Anxious About Anthrax

A Few Cases Do Not An Epidemic Make. But They're Unprecedented; Worry Over What's Next Is Contagious

At first, the anthrax scares popping up everywhere could be dismissed as the products of overactive imaginations. In Florida, where residents were already spooked by reports that last month's skyjackers had inquired about renting crop-dusters, authorities had received more than 100 calls about suspicious powders over the past few weeks; they all turned out to be innocuous substances such as plaster dust. In Trenton, N.J., two office buildings were evacuated early last week after employees reported opening packages containing a white powder. Tests found no traces of any pathogens. An Internal Revenue office in Covington, Ky., was sealed off and 200 employees briefly quarantined after powder was found in an envelope. It, too, was harmless--as was the brown powder found in an envelope sent to a state agency in Ohio, the powder in a Halloween card sent to The Columbus Dispatch and the yellow powder in an envelope that an Ohio couple opened exactly a month after the September terrorist attacks. That one also contained a note. "You are now infected with anthrax." They weren't. Nor was the divorce lawyer of a woman to whom a bitter husband sent a letter that, he warned, was impregnated with anthrax, the FBI told NEWSWEEK. Although anthrax is not contagious, fear of it was epidemic.

But if the FBI, intelligence officials, local police and--most of all--Americans who had vowed not to live in terror were tempted to dismiss these scares as hoaxes or hysteria, they were quickly brought up short. By midweek eight employees at American Media Inc. in Boca Raton, Fla., had been exposed to Bacillus anthracis; one, photo editor Robert Stevens, was dead as the result of inhaling thousands of deadly spores. On Oct. 12 in New York City, NBC News assistant Erin O'Connor tested positive for cutaneous anthrax, apparently the result of exposure to a powder in an envelope she had opened three weeks before. And the next day a letter received at a Microsoft office in Reno, Nev., tested positive for anthrax: the envelope, in which Microsoft had sent a check to a vendor in Malaysia, had been returned, with the check intact. It also contained pornographic pictures cut from a magazine, and dusted with anthrax spores. Suddenly, a hypothetical threat was all too real, and fears that had been bubbling under the surface for the past month burst into the open. In New York, Celeste Sharpe, a mother of two and former assistant district attorney in the Bronx, found out about the NBC anthrax through NYPD friends. Anxiously withdrawing cash from an ATM, she told a friend by cell phone, "I'm getting the hell out of the city."

President George W. Bush implored all Americans to live their lives as normally as possible. "Our government is doing everything we can to make our country as safe as possible," he said. But while everyone agreed that panic wasn't called for, prudence was. The U.S. Postal Service advised all Americans to monitor their mail carefully and to be suspicious of any envelopes without return addresses, with stains or odors or with too much postage (a hint that the sender really, really doesn't want it returned for insufficient postage). The State Department ordered all U.S. Embassies to buy and store three days' supplies of the antibiotic ciprofloxacin--as a precaution. Bayer, the German pharmaceutical giant, announced that it would increase production of Cipro, its trademark ciprofloxacin, by 25 percent beginning Nov. 1: wholesalers were running low on the drug throughout the United States.

The panic was understandable: people are much more afraid of exotic, seemingly uncontrollable risks like anthrax than they are of familiar ones like flu (which kills more than 20,000 Americans each year). Anthrax is nothing if not exotic, at least in America. It is caused by a bacterium, Bacillus anthracis. This rod-shaped microbe grows in soil, where it can be ingested by sheep, cows, horses and goats. That's why anthrax is labeled a veterinary disease, and why those most likely to contract it work with animals or animal products (such as wool). If growing conditions deteriorate, the bacteria form microscopic spores, which can remain dormant (and lethal) for decades. In the worst-known anthrax outbreak, at least 66 people died when spores were released from a bioweapons plant in Sverdlovsk, Russia, in 1979.

At every step in the anthrax investigations, officials were quick to minimize the threat. Yet those reassurances were eclipsed by other cases or by evidence that authorities are poorly prepared for a bioterror attack. When Bob Stevens was diagnosed with inhalation anthrax, his was an "isolated" case, Florida and federal health officials insisted, and almost certainly the result of accidental, natural exposure--even though anthrax has never been reported in animals or soil east of the Mississippi River and even though the United States recorded only 18 cases of inhalation anthrax in the 20th century and none since 1978. But when alert doctors found anthrax spores in the nose of AMI mailroom supervisor Ernesto Blanco, 73, who was hospitalized with pneumonia, "isolated" looked like it had company. FBI agents sealed the building two days after Stevens died, and agents in airtight jumpers and oxygen masks swarmed through AMI's offices, scouring it for traces of anthrax. The next day, Oct. 8, AMI's 700 employees and recent visitors lined up at the white annex building of the county Health Department in Delray Beach to have nasal swabs taken. By midweek AMI mailroom worker Stephanie Dailey, 36, had also tested positive for the presence of anthrax spores in her nose. Although hardly an official statement went by without the assurance that anthrax is not contagious, the message wasn't getting through in south Florida. In Boca Raton, when 3-year-old Alexander de Jesus got ready to climb into a barber's chair, the hair stylist showed him and his mother the door: she works one floor below The Sun, one of AMI's five supermarket tabloids.

Panic, and perhaps copycats, spread like a nasty flu. Early last week St. Petersburg Times columnist Howard Troxler received a letter warning, in unsteady handwriting, "Howard Troxler... 1st case of disease now blow away this dust so you see how the real thing flys." "This" was a white, sugarlike substance. By the weekend it had tested negative for the presence of anthrax and other pathogens.

Although seemingly every sicko with a grudge had decided that there's nothing like an anthrax threat to strike terror in the heart of your target, the copycat threats that followed the Florida case seemed empty--until Oct. 12. Before dawn that morning the FBI learned that the anthrax bug had hit New York. NBC, the FBI reported, had received a suspicious business letter addressed to "Nightly News" anchor Tom Brokaw. Postmarked St. Petersburg, Fla., it arrived Sept. 25, with no return address. When Brokaw's assistant, Erin O'Connor, opened it, she found white powder and a note: "The unthinkable. See what happens next." NBC's security office called the FBI, which picked up the letter the next day. Within days O'Connor, 38, developed a rash below her left collarbone. After it became more irritated, ulcerous and necrotic (filled with dead tissue), she saw a doctor. The Cipro he prescribed on Oct. 1 cleared the lesion. But it was a call from one of O'Connor's doctors to the city Health Department, reporting a possible case of anthrax, and a call from the city to the FBI, that lit a fire under the bureau. The FBI ordered tests on the powder in the letter O'Connor opened, as well as a skin biopsy from O'Connor, at the U.S. Centers for Disease Control and Prevention in Atlanta.

O'Connor tested positive for cutaneous anthrax. But the powder tested negative. When the FBI interviewed O'Connor more extensively, she recalled that she had gotten another letter, postmarked Sept. 18. She hadn't thought anything of it. But, she finally remembered, it did contain some kind of dark, sandlike powder. That letter, postmarked Trenton, N.J., contained traces of anthrax, the FBI reported over the weekend. The delay in identifying the powder, and O'Connor's lesions, confirmed fears that neither public-health officials nor law-enforcement agencies will recognize bioterrorism quickly. That would be especially horrific if the bug were a contagious microbe such as smallpox.

On the same day that O'Connor was diagnosed with cutaneous anthrax, The New York Times received a letter, postmarked St. Petersburg, on the same date as the letter sent to Troxler. It was addressed to Judith Miller, coauthor with three Times colleagues of the new best-seller "Germs: Biological Weapons and America's Secret War," and filled with white powder. There were "some similarities" in the handwriting on the letters to NBC and the Times, said Barry Mawn, head of the FBI's New York office. Although the substance contained no anthrax, the Times assured readers in a front-page box in its Saturday edition "that no copies of the newspaper are printed in [our] Manhattan headquarters."

To trace the postal anthrax, investigators are trying to identify the strain in the Florida, Nevada and New York cases. To do that, they first grow the suspected anthrax spores in a nutrient medium, such as beef broth, until they germinate into live, rod-shaped bacterial cells, says Calvin Chue, research scientist at the Center for Civilian Biodefense Studies at Johns Hopkins University. If anthracis is present, antibodies in a test kit bind to antigens on its surface. If they do--the test takes half an hour--the antibodies fluoresce. In Reno, however, the state lab tested directly for anthrax spores and got a hit. In the current criminal investigations, the FBI hopes to determine which of the hundred-plus genetically distinct strains of anthrax were sent to AMI, NBC and Microsoft. They have not yet succeeded, and it's not clear that doing so would help much. Many types of anthrax can be found at microbiology labs across the world. The Ames strain, for instance, named after an Iowa lab where it was first isolated half a century ago, "is a very common virulent strain that's used in every antibiotic and vaccine" study, says Martin Hugh-Jones of Louisiana State University.

If the science offers few leads, old-fashioned police work might. In Florida, investigators focused on a one-page, handwritten love letter addressed to Jennifer Lopez, NEWSWEEK first reported on its Web site. It was sent to The Sun, says a source, in Lantana, Fla. It reportedly arrived sometime after Sept. 17. Staffers laughed over it and passed it around the third-floor editorial offices. Enclosed was a small Star of David and a tablespoon or so of a bluish substance that resembled dishwashing powder. Bob Stevens was among those who handled the letter. As one staffer recalled to NEWSWEEK, "The only difference between Bob and those who watched him open it was that Bob [who had poor eyesight] held it up to his face." Stevens's spartan workstation--Macintosh computer, a mousepad decorated with photos of his friends, crayon drawings from a colleague's young son--was a hot spot of anthrax. So was a receptacle in the mailroom, where Blanco and Dailey worked. But how five additional employees were exposed (blood tests came back positive over the weekend) is a mystery: some work for The National Enquirer, whose offices are "way the heck down the hall and around the corner," says The Sun's Carla Chadick.

Even if anthrax reached AMI through a letter, it wasn't much to go on. "I'm not sure the FBI is ready for the amount of weird mail we get," says Grant Balfour, a Sun writer. When you write about alien abductions, celebrity brawls and the size of Osama bin Laden's private parts, you're not surprised when letters arrive with dirty underwear, human feces, claims to being a Romanov heir and other rants.

FBI officials are skeptical that the anthrax at NBC, Microsoft and American Media Inc. came from Osama bin Laden or any other known terrorist. The connections so far are circumstantial. This summer Mohamed Atta and Marwan Al-Shehhi, who piloted the planes that hit the World Trade Center, rented an apartment in Delray Beach, a few miles from the AMI building, and took flying lessons nearby. Last week the White House was calling the FBI every two hours one night after a report that the two skyjackers had asked a Delray Beach pharmacist for an antibiotic to fight anthrax. Rather than antibiotics, in fact, Atta asked for something to soothe an inflammation of his hands. The redness resembled the irritation caused by detergent or bleach. The pharmacist gave him a cream called acid mantle. The incident raised fears that Atta had been using caustic chemicals in a bioterror experiment: detergent effectively breaks up clumps of anthrax spores into smaller, deadlier particles.

Although the FBI has not ruled out a connection to Al Qaeda, says one senior U.S. official, "my instinct says it's a nut case." One death, one easily treated rash and seven symptom-free people with anthrax spores in their noses or antibodies in their blood are hardly what experts expected from terrorists wielding a bioweapon. Every scenario until now has envisioned anthrax spores being aerosolized--dried and turned into a powder--and then disseminated widely in the air, probably into an enclosed space like a building or airplane. The goal would be to spread the spores like an invisible, lethal fog, keeping the particles small enough so that they could be inhaled before settling to the ground. In addition, many bioweapons experts thought terrorists intent on mass murder rather than just mass panic would use an antibiotic-resistant strain. The Russians engineered anthrax strains resistant to penicillin, doxycycline and other antibiotics by splicing in genes from naturally resistant strains of, say, the common intestinal bacterium E. coli. The Florida strain was not genetically engineered, the CDC says, and is vulnerable to antibiotics.

But there is another reason law-enforcement officials have been at pains to emphasize that the anthrax cases have not been linked to Al Qaeda or any other terrorists. "Biological-weapons agents can easily be obtained," Ron Atlas, president of the American Society of Microbiology, wrote recently. "A survey of nearly 1,500 U.S. academic institutions indicates that 22 percent work with pathogenic microorganisms and toxins that could be used in biological-weapons development." You can't just walk into a lab and swipe a vial of anthrax, but researchers admit that nothing would stop a determined individual from hiring on at a lab, as a student or technician, and obtaining a starter culture. "We all use student workers who are 18 or 19," says LSU's Hugh-Jones. "Most of them don't even have any background you can check."

Until the Feds cracked down in the late 1990s, pathogens could also be bought. In 1995, white supremacist Larry Wayne Harris ordered three vials of freeze-dried bubonic-plague bacteria from the nonprofit American Type Culture Collection, for $240. The germs turned out to be an innocuous vaccine strain (weakened, or attenuated, so they don't give you the disease itself rather than trigger immunity to it). In 1986 ATCC sold three types of anthrax to the University of Baghdad, and in 1988 sold four strains to the Iraqi Ministry of Trade. All of ATCC's sales were legal. During the gulf war, however, American intelligence agencies became convinced that ATCC's strains were among those that Iraq used in its biological-weapons program. A 1996 law restricts sales of the most deadly microbes, including anthrax and Ebola, but if scientists are denied access to the bugs, research on vaccines and cures will stop.

The current anthrax cases have not changed one crucial reality: turning path-ogens into weapons of mass destruction is hugely difficult. As far as intelligence agencies know, the group that put the greatest effort into bioterror was Japan's Aum Shinrikyo cult. In April 1990, members drove an automobile outfitted to disseminate botulinum toxin around Japan's Parliament building. In June 1993, they tried to disrupt the wedding of Japan's crown prince by spreading botulinum toxin the same way. They also tried, for four straight days that month, to spread anthrax from a rooftop in Tokyo. "Nine failures in nine attempts attest to the difficulty of actually deploying biological weapons to cause mass casualties," says Atlas. And Aum Shinrikyo had a war chest estimated at more than $300 million, as well as half a dozen labs and experienced biologists. Growing anthracis is hardly more difficult than growing sourdough starter. But turning bacteria into spores, the only form hardy and stable enough to be spread, requires the tricky step of shocking the bacteria with heat or chemicals without killing them. Perhaps the greatest hurdle is getting particles of the right size. Spores tend to clump. Yet particles must be between one and five microns to enter the lungs and trigger inhalation anthrax; it's not easy to get a sprayer to dispense such a fine mist, as Aum Shinrikyo found. Assassination by microbe, however, is a different story. In 1978 the Bulgarian secret police killed dissident Georgi Markov by injecting deadly ricin (derived from castor beans) into his thigh with a pellet shot from an umbrella. And someone killed Bob Stevens. It all seemed like a bad movie. "What are the chances?" asked Penny Robbins, who works in the Microsoft building. "Reno and anthrax?"

It would be foolish to think we can guess what criminals and terrorists will try next. But we might take note that, after 19 men turned planes into bombs, we ramped up airport security--just when people started sending anthrax through the mail. Now we treat our mail like toxic waste, planes with "mysterious powders" on bathroom counters get impounded and doctors bone up on anthrax. Perhaps, instead of fighting the last battle, it is time to anticipate the next. "If we just focus on anthrax," says Ken Alibek, a top scientist in the Soviet bioweapons program who defected to the United States, "we're going to get surprised." We saw the effects of surprise, all too horrifically, on Sept. 11.