Course Trains 'Select Few' on Biological Warfare Agents
By Caree Vander Linden
Special to American Forces Press Service
FORT DETRICK, Md., Nov. 30, 2004 The narrow gravel path leads to a cluster of mobile tactical shelters at Fort Detrick's "Area B," 400 acres of farmland on this Maryland base. A brown sign marks the Field Identification of Biological Warfare Agents, or FIBWA, Laboratory Training Site. Inside, the air conditioning is blasting while Top 40 music plays from a portable stereo atop a file cabinet. Two laboratories, each with four workstations, adjoin a central tactical shelter that serves as a conference room.
Army Spc. Kelly Miller runs a test to identify a substance
during a course in field identification of biological warfare agents. Photo by
(Click photo for screen-resolution image);high-resolution image available.
In this nondescript setting, eight students at a time learn to set up, maintain, and operate a deployable laboratory under field conditions. The four- week, hands-on FIBWA course offers training in the most advanced field technologies for confirming identification of biological-warfare agents. Developed by the U.S. Army Medical Research Institute of Infectious Diseases, FIBWA is the only course of its kind in the Defense Department.
According to Mark Wolcott, head of the field operations and training branch within USAMRIID's diagnostic systems division, FIBWA grew out of the need for battlefield detection of biological warfare agents. As field detectors were developed and deployed, the ability to confirm what the detectors were "seeing" was crucial to add confidence for battlefield, medical, and National Command Authority decisions. The requirement for a deployable BW agent confirmation laboratory was born.
Since the FIBWA course was first offered in 1999, nearly 200 students from the military services and other government agencies have attended. To ensure that the training stays on the cutting edge, concepts of operations and diagnostic materials, equipment and technology are continually evaluated and transitioned into the field.
Bill Dorman is the FIBWA training coordinator. A former noncommissioned officer, he came on board as a civilian during the first course in 1999. At that time, USAMRIID had put together a laboratory/training package at the request of U.S. Central Command, which wanted its own full-time lab capability. The demand grew, and there are now six laboratories under five major commands. CENTCOM, U.S. Pacific Command, U.S. Army Center for Health Promotion and Preventive Medicine, and U.S. Army Medical Command each have one laboratory; Army Forces Command has two.
"The course is unfunded," said Dorman, "so everyone who comes has to pay their own way." The cost -- $7,000 per student for the four-week course -- means "we get a select few," he added.
The course's first two days are spent largely in the classroom. Students receive an overview of the history of biological warfare, along with briefings on laboratory concepts, current techniques, and field laboratory operations. The fundamentals of biological safety are also introduced. Next, they spend nine days learning how to extract genetic material -- deoxyribonucleic acid and ribonucleic acid, or DNA and RNA -- from multiple sample types, along with a technique called polymerase chain reaction, or PCR, which is used to identify the extracted DNA and RNA.
"Sensitivity" and "specificity" are two frequently heard buzzwords in the field of medical diagnostics. Sensitivity refers to the ability to detect even a small amount of biological agent in a sample. Specificity is the ability to detect a particular agent. Both are critical. According to Dorman, if a testing agent is not sensitive enough, false negatives can result; if it's not specific enough, false positives can happen.
"Operation Desert Storm taught us that we need to have sensitive and specific technologies in a deployable laboratory, capable of analyzing both biomedical and environmental samples," said Army Maj. John Scherer, chief of the diagnostic systems division. Biomedical samples consist of tissue or bodily fluid samples from humans or animals, while environmental samples include air, soil, foliage, and water samples. All are important in a field setting, where the medical laboratory has three major roles: to support medical-treatment facilities, to support preventive-medicine surveillance, and to analyze samples from field detection systems.
One component of the FIBWA training is "real time" PCR using an instrument called the "Ruggedized Advanced Pathogen Identification Device," which was specially designed for military field labs. RAPID is a portable, impact- resistant package about the size of a briefcase that offers quick, safe and accurate field identification of potentially dangerous pathogens.
Sgt. Sean Brown, from Fort Leonard Wood, Mo., is a microbiologist with clinical laboratory and blood bank experience. "Pretty cool!" he said when asked to describe the FIBWA course. "I love the field work. It's a lot of fun."
Having a good grasp of molecular biology helped, said Brown, who had done PCR before but enjoyed being trained on the latest instruments. In January, he will be assigned to the CENTCOM testing lab.
"Getting to work with the real agents" Is the most surprising aspect of the course, he said, though he was quick to add that all bacteria and viruses are deactivated before students handle them. "It still gives you a new level of respect for what we're doing," he noted.
Dorman strolls through the labs, pausing to check on each student's progress. Despite being peppered with questions from course attendees, he patiently describes the scene for a visitor. His group keeps busy; six student courses are offered per year, along with three "manager" courses. The latter are designed for decision makers like laboratory officers and commanders, who would get the lab results and act upon them.
During the course, students take both written and practical exams. The true test, however, comes during the final week of the course, when they perform a field training exercise. According to Dorman, this provides an opportunity to integrate the course material with real-world scenarios that challenge the students' understanding and skills.
Participants are given five scenarios to respond to and must set up and operate a lab under field conditions. Working together as a team, they develop and implement a test plan based on the sample type and information received with each scenario. They are then expected to analyze the sample, troubleshoot any problems that may arise, and provide a final identification, if any, to the instructor. Evaluations are based on how well the students respond and solve problems throughout the exercise.
Army Pfc. Kelly Miller, from Fort Eustis, Va., works in a hospital clinical laboratory and said she finds the FIBWA focus on environmental samples "totally different." Unlike a clinical lab, she said, "out here you don't realize you messed up until you get your results back. In the field we would have to do it over; in the classroom, we try to figure out where the error occurred."
Miller has been in the Army two years and said she plans to make it a career. Like Brown, she'll do a tour of duty at the CENTCOM lab and says she is looking forward to it. Right now, though, she's up to her ears in the final field exercise.
"You have to put together everything you learned in the past three weeks, in one week!" she exclaimed.
While the FIBWA course is designed for organizations within DoD, special considerations can be made for other governmental agencies. Several civilian employees of the Department of Homeland Security's National Biodefense Analysis and Countermeasures Center recently completed the course. In addition, students from National Guard Weapons of Mass Destruction Civil Support Teams in Georgia and West Virginia attended over the summer, and Scherer is in the process of designing a specialized course just for those units.
"USAMRIID continues to demonstrate its commitment to the warfighter, whether it's through research, direct analytical support, or training courses like FIBWA," said Army Col. Erik Henchal, USAMRIID commander. "In addition, as a partner in the National Interagency Biodefense Campus at Fort Detrick, we contribute to the nation's overall defense against bioterrorism."
(Caree Vander Linden is assigned to the U.S. Army Medical Research Institute of Infectious Diseases.)