The number of U.S. anthrax exposures rose over the weekend, with new cases appearing in New York, Florida and possibly Nevada (see GSN, Oct.12).  U.S. Health and Human Services Secretary Tommy Thompson described the anthrax situation as “an act of terrorism” and authorities in Florida revealed a possible, if tenuous, link to suspected terrorist mastermind Osama bin Laden.

Latest Cases

A letter mailed to a Microsoft subsidiary in Reno, Nevada, tested positive for anthrax after two earlier tests came back inconclusive, Nevada Governor Kenny Guinn announced Friday.  The envelope was originally mailed with a check from Microsoft to Malaysia.  The check was returned along with pornographic pictures, officials said, one of which tested positive for anthrax.  There was no powder in the envelope, meaning it would be very difficult for the bacteria to become airborne, said state epidemiologist Randy Todd.  “We feel this is a very, very low risk for public health,” Todd said (CNN.com, Oct. 13).  Of the six people who came into contact with the letter and who were tested for possible exposure to anthrax, four tests came back negative and results were still out for two others, Nevada officials said today (National Post, Oct. 15). 

Malaysia said it would prosecute anyone found responsible for the letter mailed to Microsoft from that nation.  “As a matter of policy, this government … will extend its fullest support and cooperation to the U.S. authorities,” Malaysian Foreign Minister Syed Hamid Albar said on Sunday.  “We will not hesitate to use the full weight of the law against anyone found to be involved in such dangerous and malicious acts.”  Hamid said Malaysia had not confirmed that the letter had been sent from Malaysia or “that it was not tampered with in the United States itself” (Sean Yoong, Associated Press/Nando Times, Oct. 14).

New York

A policeman and two laboratory technicians who handled the tainted latter to NBC News tested positive for exposure to anthrax, said Mayor Rudolph Giuliani.  The tests showed the exposure was small and that the three are not ill, said Giuliani, but they are taking antibiotics as a precaution (Joyce Howard Price, Washington Times, Oct. 15).  More than 400 NBC employees who had visited the offices around the time two tainted letters were received in September are being tested for possible exposure.  Employees were being kept away from the NBC News offices and the nightly newscast moved to the Today Show studio across the street, however, public health officials said there was little to fear.  “The public health risks associated with that building right now are minimum, and pretty close to negligible,” said Stephen Ostroff, chief epidemiologist at the Centers for Disease Control.  “So people who work in that building, spend time in that building, should go about their business” (Lipton/Rutenberg, New York Times, Oct. 14).

Health officials have also tested workers at the New York Times for possible exposure after reporter Judith Miller opened a letter that contained a suspicious powder.  Test results on the powder so far have come back negative for anthrax (Slevin/Powell, Washington Post, Oct. 15).

The latest New York cases illustrate flaws in the way the city handled its initial response to two suspicious letters received in mid-September, federal and city officials said.  The mistakes included a police detective at the NBC office mishandling one of the letters, lab technicians wearing protective gear that was not secure enough and the Health Department and federal law enforcement officials delaying their report to the mayor’s office about the potential threat to NBC.  “What we’re going to do as we learn these things, we’re going to move forward, recreate our procedures, do these things differently,” said Giuliani.  “Three weeks ago if I got an envelope like this I would have passed it around to seven or eight people or 10 people.  I wouldn’t have known the difference.  Now you know you shouldn’t,” Giuliani said (Eric Lipton, New York Times, Oct. 15).

The FBI has also come under criticism for a slowed response to the NBC letters, according to the New York Times, including not testing them until two weeks after they had been notified.  The FBI laboratory ran no tests on the powder or skin samples brought in by Erin O’Conner, the NBC employee who tested positive for exposure.  “That, unfortunately did not take place,” said Barry Mawn, assistant director of the FBI’s New York office.  The FBI picked up the letters from NBC on Sept. 26, but New York officials were not informed until days later, according to the Times.  “Information sharing between the FBI and the [New York Police Department] has always been poor,” said one official.  “There is often a lack of willingness on the FBI’s part to share information, although it is getting better.  As they move forward, clearly the FBI is going to have to be more forthcoming” (Steinhauer/Dwyer, New York Times, Oct. 13).

Florida

Investigators at the American Media Inc. headquarters, the location of the first anthrax exposures, are focusing on the company’s mailroom as the main contamination area, according to officials.  The contamination was believed to be in the mail receptacle for the Sun tabloid, where the man who died from anthrax worked, said FBI spokeswoman Judy Orihuela.  Postal workers who handled mail for AMI are being tested for possible exposure.  “Because of the possible link between the bacteria and the mailroom, which is where we have it located, we have taken the additional public health step of looking very closely at the mail facilities that serve this location,” said Hector Pesquera, head of the FBI in Miami (Canedy/Yardly, New York Times, Oct. 13).  Five more workers from AMI tested positive for anthrax antibodies in their blood, which means at some point in their lives they were exposed, said AMI General Counsel Michael Kahane.  None have displayed symptoms and all are being treated with antibiotics, said authorities.

In a possible link between the Florida exposure cases and the Sept. 11 terrorist attacks, the wife of the editor of the Sun rented apartments to two suspects killed in the suicide attacks, the FBI said Sunday.  Gloria Irish rented one apartment to Hamza Alghamadi and another to Marwan al Shehhi over the summer, said Orihuela.  Both men were on the second flight to hit the World Trade Center.  “There is now a link between the editor’s wife and the terrorists, said Orihuela, who declined to make the link to the AMI anthrax exposures.  “Right now it looks like a coincidence.  We are not searching the apartments at this time.  We are focusing on [the AMI] building,” Orihuela said (Miami Herald, Oct. 15).

The outbreak of anthrax exposures in the United States may not be the work of Osama bin Laden’s organization, but it is likely to be bioterrorism, according to federal officials.  “Is this the al-Qaeda?  We don’t know,” said Health and Human Services Secretary Thompson Sunday.  “But it certainly is an act of terrorism to send anthrax through the mail.”  U.S. Attorney General John Ashcroft refused to rule out a link between the cases and bin Laden.  U.S. Senate Foreign Relations Committee Chairman Joseph Biden (D-Del.), however, was not as sure.  “If [bin Laden] had this capacity, do you think he’d be sending it in envelopes?  We should calm down a little bit,” he said. (David Jackson, Dallas Morning News, Oct. 15).

Bioterrorist Version of the Unabomber

Many experts agree that the anthrax cases do not fit the bin Laden’s profile, as they have targeted small numbers of people and have succeeded in killing only one.  Bin Laden “likes big, very dramatic events,” said Jason Pate, manager of the Weapons of Mass Destruction Terrorism Project at the Monterey Institute of International Studies.  “Yes there’s lots of media attention on the anthrax cases, and it has a very ominous, sinister effect psychologically.  But it doesn’t have the boom that has been al-Qaeda’s [method] for the past three years.”

More likely, according to terrorism experts, is a bioterrorist version of the Unabomber, with the Sept. 11 attacks acting as a catalyst (Liz Marlantes, Christian Science Monitor, Oct. 15).  “If someone asked me now, I would probably opt for a man with a grudge, or maybe two of them, wanting to cause mayhem on the back of the World Trade Center attack,” said Martin Hugh-Jones, professor of epidemiology at Louisiana State University.  To use anthrax as a weapon, a “cake” must first be made of spores and stabilizing chemicals that would be ground down into a powder, according to Hugh-Jones.  “I would say that a first-year microbiology student with a very good centrifuge could mix a crude powder,” Hugh-Jones said.  The chemicals in the powder used to stabilize the anthrax could reveal who created it.  “What matters as much are the chemicals you mix with the anthrax to stabilize it because that tells you about the sophistication of the people who mixed it,” said Hugh- Jones, adding, “because the microbiological world is a small place, you know how the scientist working in Russia, or that scientist working in Iraq, will stabilize his anthrax” (Neil Tweedie, London Telegraph, Oct. 15).

Flaws Found in Public Health System

The anthrax exposure cases have exposed flaws in the public health system in the event of a more massive bioterrorist attack, according to the New York Times which reported that better diagnostic tests and laboratories were needed.  “The thing [the anthrax exposures in New York] did test, and I would say validly, was the early detection mechanism, and the laboratory response, at least for that area,” said D.A. Henderson, who was recently appointed chairman of an advisory committee on bioterrorism.  “If this had been an outdoor release involving as much as 500, or 1,000 people, that would have been a very different test of the health system,” said Henderson.  The supply of antibiotics in the national pharmaceutical stockpile came under criticism for being too small.  “If there was even just a moderate hit in New York or Washington, that would be exhausted immediately,” said Michael Osterholm of the University of Minnesota.

The government also needs to do a better job of relaying information to the public, according to some experts, who say that in times of public health crisis people want to hear credible, accurate information from doctors, not politicians.  Two potential choices are U.S. Surgeon General David Satcher and Centers for Disease Control Director Jeffrey Koplan, said U.S. Senator Barbara Mikulski (D-Md.).  “I would have liked to have seen Dr. Satcher.  I would have liked to see Dr. Koplan,” Mikulski said.  “They have devoted their lives to being germ warriors.  If they don’t know how to talk about it, nobody can.”  Other experts agree:  “One of the lessons drawn from Florida is the first thing Americans need to hear is a voice that speaks from knowledge, not from hyperbole,” said Amy Stimson, a bioterrorism expert at the Henry L. Stimson Center (Sheryl Gay Stolberg, New York Times, Oct. 14).

The media has also been faulted for providing wrong information to the public with two recent headlines, one on the anthrax being modified and the other on the Florida strain coming from an Iowa facility, being singled out.  “From the indications we have, the strain seems to occur naturally in sick animals in the United States and other parts of the world,” said Koplan, adding that the Florida strain “doesn’t look like the strain” that was collected in Iowa in the 1950s.  Health officials often fail to share information with reporters and when they do, fail to explain it in a way for reporters to understand, according to USA Today.  “Every bioterrorism exercise, every policy analysis that’s been done emphasizes the importance of continuously supplying reliable information to the public,” said Tara O’Toole of the Johns Hopkins University Center for Civilian Biodefense.  “I would hope this incident would be a useful lesson on the need to change the way that information is presented to the public,” O’Toole said (Steve Sternberg, USA Today, Oct. 15).

Officials and citizens alike have complained about getting mixed messages on the level of threat.  “Contradictory statements from Washington” made it hard for people to know what to do, said Boston Mayor Thomas Menino.  U.S. Vice President Dick Cheney said Friday, that “It’s bound to be a confusing time for people” (R.W. Apple Jr., New York Times, Oct. 14). 

The government has enough drugs available for isolated incidents, said U.S. Senator Bill Frist (R-Tenn.), but not for a widespread attack.  “If an airplane flew over and exposed hundreds of thousands of people, you couldn’t handle it in our public health infrastructure,” said Frist.  U.S. Health and Human Services Secretary Thompson said yesterday he wanted to increase the available federal stockpiles of anthrax antibiotics by 10 million doses. A spokesman from Bayer, the manufacturer of the popular antibiotic Cipro said, “We could meet an order like that” (Andrew Pollack, New York Times, Oct. 15).

Anthrax Around the World

In Australia, the U.S. consulate-general in Melbourne was evacuated after a suspicious package arrived.  Similar incidents occurred throughout Australia including the Australian taxation office in Canberra, a Melbourne newspaper, a Sydney post office and the British consulate in Brisbane.  Twenty-six people underwent decontamination, however, politicians have said there is no need to panic.  “I think it’s important that we don’t start leaping at shadows,” said New South Wales state Premier Bob Carr (CNN.com, Oct. 15).

Several hundred people were evacuated from the Canterbury Cathedral in Great Britain yesterday after a worker said he saw a man dropping white powder in one of the chapels.  It was unknown what the powder was and police were unsure how long tests would take (Associated Press/Atlanta Journal-Constitution, Oct. 15).  Three people from Britain are being tested for anthrax, according to the British Department of Health.  They are workers from U.S. buildings where anthrax exposures have occurred (Lean/Buncombe, London Independent, Oct. 14).

A powdery substance was discovered in a letter in Calgary, Canada, on Friday.  The material was found in a letter sent from a man in the United States to a friend in Calgary.  When the Calgary man discovered the powder, he immediately called the police. When the man called his U.S. friend, he was told no powder should have been inside (Kerry Williamson, Calgary Herald, Oct. 13).   

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