In light of the death of Benazir Bhutto by a suicide bomber, I was reminded of a story I saw on the BBC website back in 2002. I noticed that usually when a suicide bomber kills people, the carnage created by the shrapnel is what is usually reported. Rarely, do you find references to whether or not, the bomber may have been sick with diseases like hepatitis, AIDS etc. Or that people may have been killed by body fragments by the bomber or the other victims. By blowing him or herself up, the terrorists are also practising biological warfare at the same time. Also, the victims may be subject to long term health risks as a result. I was always puzzled by this omission in the media, regardless of where it takes place.
Suicide bombers may not just cause carnage when they blow themselves up - they may also spread disease from beyond the grave.
Israeli doctors have analysed bits of bone embedded in a bomb survivor, and found that they tested positive for the liver infection hepatitis B. The team believe this is the first recorded instance of human fragments acting as foreign bodies in a blast injury.
New Scientist magazine reports that a team of emergency staff at the Hillel Yaffe Medical Centre in Hadera headed by Dr Itzhak Braverman treated 32 victims of one blast. They used CT scans to check for metal fragments in the survivors.
In one 31-year-old woman, the scan revealed dense fragments in her neck, breast and groin. Further analysis revealed they were not bits of metal but shards of bone from the suicide bomber. Dr Braverman sent a fragment to the Institute of Forensic Medcine in Tel Aviv to be tested. It came back positive for hepatitis B.
No-one had considered this danger before.
Dr Braverman said: "As a result of that case, all survivors of these attacks in Israel are now vaccinated for hepatitis B."
He said it might also be wise to test for other diseases that could potentially be spread in the same way. These include four kinds of hepatitis, dengue fever, syphilis, CJD and possibly malaria.
Doctors are most concerned about the potential for spreading HIV. Dr Braverman said HIV tests on the bone fragment taken from the woman tested negative. However, he added: "These test kits are designed for blood. It is very hard to test bone."
Only 50 cases of HIV/Aids have been reported in the West Bank and Gaza. However, the true extent of infection is difficult to assess.
Dr Mary Ramsey, a consultant in public health medicine at the UK Public Health Laboratory Service, said there was a risk of infection from hepatitis B whenever the virus came into contact with an open wound. "This is why health workers in the UK are generally vaccinated against the disease," she said. "The good news is that we can vaccinate after exposure to the virus." 
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