Beware bioterrorism - Authorities learn to handle threats

Thursday, November 1, 2001


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.

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.

Reluctant to react hastily

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.

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 25 years. 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.

"Dealing with hoaxes and rumors is 99 percent of what you do," said Rusty Capps, president of the Centre for Counterintelligence and Security Studies.

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