The Anthrax Letters: The Attacks That Shocked America (44 page)

T
he case of William Paliscak is emblematic of much about anthrax that remains a mystery. In the context of public health, even describing his case as anthrax related has been a matter of dispute. In its medical context, as with most of the inhalation anthrax survivors, the course of his difficult illness has been puzzling. In the larger perspective of bioterrorism, it underscores the agonizing consequences that can result from a germ attack. For years after the anthrax letters were mailed, victims remained sick, buildings contaminated, and many people anxious.

The bioterrorism attacks in the fall of 2001 have become a learning exercise, and many previously held assumptions have been turned upside down. Even the quantity of spores necessary to cause inhalation anthrax has come under question. Some individuals who were exposed to huge numbers of bacilli did not become ill. Others, who apparently inhaled only a few organisms, contracted the disease and died.

Before the attack it was commonly believed that a patient would need immediate antibiotic treatment to survive inhalation anthrax. In fact, none of the six inhalation survivors were treated with antibiotics until after they had been sick for several days. Similarly, pre-attack dogma held that a chest X ray of an anthrax victim would almost always reveal a widened mediastinum, the area between the lungs. But X rays of at least four of the 11 inhalation victims showed no mediastinal enlargement.

Perhaps the biggest surprise produced by the anthrax incidents was the effectiveness of the U.S. mail as a means of delivering disease. Not only did the anthrax letters carry their poisons to the target addresses, they left a trail of bacteria along the way. Before the attack, evidently no one considered the fact that 3-micron spores could leak through 20-micron pores—the diameter of microscopic holes in the envelope paper.

While the letters caused illness and death to relatively few people, they disrupted the lives of millions. The effects were bad enough from just those five or six letters. But they hinted at the devastation that could arise from hundreds of letters or from other means of delivery and exposure, or from organisms that cause contagious diseases like smallpox and plague, or from a strain of bug that is resistant to antibiotics and vaccines.

The anthrax letters moved concerns about bioterrorism from theory to reality. Complacency has since given way to a broad recognition of the country’s vulnerability to germ weapons. Since the fall of 2001 the nation has been responding to the threat with additional money and programs. Whether in the area of law enforcement, public health, or scientific research, more resources have become available to protect against a biological attack. Opinions differ about how much more or less is needed and where the money should be spent, but most experts agree that the United States is better prepared for a bioattack than it was in 2001.

Still, gaps remain. A dedicated terrorist could doubtless find a vulnerable location or pathway to release his poisons; if not through the mail, then in a building ventilation system. If not by way of a crop duster, then in a subway. Of course, no amount of money and preparation can ever assure absolute protection, but if sensibly applied, they can help.

On February 5, 2003, Secretary of State Colin Powell appeared before the U.N. Security Council to speak of the danger posed by Saddam Hussein’s regime in Iraq. In particular, he deplored Hussein’s presumed arsenal of biological weapons. Dressed in a dark business suit with an American flag emblem in his lapel, Powell held up a glass vial of cream-colored powder. Gingerly grasped between his right thumb and index finger, the vial was the size of his pinky. “Less than a teaspoon of dry anthrax, a little bit, about this amount,” he said, “shut down the United States Senate in the fall of 2001.” (The powder in the vial was not anthrax, but a harmless simulant. )

That the secretary should highlight his concern about Iraqi germ weapons was not surprising. A year earlier in a brief conversation he remarked to me that he considered biological agents to be the most worrisome of all weapons. His deep-seated concern was consistent with that of President Bush. After the anthrax attacks, Bush referred to biological weapons as potentially the most dangerous of weapons. The remarks by these leaders, as well as President Clinton, embrace a general wisdom that biological weapons are especially loathsome.

Meanwhile, the specter of a biological attack was raised again at the end of 2008. In December, after extensive deliberations, the Commission on the Prevention of Weapons of Mass Destruction Proliferation and Terrorism issued its report. The bipartisan body, which had been appointed by the leadership of the U.S. Senate and House of Representatives, concluded that a terrorist attack with a weapon of mass destruction was likely before the end of 2013. Based on several indicators, including the 2001 anthrax attacks, the commission determined that the assault agent would likely be a biological weapon.

As a backdrop to preventing the use of biological weapons, reinforcing long-held attitudes about their immorality is important. But more immediate prospects for minimizing the chances of their use lie with science. Laboratory tests to identify a bioagent, experiments to learn how infected mail contaminates other objects, research on diagnostics and treatment, and interpreting the mind-set of people who send both false and real biothreats—all point to the role of medical and biological science in preventing and responding to bioterrorism. Continued advances in these areas will diminish the threat of germs as weapons and, in consequence, lessen interest in their use.

Meanwhile, it is incumbent on decent people to continue to condemn the use of these weapons as a debasement of civilized society everywhere.

O
n August 4, 2008, three days after news reports about Bruce Ivins’s suicide, Leroy Richmond received a letter from the FBI. It was an invitation to the survivors and family members of the victims who died of the 2001 anthrax attacks. The government wanted to brief them on its case against the former Fort Detrick scientist, whom it deemed to be the perpetrator of the attacks. Ivins’s death abruptly ended plans to bring charges against him, and a federal judge was about to unseal documents that supported the government’s case.

On the morning of August 6, Richmond sat among forty attendees in a packed conference room at the FBI Headquarters in Washington. Others participated via videoconference, their images visible on overhead screens. As Richmond glanced about the room, he thought of his near-death experience seven years earlier. The large Washington postal sorting center on Brentwood Road, where he had worked, had become saturated with anthrax spores. Unwittingly, he had inhaled huge doses.

Richmond was momentarily unnerved by the memory of his painful gasps for air in the days after exposure. His lungs barely withstood the suffocating pressure from fluids generated by the anthrax poison. His recovery had been difficult, and he still feels joint pains and emotional distress that he attributes to the ordeal. “I’m taking all these vitamins to pep me up, though nothing is really helping,” he told me. “I believe these effects are from the anthrax event. I’ve just stopped trying to rationalize why things are happening to me this way, and live with the fact that this is the way things are going to be.”

Richmond’s experience mirrors that of five of the six survivors who contracted inhalation anthrax. Most of those with cutaneous infections recovered fully, but among the inhalation survivors, only Ernie Blanco was able to return to work during the year following exposure. Many years later, like Richmond, the others still complained of the effects. Jyotsna Patel, who had contracted a near-fatal inhalation infection while working in the postal sorting center in Hamilton, New Jersey, continued to suffer fatigue and memory loss. Norma Wallace, an employee at the same facility, remained plagued by joint pains and back spasms that began with the onset of her illness in 2001.

Mary Wright, a physician who works at the National Institute of Allergy and Infectious Diseases, has found similar effects in her study of survivors of the anthrax attacks. As the principal investigator, since the attacks she has annually examined survivors. After seven years, some have not, as she put it, “returned to their pre-infectious disease baseline.” One of the survivors told me that he, like other men in the study, now has low levels of testosterone, which requires continuing treatment. The reasons remain unclear, as they do for the other persistent conditions following exposure to anthrax. Dr. Wright continues to search for explanations.

Of course, some of the anthrax victims never recovered at all. Sitting near Richmond for the briefing was Mary Morris, who had flown from Indiana where she had moved after her husband’s death. Thomas Morris and Joseph Curseen, two of Richmond’s friends and coworkers at Brentwood, were killed by the anthrax.

The briefing was at the J. Edgar Hoover Headquarters Building on Pennsylvania Avenue, two miles south of the Brentwood postal facility. But victims from far greater distances also came to hear the government’s case. A few traveled from New York City, including
New York Post
editor Mark Cunningham, who had recovered from an anthrax lesion on his forehead. Others were from New York -based television news studios, which had been contaminated with spores, and from New Jersey, where workers at the postal sorting center in Hamilton had been infected. Ernie Blanco, who had inhaled a critical dose of spores in Florida, had flown in, as had Maureen Stevens, the widow of Robert Stevens, the first identified victim.

Some of the survivors refused to participate, convinced that they would gain nothing from the briefing. David Hose, who had become severely ill after inhaling a massive dose of spores, remained at home in Virginia. “I don’t believe he did it,” Hose said about Ivins. “It’s too easy to blame someone who’s dead.” Norma Wallace, from New Jersey, also stayed away. She was convinced that if he were guilty, Ivins could not have acted alone. She was not interested in participating because, as she said, “I think the FBI has already made up their minds.”

The mood in the conference room was subdued as the FBI director, Robert Mueller, welcomed the group and expressed sympathy for their experiences. The documents at hand would soon be made available to the public, but the FBI wanted first to brief the attendees and provide them with copies. Mueller introduced other officials present from the FBI, the Justice Department, and the U. S. Postal Service. Then Jeffrey Taylor, the U. S. Attorney for the District of Columbia, offered a review that he would repeat at a press conference later that day. The government was disclosing its evidence even though Ivins’s death precluded charging him, Taylor said, because of the “extraordinary and justified public interest in this investigation.” Peering through rimless glasses, he explained that this was a step toward concluding the investigation. Once that process was completed, “we will formally close the case.”

In reviewing the government’s contentions, Taylor summarized seven items of presumed evidence. The first was the genetically unique connection between the anthrax spores in the letters and those that Ivins had developed and maintained in his laboratory at the U. S. Army Medical Research Institute of Infectious Diseases (USAMRIID) in Fort Detrick, Maryland. Second, Ivins was one of few scientists with the knowledge to produce the highly-concentrated, pure spores used in the attacks. Third, his access records showed that in the days leading up to each of the mailings, Ivins uncharacteristically had worked alone in his laboratory late into the night. (The dates of the mailings were derived from the postmarks on the recovered letters, September 18 and October 9.)

The fourth item was that Ivins had made statements that suggested consciousness of guilt, such as threats in recent group therapy sessions to kill people who have wronged him. Fifth, he had a history of mental health problems. In mid-2001, he e-mailed a coworker, explaining he had paranoid, delusional thoughts. This was about the time that an anthrax vaccine he was working on was failing. Sixth, he was a prolific writer to Congress and the media (the targets of the anthrax letters), and often used false names to disguise his identity as the sender. Investigators had found sixtyeight letters to such entities in his house during a November 2007 search. Seventh, the pre-stamped envelopes used in the attacks contained printing defects that limited the time and locations of their availability. These envelopes were sold in late 2001, only in Maryland and Virginia post offices, including the one in Frederick, Maryland, where Ivins maintained a post office box.

Following Taylor’s comments, one of the FBI’s assistant directors, Joseph Persichini, noted the strenuous efforts that had been applied to the investigation, including 9,100 interviews, seventy searches, and the pursuit of leads in six continents. After the presentations, some of the attendees asked questions. Mark Cunningham inquired about the validity of the science that linked the spores in the letters to those in Ivins’s laboratory. Maureen Stevens wondered why Ivins had retained his security clearance long after he was considered a suspect. Persichini’s answer, that the authorities did not want to alert him that he was under suspicion, seemed to satisfy her. Leroy Richmond mentioned to an agent that a researcher at Fort Detrick had told him that the anthrax in the attacks had been “weaponized.” “Not true,” the agent insisted. “You must have misheard the researcher.”—a response that left Richmond baffled.

But after the meeting, many expressed relief that the FBI appeared to have found the culprit. Cunningham and Stevens said they now believed the FBI had solved the case. “It’s over,” said Ernie Blanco. “Today convinced me.” Patrick O’Donnell, a New Jersey postal worker who had developed a severe cutaneous anthrax infection on his neck, was equally impressed. “It is hard not to be convinced with what they have,” he said. Ramesh Patel and his wife, Joytsna, participated by videoconferencing from the FBI’s offices in Newark. After the government’s presentation, they too pronounced satisfaction. “We feel at ease,” Ramesh said. “It looks like all roads lead to Dr. Ivins.”

The atmosphere at the afternoon press conference was less congenial. The government distributed copies of the unsealed documents and made the same presentation as at the morning meeting, but the probing was more intense. One reporter wondered if the government had any direct evidence: “For instance, do you have any tape that was used on the envelopes that was recovered from his home?” No such tape was found at his home. Taylor acknowledged that much of the evidence was circumstantial, but that it was compelling and, he believed, would have proved the case beyond a reasonable doubt.

Another reporter asked if the government had taken handwriting samples from Ivins for comparison with the writing in the letters. Taylor’s response: “We examined handwriting samples but then there was no comparison made or a specific identification of the handwriting.” Consequently, “we did not have a scientifically valid conclusion that we thought would lead us to be able to admit that in evidence.” The absence of a comparison of handwriting samples seems curious, though the matter was not pursued further at the press conference. Also missing was an indication of whether Ivins’s samples included block lettering, which was the form of writing in the anthrax letters.

When asked about motives, Taylor mentioned Ivins’s apparent concern about the possible termination of the vaccination program he was working on. The attorney theorized that by launching the attacks, Ivins wanted to create “a situation, a scenario, where people all of a sudden realize the need to have this vaccine.”

Another question was important not only to this case but for its implications beyond: “How could a guy in his fragile state, as you describe it in these papers—you know, alcoholism, mental problems, paranoid, delusional, things you described—how could he get away with this for so long?” Neither Taylor nor anyone else could offer a satisfying answer. Ivins’s work performance had not raised suspicions, and it was unclear whether the army knew that he had received psychiatric treatment as far back as 2000. Caree Vander Linden, a spokeswoman for USAMRIID, where Ivins had worked for 35 years, observed that disclosure depends on “an element of self-reporting, and that does make it difficult.” The challenge of identifying a troubled individual working in a high-security position is sure to receive more attention as a result of this case.

The issues raised at the press conference were later revisited by several critics including Paul Kemp, who was Ivins’s attorney, and by members of Congress. In an interview on National Public Radio after the court documents became public, Kemp challenged many of the government’s arguments. Insisting that the case against Ivins was speculative, he ignored the FBI’s contention that everyone else with access to Ivins’s laboratory had been investigated and ruled out. Rather, he argued that more than 100 individuals had access to the unique strain of anthrax kept in Ivins’s laboratory and that there was no evidence that Ivins was the single culprit among them. Nor was there evidence, Kemp maintained, that Ivins had purchased the envelopes with the distinctive defects, traveled to Princeton to mail them, or was motivated to commit the crime because of difficulty with the vaccine he helped develop.

By the time FBI Director Mueller testified before the Senate Judiciary Committee on September 17, the bureau’s hope to quickly close the case had evaporated. The director’s announcement that the FBI had asked the National Academy of Sciences (NAS) to review the scientific evidence signaled that recognition. The process was bound to be lengthy.