By Douglas J. Gillert American Forces Press Service FORT DETRICK, Md. -- Few American military physicians have seen one of medicine's -- and the military's -- most treacherous enemies: anthrax. To learn about the deadly biological agent, they rely, instead, on textbooks and reports from foreign countries that have experienced anthrax attacks. And attack it does, swiftly, horribly and often lethally, according to Army Dr. (Col.) Arthur Friedlander. In minute, graphic detail, he described the biological agent that historically attacks domesticated animals but now poses a threat to humans as a lethal new weapon. How deadly anthrax can be was demonstrated in 1979 when a laboratory producing the agent blew up in Sverdlovsk, Russia. At the time, Soviet Union leaders denied that the subsequent 42 deaths attributed to the explosion were caused by anthrax, claiming instead that tainted meat caused the fatalities and hundreds of reported cases of sickness. It wasn't until 1993 that press reports from the former Soviet Union substantiated earlier claims than anthrax was, indeed, the culprit. The fatalities would have been much higher in a more heavily populated area, Friedlander said. "The same release over Washington could cause an estimated 2 to 3 million fatalities," he said. What most concerns military planners and medical experts today is how easily many biological and chemical agents can be concealed and brought unsuspectingly into communities and on or near military installations -- how easily the agents can be made into weapons of mass destruction. Friedlander, senior military research scientist at the Army Medical Research Institute of Infectious Diseases on post, raised the specter of such a debacle to physicians attending the first annual joint conference for biological vaccines here May 25-27. In great medical detail, he dissected the disease and told how, in its aerosol form, anthrax can cover wide areas and attack large populations quickly and fatally. Much of the conference dealt with the anthrax vaccine Defense Secretary William S. Cohen ordered all service members to get. But the military physicians also discussed other biological and chemical threats and what's being done to counteract them. Some of those biological others include Q fever, smallpox, tularemia, encephalitis, botulism, plague and hemorrhagic fevers. Dr. Richard Kenyon, project manager for the Joint Vaccine Acquisition Program, said it would take more than 10 years for DoD contractors to develop and stockpile new vaccines. Key to developing a new vaccine is FDA licensure, he said. "We have to integrate the acquisition process with FDA requirements, then demonstrate that we're able to provide protection against aerosol exposure to biological warfare agents," he said. Drawbacks include limited commercial interest in developing the relative small amounts of vaccine the military requires and the inability to test experimental vaccines on humans. Civilian governments concerned about domestic terrorism also may have needs different from the military, Kenyon said. "We don't want competition for manufacturers between DoD and civilian response agencies," he said. Meanwhile, DoD is helping U.S. cities train and prepare for potential terrorist attacks involving chemical and biological agents and would be a key participant in any emergency response. Dr. Thomas Inglesby, an assistant professor of infectious diseases at Johns Hopkins University, said DoD involvement in ongoing medical research also is important and instrumental to helping cities prepare for such an emergency. He said the Fort Detrick institute is the most important component of ongoing research and development of effective defenses and treatment. The physicians attending the conference didn't leave with as many answers as they did challenges and new reasons to be concerned about troop health on the battlefield. What they learned is that preparing for acts of terrorism in general is one thing, preparing for biological and chemical terrorism quite another. From what Friedlander, Inglesby and others told them, they face a fierce enemy.