Plague fears

A bioterrorism expert talks about the wicked ways of anthrax and the even deadlier potential scourge of smallpox.

By Suzy Hansen

Oct 9, 2001 | With at least two mysterious anthrax cases in Florida, Americans are wondering if the next wave of terrorist attacks has begun. Anthrax and smallpox have long been considered the ideal bioterrorist weapons; in fact, smallpox may have been used as long ago as the French and Indian War. President Richard Nixon officially renounced biological warfare in 1969, but other countries, significantly Russia, continued their development programs. Jonathan B. Tucker, an expert on chemical and biological weapons in the Washington office of the Monterey Institute of International Studies, is the editor of "Toxic Terror: Assessing Terrorist Use of Chemical and Biological Weapons" and, more recently, "Scourge: The Once and Future Threat of Smallpox." Salon spoke to Tucker from his office in Washington.

What are the first signs of anthrax?

Nonspecific flu-like symptoms followed by fever, difficulty breathing and death. There are treatments -- Cipro and other antibiotics -- but they're only helpful if administered before the development of acute symptoms like difficulty breathing.

What do you think about what's going on in Florida right now with the two anthrax cases?

From the evidence that has been made available thus far, it is highly suspicious, but not conclusive that this is a bioterrorist incident. It is puzzling that only two people appeared to have been exposed. One would have expected that if in fact aerosolized anthrax was disseminated through the ventilation system, more people would have been exposed. Why only two? Unless they are particularly susceptible to the disease depending on the state of their immune system.

There's the suggestion that this could have arrived by mail. Is anthrax effective in a powder form?

It definitely could arrive in a powder form. It could survive indefinitely if it wasn't exposed to light. It would be killed if exposed to ultraviolet rays. If it was a fine powder then it could easily be suspended in the air. It takes 8,000 to 10,000 spores to cause an infection -- that's a speck of dust. But the spores have to be small enough that they could be inhaled deep into the lungs and be retained. If they're too big, they'll get caught in the nose or throat.

This could be a low-tech terrorist attack, some local deranged individual or domestic terrorist group. There have been literally hundreds of anthrax hoaxes over the years. But the timing is extraordinary. If we weren't in a state of high-vigilance, we might not have diagnosed this case. It does show that the system worked.

How fast do symptoms show?

It really depends on the dose and the immunological competence of the host. Anywhere from two to three days up to more than a month, depending on how well the body can fight off the infection. Also, it depends on the amount of spores that are inhaled.

But in contrast to smallpox, people do not spread this to others.

Anthrax is not contagious. Only those directly exposed would be at risk of developing the disease.

Exactly what does it do to you?

There are different types, but the most lethal form is pulmonary anthrax, which results from the inhalation of spores. Spores are a form of bacterium that's in a kind of suspended animation -- the bacterium forms a tough outer coating so that it can survive under harsh conditions for long periods. Once inhaled into the lungs -- roughly 8,000 to 10,000 spores are sufficient to cause infection -- they will germinate, multiply in the bloodstream and release toxins that cause damage to vital organs and cause a lethal outcome. It's a highly virulent disease. If the strain of the bacterium is a virulent strain, it can cause an upwards of 85 to 90 percent fatality rate.

Typically, how fast can this happen?

In the case of the individual in Florida, it was within a week or two.

Could this man have gotten it from an animal?

Back when there was a serious problem with natural anthrax, most people contracted it by coming in contact with contaminated wool or animal hides. In the 19th century it was called "wool-sorters disease" because people who dealt with contaminated wool or yarn or worked in tanneries could inhale spores from the contaminated hides.

Do you think that they're taking the necessary precautions down there?

The Centers for Disease Control is investigating this. They are testing everyone. They are administering antibiotics to everyone in that building in Florida. They are obviously treating everyone in the Sun building with antibiotics because of the possibility that they might have been exposed to anthrax, and that is the prudent thing to do. If antibiotics are administered before the appearance of acute symptoms of anthrax, it is possible to prevent or cure the disease.

Next Page: Smallpox, a potential catastrophe

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