're going to target next."

Periodically during the war on terror, various people have placed stories in the mainstream newsmedia on the ease of making botulinum toxin and what al Qaeda would do with it.

There are two notorious examples, one which comes -- unsurprisingly -- from the Washington Post.


Image reproduction of al Qaeda 'easy to make' botulinum toxin from a Sunday edition of the Washington Post a few years ago.

The above snapshot comes from a Washington Post story in 2005 entitled "Terrorists Turn to the Web as Base of Operations."

As part of the story, Post reporters tried to pass off the idea that terrorists could make dangerous agents like plague from documents cadged off websites run by jihadis. The above snapshot, which purports to show how to easily make botox was one of the newspaper's illustrative examples. It was rubbish and it was debunked -- by DD -- in the Federation of Scientist's Secrecy Bulletin here.

"Unfortunately, the Post did not critically examine the materials that it presented," it reads.

Also in 2005, the New York Times opinion page attempted to present the idea, flogged by a scientist who was publishing a paper on the subject in the Proceedings of the National Academy of Science, that terrorists could contaminate almost the entire US milk supply with easily made botulinum toxin.

"On May 30, the New York Times published a guest editorial that described a potential attack on the nation's milk supply by a terrorist armed with a gallon jug containing a few grams of botulinum toxin," I wrote with colleague Milton Leitenberg on the Federation of American Scientists website.

"For it to be plausible, one has to accept several assumptions. The first of these is that terrorists can easily brew the amount of toxin cited. But can they?

"[The scientist's] initial claim concerning terrorist knowledge on production of botulinum toxin was an alarming one. He wrote that all that was necessary would be for a single terrorist to have the jihadi manual called 'Preparation of Botulism Toxin,' secured from the Internet.

"We have a copy of the 28-page jihadi manual. It is an oft-stated canard that terrorists, or a single one, can simply download their capabilities for mass death from the world wide web. The assistance that the manual is alleged to confer is greatly exaggerated. While its text certainly appears technical to laymen, its compiler does not explain, except in the most general terms, how to obtain a toxic strain of Clostridium botulinum in the first place. Any strain of the bacterium which produces botulinum toxin won't do, an aspect even noted in the manual. Many strains of Clostridium botulinum in nature produce very little or no toxin. Finding the right one in nature out of literally 600 or 700 strains can take a long time. For example, the task took the pre-1969 US offensive BW program many man-years of work by highly trained and competent professionals.

"[The scientist] also posited that botulinum toxin could be bought from an overseas black-market lab. In the real world no 'black market' botulinum toxin producer is known to exist." (The rest of the piece is here.)

That was in 2005, when no examples of production of botulinum toxin and misuse by criminals had yet made news. This was changing, though, due to the actions of an American business. Which brings us to Warrick's article for the Washington Post.

Now, two scientists have tried to reproduce the 'black market lab' idea and have done so successfully, so it is said. It is part of the threat assessment industry's (and DD makes no distinction between contractors commissioned by the government to do threat assessment, the academy, and indigenous US government operations) process of regularly upping-the-ante on various menaces always said to be coming or doable. If, for example, intelligence from al Qaeda is insufficient to paint such a picture then we must paint it for them.

And it illustrates one of the ongoing problems associated with US-generated threat assessment in the war on terror: No real attention paid to what has been taken off terrorists and what their capabilities actually are from careful intelligence. Instead, expansion of what is said they can do because we say we can do it for cheap through some exercise.

"Last year, [Kenneth Coleman] and fellow researcher Raymond Zilinskas set out to test whether militant groups could easily exploit the counterfeit Botox network to obtain materials for a bioterrorism attack," reported Warrick. "In a project sponsored by the James Martin Center for Nonproliferation Studies, two scientists found that a biologist with a master's degree and $2,000 worth of equipment could easily make a gram of pure toxin, an amount equal to the weight of a small paper clip but enough, in theory, to kill thousands of people."

Jason Sigger of Armchair Generalist had this to say about it this morning:

"Now here's the first indication that this is a bogus article - a physician who claims to have insight on terrorist capabilities and intent. Both Coleman and Zilinskas come from the James Martin Center for Nonproliferation Studies, though, and they ought to know better than to float this idiotic idea. Botox for cosmetics has been around for, what, five years now? And we've never seen a terrorist bot tox hit yet. These guys are used to talking about nation-state WMD programs, not WMD terrorism - but hey, it's all the same when you talk about WMD, right?"

The rest of the article goes into Muslim terrorists' alleged motivations and desire to get botulinum toxin and the newspaper's fruitless search in China and other regions for black-market-made poison.

In this, it executes a rather large error of omission -- one which would be utterly missed by most of the newspaper's daily readers.

It glosses over and peddles only a brief bit of information on how botulinum toxin was actually diverted from a US commercial research enterprise in the last few years -- the ONLY solidly documented example of purified botulinum toxin being given over to people who would subsequently criminally misuse it.

Readers know botox is hot property in cosmetic surgery. What they don't know is that there isn't quite enough of it in a treatment vial to kill someone, for obvious reasons. It's literally distributed in vanishingly small amounts.

Now, if you're going to go after botox made on the black-market for profit for use in cosmetic surgery, to replace the product marketed exclusively by Allergan in the US, you need to buy hundreds of bottles. And they're not cheap. But if you can get them made more cheaply than what Allergan will require you to pay, you can make a substantial profit on the business. And that is what was done in the United States. It's not theoretical and the botox was not made by a black market or a counterfeit drug manufacturer.

However, if one is going to use the botox for terrorism, one needs a lot more of it. And it will still most likely come in vials which contain way too small amounts for this purpose, mandating that they be pooled and concentrated in some manner. With no losses. (This is a bit of tricky business and the trickiness will be discussed momentarily.)

Essentially, all this was done -- on US soil. By and for Americans, made in an accredited American laboratory, not a Chinese black-market operation.

And in one instance, a larger research amount was sold, presumably to be subdivided and stepped on. And it is because of this, when a defrocked doctor made a mistake and used far too much of the poison on cosmetic patients, that the work was uncovered.

The Post tells readers none of this. It deletes by inaction all the interesting details. Instead, it writes:

"No laboratories for fake Botox have turned up in the United States, but there have been prominent examples of doctors and vendors who obtained cheap, unlicensed botulinum toxin to sell to unsuspecting patients and customers, sometimes with lethal results.

"In 2004, U.S. Justice Department officials raided a string of clinics in five states after uncovering a supply network that substituted industrial-grade botulinum toxin for commercial Botox. The inferior toxin, which was made legally for laboratory research and not licensed for human use, paralyzed four patients."

The newspaper omits the name of the single-source, the firm that made the botox.

It's called List Laboratories and it's in Campbell, California. And it was raided by the FBI as part of an investigation which transpired only after a number of people landed in ventilators as a result of botulism, botulism which would have been fatal had they not been kept on supportive maintenace for quite some time.

Those medical cases were covered in a peer-reviewed medical journal. DD will get to this in moment.

And the laboratory which purified the botulinum toxin which was later misused was well-known for manufacturing fine biochemicals and toxins, primarily for use in the US biodefense research industry. As such it had to be within the US government's control regime for select agents, the latter term which is used to describe materials and organisms thought to be of use in terrorism. (The US government does not divulge the list of companies involved in the monitoring regime but this lab was certainly one of them.)

In 2006, I wrote about the affair for The Register. And for the sake of informative discussion, I'll simply reprint wholesale from it (for the links, you will need to go to the original):

How easy was it to buy an eye-popping 3,081 vials of research botulinum toxin, the deadly neurotoxin produced by Clostridium botulinum, always found on jihadist terror wish lists? Very easy in 2003 - unlike so many other things alleged to be simple to do by designated evil-doers in the war on terror. Two Arizona scammers in pursuit of profit in the anti-aging industry found it elementary to order the most poisonous substance known fresh from List Labs in Campbell, CA, a purifier of biochemicals and toxins used in counter-terror research.

Chad Livdahl and Zahra Karim had set up a series of shell companies in Tucson with the aim of acquiring botulinum toxin cheaply and repackaging it as "Mimic Botox." The "Mimic Botox" would be shilled to cosmetic surgeons, fraudulently misrepresented as Botox, undercutting Allergan's product, the only company that can sell it as a trademarked and licensed drug.

The scam worked. Using the front company Toxins Research International, Livdahl and Karim ordered thousands of 5 nanogram vials of botulinum toxin ( order form, and intro page) from List Labs sight unseen and promptly diverted it for resale on a collection of websites, as well as through anti-aging seminars.

According to the US government's indictment, Livdahl and Karim paid List Labs about $30,000 for the botulinum toxin shipment, subsequently making about one and a half million dollars in profit through the operation. It unraveled when one of their primary customers, Bach McComb, a doctor in Florida whose license to practice medicine was suspended for overprescription of painkillers, accidentally mistreated - or overprescribed, if you will, himself and three others with purified toxin.

Which brings us to a 2006 report in the Journal of the American Medical Association's November 22 edition entitled, "Botulism in 4 Adults Following Cosmetic Injections With an Unlicensed, Highly Concentrated Botulinum Preparation." (Subscription only.) Although the paper does not name them, it describes the poisoning of McComb and three patients, one of whom was his girlfriend. The onset of paralysis required hospitalization for all which, in turn, led to investigation and jail terms on intent to defraud for him (three years) - as well as Livdahl (nine years) and Karim (six years).

In late November of 2004, McComb received a 100 microgram vial of highly purified botulinum toxin from List Labs. He injected himself and three others with aliquots taken from it in treatment for wrinkles. Three to four days later McComb and his patients were on hospital ventilators to keep them alive. McComb's girlfriend took the worst of it, requiring about six months on a machine, saying in a videotaped statement for the criminal trial that her body wasted away until it was unrecognizable.

The JAMA paper describes the poisonings as equivalent to "21 to 43 times the estimated human lethal dose by injection." The vial from which McComb took his injections was thought to contain enough material for 14,286 fatal doses.

At first look this seems to make the 100 micrograms of botulinum toxin as sold by List Labs a potential weapon of mass destruction. The JAMA paper informs that federal regulations allow for transfer, possession and use of up to 500 micrograms, or half a milligram, of the poison "without registration or notification of the Select Agent Program," a US operation administered by the Centers for Disease Control to control and monitor the use of toxins and microorganisms with potential applications in biochemical terrorism.

As a consequence, the authors of the paper recommend that the current weight limit for botulinum toxin be revised downward for individual shipments, a task that's performed by a national interagency working group of researchers and medical doctors, which includes the authors of the paper, all plugged into the science of botox. More stringent examination of credentials is also called for, they say.

For additional perspective the CDC was contacted. This resulted in being put in touch with with Charles Millard at the Walter Reed Army Institute of Research, which supports the CDC in this matter. Millard is a botulinum toxin expert and also part of the interagency working group on the poison.

While over fourteen thousand lethal doses sounds like an awful number, and one imagines the toxin reconstituted from the delivery vial and deposited with great malice into a vat of dressing at a serve-yourself bar, the feat is perhaps not that cut and dried or obviously practical. One hundred micrograms of the toxin is a vanishingly small amount, the high number of lethal doses being a theoretical number. (The method of reconstitution and toxicity of the toxin sold to McComb and Livdahl is described here and here.)

However, as Millard explained, the actual amount for lethality in humans is not an exact science and extremely small amounts of highly purified protein complexes, which is what botulinum toxin is, tend to be unstable when put into much larger volumes. In other words, they denature, degrade and disappear. Millard indicated the vial contained much less practical material than the stated number of theoretical lethal doses. (In terms of oral toxicity, botulinum A toxicity depends upon its protein complex, with some components necessay to prevent gastric degradation and subsequent absorption. Depending on what one has, or what is purified, there are signficant differences.)

Millard suggested this uncertainty was perhaps seen in the variance of the severity of the disease suffered by McComb and his girlfriend. The levels of botulism toxin seen in blood samples from McComb's girlfriend and another patient appeared identical, yet the former was gripped by a deadly paralysis much greater than the others. The reasons for it remain unclear.

What is clear from a reading of the court files and the JAMA paper is that diligence was absent everywhere in the case. No eyebrows were raised when over three thousand vials of botulinum toxin - about 0.7 of a theoretical lethal dose/vial - were ordered by people with no legitimate research connections, persons the Department of Justice described as wishing to "enrich themselves unjustly" by selling the material.

Nary a peep was heard when List Labs sold the 100 microgram vial of purified toxin to a physician who'd had his license suspended, described in court by one of the case-patients tracked by JAMA as one "who practiced medicine like Dr. Frankenstein would have practiced medicine," according to The Palm Beach Post. In the hospital the man laid, his body wooden, saying at McComb's sentencing last January, "At first I thought I was at my own funeral... I thought I was dead."

The same newspaper reported that a federal investigator in the McComb/Livdahl case, "[posed] as an employee of a company that sells the toxin to researchers" and was offered a few vials of it by List Labs. "He was asked only for his name, address and credit card number," added the newspaper.

It is certain that more scrutiny is now being directed at those who purify and sell botulinum toxin in the US. The CDC, however, does not release the names of companies and researchers being regulated through its select agent program out of security concerns, paradoxically, over revealing information on where potential terrorists could get dangerous biochemicals and microorganisms.

Thus the dilemmas posed by the McComb case become fairly obvious.

One, this misuse of man-prepared botulinum toxin came not from al Qaeda terrorists, said repeatedly by terrorism experts and the mainstream media to be wishing for it, but fresh from a California lab which delivered it into the hands of people motivated by the pursuit of illegal profits. It underscores the dichotomy that while Islamists have shown no scientific know-how in the manufacture of ... botulinum toxin, an American purifier and three bad people unexpectedly collided in the delivery and employment of it through no more effort than a few telephone calls.

The original piece and court documents, from 2006 are here.




Related note:

"In early 2006, a mysterious cosmetics trader named Rakhman began showing up at salons in St. Petersburg, Russia, hawking a popular anti-aging drug at suspiciously low prices. He flashed a briefcase filled with vials and promised he could deliver more -- 'as many as you want,' he told buyers -- from a supplier somewhere in Chechnya," reported the Post.

"Rakhman's 'Botox was found to be a potent clone of the real thing, but investigators soon turned to a far bigger worry: the prospect of an illegal factory in Chechnya churning out raw botulinum toxin, the key ingredient in the beauty drug and one of world's deadliest poisons."

Coincidentally, 2006 is still in the time frame for circulation of Toxins Research International's rebranded botulinum toxin, made by List in the US.

"3,081 vials of research botulinum toxin" goes a long way. TRI advertised their rebranded botox on the web, actively marketing it worldwide.

While one may have been persuaded that some lab in Chechnya was pumping it out, it's hardly out of the question to reason, since it does not appear to have recurred, that it was possibly related to the US operation, the economics of which would allow resellers to still make a profit. TRI was apparently interested in resellers, if memory serves, anything to grow the business. On an initial investment of $30,000, TRI made a profit of one and a half million dollars possibly indicating they resold quite of lot of the stash to various parties. Years later the FBI was still trying to run it all down domestically.

Another view, by way of reading AG.

This story has been updated.

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