Amerithrax (10 page)

transformer oils and diesel fuel had escaped beneath the twisted landscape. The day before, EPA monitoring had dis- covered high levels of dioxins and heavy metals in runoff water and air around Ground Zero. USGS scientists’ chem- ical leach tests of the corrosive dust and airfall debris sam- ples found them “quite alkaline,” due to high levels of concrete, gypsum, and glass fiber particles. Like Ameri- thrax’s anthrax, any fibers in settled dust would eventually become airborne by rainfall, changes in wind direction, or such simple human activity as walking.

Emergency workers and volunteers at the scene were still wheezing and suffering from upper and lower respiratory distress. Asbestos, heavy metals, and dioxins drifted through the dusty downtown air. As New York tried to catch its breath, the White House struggled to guess the terrorists’ next move. They speculated loudly that an airborne biolog- ical terrorist attack might be next. The public reacted in a burst of panic buying. Over the last two days there had been a run on fifty-dollar gas masks, one-hundred-dollar water- purification kits, and thirty-eight-dollar chemical body suits. Into this atmosphere of dread, flew Amerithrax’s latest letter. It arrived without fanfare in New York, between 48th and 51st Streets and Fifth and Sixth Avenues, and was addressed to the anchor of the
NBC Nightly News
:

T
OM
B
ROKAW NBC
TV

30
R
OCKEFELLER
P
LAZA NEW YORK
NY
10112

Erin O’Connor, Brokaw’s thirty-eight-year-old assistant, noticed there was no return address, but the transmittal en- velope was postmarked “Trenton, New Jersey, 09/18/2001 (Tues.).” The metered numbers read: “10112
+
0002.” She opened the envelope slitting it right to left. The letter inside, a Xerox copy, read:

09-11-01

T
HIS IS NEXT

T
AKE PENACILIN NOW

D
EATH TO AMERICA
D
EATH TO ISRAEL
A
LLAH IS GREAT

The killer was either anti-Semitic or wanted people to think he was. He had misspelled penicillin, possibly on pur- pose. The note was in capital letters. Every maniac from Zodiac to the Unabomber favored uppercase printing. It was harder to match to an individual and gave a more terrifying aspect to messages, as did purposeful misspellings. A zero in front of a single-digit month suggested someone who worked with computers. The poor block printing suggested someone inexperienced with writing by hand. The writer was definitely unused to printing in both upper- and low- ercase. He had made the first character of each sentence larger in an attempt to capitalize uppercase letters. The ini- tial character of the first two sentences and the last line were also boldfaced: “T-T-A.” As in the terrorist “A-T-T-A”?

The one-page letter itself was odd-sized. Because of the irregular edges it was easy to see it had been cut by scissors. The NBC letter measured 225 millimeters long by 215 mil- limeters wide. It had been cut from standard copy paper 279 millimeters long and 215 millimeters wide. Amerithrax had trimmed 54 millimeters from its length to create an almost square letter.

Why? He might have wanted the letter to appear as if someone European had composed the letter since European letters had a height-to-width ratio of 1.41 to 1. Yet Ameri- thrax had cropped it so clumsily. Why did he trim the letter? He had another reason.

The threatening letter was slightly damp along one side as if it had been in water. The writer promised, “THIS IS NEXT.” What was next? O’Connor found out as she stapled the letter to the envelope, a common practice to keep the two pieces together and easy to access. As she shot a staple into the porous paper, a “relatively crude” substance spilled onto her. The envelope had contained some kind of “dark, sand-like powder.”

When anthrax bacteria are dried and form tiny protective

spores, anthrax turns into a white or beige powder. NBC had gotten an earlier letter filled with powder, but that was not unusual. For the three years preceding 9-11, the threat of bioterrorism had received widespread publicity in the United States. Dozens of offices had received envelopes containing white powders alleged to be anthrax. So far not one had actually contained anthrax.

On Tuesday, September 25, the phone rang at the New York FBI Field Office. Since 9-11, agents had been working out of a makeshift, but secure, bunker. The phone lines had been constantly busy. Most of the agents were out on cases. NBC-TV security was on the line about a letter to Tom Brokaw postmarked September 20 from St. Petersburg, Flor- ida. The letter contained powder resembling talcum and a “threatening” note which read, “The unthinkable. See what happens next.” Like the Trenton letter O’Connor had opened, this one carried no return address.

The next day two FBI agents normally assigned to in- vestigate drugs dropped by NBC to pick up the letter. They entered by the main entrance on Fifth Avenue between 49th and 50th Streets. Flags of a hundred nations blew in the wind. A sunken space, Tower Plaza, was topped by the gold- leafed statue of Prometheus. Behind Tower Plaza loomed a seventy-story tower, the GE Building.

As it turned out O’Connor had no time for an interview, so the agents stuck the St. Petersburg letter in an evidence vault until she did. As a result they did not test the powder until at least two weeks later. Nor did they immediately notify City Hall. Their delay in identifying the white powder later confirmed fears that the FBI wouldn’t recognize bio- terrorism when they saw it.

Over at the New Jersey Post Office, postal repairman Richard Morgano was studying his hand. What once had been a minor cut was now a small lump—like an insect bite. By day’s end that bite had developed into a rash. Ameri- thrax’s media letters had been sealed and taped when they passed through the postmarking machines Morgano had been repairing. Had the hardened spores been microscopic enough to pass through the porous envelope? Experts said that was not possible. But it was true that paper has tiny

invisible pores and merely handling the unopened letter could have given a postal worker anthrax.

At NBC–New York, another assistant, Casey Chamber- lain, twenty-three, remembered a St. Petersburg letter that contained talcum powder. By Friday she too saw the begin- ning of a small, localized lesion on the surface of her skin, then a rash just like Richard Morgano’s.

On Saturday, September 29, the seven-month-old infant son of a producer to Peter Jennings at ABC–New York fell ill, apparently bitten “by a spider.” As far as his mother could tell, the baby got the bite while visiting the ABC head- quarters with his baby-sitter. That was the only time she had ever taken the infant to work. The baby spent almost an hour and a half in her office, the cafeteria, and at a birthday party on an upper floor. The following day, the boy devel- oped a non-tender, abnormal accumulation of serous fluid in the connective tissue of his left arm. The back of his arm swelled to frightening proportions. His mother was frantic. Doctors treated the two circular skin lesions, which had be- gun weeping, with intravenous antibiotics.

Over the weekend, O’Connor felt like she was coming down with an illness. Her low-grade fever was accompanied by a throbbing headache. Within days she had a bad rash below her left collarbone. The rash had started with a small painless lump that resembled a bug bite. Within a few hours, the bite became a reddish brown irritation that started to swell until it was a solid bump. The papule enlarged and ulcerated. The rash became more irritated and necrotic (filled with dead tissue). She saw her doctor, Richard Fried, who was concerned enough to take a biopsy, a sliver of the tissue, and send her to a specialist.

On Monday, October 1, the same day Ernesto Blanco was hospitalized with pneumonia in Florida, postal worker Teresa Heller and Claire Fletcher, Dan Rather’s assistant at CBS, developed inflammations with purplish brown or black centers. That afternoon, Erin O’Connor went in to see her doctor to get some relief.

The physician studied the wound and described it as: “an approximately five-centimeter-long, oval-shaped lesion with a raised border, small satellite fluid-filled spots.” The out-

break was less than 0.2 inches in diameter, but he noted a profound swelling filled with fluid. He associated the strongly defined injury with a swollen gland in her neck— lymph nodes fighting back against infection. Serous fluid from the injury tested negative by gram stain and culture in preliminary tests. Doctors had not seen anthrax in decades and so, until Bob Stevens’s death, that disease seemed out of the question, especially in the big city.

Over several days O’Connor’s inflammation developed a purplish black center, depressed and surrounded by an area of swelling. Encircling it were one- to three-millimeter ves- icles, pouches filled with yellow fluid. As is classic with skin anthrax, there was little pain. The malignant pustule, a blister containing pus from a collection of white blood cells, progressed from a fluid-filled blister to a painless ulcer one to three centimeters in diameter in two days. The “feverish blister” split the skin and the painless welt developed a black, ulcerous scab that soon loosened and fell off. The doctor prescribed the heavy-duty oral antibiotic Cipro. Since that cleared the injury, O’Connor was given two weeks’ worth.

On Tuesday the infant’s “spider bite” had become ulcer- like and developed a black scab like O’Connor’s. Anthrax was so rare that no one realized the well-defined injury was not from a spider. Spider bites often have a black spot at the center. The baby required intensive care, his clinical course of treatment “complicated by hemollytic anemia and thrombocytopenia.”

O’Connor’s serum specimen was collected for PCR test- ing. On Saturday, October 6, her doctor alerted the New York City Health Department that “We’ve got a possible anthrax case.” In turn Dr. Marcie Layton rang up Stephen Ostroff of the CDC. Only after the Health Department called Barry Mawn did the fifty-six-year-old head of the New York FBI Field Office discover the delay in investigating the St. Petersburg letter to Brokaw. Mawn and his eleven hundred agents had been working eighteen-hour days since 9-11. The call from NBC about the first letter was “one of maybe about eight thousand leads we had received,” Mawn told FBI expert Ronald Kessler. “The letter should have been sent to

headquarters for immediate testing. The agents who nor- mally pursue drug cases handled it like a drug case.” Mawn made sure the powder was tested as soon as possible at the CDC. There was crucial urgency because it might be the first salvo in another terrorist attack on New York City. The St. Petersburg letter was delivered to lab chief Richard Meyer in Atlanta. Surprisingly, it turned out not to contain anthrax. That afternoon, three technicians began processing a variety of objects from O’Connor’s workstation. They found no spores either.

By jet that afternoon Dr. Zaki’s pathology lab at the CDC received O’Connor’s tissue sample encased in an inch- square paraffin block. The sample was sliced into hundreds of wafer-thin sheets, each mounted on a glass slide. Zaki and research assistants Jeannette Guarner and Wun-Ju Sheih ran each slide, working frantically to locate any magenta- colored anthrax rods on the landscape of tissue. By 1:00 a.m., Zaki had found only two, both on one of the last slides, at opposite ends. But that was enough. O’Connor’s tissue sample had tested positive by immunohistochemical staining for the cell-wall antigen of
B. anthracis.
An hour later, Mayor Rudolph Giuliani was on the phone with the CDC. He wanted to make a public announcement, but was getting conflicting information. Army analysts, studying some of the same tissue as Zaki, had found no rods. Since the St. Pe- tersburg letter was a hoax, the question was: “How and where had O’Connor gotten infected with anthrax?”

The cutaneous variety she had contracted was the most common type. When treated with penicillin it was rarely lethal. With treatment virtually all cutaneous patients sur- vive; without treatment some 80 percent survive. The fatal- ity rate is approximately 20 percent and death occurs only if generalized blood poisoning ensues. With antibiotic treat- ment the rate of fatality is only 1 percent. Antibiotics often are effective, as in the case of Brokaw’s assistant, even after the skin lesion turns black.

Cutaneous anthrax is contracted when spores breach the skin through minor cuts and abrasions. Underneath the sur- face, they flourish into toxin-producing bacteria that assault surrounding tissue. The body responds by sending immune

cells to consume the invading microbes. However, as in the case of inhalational anthrax, the poison spreads as immune cells carry microbes back to lymph nodes and infect them too. After an incubation stage of one to twelve days, a pain- less, depressed, black scar (usually with surrounding water- filled swelling) develops. It is the black scablike crust that gives the disease its name—
anthracis
—the Latin translation of the Greek word for coal,
anthrakis.

On Friday, October 12, O’Connor was at home recov- ering. When the FBI reinterviewed her by phone, she sud- denly remembered a second envelope addressed to Brokaw. It had been received within a week of the St. Petersburg letter and filed in an interoffice folder reserved for question- able mail. At the time she hadn’t thought much of it, but now recalled that a “dark, sand-like powder” had spilled out. Following her directions, an NBC security guard took the elevator down to her third-floor office. He quickly found the folder in her drawer. Inside was the missing letter. He de- cided to open it for further examination in a second-floor mailroom, then returned to the sixteenth-floor security of- fice. Now the elevator and the second, third, and sixteenth floors were contaminated.

It was still very early Friday morning when NYPD of- ficers, with the Brokaw letter in a plastic bag, raced up to the city health department lab. “They took it to our lab,” said the city deputy health commissioner, Dr. Isaac Weis- fuse, “and the handling of it caused a contamination event at our lab later that day. The police didn’t know how to handle samples.” As anthrax powder puffed out of the en- velope in clouds, two of the three lab workers inhaled it. Unlike their counterparts at the CDC, the technicians had never been offered anthrax vaccines. The two men took Cipro then conducted nose swab tests on themselves. After both technicians tested positive, they were too traumatized to continue work. The lab was sealed until cleanup could be accomplished and this delayed analysis of the second Bro- kaw letter.