SPECIAL REPORT: Polio-Carrying Lab Seized in Sudan - A Valid Threat?

As civil war ravages Sudan (again), we now are hearing reports of a laboratory containing deadly pathogens that have been seized by one of the warring parties. What is the story, and what are some of the potential implications?

Let's take a look.

Table of Contents

• 01

  Why Are People Fighting in Sudan?

• 02

  Polio-Carrying Lab Seized in Sudan by Fighters

• 03

  Do Problems in Sudan Make for Problems in America?

• 04

  So Then What Do We Do?

• 05

  Frequently Asked Questions

Why Are People Fighting in Sudan?

After a military coup seized control of the Sudanese government in 2019, two generals involved in the coup turned against one another, each wanting the top position of power. The result was the country splitting into a civil war with the Sudanese armed forces headed by General Abdel Fattah al-Burhan on one side and the Rapid Support Forces (RSF) paramilitary led by General Mohamed Hamdan Dagalo on the other.

(Image courtesy of al-Burhan)

The infighting began on April 15, and as of this writing, it is estimated that approximately 500 people have been killed and over four thousand have been injured in the fighting. Actual figures are likely much higher.

Polio-Carrying Lab Seized in Sudan by Fighters

As the fighting took to the streets of Khartoum, the capital of Sudan, one of the sides seized control of a former government-run laboratory containing deadly pathogens. The technicians were kicked out of the lab, and the soldiers moved in.

(Image courtesy of Khartoum, 2019. )

For reasons unknown, the World Health Organization, which knows which side has seized control, has as of yet reported on which side this is. We do know that inside this laboratory's walls are specimens of cholera, measles, and polio. It's been reported that other dangerous pathogens and hazardous materials are also present within the laboratory.

It's worth pointing out that we can't automatically assume that the reason the lab was taken over was for the deliberate spread of a bioagent. If there is a war going on in an area and there is an area where these types of pathogens – which could easily be used as weapons – are just sitting there, free for the taking, both sides would logically want to take it if, for no other reason, than to deny these potential weapons to the other side.

The true motives here are challenging to determine, but that side of the argument is worth mentioning.

Do Problems in Sudan Make for Problems in America?

There are a couple of potential implications for Americans with the lab seizure. For starters, we need to remember that approximately 16,000 American citizens are trapped in Sudan, of whom Washington, DC, says it will not help to evacuate. Instead, these Americans have been told to "shelter in place."

Soldiers who can seize control of a government can most certainly take control of whatever hotel these Americans may be hiding in.

In 1998, the People's Liberation Army (the Chinese Army) published a military manual titled Unrestricted Warfare. Within this text, they note that in the modern age of war, it is absolutely foolish for a nation to fight without the world's support. The authors cite Iraq and The Gulf War as potent examples. As mentioned above, at the moment, the United Nations knows which group has seized control of the laboratory but has mysteriously remained silent on which party this is. While many have pointed out that these pathogens could be used as a form of biowarfare – and they're absolutely right – if these generals have ever read Unrestricted Warfare, they'll know they cannot use these pathogens overtly without bringing the entire world against their cause.

If they use these pathogens, they will use them covertly. Refugee populations already have exceptionally high rates of measles and cholera, in particular. It would be hard for somebody to say, "Hey, this came from the bad guys over there," as everybody would have reason to believe this was simply the ordinary course of events.

(Image courtesy of Boy with measles )

But for Americans, this becomes of concern when we consider our trapped countrymen over there. Let's say these pathogens are released (or otherwise escape) from this laboratory. Either option is highly possible, as it is implausible that the soldiers who took over the lab have the slightest clue about infectious disease control, laboratory protocol, etc. If that happens and then we decide to start flying back, fellow Americans, then we could end up bringing those things back here.

Or consider that, at the moment, the United States is flying in so-called refugees from around the world. If we start to ship Sudanese refugees into this country, they could likely have some of these pathogens with them. Or consider what happens if we put boots on the ground here in Sudan. Then, soldiers could catch whatever was spreading over there and bring it back here.

Now, granted, we spent a lot of time in Afghanistan and didn't end up with an Afghani-sourced American pandemic, but if we're solely talking about possibilities, this is one of them.

US soldiers en route to Sudan, 2013.

Cholera is historically a killer, but this isn't likely to be a massive issue within the American population. It's relatively easy to treat, and Americans have safe drinking water and adequate sewage facilities. Measles is quite a bit nastier, but it's polio in that lab (for what reason, it's hard to say) that this author believes is the actual threat here.

If that were to find its way into America, you would truly have a nightmare.

How many Americans that are under 50 years old have a polio vaccination? Likely none. This means that this disease would spread like wildfire once it reached the US, and we must remember that though this virus can impact anyone, it tends to affect children the most. It wasn't that long ago that the US still had entire hospital wards filled with "iron lungs" where artificial respiration was used to keep dozens of people alive.

Boy in iron lung. (Image courtesy of National Museum of Health and Medicine via Wikimedia Commons.)

This would result in a massive polio vaccination campaign throughout the US, particularly amongst children. We've primarily eradicated polio in the past, except for Afghanistan and Pakistan, where eradication workers typically end up getting shot. (Polio is still not gone, and Bill Gates threw 1.2 billion dollars to the Global Polio Eradication Initiative in both countries last year.) Granted, there was already evidence that polio was spreading through New York last year, but if we end up with "Sudanese" polio in the US in addition to the New York polio? That's a big deal.

There are currently two preventative treatments for polio: IPV and OPV. IPV is an injected, dead virus vaccine, while OPV is a weakened live virus given orally. OPV is commonly used because it can be shed by other people in the area. You then end up with one person – who has consented to the vaccine and its risks – then giving the vaccine to other people who have not consented to the vaccine or its risks.

This makes it easier for eradication workers to inoculate a sparsely populated mountainous region because they know that this one teenager they have just given OPV to will now take it back to their community for the eradicators and spread the vaccine in their stead. This then saves the eradicators a lot of time, effort, and money. Of course, you're also medically treating people without their knowledge or consent.

(Image courtesy of OPV administration, India. )

One of the arguments the people use in defense of OPV is that it better grants intestinal immunity than IPV. In areas with poor hygiene where it is highly probable that somebody will eat food contaminated with feces, this makes OPV an attractive option.

We no longer give polio vaccines in the United States, even though it's not 100% eradicated from the planet, because the risks outweigh the rewards. This is particularly true of OPV. One of the issues with using a live virus is that it can mutate. It's not entirely uncommon to hear of polio outbreaks in an area directly attributable to a mutated OPV strain.

Just last year, we saw polio spreading in London and Jerusalem. The source is OPV.

Now what happens if you end up with aid workers in the refugee camps around Sudan deciding to inoculate all of these people with OPV as soon as they can? What happens if those people are flown into Western countries soon after? Can you then end up with polio outbreaks in Europe, America, and elsewhere?

Absolutely.

So Then What Do We Do?

While Sudan is a long way away from America, we must remember that a plane ride could quickly bring whatever pathogens are over there to our home within hours. It takes less than 15 hours to fly to Sudan. When Sudanese refugees begin pouring into Europe and the United States (and they will), they could be bringing a lot of pathogen "baggage" with them.

And whether that pathogen threat comes from the deliberate release of something or the preventative actions that are taken because there could be a threat doesn't matter. The end result is a pathogen spread in the United States.

Refugee camp in Zaire after the Rwandan Genocide.

Are we saying that private, charitable organizations shouldn't do anything here? No.

We're saying that you must keep your heart attached to your brain.

Playing baseball with your son is a good gift of your time to him. But if he recently broke his arm, giving him the gift of playing baseball is not in his best interest. Providing food to starving people is good. But if we're not using discretion and completely undermining any local economy in our giving process, that's bad. Doctors treating sick people during the American Civil War was good. But why did so many people die from infection back then? Because the men attempting to do good were not washing their hands between patients, and people died as a result.

This doesn't mean that you should never again engage in an act of charity to protect yourself. Ebeneezer Scrooge is not a role model. This doesn't mean that you treat people as less than human and simply view them as germ bags. That would be morally wrong (historically, it always leads to atrocity). A person is still human regardless of what they are sick with. But it's because they are suffering from something that we take appropriate measures to protect others.

Why? Because we recognize that illness is terrible, and we don't want sickness to spread, mainly when it is within our ability to do something to halt it.

This is why people become doctors and nurses, is it not? To help those who are sick. To cure maladies and to kill disease where it stands.

But remember that a doctor who, of his own volition, is performing surgery on an AIDS patient will take steps to protect himself, not only because this keeps his health in order but because it protects his family and friends as well. Would it be just for this doctor to go out on the street, use force to compel 15 other people to come with him to work with this same patient, and then not give them any PPE?

If we start bringing Sudanese refugees into the United States, particularly if they've recently been given OPV, we're doing this. There will be polio cases in the US as a result.

These people won't be placed in one spot they cannot leave on American soil. You'll end up with some plopped in Nashville, some in Atlanta, some in Austin, etc. What happens if you then end up with American kids getting polio as a direct consequence? What happens when these people are dropped in the communities of Americans who did not decide to bring them to their communities? These are things we do have to think about here.

So what can you do?

From a PPE perspective, not much, honestly.

Vibrio cholerae is chiefly a waterborne disease that comes about from drinking poopoo water. Even if this pathogen were to find its way from Sudan to the US, this wouldn't be something you would have to worry about as much. Polio is chiefly transmitted from the fecal-oral route and can be shed by an infected person for over two weeks. Washing your hands is one of the top things that you can do here, but the average human being touches their face so many times throughout the day as it is that if this finds its way circulating throughout the US at length, it's going to be a monster to attempt to stop.

An IPV ring vaccination campaign is likely the only thing that could stop this in its tracks; honestly, this option would have seen more tremendous success in a pre-2020 world. Would it gain traction today? No. Imagine a group of soldiers moving throughout the US telling everybody in X, Y, and Z neighborhoods that you are taking this inoculation because that guy over there got sick. How would that fly?

What about measles?

Here, you could do something of note other than just wash your hands. Measles is airborne. While not typically considered a bioterrorism agent, there's no doubt that a measles epidemic throughout the United States would be a cause of concern. Hypothetically speaking, you did end up with a massive measles epidemic in New York City. This wouldn't be a colossal killer within the US (in developed countries, measles has a case-fatality rate of around 1%), but it would cause a great deal of chaos.

The chief threat here, though, particularly to America's children, is polio. And for that, the best thing America can do is just keep it out. (If you personally still want to help out, check out this option.)

So is what is happening in Sudan with this laboratory something to be terrified of? No, but that doesn't mean that it's still not a problem, that it's not a potential problem for the US, nor that it's something that we should just dismiss out of hand.

What are your thoughts on all this? Let us know what you're thinking in the comment section below.

Frequently Asked Questions