The Anthrax Letters: The Attacks That Shocked America (6 page)

The discovery of anthrax at AMI raised enormously important questions: How did anthrax get into the building? Was anyone else there infected? Were others at risk? Was the AMI building the sole target? Who was responsible for releasing the germs and why did he, she, or they do it?

O
n Monday, October 1, 2001, the day before Bob Stevens entered the JFK Medical Center in Atlantis, Florida, Ernesto Blanco was admitted to Miami’s Cedars Medical Center, 65 miles to the south. “Ernie,” the name favored by his fellow American Media, Inc., employees, was the company’s mailroom clerk. At 73 he had an elfish smile and a full head of hair, more black than gray, which suggested a man 10 years younger.

Toward the end of the previous week Ernie had been “feeling something funny,” he recalls in accented English. The Spanish-language rhythms of his native Cuba, where he had been an accountant before fleeing the 2-year-old Castro regime in 1961, still flavor his speech. On Friday fellow workers noticed that Ernie seemed dazed. As noon approached, Maria Wolcott, a clerk in the advertising department, called the security office to see if someone there might drive him home. “Maria, why did you do that? I feel fine,” he protested. His bravado was short lived. Soon after, he confessed to feeling dizzy to his boss, Daniel Rotstein, AMI’s vice president for human resources and administration. “Go home and don’t worry,” Rotstein said.

After retiring from his own carpet installation business in 1989, Ernie began working for Globe Communications, a tabloid publisher. Ten years later AMI acquired Globe and then moved its headquarters from Lantana to the Globe building in Boca Raton, where Ernie continued to work. His daily commute from his Miami home began with a 7-minute drive to the Golden Glade Tri-Rail station. After parking, he’d board the 6:35 a.m. train north. Sixty minutes and seven stops later he was at the Boca Raton station, a short bus ride away from the AMI building on Broken Sound Boulevard.

By 8 a.m. Ernie was driving the company van to the post office to pick up the mail, somewhere between 3,000 and 5,000 pieces a day. Upon returning to AMI, he would wheel the pile into the mailroom. Then began the sorting process, which he usually did alone, though occasionally with help from Stephanie Dailey or another clerk. With lightning speed, Ernie flipped letters into their mailboxes, a honeycomb of 300 open compartments. “I know where most of the letters go without looking at the names on the mailboxes,” he says. No small achievement, considering the plethora of departments, offices, and individual addressees at AMI. Once sorted, the letters were transferred to mail carts for delivery throughout the three-story building.

In the course of wheeling the carts around, Ernie came to know people everywhere. On the ground floor, near the mailroom, was Martha Moffett, who ran the library. Down the hall were the offices of the legal staff, the photo library, and the personnel department. An elevator brought Ernie to the second floor, where the
Globe
, the
Star
, and the
Weekly World News
had their offices. On the third floor, continuing his deliveries, he’d wave to Ed Sigall, senior editor of the
National Enquirer
, and to Ray Villwock, editor-in-chief of the
National Examiner
. If Ernie saw Bob Stevens at the
Sun
, they were sure to exchange a quip or two. In the sweeping executive offices next to the
Sun
, David Pecker, AMI’s president and owner would offer a smile. Ed Sigall thought of Ernie as a company fixture whom “everyone knows and likes.”

On the Friday he felt dizzy, when the head of security came to take him home, all Ernie remembers hearing was, “Okay, Ernie. Let’s go home. I’ll drive.” An hour later he was back in the Miami house in which he had lived since 1976. His wife, Elda Rosa, dosed him with hot lemonade, honey, and aspirin. He felt a bit better. Convinced that he had the flu, Ernie was sure he’d be back at work on Monday. But as the weekend progressed, he developed a cough and fever, his fatigue worsened, and he became more disoriented. Early Monday morning Elda drove him to the Cedars emergency room.

Ernie was admitted and diagnosed with pneumonia. He was given intravenous azithromycin and cefotaxime, antibiotics that are effective against a range of bacteria. But Ernie’s delirium worsened and he began to have difficulty breathing. On Tuesday the treating physician called in Dr. Carlos Omenaca for consultation. Omenaca, tall and dark, as handsome as any character on TV’s “General Hospital,” speaks with a light Castilian accent. In the 1980s, after attending medical school in his native Spain, he came to New York to do research at New York’s Hospital for Joint Diseases. He studied further at New York University and completed a residency in infectious diseases and critical care at St. Luke’s-Roosevelt Hospital. In 1997 he moved to Florida.

Omenaca examined Ernie, looked at his chest X ray, and concurred that he had pneumonia. During the next few days, Ernie failed to improve. His X ray showed a pleural effusion, a collection of fluid in the space between the lungs, which suggested bacterial pneumonia. But Omenaca says, “The funny thing was that he had a typical presentation of a viral illness. There was nothing else to suggest bacterial pneumonia.” Omenaca was referring to the fact that Ernie’s fever, nausea, confusion, and fatigue were consistent with viral symptoms. At the same time, his blood culture, taken the day after his admission to the hospital, revealed no suspicious bacteria. If the usual bacterial suspects for pneumonia, such as
pneumococci
or s
taphylococci
, were responsible, a day or two of antibiotics should have produced some improvement. By Thursday Omenaca felt stymied:

On Thursday morning, October 4, Daniel Rotstein was in his AMI office when he heard from the Palm Beach County Health Department that Bob Stevens, whom he knew was in the hospital, had meningitis. Worried about the effect of this news on other employees, Rotstein contacted a medical consultant the company had used in the past: “We need to draft something about meningitis to tell the employees what they need to do and not do.” He also was considering inviting a doctor in to answer questions the employees might have. Later, in the afternoon, his secretary told him that Bob Stevens’s wife, Maureen, was on the phone. He was stunned to hear her say, “I just found out Bob has anthrax.” “We’ll do all we can to help,” Rotstein assured her. After hanging up, he realized that all he knew about anthrax was that it was scary.

Soft spoken and professorial, Rotstein, 36, confided, “You know, the first thing I did after that was call my father.” Was he a frightened young man seeking parental comfort? Not really, he grins. “My father is a physician, and I asked him about anthrax.” Like most doctors, Rotstein’s father, a neurologist and psychiatrist, had limited knowledge of the disease. “He told me what he could. He also knew about that island in Scotland.”

Rotstein was referring to Gruinard Island, a small body of land, less than 2 miles off the northwest coast of Scotland. His father knew that the island had been contaminated with anthrax, but little more. In fact, during World War II, British and American scientists had performed biological warfare experiments there. Seeking to determine how lethal anthrax spores would be after they were released by explosive devices, the scientists conducted several tests. In one they tethered sheep at measured distances from a central point. Then they exploded cannisters that had been filled with a gruel containing anthrax spores.

Within a day the animals were dead or dying. After more experiments, anthrax-infected carcasses began to litter the site. The scientists and their staffs removed or incinerated the remains. In 1943, when the testing program ended, they set fire to the island, anticipating that the spores would be destroyed. But by the end of the war the scientists were surprised to find that spore counts in the soil were undiminished. In succeeding decades, periodic testing confirmed that concentrations of anthrax remained unabated. For more than 40 years, no one was permitted to go on the island. Not until 1990, after soaking portions of the island in tons of formaldehyde and seawater, did the British government deem it safe for human visitation. By then Gruinard Island had become a monument to the danger and durability of anthrax spores.

Soon after Maureen Stevens called Rotstein, news of her husband’s anthrax “started hitting the media,” as Rotstein put it. Within minutes of the first broadcast, he received a call from Martha Moffett, AMI’s head librarian. She was home with a stomachache and diarrhea. “I had just taken my temperature and was looking at the thermometer when I heard a radio news bulletin,” she recalled. “It said that an employee at AMI had been diagnosed with anthrax.”

Moffett, who holds a library science degree from Columbia University, began working for the
National Enquirer
in 1976. She had been thinking about retirement, but AMI management convinced her to stay on. Now, alone in her small Lake Worth home, surrounded by shelves of books and papers, she spoke nervously into the phone:

“Dan, I just heard the radio announcement. Look, I’m sick and I don’t know what it is.”

Rotstein replied, “We really don’t have much information about all this yet.”

“What should I do?”

“Go to the hospital immediately and tell them what you just told me.”

Rotstein said he believes in “erring on the side of caution.” Moffet packed a few things, drove to Congress Avenue and headed south less than a mile to the nearest hospital—JFK Medical Center, in Atlantis. “I knew Bob Stevens was there,” she said later, “but it’s my hospital. That’s why I went there.”

The other AMI employees also quickly learned about the anthrax “because we have CNN on all the time,” Rotstein said. It was almost 5 p.m., and people were leaving for home. He heard several express concern about Stevens’s condition. They were plainly eager for more information. Rotstein remained at his desk, planning for the next day. He thought about his earlier idea to notify everyone about Stevens’s meningitis. Now with anthrax in the picture, a meeting the next day with all employees seemed imperative.

Sometime after 7 p.m., as he was developing an agenda for the meeting, a frightening thought popped into Daniel Rotstein’s head. “I put two and two together,” he said. “I remembered that when Ernie Blanco left here, he was very disoriented.” People from AMI had kept in touch with Ernie’s family, and Rotstein knew that Ernie had been diagnosed with pneumonia. But to Rotstein the symptoms sounded similar to those that had been reported of Bob Stevens. “I decided to call his hospital to alert them to the Stevens situation.”

Rotstein reached the Cedars operator and asked to speak to Ernesto Blanco’s floor nurse. She was unavailable. “Please have her call me as soon as possible,” Rotstein said. A half hour passed with no word from the hospital, so he called again. Again he was told that no one involved with Mr. Blanco’s case could take his call. Rotstein went home and continued to phone the hospital, each time requesting a return call. After a half dozen futile attempts, at 11:30 p.m. he received a call from the hospital’s infectious diseases nurse. She sounded very interested in what he had to say and promised she would give the information to a doctor.

Half an hour later, at midnight, Rotstein’s phone rang. It was Dr. Carlos Omenaca. “I told him about the situation with American Media and with Bob Stevens and how some of the symptoms appeared to be very similar,” Rotstein later said. Omenaca remembers the conversation with appreciation: “I started looking at Mr. Blanco’s case as possible anthrax immediately after he called.”

In May 1999 an article appeared in the
Journal of the American Medical Association (JAMA)
entitled “Anthrax as a Biological Weapon: Medical and Public Health Management.” Based on a review of the literature on anthrax, the article represented a consensus view of 21 leading medical, public health, military, and emergency management experts. Among them were Donald A. Henderson, Tara O’Toole, and Thomas Inglesby from Johns Hopkins University’s civilian biodefense program, and Edward Eitzen and Arthur Friedlander from the U.S. Army’s Medical Research Institute of Infectious Diseases at Fort Detrick, Maryland. The experts were described as the Working Group on Civilian Biodefense. Their article was generally viewed as the most up-to-date compendium on anthrax as a weapon.

In treating inhalation anthrax, the working group advised that, initially, a patient be given intravenous doses of ciprofloxacin, or Cipro. Studies had shown that Cipro, more than other antibiotics, was effective against a large variety of anthrax strains. But the article also said that if a strain is shown to be susceptible to doxycycline or penicillin, these antibiotics would be preferable. That is because overuse of Cipro would promote the development of resistant strains of other more common pathogens, including
staphylococci
and s
treptococci
. Frequent use could also lead to unwanted reactions such as nausea and diarrhea or central nervous system disturbances and irregular heartbeats.