The Anthrax Letters: The Attacks That Shocked America Read Online Free Page B

mind: “They’re large. Really. You know, it could be anthrax,” he said. Her pleasant smile melted: “Oh my God. Don’t say that.” “Look, in my mind this is anthrax until proven otherwise. But we don’t know yet, so don’t say anything to anyone.”
    Kandy was so frozen by the thought that for days she refused to talk about it. Even her family didn’t find out about her involvement until the news became public. She calls the experience “exciting and scary, like nothing else in my life before.” And, “I hope I never see anything like it again.”
    Physicians are largely unfamiliar with many of the germs likely to be adapted as biological weapons. The variola virus, which causes smallpox, killed hundreds of millions of people in past centuries. But by the mid-20th century, vaccinations against the disease had markedly reduced the numbers. The last recorded case in the United States was in 1949. A global vaccination program by the World Health Organization to eradicate smallpox from the earth was declared successful in 1980. Thus, few doctors practicing today, especially in the United States, have ever seen a case of smallpox.
    Plague is equally obscure. Caused by the bacterium Yersinia pestis , outbreaks in the past wiped out huge populations. In the Middle Ages a plague epidemic killed one-third of Europe’s population in just four years, 1346 to 1350. The disease became less fearsome after the development of penicillin and other antibiotics in the mid-20th century, since they offer protection if administered soon after exposure. In the United States, beyond a few locations mainly in the Southwest, where an infected rodent occasionally transmits the bacterium to a human, today’s physicians have never treated a case. Timely diagnosis thus is less likely.
    Still, in the cases of smallpox and plague, historical experience provides a bank of knowledge. Symptoms, treatment, and methods of prevention are well established. None of this is true for anthrax, which in recent centuries has never been widespread among humans. In the United States only 18 cases of anthrax from inhaled spores were recorded in the 20th century. Dr. Bush’s early suspicions therefore seem all the more remarkable. Despite the increased publicity about bioterrorism, the cold fact is that the use of biological agents for hostile purposes has been rare. The only known large-scale incident in the United States was in 1984, when the Rajneesh cult in Oregon poisoned restaurant salad bars with s almonella bacteria. At least 750 people became ill, but none died. As far as we know, anthrax had never been used in this country for hostile purposes—never deliberately to infect or kill anyone. Dr. Bush was running against the grain of history and experience.

     
    Anthrax spores normally lie beneath the surface of the soil. Grazing animals, like sheep, goats, or cattle, may become infected by ingesting or breathing in the bacteria. Human anthrax infections almost always arise from contact with such an infected animal or its wool, hair, or hide. Cutaneous anthrax, which occurs if spores enter through cuts or other skin openings, is largely treatable with antibiotics. But if the spores are inhaled, they are far more likely to be deadly. Unless antibiotics are administered soon after exposure, recovery is uncertain. Moreover, 90 percent of untreated victims of inhalation anthrax die.
    In spore form, anthrax bacteria are tough and durable. Potentially dangerous anthrax spores have been found in locations where infected cattle carcasses were buried 140 years earlier. After lying dormant for decades, certain conditions can transform spores into active, germinating organisms. Paradoxically, one such condition occurs if a spore is engulfed by a macrophage, one of the body’s natural defense cells that ordinarily destroy such foreign bodies. Thus, the very cell that usually protects a person from an invading microorganism may transport and activate an