No play book to fight bioterrorism

U.S. authorities learning to handle anthrax in school of hard knocks

Posted: Monday, October 29, 2001

NEW YORK -- If the doctors who examined Joseph Curseen had known where he worked, they might have recognized the Maryland postal worker had anthrax instead of the flu.

Gov. George Pataki's office in Manhattan might not have become a ''hot zone'' if, as state health officials believe, his police escort hadn't tracked anthrax spores back there from NBC.

Postal workers in New Jersey and Washington might have been given Cipro more than a week ago if CDC epidemiologists had understood the unusual potency of the spores mailed to Sen. Tom Daschle.

And federal labs might not have wasted valuable time on a hoax in Nevada if the governor of that state had quietly let state labs complete all the testing before announcing there might be anthrax in a letter there.

America has learned some difficult lessons about bioterrorism in the last month. Some have cost lives; others have eroded the confidence of an already shaken public. Even so, public health and counterterrorism experts say, the government's response to the anthrax mail attacks has been as good as can be expected given the demands they have faced.

''Everybody's learning,'' said Allan Rosenfield, dean of the Mailman School of Public Health at Columbia University. ''No one has all the answers to this.''

After an anthrax-tainted letter arrived in the office of Senate Majority Leader Tom Daschle Oct. 15, the House of Representatives abandoned the Capitol for four days. Speaker Dennis Hastert announced that anthrax spores had penetrated the Capitol's ventilation system before any tests were done, making the situation sound more serious than it actually was.

''It's not setting the example that you would want to have your leaders set,'' said Rusty Capps, president of the Centre for Counterintelligence and Security Studies and former FBI agent.

If people perceive the U.S. House panicked in the face of the anthrax threat, Capps said, they are more likely to take irrational and counterproductive steps themselves, such as avoiding their mail, buying gas masks and stockpiling Cipro.

Still, it wasn't a major blunder to leave the Capitol, said L. Paul Bremer III, the State Department's former ambassador-at-large for counterterrorism.

''I wouldn't want to exaggerate the impact,'' he said. ''I think it was an embarrassment.''

More serious has been the failure to protect postal workers from anthrax. Public health officials did not immediately realize that the anthrax spores inside a letter opened in Daschle's office were more deadly than the ones sent to Florida and New York.

The spores sent to Daschle's office had been refined into finer particles more likely to escape from an envelope, float in the air and stay airborne than the ones sent to Florida and New York. That meant they were more likely to be sucked into the lungs, where an anthrax infection is most life-threatening.

On the day the Daschle letter was opened, Sen. Olympia Snowe, R-Maine, described it as ''very refined, very pure.'' Daschle said that whoever sent it obviously knew what they were doing.

But five days later, Homeland Security chief Tom Ridge and other officials were playing down the sophistication of the anthrax spores, saying that they had not been ''weaponized.''

''I don't know why they were saying that,'' Rosenfield said. ''It certainly is more sophisticated than what people expected to see.''

The spores sent to Daschle were analyzed at Fort Detrick, Md., home of the Army's biological warfare research division, rather than the federal Centers for Disease Control and Prevention.

That may explain why CDC's epidemiologists did not consider the Washington situation much different from Florida or New York, where much less mobile spores had been sent. Most of the cases that had turned up were easily treatable anthrax skin infections.

''The accumulated science ... did not lead us to believe there was a risk of inhalation anthrax in postal workers,'' said CDC epidemiologist Rima Khabbaz. ''We've been on a steep curve of learning.''

In fact, the learning curve has been precipitous. When National Enquirer photo editor Robert Stevens died of inhaled anthrax Oct. 5, doctors in the United States had not seen a pulmonary example of the disease in a quarter century. There had never been a lethal bioterrorism attack in U.S. history. In thousands of scares involving powder in years past, not one had actually turned out to be anthrax.

So some missteps along the way should probably not be too surprising.

But officials have even made trouble for themselves in the course of responding to the anthrax attacks. State police officers assigned to the New York governor's Manhattan office helped investigate NBC Nightly News offices after an employee there developed an anthrax skin infection.

The officers apparently contaminated themselves with some spores at the scene and carried them back to the governor's office, according to health officials, because a few days later, tests discovered anthrax in a room used by the police.

The state health department ended up testing more than 100 additional samples from the governor's office. None tested positive for anthrax.

Almost 3,000 miles west, a Microsoft office in Reno, Nev., had a piece of mail returned from Malaysia Oct. 12. It had been a check mailed to a vendor, but the enveloped had been opened, and inside along with the check were some pornographic pictures clipped from a magazine. At least one of the pictures had been soaked with a liquid.

Nevada's epidemiologist said early tests indicated the possibility of anthrax. Gov. Kenny Guinn announced that bit of news. Then for several days, local and state officials offered confusing statements. A test done at the scene indicated anthrax; another test was negative; a third test was positive.

Finally, a week after the letter's existence became public, the CDC announced that it did not contain anthrax. Local, state and federal health officials had wasted precious resources pursuing a hoax. It was only one of thousands gumming up the works since the anthrax letters started coming.

''Dealing with hoaxes and rumors is 99 percent of what you do,'' said Capps, who commanded the FBI's antiterrorist operations center at the 1984 Olympics in Los Angeles. ''And you have to deal with each one of them because you can't afford for the one that you don't deal with to have validity to it and to be the one.''

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