U.S. health inspectors expanded their anthrax investigation and treatment programs today as the number of suspicious cases increased, according to reports.
About a dozen possible cases of inhaled anthrax, including one person linked to the U.S. Senate, were being investigated, according to Washington and New Jersey health officials, who added that another 20 people in the Washington area who might have been exposed to anthrax were under observation.
Recommendations have been made to expand antibiotic treatment to all workers in 120 public and private institutions in the Washington area that receive bulk mail. The decision was made based on fears that such mail may have been contaminated at the U.S. Postal Service Brentwood Road mail facility, the emerging epicenter in the Washington anthrax incidents, according to the New York Times (see GSN, Oct. 24). There is growing evidence that anthrax spores from the tainted letter sent to U.S. Senate Majority Leader Tom Daschle (D-S.D.) spread through the mail-handling machines at the Brentwood center, according to investigators. Tests have found anthrax spores along the path taken through the center by the Daschle letter and others sent to the same ZIP code (Todd Purdum, New York Times, Oct. 25).
About 40 people in the Washington area are hospitalized and under observation, but except for two inhalation anthrax cases, none of the others are expected to be confirmed anthrax infections, said Washington Health Department Director Ivan Walks. Only one of the monitored patients did not work at the Brentwood facility: a woman who was in the Hart Senate office building the day the Daschle letter was opened, said a hospital spokesman.
The low number of possible anthrax cases in Washington indicates the danger has passed, said Walks. "I do think we're turning the corner," Walks said.
About 120 workers at an offsite White House mail sorting facility, where anthrax spores were detected yesterday, tested negative for anthrax exposure, said White House spokesman Ari Fleischer. Another 80 workers from that facility and the White House mailroom will be tested today, Fleischer said, adding that all had been given the antibiotic Cipro as a precaution. FBI officials have questioned whether anthrax spores were actually present at the offsite White House mail facility, according to the Washington Post, and are awaiting further test results.
The U.S. Postal Service will begin taking some mail to private firms in Washington and New York that are equipped to kill anthrax spores by spraying them with electrons, officials said, adding that they hope to have similar technology in place at many postal facilities within two months. The Postal Service is also examining using more automated machines to sort mail, reducing the hands-on risk to workers, said Chief Operating Officer Patrick Donahoe. More than 500,000 U.S. postal workers will be given gloves and masks as protection, said Senior Vice President Deborah Willhite.
"We cannot be 100 percent sure the mail is safe," Donahue said. "It would be irresponsible to say it's 100 percent safe ... [but] our operations are up and running now. We've got mail going in and out. It will be pretty much back to normal."
The Brentwood facility, which handles nearly all of Washington's mail, will be closed for three to four more weeks while contractors approved by the Centers for Disease Control clean and test the site, according to the Post. Anthrax spores at the facility might have come from tainted letters other than the Daschle letter, according to the FBI and postal officials. Those tainted letters may be in Senate and House of Representatives' mailrooms or in congressional members' offices, according to the Post. Investigators are waiting for the Defense Department to provide a biologically secure facility before examining that mail (Tucker/Nakashima, Washington Post, Oct. 25).
Anthrax spores were discovered in a new section of the Hart building yesterday, according to investigators. The spores were found near a freight elevator on the first floor in the southwest section of the building. Mail to the Hart building is often brought up through that elevator, but it is unknown if the Daschle letter took that route, according to CNN. The southwest section of the building has been sealed off. The southeast section, where Daschle's office is located, still remains closed. The other two sections of the building remain open (CNN.com, Oct. 25).
Congressional staffers were allowed back into the Russell Senate office building yesterday. The House Rayburn and Cannon office buildings were expected to be opened today, said Capitol Police spokesman Lt. Dan Nichols. The anthrax-contaminated areas in the Dirksen Senate office building and the Ford House office building would be cleaned overnight with an antibacterial foam, according to Nichols. "The foam will be used with everything still in the room, with the goal, of course, of killing the anthrax bacteria," Nichols said.
Senator Daschle said he hoped the Dirksen building could be opened as early as Friday. "We want to get back to normal as quickly as we can," Daschle said. "Allowing senators the opportunity to get back into their offices is a part of our ability to do that" (Alan Fram, Associated Press/RealCities.com, Oct. 25).
U.S. health officials announced yesterday that a deal had been reached with Bayer to buy 100 million doses of Cipro. Health and Humans Services Secretary Tommy Thompson said the government would pay 95 cents per pill, which is about half of the usual price. The number of people taking Cipro and other antibiotics given by government officials is "approaching 10,000," said CDC spokeswoman Kay Golan, though a precise number was unknown (Associated Press/London Guardian, Oct. 25).
Thompson also announced yesterday the immediate release of $3 million through the CDC to supplement public health grants to the anthrax-affected locations: New York, Washington, New Jersey and Florida. "The award will accelerate active surveillance detection and confirmation of anthrax cases," Thompson said. "These actions will help improve our public health response capabilities" (Federal News Service transcript, Oct. 24).
Health officials yesterday offered antibiotics to any postal workers who might have handled anthrax-tainted mail to the American Media Inc. building, the site of the first anthrax incidents. Health officials had previously said it was not necessary to test all postal workers, according to the Miami Herald. The decision to provide antibiotics, as well as masks and gloves, to postal workers came in response to heightened fears over recent anthrax infection cases in New Jersey and Washington involving postal workers, according to the Herald. "The health professionals still believe the amounts of anthrax found are not enough to make anyone sick," said Postal Service spokesman Joseph Breckinridge. "But because of the seriousness of what happened with our two postal employees in Washington, we realize there is a lot of anxiety."
Anthrax spores had previously been detected in a fourth Florida post office, health officials said. Trace amounts of anthrax spores were found in a nonpublic section of the post office where mail is processed, said officials. "There is no indication that these spores pose a health risk," said the Florida Health Department. "The testing has been completed, and all areas have been cleaned, retested and are now negative for the presence of the spores" (Miami Herald, Oct. 25).
Ernesto Blanco, the second man to have been diagnosed with inhalation anthrax, was released from the hospital on Tuesday. "He's lost some weight but overall he looks pretty good," Maria Orth, Blanco's stepdaughter, said yesterday. Doctors have told Blanco to continue taking Cipro for two more weeks, according to the London Independent. Blanco said he feels a little sluggish, and occasionally coughs, but expects to be back to normal in a couple of days.
"God chose me as an example to serve as spokesman to humanity to not be afraid," Blanco said. "We feel satisfied that at least we've won one point in this battle. We know this can be beaten" (Amanda Riddle, London Independent, Oct. 25).
U.S. and Kenyan medical experts have argued over whether a package sent to a Kenyan businessman contained anthrax, according to the Daily Nation. U.S. investigators said yesterday that the package did not contain anthrax. Kenya said that tests conducted by the Kenya Medical Research Institute, which showed anthrax spores, "were 100 percent correct."
"We have reviewed the slides of the stain and smear tests done on the powder and confirmed the presence of anthrax spores," said Kenyan Director of Medical Services Richard Muga. "Laboratories can disagree, but our position was made clear and we don't see any reason why we should change," Muga said.
The CDC conducted further tests on the suspicious powder, using equipment unavailable to Kenyan investigators, according to Nairobi Hospital Director Andrew Stenton. "There are other bacillus which look a lot like anthrax and you can make an error on that," Stenton said (Mike Mwaniki, Daily Nation, Oct. 25).
Tests conducted on a U.S. letter sent to Argentina showed "minuscule traces of harmless" anthrax on the surface, according to spokesman for the Florida company that mailed the letter. "The letter probably came into contact with the bacteria at a mail-sorting facility or some other stop during its journey from Florida to Buenos Aires," said Barry Epstein, a spokesman for Plaza Resorts Orlando-Fort Lauderdale Vacations. "The bacteria, therefore, was not purposefully placed in the brochure the envelope contained, as health and law enforcement officials originally suspected," Epstein said.
In response to Plaza Resorts comments, the FBI and a U.S. official in Argentina said they could not confirm if new test results had returned. "To our knowledge, the results of the tests have not come back," said the U.S. official. There is no such thing as harmless anthrax, according to doctors. "All strains are potentially virulent," said Frederick Southwick, chief of infectious diseases at the University of Florida College of Medicine (Alfonso Chardy, Miami Herald, Oct. 25).
The composition and manufacturing process used on the anthrax spores sent to Senate Majority Leader Tom Daschle (D-S.D.) are more sophisticated than previously thought (see GSN, Oct. 24), investigators said yesterday, and may reveal clues into the spores’ origin.
The spores in the tainted letter sent to Daschle had been treated with an advanced chemical designed to enable the spores to float in the air longer by removing their electrostatic charges, investigators said. Only three nations are believed to have developed this kind of chemical: the United States, the former Soviet Union and Iraq, according to experts. The totality of the evidence, however, suggests that the spores were not produced in the Soviet Union or Iraq, according to a government official.
The presence of the advanced chemical was confirmed yesterday through studies at the Army Medical Research Institute of Infectious Diseases. There was no doubt the spores sent to Daschle had been specially treated because of their high dispersal rate, said four anthrax weapons experts. “The evidence is patent on its face,” said Alan Zelicoff, a senior scientist at Sandia National Laboratories’ Center for National Security and Arms Control. “The amount of energy needed to disperse the spores [by merely opening an envelope] was trivial, which is virtually diagnostic of achieving the appropriate coating.” David Franz, of the Southern Research Institute, said, “In order for a formulation to do what the one in Daschle’s office appears to have done—be easily airborne—it would require special treatment” (Weiss/Eggen, Washington Post, Oct.25).
The producers of the spores sent to Daschle produced a dry powder that was remarkably free of extraneous material, said William Patrick, a microbiologist who worked for the U.S. biological warfare program before it was stopped in 1969. Removing the charges is a major step towards making an effective anthrax weapon, according to biological warfare experts. Whoever sent the spores in the Daschle letter had achieved that step, said Patrick. “It’s fluffy,” Patrick said. “It appears to have an additive that keeps the spores from clumping.” The process to remove the charge is a black art, Patrick said, of which few details are known publicly.
The idea that the Daschle spores were not the type to be used in weapons was “nonsense,” Patrick said. “The only difference between this and weapons grade is the size of the production. You can produce a very good grade of anthrax powder in the lab. The issue is whether those efforts can be expanded in scale, so you can make large quantities” (William Broad, New York Times, Oct. 25).
The spores used in the Florida, New York and Washington incidents appear to have gotten progressively smaller and more potent, investigators said. The ones that arrived at Senator Daschle’s office were the smallest and most lethal. The ones discovered in the Florida incidents, however, were larger and least likely to be dispersed and inhaled, according to the Wall Street Journal. The diminishing spores size may mean the producers have been experimenting with a large amount of anthrax and had access to laboratory equipment, said a law enforcement official.
Investigators are looking at the texts of anthrax tainted letters sent to NBC News, the New York Post and Senator Daschle for clues as to who might have sent them (see GSN, Oct. 24). The three letters each had “09-11-01,’ written across the top, as if following up on the Sept. 11 terrorist attacks, however, the wording of the letters is inconsistent with past messages sent by suspected terrorist mastermind Osama bin Laden and his al-Qaeda organization, said investigators. Past messages from bin Laden refer to the United States and Israel as “Crusaders” and “Jews,” according to the Wall Street Journal. The anthrax letters use “America” and “Israel” (Wall Street Journal, Oct. 25).
Retired Air Force antiterrorism specialist Gerald Brown said he doubts the anthrax incidents are the work of Muslims or recent U.S. immigrants. “We believe this is home grown,” said Brown, adding he thought the Daschle letter was crafted to be deadlier and to attract more attention after letters sent to news organizations had not achieved a larger response.
A case could also be made that the writing in the letters are a disguise by a native English speaker to shift attention to foreign terrorists, other analysts have said. “This is not natural handwriting,” said forgery expert Richard Galasso. “The baseline quality of all this writing is poor. The slow, deliberate, labored writing is either disguised … or could mean the writer is unskilled or not very literate in writing English.” The numeral “1” used in the letters was crafted from three lines, said Galasso, as if ‘writing from a text. This is the way you would formulate ones when you were learning in kindergarten. It’s a person who could be attempting to be childlike in deception.”
Some experts say someone unfamiliar with English may have written the letters. “This is just somebody who has learned his letters,” said John Voll, professor of Islamic studies at Georgetown University. “When I try and write Arabic, it looks kind of like that,” Voll said. The message of the letters is “pretty simple minded,” said Voll, adding the letters are “in league with a simple minded fanatic or, as some people are saying, a hoax. It’s what every American thinks a Muslim fanatic would write.”
The Daschle letter stands out from the others in several ways, said Brown. The handwriting is more forceful, the sentences punctuated and the language more emphatic. This could mean it was written by a different person, Brown said. The letter specifically mentions anthrax, as opposed to the ones sent to NBC News and the New York Post, which could mean the author wanted to attract more attention, according to Brown.
The anthrax incidents may be the work of domestic terrorists, said Brown, partly because a letter was sent to Daschle, “who’s on the left. If it’s a home grown militia effort, Daschle’s a likely target”(Peter Slevin, Washington Post, Oct. 25).
Officials yesterday announced an agreement in which German drug maker Bayer is to supply the United States with 100 million tablets of the anthrax antibiotic Cipro at 95 cents per tablet (See GSN, Oct. 24).
Under the agreement, the United States will have the option of purchasing a second order of 100 million pills at 85 cents per pill, and a third order at 75 cents per pill. Also, Bayer will rotate the government’s inventory, assuring a continuously fresh supply.
The initial order for the U.S. will increase the government stockpile of antibiotics enough to allow for treatment of 12 million people, up from 2 million people (U.S. Department of State release, Oct. 24). Drug makers are also petitioning the U.S. Food and Drug Administration to approve additional antibiotics for use in treatments against anthrax, the New York Times reported today (see GSN, Oct. 23). Bayer asked for approval of its drug Avelox (Keith Bradsher, New York Times, Oct. 25).
Additionally, Bristol-Myers Squibb and Johnson & Johnson asked for approval of two Cipro-related drugs, called Tequin and Levaquin (Hensley/Zimmerman, Wall Street Journal, Oct. 25).
After finalizing its agreement with the United States, Bayer announced that it would supply Cipro to Health Canada at the same price that it offered the U.S. Earlier this week (see GSN, Oct. 23), the company had offered $1.30 per pill (Dennis Bueckert, Canadian Press/Miami Herald, Oct. 24).
Canadian Health Minister Allan Rock yesterday engaged in a round of political spitfire with opposition leaders in parliament over how he handled the Cipro purchase. The opposition have criticized Rock for attempting to build a stockpile of ciprofloxacin—the active ingredient in Cipro—by purchasing it from a generic supplier that is not licensed to supply the drug because Bayer owns the patent.
While members of parliament questioned Rock, other officials released documents that appeared to show that Bayer initially had told Health Canada that it would not be able to fill the national health service’s order because “Bayer had other demands” and the company “had no more Cipro available” (Fife/Friscolanti, National Post, Oct. 25).
The Bush administration yesterday proposed allocating $45.2 million to improving the security of the nation’s food supply. The money would come from a $20 billion administration request to strengthen U.S. biosecurity efforts.
“We must remain vigilant in protecting our nation’s food and agriculture,” said U.S. Agriculture Secretary Ann Veneman.
Yesterday, Health and Human Services Director Tommy Thompson put the administration’s concerns about food safety even more strongly: “I’m more fearful about this than anything else” (see GSN, Oct. 24).
The proposed funding would enhance the U.S. Department of Agriculture by providing $17.2 million for improved security at USDA facilities, $14.1 million for building a research facility in Ames, Iowa, $5 million for technical assistance to local, state and federal agencies and $8.9 million to improving response mechanisms to potential threats (U.S. State Department release, Oct. 24).
Ten drug companies have submitted proposals to supply smallpox vaccine to the U.S. government, Health and Human Services Secretary Tommy Thompson announced yesterday, adding that the deadline for proposals had been extended to today.
The pharmaceutical industry could produce the amount of vaccines Thompson said he wanted in a year, said Adel Mahmoud, president of the drug company Merck Vaccines, which has submitted a proposal. “We can speed up production of the vaccine. We have the scientific capability. We have the know-how,” he said (Bradsher/Petersen, New York Times, Oct. 25).
Experts have said the 12-month deadline would require shorter testing periods than the government currently requires (see GSN, Oct. 24). Senators Edward Kennedy (D-Mass.) and Bill Frist (R-Tenn.) have drafted legislation that would streamline the drug-approval process and provide new legal immunity for companies working on bioterrorism treatments (Julie Appleby, USA Today, Oct. 25).
The United States is likely to allow drug companies to speed up safety trials on the vaccine, pharmaceutical industry experts said after Thompson asked drug companies last Friday to present proposals describing how quickly they could produce smallpox vaccine (see GSN, Oct. 23).
This could be accomplished by shortening clinical trials to 12 months rather than the several years testing normally requires, experts said. No U.S. company currently produces the smallpox vaccine, so companies would probably have to start from scratch (Charlotte Denny, Guardian, Oct. 25).
Large-scale production would probably begin with vaccines made from a live but less dangerous form of smallpox called vaccinia virus (see GSN, Oct. 24), but some companies are working to develop safer vaccines that would use dead virus particles. The dead-virus vaccine has only been tested on animals, and there are no current plans to include it in the national stockpile, government officials said (Bradsher/Petersen, New York Times, Oct. 25).
Meanwhile, people should not panic about potential smallpox threats, said Elizabeth Whelan, president of the American Council on Science and Health. There is no hard evidence rogue states possess smallpox, she wrote in an article published in the Wall Street Journal. “Smallpox is not immediately contagious,” she said, adding that a victim does not become contagious until the smallpox rash breaks out and the person becomes very ill—probably too ill to walk around public places. A suicide terrorist could infect himself or herself with the virus, but the person would probably be too sick to walk around and seriously spread the disease, Whelan said, adding that a terrorist release of an aerosolized version of the virus, however, would be effective.
Government and health facilities have plans to contain smallpox outbreaks, Whelan said, noting a smallpox case that was contained in New York City in 1947. After a man sick with smallpox arrived in the city and two people in his hospital contracted the virus, authorities isolated the victims, inoculated the healthcare workers and then inoculated all New Yorkers who had not received recent vaccinations. In just over a month, more than 6 million people received vaccinations and only 12 smallpox cases resulted (Elizabeth Whelan, Wall Street Journal, Oct. 25).
The U.S. Postal Service said yesterday they plan to test mail processing centers along the East Coast for anthrax, as well as begin purchasing devices that would sanitize mail before it reached recipients.
The mail processing centers to be tested for anthrax include nine in New York and New Jersey, which are believed to be part of a chain that handled anthrax tainted letters sent to NBC News and the New York Post, according to USA Today. “They believe infected mail went through these facilities,” said Jeff Perry, a mail handler’s union president in New York (USA Today, Oct. 25).
The Postal Service also said yesterday it would buy devices designed to kill anthrax in mail through the use of powerful beams of high energy electrons. Ion beam sterilization is already in use in the food and medical-device industries. The machines will be installed first in sites where there are clear threats of encountering tainted mail, said Postal Service spokeswoman Sue Brennan. “This appears to be the best way to eliminate contaminants from the mail,” said Brennan.
Ion beam systems were chosen because they could be retrofitted for mail centers and because the Postal Service believes they are safe for workers and customers, said Brennan. It could take months to get equipment designed for food and medical industries deployed in mailrooms and U.S. mail centers and the initial investments would run into the tens of thousands of dollars for the smallest systems, according to experts. The Postal Service said that its first purchases of the new systems would come out of a recently approved $200 million security fund. The costs could run into the billions of dollars if the systems are eventually installed into all of the more than 300 U.S. regional mail centers, according to the New York Times.
Sterilization machinery would be harmless to most letters, but in some cases could damage computer disks and other electronics and discolor photographs, according to the Times. Some of the systems could pose environmental challenges that would add to the costs.
“It’s a relatively specialized field administered by people with lots of training,’ said A.E. May, sales director for Anderson Products, a company that produces sterilization equipment. “It’s a very sensitive time to be in this field. You want to help but you’ve got to be very frank about the limitations” (Feder/Revkin, New York Times, Oct. 25).
An effective enforcement mechanism for the Biological Weapons Convention needs to be developed with the cooperation of U.S. drug and biotechnology researchers, said Henry L. Stimson Center analyst Amy Smithson in today’s Wall Street Journal.
“The pharmaceutical industry overflows with brilliant scientists who relish the tough problem,” she said. “They should be cut loose to take a crack at this one—how to create a feasible, meaningful biological weapons monitoring regime.”
Smithson said the success of the Chemical Weapons Convention was due in large part to the chemical industry’s involvement during treaty negotiations. The industry “took the lead in eliciting the kind of information that would make the treaty work,” Smithson said. “They opened their doors for national trial inspections. And that’s where you figure out what does and doesn’t work.”
The pharmaceutical industry opposed the long-negotiated treaty verification protocol which the Bush administration publicly rejected in July. “What we didn’t want was a bad protocol that gave a false sense of security and also unfairly targeted our industry,” said Gillian Woollett of the Pharmaceutical Research and Manufacturers of America (PhRMA), the industry’s trade group in Washington.
PhRMA disapproved of several of the protocol’s measures. It felt that random inspections would be ineffective because even with short-notice, plants conducting illegal activities could “quickly obliterate traces of any development, manufacture or storage of a biological weapons agent,” according to PhRMA sources. PhRMA said it could live with challenge inspections, where is a site is visited because of specific suspicions, if the inspected company were given final determination of what was proprietary information and could be withheld from inspectors (Chris Adams, Wall Street Journal, Oct. 25).
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