In the age of unknown microbes and deadly diseases caused by them, terrorism has a lot of different possibilities for any kind of asymmetric war. One of them is biological terrorism as a specific form of non-conventional terrorism which includes the misuse of live pathogens against humans.

Cutaneous Leishmaniasis/CDC
Cutaneous Leishmaniasis/CDC

ISIS-ISIL-DAESH is not capable to produce qualitative biological weapons at this moment but there are some technical and natural circumstances in this region, full of sand, dust and blood, what make conditions for terrible health crisis and new coming diseases to be occurred.  Those diseases will hit poor people who are suffering on daily basis from Islamic terror,  but they could also grow up into the deadly epidemic trend, which won’t be limited on the Middle East.

In April 2015, there were reports about the number of terrorists from DAESH who have been  infected by Flesh eating bacteria. The main problem was noted in Syrian city of  Raqqa, where poor sanitary and health situation make a big problem for people who are trying to survive,  not only bombs and terrorists but also many natural invisible enemies. But, what is very important to analyze here is the fact that Flesh-eating bacteria and flesh-eating disease known as Leishmaniasis disease aren’t the same, as far as I understand the epidemiology vocabulary. Unfortunately, media keep informing us that those two are the same disease. It is so obvious that they have similar “expression” on the patient, but there are some differences. Flesh -eating bacteria or Necrotizing Fasciitis  is based on Streptococcus pyogenes bacteria which leads to bacterial infection toxins and total damage of the skin, muscles, and fat.

Leishmaniasis is a parasitic disease caused by infection with Leishmania parasites, which are spread by the bite of infected sand flies. There are different forms of leishmaniasis disease  in people. The most common forms are cutaneous leishmaniasis, which causes skin sores, and visceral leishmaniasis and affects several internal organs (spleen, liver, and bone marrow).

The way that this endemic disease looks like reminds on the flesh eating bacteria results, but we deal here with the parasite. It is very important to say that this disease is very common for the  Middle East area for years back but with the destruction of health system, especially in Syria, this “Aleppo evil” as it is known in records, come back stronger and more aggressive.  

The collapsed medical infrastructure in Syria and Iraq as well as the lack of drugs for a successful treatment open the door for the increased amount of sick people and failed medical response let us think that we are facing  with the new sand plague. Amphotericin B is missed in medical stock in the new terrorist land, so the patients have no chance to be treated the best way. Many of them dont react at all and the disease progress and ends up fatal. Some of them are fleeing as refuges into another country and they can carry this disease but for this parasite is very hard to survive under cold clime conditions.

The main problem now is spreading of the disease in the neighboring countries like Lebanon, Jordan and Turkey, where most of the endangered Syrian people are fleeing. However, the river of immigrants who are on their way to Europe are definitely under the big and serious risk to bring this disease and to cause the epidemiological chaos if medical treatment is failed. The fact is that the disease can occur 2 – 6 months after the bite of tiny sand flies which makes this alert to be higher. Just to take into consideration, that is a long period of time and many people do not have a single chance to consult doctor or to report the case but to move on and carry this terrible disease into new lands, among new people.

Who will organize medical check of immigrants when they step into Europe? It is not only about the quarantine measures but also about helping those who are infected and reducing the possibility for others to be hit by disease. Actually, it is a professional epidemiological approach to the migration issue. If we imagine for a moment that instead of Aleppo evil we have to deal with Ebola and the mass of fled people from African continent, what would have been changed? I would like to add one more concern regarding the migration and epidemiological diseases. What about Libya and its people? As far as I am informed, there are some of them who are leaving unstable Libya to reach European countries. Among African migrants, could be also those infected with some rare and dangerous diseases, like Ebola or Marburg or even Congo-Crimean fever. The list of potential invisible enemies is never-ending. I am not suggesting here to shut down the borders for the real refugees or for the sick and injured people. I am only referring about the necessity to organize medical check points, at least there where a hot entry is.

The security background check of immigrants is a question of counter terrorism aspirations and policies. The epidemiological background check of immigrants is an urgent need of biological security and safety of our own countries and people as well as a rational strategy for people who are the first victims of the infectious deadly diseases.  

We will be in the real problems if our epidemiological preventive platform is not applicable when we require it. The risk is bigger than it is previously thought because some diseases are typical for specific regions but catastrophically dangerous for new environments.  

This is not the demand for one country but for the whole European Union to deal with and to embrace the solutions as soon as it is possible. Otherwise, the infectious diseases wont be stopped by any border but rather will become borderless threaten, more dangerous than uncontrolled terrorist state of DAESH.

Sandra Maksimovic-Sara, has an MA in Biological  Counter Terrorism Studies, with special interests of researching and writing about  Biological Weapons, Biosecurity and Biodefense. Sandra hails from Serbia.