Amerithrax (30 page)

There was a nervous lowing in the fields—as if the herds sensed something. A plump lamb frisking about in the flock at morning, by evening was refusing to eat. At dawn on Monday, the farmer found the lamb’s carcass cold and stiff, belly distended and blood oozing from its anus—blood that had turned ghastly black. Then the same thing happened with another sheep and another until there was a field of dead sheep. Other hoofed animals began to die.

The blackened blood of a dead cow or bull stained the earth, blacker still where it drained into the ground like crude oil. Whatever the sickness was, it was spreading. Bris- tled hogs, some white, some black, some brown, and some spotted, made low squeals and agonizing grunts in their pens, but remained curiously untouched. But the farmer himself, and a shepherd, and a hides dealer, sickened and broke out in horrible boils—or, more horribly, choked out their last breaths in a breakneck pneumonia.

On Wednesday, five days after inhaling spores that caused the onset of what seemed to be a mild cold, dozens of patients in the city rushed to hospitals with more severe symptoms: quick, powerful flu with vomiting, chills, and high fever. Some had breathing difficulties, higher fevers, and blue lips. Six patients were admitted to Hospital 40, a

central facility located north of Chkalovskiy. But doctors, not knowing of a secret military biological facility in town, were still puzzled. They diagnosed the disease as pneumo- nia, but as more and more blue-lipped patients straggled in, their panic grew. The region faced an unknown infectious disease.

The victims with the earliest onset of disease were Anna Komina and Aleksandra Volkova. “My mother often walked home,” Anna’s son said, “to fix the noontime meal for us, instead of having us eat in the cafeteria. Her symptoms— faintness, dizziness, trouble breathing—began then she seemed to get better.” Speridon Zakharov was too sick to go to the ceramics factory on Friday, April 6, a week after the accidental release. He went to work the next day, only to collapse. Distinctive dark swellings along his chest and neck marked the onset of inhalational anthrax. His body erupted with massive, excruciating blisters, turning his skin black and leathery. His lungs filled with fluid. He was rushed to Hospital 20 where he died.

On Sunday, April 8, Anna went completely into failure. The first doctor called to her house lacked intensive care equipment and rang the emergency medical center for an ambulance. Two medics labored for five hours to bring Anna’s blood pressure up to a safe enough level to transport her to Hospital 20. The earliest cases—Mikhail Markov and Vera Kozlova—had come from Hospital 20 in the southeast section of Chkalovskiy. One doctor suggested plague as the cause of Anna’s illness, another smallpox. Everyone rejected cholera as the answer. But the recent cattle cases came to mind—was it anthrax?

Sick people choked Hospitals 24 and 20. Hospital 40’s five-hundred-bed infectious disease wing was designated the centralized care facility. Patients with high fevers and breathing problems were rushed to Hospital 40 for special screening and intensive care. Autopsies were done there too: four patients had been dead on arrival (“as if struck by light- ning”) and thirteen had died at home. Meanwhile, Anna slipped into a coma.

She died on Monday. Soldiers scrubbed the walls of her hospital room, stripped the hospital bed, bathed her corpse

in chemical disinfectant, then transported her body to Hos- pital 40 where it was held for five days. The embargo pre- vented her relatives from performing the traditional Russian washing and dressing rituals and from holding a wake. In the interim, public health workers visited her home and gave tetracycline pills to Anna’s son, Yuriy, and his wife, but not to their infant.

Anthrax-tainted meat might explain the outbreak, but Anna’s family had bought no meat from private or black market sources. Though they all ate the same food, only the mother became ill. “Why her?” said her son. “Why her if from infected meat? Our house was disinfected, bed linens taken away.” By truck, Anna’s coffin was clandestinely transported from the hospital directly to the cemetery and buried in chlorinated lime. Her family learned of the burial on a tip from hospital staff, but police at the gate barred them from entering. Section 15 of the Eastern (Vostochniy) Cemetery was declared off-limits. Anna’s husband died soon after with a broken heart.

Bodies on metal gurneys lined the halls at Hospital 40. More were stored in a cold-room next to the white-tiled autopsy room. On Tuesday a female doctor performed the first autopsy. Because there were so many rapid unexplained deaths, victims were laid out three at a time on long soap- stone tables. Orderlies screwed wooden blocks, neck sup- ports, into the soapstone for the autopsies. A wide shallow groove on all four sides of the tables normally channeled blood to floor drains, but those were plugged to contain the disease. A tray of instruments, an adjustable round lamp, notebooks, and a black hose for cleanup completed their equipment.

The postmortem of the third case, Vera Kozlova, re- vealed massive internal hemorrhaging. It puzzled the pa- thologist to see infection in the lymph nodes and lungs and, significantly, hemorrhaging in the small blood vessels of the brain membrane—producing a so-called cardinal’s cap. She knew that such bloodied brains were caused by anthrax. But from where? Materials from the autopsied corpse, a blood culture from another dying patient, and the pathologist’s

notes were forwarded to Moscow bacteriologists for evalu- ation.

Each of forty-two bodies studied showed hemorrhagic destruction of the thoracic lymph nodes and hemorrhagic inflammation of the mediastinum, the area between the lungs. The route the white blood cells take in transporting anthrax spores out of the lungs is directly to the thoracic lymph nodes. Eleven patients showed necrotizing anthrax pneumonia.

Spread of hemorrhagic lesions in the intestines of all but three of the victims was caused by the spread of bacteria through the bloodstream directly from the gastrointestinal tract, not from tainted meat infecting the gut. Lesions in the mesentery lymph nodes were noted in nine of the autopsy cases as coming after inhalatory infection. They died at home, in the street, and in ambulances, either misdiagnosed or with a sudden onset of severe symptoms. Two bodies had been sent home by mistake, then retrieved.

That afternoon, Dr. Vladimir Nikiforov and his assistants arrived in Sverdlovsk to arrange medical responses to an apparent ongoing epizootic south of the city. Outside public health crews, still not certain of an anthrax source, entered Syserskiy
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to investigate. A “bushel” of Moscow vet- erinarians entered Abramovo and discovered seven sheep and a cow dying. Three of the sheep tested positive for anthrax. The doctors demanded the ears of a calf that had died. Two sick sheep were slaughtered in Rudniy village. Sulfamides, penicillin, or tetracycline, which reduced the death rate from gastrointestinal anthrax to 5 percent or less, were dispensed to villagers.

The emergency team disinfected Mrs. Lomovtsev’s house and yard with chlorine, ripped out floorboards in her shed, and hauled away a wooden walkway covering the mud in her yard. They did the same at the Kostarovs’ next door, then nailed a quarantine sign on both houses. Health work- ers, actually KGB agents, descended on the Kostarov family that night. They questioned Mrs. Kostarov “like a spy or a criminal,” and confiscated the ram’s wool she had stored in a can. Because she had handled the wool, they forcefully vaccinated her on the hip. A Moscow investigator asked

Mrs. Krutikov, who had lost the first sheep in Abramovo, “Who sent this bacteria to you? Where did you get it?” and acted as if they suspected her of plotting to kill livestock.

On April 12, the Moscow microbiological experts con- firmed anthrax was the source of the outbreak. Two days earlier, they had injected materials from the last autopsied corpse and a blood culture from a dying patient into white mice and guinea pigs. All the test animals had died of an- thrax blood-poisoning. Vets quarantined the area and set up checkpoints. Moscow senior health and military officials flew over the site by helicopter, but refused to enter the danger zone. In the countryside, burning of all animal car- casses was now supervised. Formerly, villagers had burned sickened animals in the local quarry, or buried them in the forest, or left them in the streets to be eaten by dogs. Hun- dreds of stray dogs were rounded up and shot as “a danger to public health.”

Ambulance drivers worked daily with Hospital 40, and local hospitals and clinics screened patients. By April 15, response to the epidemic was in operation around the clock, extending from neighborhood to city to oblast offices. Vol- unteers brigades commenced a house-to-house community- wide vaccination campaign to distribute antibiotics to victims’ families and to disinfect homes. At the ceramics factory, doctors inoculated workers three times with a “pis- tolet,” a jet-pistol injector. Vodka was used to reduce ad- verse reactions to a traditional Soviet STI vaccine. After the first injection, a huge ulcer appeared on one worker’s upper left arm. “At the time,” he said years later, “the authorities said it was for anthrax. But now I know it was bacterial warfare from Compound 19.” Anna’s son agreed. “It came through the air—from Compound 19,” he said.

However, few officials in town suspected Compound 19 was the true source of contagion. Those who did depended on the army for their livelihood and cooperated. The Soviet military seized control of the area and posted sentries in the immediate neighborhood of Compound 19 to keep intruders away. The plant’s floors were ripped up; its plastering re- moved. Soldiers in gray-green protective suits and gas masks took soil samples, sprayed streets, sidewalks, and

trees with disinfectant, and laid down topsoil to cover con- tamination.

Gen. Valentin Yevstigneyev, an immunologist, said of Moscow’s handling, “They isolated the camp and put it into quarantine. They immediately decided that all the infection came from there, you see. The security organs and the san- itary services created such an atmosphere of secrecy and intimidation around the population that there was no longer any doubt about it.”

On the first of May, decontamination really began. The local Communist Party boss, learning of a hazardous mate- rials leak, ordered firemen to spray roads, trim trees, and hose down roofs and walls with caustic solutions, especially near the ceramics factory because so many had died there. Soldiers disinfected Hospital 40’s autopsy room with buck- ets of chloramine and burned records and pathologists’ re- ports. When the KGB came to retrieve the autopsy materials used at Hospital 40, a cleaning woman, Maria, refused to let them in to search a locked cabinet where the records were kept. She so intimidated them, they never came back for them. Thus valuable clues to the outbreak were retained. In Abramovo, soldiers paved contaminated dirt roads with asphalt—making it the only asphalted village in the Urals. Tainted topsoil was dredged up by bulldozers and dumped in pits. KGB officers, pretending to be doctors, vis- ited the homes of victims’ families with falsified death cer- tificates. To further hide the presence of pulmonary anthrax, they confiscated records at Compound 32 and displayed photos suggesting victims had contracted intestinal anthrax, the rarest form. The government printed flyers that read: “Stay away from ‘unofficial’ food vendors.” Un-inspected

meat and feed were confiscated and burned.

By mid-February 1980 there were low-level reports in the West of a thousand estimated deaths. Two to three hun- dred military personnel may have died. Moscow denounced

U.S. allegations of an outbreak as “an epidemic of anti- Soviet hysteria.” The Soviet invasion of Afghanistan had President Jimmy Carter taking a harder line toward Moscow and tension had grown between the two countries.

The CIA knew the Soviet defense minister had made an

emergency visit to Sverdlovsk in April 1979. And U.S. spy satellites had photographed burning bodies, decontamination trucks, newly paved roads, large numbers of Soviet military and roadblocks in Sverdlovsk. On June 12, 1980, the Soviet news agency TASS declared only that there had been a “nat- ural outbreak of anthrax among domestic animals” in the Sverdlovsk region. “Cases of skin and intestinal forms of anthrax were reported in people, because dressing of animals was sometimes conducted without observing rules estab- lished by veterinary inspections. All patients were treated successfully at local hospitals.” Moscow lived in fear that Western inspectors would show them in violation of the 1972 Biological and Toxic Weapons Convention, which the Soviets had been the first to sign and ratify. It prohibited such research as done at Compound 19. They concocted a near-perfect cover story—

A meat-processing center near Sverdlovsk was claimed to have ground up waste products to make bone meal, but failed to properly sterilize them. This oversight had resulted in anthrax-contaminated bone meal. Next, the bone meal was mixed with grain and other slaughterhouse products to make combined feed. One or two days before the outbreak, the meat-processing plant delivered 2,121 tons of combined feed to the local farms around Sverdlovsk. At one state farm where a small load of this feed had been received, an un- vaccinated breeding bull became ill and died within a day. The same feed was delivered to local collective farms.

Once their livestock became sick, farmers butchered them, gave some meat to relatives, and black-marketed the rest as raw or processed meat (cutlets and mincemeat). Two black market vendors just outside Sverdlovsk were arrested and imprisoned on charges of selling bad meat. More anthrax-contaminated meat was confiscated on April 22, 1979, from “an unknown citizen” who had attempted to sell it in the open market. Many of the victims were ceramics workers, because most of the bad meat had been sold at the ceramics factory. It was simply “a minor, routine public health problem—due to poor food controls.” The govern- ment’s official tally was ninety-six stricken, sixty-four dead. A similar infected meat epidemic had occurred fifty-two

years earlier 150 miles northeast of Moscow in Yaroslavl. Twenty-two of the twenty-seven victims were men, all bachelors. All died within the first week. First, the victims developed lesions at the base of their tongues and had dif- ficulty swallowing. Then they were overcome by nausea, vomiting, fatigue, and appetite loss. Severe abdominal pain preceded fever, severe cramps, bloody diarrhea, and signs of blood poisoning. As the deadly infection ran its course, each victim’s temperature declined sharply. A sudden and unexpected cardiac collapse was preceded by a sudden chill- ing of the limbs, a bluish or purplish discoloration of the skin, and a rapid thready pulse.