Amerithrax (28 page)
Was the anthrax killer after revenge or did Amerithrax have a darker, more rational motive than “He done some- thing to me”? And what of Amerithrax’s threatening notes, with their racist tinge (anti-Semitic and at the same time anti-Arab); what of his helpful medical suggestions?
And so, in the absence of new forensic clues, postal in- spectors fell back on traditional shoe-leather methods. They visited hundreds of households that received letters mailed through the Trenton sorting hub around the same time as the letter to Senator Daschle had passed through. The postal inspectors’ goal was to get people to remember where the mail came from. This way, they might be able to trace which
neighborhood the particular bin of mail that included the poisoned letters came from.
In Trenton, the Task Force interviewed residents and be- gan swabbing mailboxes for clues to the source of anthrax- laden letters posted in September and October. Residents in Ewing Township were shown photos of the known and sur- viving letters and asked whether they recognized the hand- writing: “Have you noticed anything suspicious lately?” “Do you know of any chemists living among your neighbors?” “Have you seen any cars with out-of-state licenses?” “Do you routinely leave outgoing mail in your personal mailbox for letter carriers to pick up or do you typically drop your letters in a public box?”
Some residents kept mail picked up at the post office weeks earlier unopened and double-bagged on their back porches. They planned to wait until it was safe. But anthrax spores were hardy and lethal for roughly seventy years. In- vestigators swarmed over the neighborhood after skin an- thrax was diagnosed in a mail carrier, Teresa Heller. Agents hoped to trace the sources of any contaminated letters she may have handled. They had seized several mailboxes in the past few days.
Meanwhile police and the CDC under Dr. Stephen Os- troff’s direction searched Kathy Nguyen’s one-bedroom Bronx apartment. Entering the sturdy, black-trimmed metal door, they swabbed every surface. Biodetectives vacuumed all her clothes looking for spores. Agents poured over her phone records and inspected her regular post office, her usual laundry, and her favorite grocery store, the Freeman Grocery on Freeman Street. She was a churchgoer at St. John’s Chrysostom Church, so they tested that too.
Using Nguyen’s subway fare card, police traced her path around the city as she commuted to work from the elevated Whitlock Street Station, taking the No. 6 to the East 86th Street Station. She often traveled the subway to Chinatown. The Department of Health analyzed every subway station she passed through or frequented. Had she been infected by someone she passed?
Over a four-day period in June 1966, Army researchers traveling by train smashed glass lightbulbs filled with
Ba-
cillus subtilis variant
along the tracks of the three main north-sound underground lines in mid-Manhattan. The Institute’s anthrax exercise included the Seventh and Eighth Avenue trains. Forceful tunnel winds propelled clouds of fine gray dust, five to three microns in size, out subway entrances, contaminating the city from Times Square to the Bronx. This was confirmed by sampling devices and sensors at the far ends which measured the spread within as a suc- cession of speeding trains endlessly transported germs from one station to the other through pulverization and suction. The Institute also secretly released clouds of
Serratia mar- cescens
(SM), an anthrax substitute, into the New York City subway. SM germs grow as red-colored colonies that can be effortlessly detected.
The Institute’s own classified report, “A Study of the Vulnerability of Subway Passengers in New York City to Covert Action with Biological Agents, Fort Detrick, Mary- land,” concluded that “A large portion of the working pop- ulation in downtown New York City would be exposed to disease if one or more pathogenic agents were disseminated covertly in several subway lines at a period of peak traffic.” This became a plot element of Richard Preston’s widely read 1997 novel,
The Cobra Event
. In April 1998, journalist Lau- rie Garrett quoted former White House health advisor D. A. Henderson in
Newsday
. “Suppose that somebody throws a little bit of anthrax into the subway,” he hypothesized. “When do we decide that it’s safe to go back into that sub- way? The answer is, nobody knows.” Was Amerithrax a domestic scientist who had read the Institute’s report and been inspired to release spores into the New York subway system? The Institute’s classified tests used one of the routes that Nguyen traveled. Initial sampling tested negative for anthrax in elevated stations and underground stops along the No. 6 line and Nguyen’s other frequented routes, but there were seven hundred miles of tunnels. Through the New York subway, the bloodstream of the city, or through the mail stream, it was startling how easily anthrax contamina- tion spread.
Because Ms. Nguyen was older, she might have been more susceptible to the disease. Perhaps she picked up one
Agents wondered if Nguyen was only the first of thousands in an invisible aerosol spray attack on Manhattan. “So far,” they mistakenly thought, “there are no other new cases.” Nguyen’s apartment was near to the triangle formed by NBC, CBS, and ABC, where victims, including an infant, had been infected by cutaneous anthrax. The
New York Post
sat just south of NBC and north of the Morgan General Mail Facility where spores had also been found. In fact Morgan General, which had processed all the media anthrax letters, also provided postal service to and from the hospital where Nguyen had worked.
In light of Morris’s and Curseen’s deaths experts realized that high-speed sorting machines could shake highly refined spores from sealed envelopes or force them through the large-pored paper. Postal inspectors explored the possibility of cross-contamination in the Nguyen case. She might have been infected by exposure to a secondhand letter—a definite possibility. By checking computer records left by letter bar codes, inspectors listed the letters that had sped through the sprawling Hamilton Township sorting machines around Oc- tober 9.
One anthrax letter had gone through at practically the same moment as a letter sent on to the Bronx. However, postal records were vague on exactly which address the let- ter had been sent to. According to the
Daily News
, that letter was mailed in “the close neighborhood” of Mrs. Nguyen, although not directly on her postal route.
Health workers visited two addresses in the Bronx to see if they could find and test the letter, said Sandra Mullin, a New York Health Department spokeswoman. No letter was found, though interviews were conducted at the two ad- dresses. “No one remembered a letter with a postmark from Trenton,” Ms. Mullin said. Police found no one at either address who had fallen ill and so they had reached another dead end.
They
never
found a single spore or any other clue to how Ms. Nguyen became infected. No one has ever been able to determine how she came in contact with anthrax. Nguyen’s death and the unknown source of anthrax might have been the missing piece in the puzzle. Could she have known Amerithrax in his everyday guise?
Amerithrax might not have reckoned with the retentive minds of mail carriers. They knew every foot of their as- signed territory. Postal carriers in every nook and cranny of the nation, trodding routes that total approximately 2.5 mil- lion miles and carrying billions of pounds of mail, com- prised a powerfully effective dragnet.
Decades ago, Seattle Mayor Ole Hanson received a bomb through the mails, but his chief clerk caught it in time. Next, in Atlanta, Georgia Senator Tom Hardwick had one deliv- ered to his home. When a servant opened it, the package bomb blew off her hands. Postal inspectors assigned to both cases suspected there were more than two bombs moving somewhere through the mails.
A clerk in the parcel-post division of the New York post office, Charles Caplan, was troubled as he read his evening paper. A description of the lethal bombs (brown-paper wrap- ping, the return address of a big New York department store) tugged at his memory. Where had he seen such a package? Hurrying to his post office, he discovered sixteen identical packages on a shelf where he had placed them because of insufficient postage. They were addressed to Judge Landis of Chicago, Justice Holmes of the Supreme Court, Post- master General Burleson, Attorney General Palmer, Com- missioner of Immigration Caminetti, Secretary of Labor Wilson, and other officials. Postal inspectors ferreted out thirty-six more. They never caught the man who mailed them. Was that how the Amerithrax case would end?
* * *
DAVID
Hose, a fifty-nine-year-old contract employee at the
U.S. State Department mail-sorting facility, was working at the diplomatic mail-sorting location in Sterling, Virginia, when his facility received some mail from Brentwood which had accidentally been routed there. Sometime around Oc- tober 22, 2001, he became ill with drenching sweats. Over the next two days he developed fatigue, severe myalgia, fe- ver, chills, headache, nausea, vomiting, abdominal pain, and a cough with scant white sputum. He had substernal chest pain.
When Hose arrived at a local emergency room, his res- piratory rate and blood pressure were normal. So was a com- plete blood count. A chest X ray was initially reported as normal, but the doctor took blood cultures anyway. He thought Hose had a viral syndrome, and discharged him with a prescription of ciprofloxacin. Hose took one dose that night, but his vomiting, fatigue, and headache worsened. Vi- sion from the corner of Hose’s left eye was distorted. His wife noticed he was intermittently confused.
After seventeen hours of incubation, his blood cultures grew gram-positive bacilli. The blood isolate was subse- quently identified as
B. anthracis.
Hose was contacted and hospitalized. At admission he appeared ill and had trouble breathing. His chest X ray showed widening between his lungs. Computed tomography of his chest showed:
mediastinal adenopathy with evidence of hemorrhage, small bilateral pleural effusions, and a suspected small pericardial effusion. His vital signs were: temperature 38.2
°
C, heart rate 108/min, respiratory rate 20/min, blood pressure 121/60 mm Hg, and oxygen saturation 94% on room air. WBC count 9,500/mm3 with 81% segmented neutrophils, 9% lymphocytes, and 9% monocytes, he- matocrit 48.1%, platelet count 196,000/mm3, normal electrolytes and creatinine.
Hose was prescribed intravenous penicillin and rifampin in addition to the ciprofloxacin he was already taking. His temperature rose to 39
°
C. Subsequently, the doctor added vancomycin and discontinued penicillin.
The next day, as the Supreme Court Building was or- dered closed for testing, Hose developed gastrointestinal bleeding, which required a blood transfusion, endoscopic in- jection, and cautery of gastric and duodenal ulcers. On Oc- tober 28, Hose’s fever peaked at 39.4
°
C and then decreased
to 38.3
°
C.
The country was becoming better prepared. Local health agencies began looking for spikes in the colored graphs they drew daily. For early detection, when hours, even minutes count, they looked for jumps in clusters of symptoms, rather than particular disease diagnoses. The number of dead cats and dogs found in the city streets each day acted as a “syn- dromic surveillance.”
This became the bioterrorism alarm system for the un- derstaffed, underfunded health departments. Epidemiologists began tracking orange juice sales and increases in sales of over-the-counter flu remedies. They collected electronic data from ERs and pharmacies, monitored 911 calls, and ob- served store surveillance videos, counting how many times people sneezed. They poured over school attendance data and calculated the number of children absent from school. They listed cases of sniffles, colds, coughs, aches, and pains—all early signals of a massive bioattack.
During the first three weeks of the anthrax outbreak, Maryland had three confirmed cases of inhalational anthrax. Eighty-five other possible cases were now being investi- gated. In Maryland they established two alerts: a yellow alert, which meant a hospital’s emergency room was so busy that ambulances were to take patients elsewhere unless they were too unstable to travel; and a red alert, which meant that beds were filled except for those requiring intensive care or cardiac monitoring.
Since various federal officials sometimes offered contra- dictory advice, hospitals, clinics, doctors, and agencies in
“We all must do our part to enhance the security of the workplace,” Chief Postal Inspector Ken Weaver advised postal workers. “Make security a part of your daily activi- ties. Wear your identification badge and challenge uniden- tified individuals you observe on postal property. Keep doors locked at work. Be alert for indications of trouble and report any suspicious activities or suspicious packages to Postal Inspectors or local law enforcement officials. Lock your postal vehicles and secure the vehicle keys at all times. It’s important for your safety, the protection of the vehicle and for securing the mail... Let’s be careful out there.”
