The Anthrax Fumble | The Nation


The Anthrax Fumble

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It wasn't until the last week in October that the FBI thought to test the seepage potential by using DNA tracers, which tag the anthrax molecules and track where they go when the envelope is moved. The FBI discovered with an electron microscope that the anthrax could escape through tiny, 50-micron-wide holes in the envelope, and that it became airborne if the envelope was compressed, shaken or passed through a sorter.

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Dr. Marc Siegel
Dr. Marc Siegel is a practicing internist and an associate professor of medicine and a fellow in the Master Scholars...

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In mid-November an envelope addressed to Senator Patrick Leahy and containing anthrax was discovered. It had been postmarked the same day as the Daschle letter but had apparently been sent to the wrong ZIP code. Again the CDC wasn't included in the FBI/Army examination, which once more discovered a super-aggressive bacteria. But this time the danger was obvious even to a nonscientist. The FBI's fancy molecular tests had already discovered the potential for leakage, but the Leahy letter demonstrated leakage without a single lab test. As the letter was carried from the FBI to the Army lab, some powder leaked from a hole in the envelope into the plastic bag containing it. Unfortunately, the results of this unintentional field test came too late.

Four possibly preventable anthrax deaths--including Kathy Nguyen's on October 31 and Ottilie Lundgren's on November 21--had already occurred as a result of the mailings. Earlier precautions at the post office could have kept the deadly cross-contaminated mailings from ever reaching the last two women who died.

The Army and the CDC have the only two top response (Level D) microbiology laboratories in the country. When a federal crime involving contagion occurs, as with the anthrax mailings, the FBI automatically alerts the Army lab. But the FBI has the power to expand the scope of the inquiry to include CDC experts. Last fall, the FBI erred by excluding the CDC specialists. What is missed by one scientist might be discovered by another. And while the Army's primary interest is biowarfare, the CDC is concerned with public health issues. In fact, Dr. Julie Gerberding, the CDC's acting deputy director for infectious diseases, told Senator Grassley's staff that the anthrax should have been seen before the CDC rendered public health predictions. The CDC's specialists, she said, would have tried to determine "the concentration of the bacteria, and the chemicals that have been added to the powder to aerosolize it." These factors, she explained, "affect the impact of the anthrax on humans."

If the CDC was left out, the Postal Service was ignored, not informed and woefully underprotected throughout the anthrax scare. According to Deborah Wilhite, senior vice president for government relations at the Postal Service, the post office learned from the media--not the FBI or the CDC--on October 12 and 15 that anthrax was arriving by mail in New York and Washington. After October 15, when a Mail Security Task Force was created, the CDC sometimes provided "guest experts" at meetings, but there continued to be no formal connection between the CDC and the post office. And the FBI/Army test results were not provided directly to the office. Wilhite wrote that "the different focuses of...law enforcement and health organizations...resulted in parties speaking different 'languages.'"

The FBI was in charge of the investigation, and the Army did the testing. The CDC was responsible for informing local health departments, working to decontaminate federal and media buildings, and preparing for the possibility of a larger attack. These were significant responsibilities for a group of scientists known around Capitol Hill as working for the "Rodney Dangerfield" of federal agencies. In fact, the CDC was not aware that the Army had been making its own anthrax, even after it was found that the anthrax in the mailings was probably domestic. The CDC learned this from media reports. If it had been informed about the powerful potential of this Army-made anthrax, CDC public health experts would have been better prepared to assess risk. The CDC also wasn't told by the Army lab testing the mailed anthrax that it was sensitive to multiple antibiotics. If the CDC had known this, it could have recommended the use of less expensive antibiotics with fewer side effects than Cipro, a move that would have saved millions of dollars in health costs.

In contrast to the real Rodney Dangerfield, the CDC did not complain. Overshadowed by the more powerful FBI, the CDC kept quiet out of respect for scientists they knew at the Army lab who were working closely with FBI agents. It is a convention among doctors not to bad-mouth other members of the club publicly. And the CDC fosters a culture of nonconfrontation. It clearly didn't want to ruffle FBI feathers while relying on it for information. But the CDC's Cohen admitted that "measured tests and longer experiments were necessary to make accurate predictions," and that underestimating the risk while the tests were being done by the Army was a mistake. All three agencies were guilty, he observed.

To this day, the CDC has never seen any of the anthrax letters. And the FBI didn't respond to inquiries as to why it largely ignored the agency tasked to protect the public from disease. CDC director Koplan has now announced his resignation in the wake of the anthrax fumble. But if he is to resign, why not the director of the Army lab or the FBI?

Cohen says that communication and cooperation between the FBI and the CDC are improving. "We never really worked together before this," he notes. With billions of dollars about to be spent on the new bioterror safety net, we can only hope that he's right. In the future, teamwork will be crucial in handling a bioterrorism public health crisis--particularly if it involves a contagious bug that spreads rapidly, like smallpox. "We will be there at [FBI] headquarters," he says. "Two different cultures, public health and law enforcement, forming a partnership. Scientists use data to form hypotheses, then test them. Law enforcement agents explore a crime scene for details, looking for patterns to develop leads. What one discovers could help the other to succeed."

Anthrax cost five lives (including tabloid photo editor Robert Stevens of Boca Raton), with eighteen others sick and recovering. In the world of bioterrorism, the lives of innocent people depend on cooperation. FBI secrecy and domination is far too costly.

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