Cases handled well, but for a few fumbles

Big anthrax attack could overwhelm system, experts fear

War On Terrorism : Anthrax

October 16, 2001|By Jonathan Bor and Michael Stroh | Jonathan Bor and Michael Stroh,SUN STAFF

If public health experts had to give officials handling the anthrax attacks a report card, they would issue a passing grade - with the caveat that there is much room for improvement.

The rapidly expanding anthrax investigations in Florida, New York, Nevada - and now Washington - have put to the test a public health system that has never faced a biological attack with so deadly an agent.

While public health experts say the attack has been handled capably, there have been a number of glitches.

In New York, a police officer and two lab technicians accidentally exposed themselves to anthrax while handling a contaminated letter sent to NBC news anchor Tom Brokaw.

In Florida, employees at American Media Inc., the tabloid company where anthrax was first discovered, are angry that health officials waited four days to quarantine their building after anthrax was diagnosed in a colleague who died.

And federal and state officials have been roundly criticized for initially playing down the possibility that anthrax had been planted in the building. The case later turned into a criminal investigation.

But experts agree that the public health system contained the problem by identifying the sick and exposed patients and delivering thousands of antibiotics to people. Experts say the system worked because the attacks were limited - and they worry that health agencies would be crippled in the face of a large attack with extensive casualties.

"This has been a very mixed bag," said Jonathan Tucker, a bioterrorism expert with the Monterey Institute for International Studies. "It's obviously very small scale, and very small-scale incidents are so very easy for public health systems to handle."

An adequate supply of antibiotics and laboratories that can handle a high volume of diagnostic tests for biological agents are major concerns. Yesterday, the White House announced it would ask Congress for $1.5 billion to purchase enough drugs to treat 12 million people, six times the number that could be treated with the present stockpiled antibiotics.

Jittery Americans have been hoarding the antibiotic Cipro, the treatment of choice for anthrax, partly out of concern that the federal stockpile wouldn't be sufficient in the face of a large attack.

Even before anthrax was found in other locations, the Florida investigation required so many lab tests that the Centers for Disease Control and Prevention were forced to work around the clock to analyze them all.

The Florida health department, which was collaborating with the CDC, was able to perform nasal tests on nearly 1,000 people, but it didn't have the staff to take blood samples simultaneously. The tabloid company hired a private firm to draw the blood samples, which were sent to the CDC.

The disease centers are likely to be even more taxed by the testing required by the incidents in New York and Washington.

"Say there were a thousand exposures, then you'd have 10,000 or 100,000 or a million people who think they've been exposed," said Dr. Alfred Sommer, dean of the Johns Hopkins School of Hygiene and Public Health. "We would not have had the people to do the investigations, run all the samples and take the swabs and blood specimens."

Federal investigators in Florida, meanwhile, have come under attack from employees and executives at American Media Inc. for not keeping them fully informed of the extent of the anthrax exposure at their Boca Raton building.

General counsel Michael B. Kahane sent a letter Friday to the Florida health department and the CDC complaining that the company learned that a mailroom clerk had been exposed to anthrax only from a television news conference.

Employees, meanwhile, complain that officials waited too long to seal off their building. Even as late as Oct. 5, the day 63-year-old photo editor Robert Stevens died from anthrax exposure, officials insisted his case was an isolated event, probably acquired from natural sources.

But four days later, after finding anthrax spores on his computer keyboard, investigators quarantined the building.

"If it was so dangerous for us to be in our own building, why did they leave us in there for two extra days?" said Jose Lambiet, gossip editor at The Star, one of the tabloids. "That, to me, is borderline criminal."

Officials countered that they closed the building the moment test results confirmed the presence of anthrax in the building.

Federal investigators have already acknowledged that the anthrax case - which mixes a public health and a criminal inquiry - is like none they've tackled before.

"This is absolutely a nontraditional type of investigation," said Hector Pesquera, the FBI special agent in charge of the probe. "This is the most intensive investigation that this state has ever known."

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