Amerithrax (6 page)
The risk, according to other experts, was minimal. An official statement was issued to remind citizens that anthrax was not contagious. In Boca Raton, anyone even remotely connected with AMI’s supermarket tabloid the
Sun
was im- plored to come in and be tested. Spores can take up to sixty days before beginning to germinate and the CDC might still be in time to save lives. At seven o’clock that Sunday eve- ning, Dr. Malecki ordered the evacuation and sealing of the tabloid building.
On Monday, October 8, television cameras captured long lines stretching in front of a white annex building—the county Health Department in Delray Beach. Seven hundred plus AMI employees and a horde of recent visitors to the contaminated building had answered Perkins’s call. Physi- cians swabbed the nostrils of anyone who had been exposed to the work site for even one hour since August 1. At least two weeks passed between the time officials believe anthrax entered AMI and the office was shut down. During that span 350 employees continued to work in a hot building. Jani- torial crews vacuumed and cleaned each of those days. After the building had been closed, the air conditioner had kept running to prevent heat and humidity from damaging AMI property. All this activity might have disturbed the spores and spread them.
One thousand seventy-five nasal swabs were taken from employees and cultured in dark red agar, sheep’s blood in jelly. Anthrax spores thrive in any type of blood nutrient. The swabs were expected to pick up any spores trapped in nose hairs and mucus. Sometimes an exposed person might have a negative nasal swab, but there was no test to tell who might develop anthrax in the near future.
A preliminary test would show results within twelve to twenty-four hours. In the “quick test” antibodies bind to anthrax antigens on the spore surface. The lab would con-
firm evidence of
B. anthracis
DNA in pleural fluid and blood by polymerase chain reaction (PCR). The most defin- itive test, the gold standard, was to let the spores germinate over time and form a characteristic glassy, gray colony, on which technicians could perform a genetic test. They used the definitive test on Ernie Blanco.
As a preventive measure Dr. Perkins put all of the over one thousand employees and visitors on ciprofloxacin anti- biotics, giving each patient two weeks’ worth of Cipro pills and refills for prescriptions. Ciprofloxacin, a whitish, lozenge-shaped pill, was considered an effective and pow- erful antibiotic cure for all known forms of anthrax. Cipro sometimes causes serious diarrhea and other side effects. It also kills normal bacteria in the gut, leaving only resistant germs. To be really effective, Perkins’s patients would have to take the antibiotic for the next two months.
In the meanwhile, public anxiety escalated as fast as the tension between Dr. Perkins and the FBI. “I felt lives were on the line,” Dr. Perkins told the press. “The FBI believed some criminal was killing people and their only objective was to nab him.” The FBI took the lead, assuming control over the AMI building in the Arvida Park of Commerce, their crime scene, and making it a command center. What the feds really wanted to learn was if the bacterium was part of a second attack by the now-dead terrorists. However, so far they’d been unable to find any traces of anthrax where the terrorists had been. Gradually, they were concluding that the AMI case was an isolated case of “foul play.”
Since the FBI and Palm Beach County Health Depart- ment had ordered the AMI building sealed, the suites of offices had remained virtually untouched. Only federal agents and an air-conditioning repair crew had been allowed back inside. The FBI even excluded the CDC. Now that it was very much a criminal investigation, communication be- tween the FBI and CDC broke down. To defuse tension between the two agencies, Dr. Perkins invited an FBI agent into his inner staff, then dispatched a CDC epidemiologist to work alongside the FBI chief at the AMI site.
Dr. Perkins called his boss, Koplan. Within two hours, he had “immediate, clear support from the highest levels of
cials.
Back in Florida, Perkins’s team looked for ways to catch future outbreaks early. To do this, they looked to the ex- amples of the first two victims. During the course of illness, both men had shown markedly increased white blood cell counts. Even in the first stage of the illness, their blood cultures grew
B. anthracis.
Doctors could also identify the bacteria by pleural or transbronchial biopsy specimens by immunohistochemical staining with
B. anthracis
–specific cell-wall and capsular antibodies. They did have a less com- plicated tool. Chest X rays had been a sensitive indicator in both patients. Neither Stevens nor Blanco had a normal chest X ray. A more sensitive indicator in spotting multiple ab- normalities in the lungs and middle sternum would prove to be a CT.
Meanwhile, Florida Senator Bob Graham reported that, according to his briefings by the U.S. Health Department, the chance that two people in the same office would inhale
An Anthrax Task Force was formed, comprising mem- bers of the FBI, U.S. Postal Inspectors, CDC, and local police. They wanted to know why someone with a high degree of technical skill and an array of special equipment had gone to great effort to render anthrax spores into an aerosol. In order for anthrax to be inhaled and enter the lungs it had to be “aerosolized” into particles between 0.4 and 0.0002 inches. That was smaller than a red blood cell. The first question the Task Force asked themselves was: How had the poison been delivered?
As of Wednesday, October 10, state and federal special- ists were still speculating on how the spores had been intro- duced into AMI. Environmental Protection Agency hazardous materials teams examined the sealed plant. A fence had been built around it.
Each member of the Hazmat team donned a second skin of specially blended materials to help seal out harmful con- taminants, followed by a yolk-colored biological safety spacesuit (a pressurized airtight jumper that zips or buttons diagonally across the chest), oxygen mask, and a clear, soft plastic bubble for a helmet. Some headgear was square, some bullet-headed, and they were different colors. Racal hoods, for instance, were the familiar transparent head bub- bles. Each self-contained air supply was connected to an oxygen tank slung over the shoulder and held in place with black straps. Air pressure supplied by an electric motor sucked air from the outside and passed it through virus filters before injecting it into the suit.
This arrangement surrounds the body with superfiltered air and keeps the suit under positive pressure to seal out any hot agents. Any airborne virus particles would have a tough time flowing into it. Each man pulled on thick black Army- issue butyl-rubber gloves and attached them to the suit with locked rings. The one-piece suit slipped into the boots and
Now that they were ready, the team picked up their port- able chemical detector, the APD 2000, which recognizes chemical warfare agents. Silently, they entered the locked tomb. Palms were blowing outside. There were warm winds off the ocean between the sudden rains that were prevalent through October. Inside the deserted building everything was as it had been left. Under their soft helmets, the hum of their blowers filled their ears.
Reverently, the specialists wandered the eerie, dust- covered rooms. Dust shrouded coffee cups. Family photos were scattered on employees’ desks and workstations. The water level in the fish tanks was sinking. A smiling, broad- faced photo of Bob Stevens in a blue-gray shirt still beamed from his desk. He had combed his thin chestnut-colored hair neatly for the picture. The collection of colored crayon drawings on his computer moved slightly in a draft from somewhere or from the furtive movements of the searchers. As the Hazmat team canvassed the ghostly and shuttered offices, they were understandably wary. If there had been enough anthrax in the office to kill one worker and infect another, then there must be incalculable millions of invisible spores all around them. Spores could have been on the em- ployees’ clothes, shoes, hair, on the desks, floors, and in the outdoor air. Had any escaped into the neighborhood? And
for all intents and purposes the bacteria were immortal.
That afternoon, a third AMI employee tested positive for anthrax spores in her nose. Like Ernie Blanco, Stephanie Dailey worked in the AMI mailroom. The CDC’s theory that the deadly spores had been sent through the mail now seemed to be bearing fruit. Spores were also discovered at the post offices and routes leading directly into AMI head- quarters. Samples taken at the West Palm Main Branch, the Green Acres and Lake Worth Post Offices, and the Boca Raton Main Substation all tested hot for environmental con- tamination. Inexplicably, there was a hot spot at the Blue Lake Post Office away from the path the letter had appar-
ently taken. That made no sense unless cross-contamination was possible.
The FBI scanned some tabloid articles: bin laden ter- rorist tells all; terrorist still in america—where they are, what they’re doing, how you can spot them; and inside jennifer lopez fairytale wedding— life must go on. They wanted to know all about the mail sent to the six tabloids. “I’m not sure the FBI is ready for the amount of weird mail we get,” Grant Balfour, a
Sun
writer, told
Newsweek.
On Thursday, the team ferreted out additional spores in a receptacle in the AMI mailroom. Blanco had placed his letters on a stack of copy paper and that paper in turn had contaminated every copier in the building. The spores trailed Blanco’s route as he made his regular rounds from the first- floor mailroom up stairs and elevators to dozens upon dozens of desks and cabinets. The path was densely contam- inated. Spores presumably were stirred up and transported as mail was sorted and delivered and in the daily movements of the staff. The EPA eventually took 462 samples from inside AMI.
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A total of eighty-four places were found to be contaminated. Seventy-eight percent of the contaminated samples were from the first-floor mailroom. Sixty-six anthrax-laden samples were found on the first floor, includ- ing thirty-five from desks, computers, keyboards, file cabinets, and mail slots of cubicles. Spores were found in air filters and vacuum-cleaner bags. An additional thirty-one samples were vacuumed from the first floor.
On Saturday, October 13, Dr. Perkins learned five more of Stevens’s coworkers had been exposed to
B. anthracis.
He was glad he had already put them all on the powerful antibiotic Cipro. He did not expect the five to develop the disease. Apparently, there was no explanation why, unless one considered them simply lucky. They probably did not die because few spores do not cause illness and the immune system stands ready to defend against them. Seven days
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The EPA teams took their samples from October 20 to November 8, 2001.
later, their blood tests would show anti-anthrax antibodies. But how had they been infected? Several of the infected worked in offices for the
National Enquirer.
The
Sun
’s Carla Chadick pointed out that those offices “are way the heck down the hall and around the corner.”
The business of America, even if it was gossip, had to go on. The AMI operation moved to another Boca Raton building after their headquarters was closed. The CEO dis- cussed returning to their space off Yamato Road within a year if enough AMI employees agreed. It was doubtful they would. Stephanie Dailey was at home resting, taking anti- biotics and on the road to complete recovery. Dailey, a young woman with delicate features and big eyes, had shown up on the news dressed in a black shirt and faded jeans. She was flanked by her supportive parents. Her fa- ther’s face, as long and worried as a bulldog’s, showed the family’s deep concern. Blanco’s condition gradually im- proved and (on oral ciprofloxacin) he would be discharged from the hospital “miraculously cured of the usually fatal disease after twenty-three days at death’s door.”