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After Amerithrax: Biodefense in a post-9/11 America
By Matt Davenport. This article was originally published on cen.acs.org and has been reposted to the PathSensors blog. All credit goes to Matt Davenport as well as the Chemical & Engineering News website.
The ringing woke him up. It was years ago, but Tom R. Slezak still remembers.
The Lawrence Livermore National Lab scientist didn’t normally get phone calls in the middle of the night telling him he was needed at work. And he didn’t normally jet off aboard a military transport after arriving at the lab. When he did fly, he normally knew where he was going, how long he’d be gone, and why he was leaving. But this was October 2001. Nothing was normal in America.
The weeks following the Sept. 11 attacks unleashed a new terror on the U. S. Hours before Slezak got his call, a photo editor in Florida died from anthrax caused by white powder containing Bacillus anthracis spores sent in the mail.
More anthrax cases would follow, caused by letters tainted with spores from a potent strain of the bacterium and addressed to prominent politicians and news organizations. One was intended for NBC news anchor Tom Brokaw.
The anthrax attacks of 2001 killed five people in the U.S. and infected more than a dozen. Since then, much has changed in how the country prepares for and analyzes biological threats. But these advances don’t fully address the concerns of all those tasked to respond. A lack of federal guidance on biodetection equipment and training has left some jurisdictions more vulnerable to attacks than others. Representatives from the first responder and public health communities are now calling for standards to ensure the entire nation is prepared should another envelope contain a biological weapon of terror.
The toxic envelopes had targets, but they killed indiscriminately. Five people died before Thanksgiving: the Florida photo editor, two employees at a D.C. postal facility, a hospital worker from the Bronx, and a 94-year-old woman in Connecticut who authorities believe handled cross-contaminated mail. The letters infected at least 17 more.
On that October night, Slezak’s plane was headed to Washington, D.C. He was part of a team tasked to install a system to identify biological threats, such as anthrax, in case of a larger attack.
Billions of dollars and 15 years later, the country has better tools to bolster the capabilities of the labs and crews called on to protect citizens against biological weapons. And the way officials think about biothreats has evolved since 2001. Still, despite these advances, gaps remain in America’s biodefense according to those serving on its front lines.
When the letter arrives
Systems like those Slezak helped set up are now installed nationwide in more than 30 American metro areas as part of the federal BioWatch program. These instruments constantly collect airborne particles that officials regularly analyze for biological threats invisible to the public.
Historically speaking, however, there are far more alarms raised by letters and packages with visible suspicious contents than by BioWatch’s aerosol collectors. The polymerase chain reaction (PCR) assays performed on samples from the BioWatch network have detected potentially dangerous organisms 149 times between 2003 and 2014, according to a 2015 report from the U.S. Government Accountability Office. Subsequent testing proved none of the hits were a public health risk, though, with most being triggered by nonpathogenic microbes that resembled lethal ones.
For comparison, the Federal Bureau of Investigation was called on more than 1,600 times to investigate incidents involving white powder letters between 2006 and 2012.
Most white powder incidents are hoaxes. In the years since, the U.S. hasn’t seen anything like the 2001 anthrax attacks, sometimes referred to collectively by their FBI case name, Amerithrax.
But responders must take every incident seriously. The exact execution of a response varies between different cities and states, but there is a general blueprint.
To learn about it, C&EN spoke with David Ladd, who has 35 years’ experience in emergency response, with 17 of those in the realm of hazardous materials, or hazmat. He’s now the director of hazmat emergency response for the Massachusetts Department of Fire Services.
When someone gets a suspicious piece of mail, their reaction generally is, and should be, to call 911, Ladd says. The call alerts local police, fire fighters, and emergency medical technicians, who are the true first responders, Ladd says.
They will typically then call in a hazmat team, whose members may have additional training and gear, including personal protective equipment. Although they are not first on the scene, they are still referred to by many as first responders.
FBI field specialists and public health labs that belong to the Laboratory Response Network, established by the Centers for Diseases Control & Prevention, are also typically involved in responding to a suspected biological attack.
These labs are prepared to identify suspicious substances and, if the threat turns out to be real, to guide treatments and a broader public health response. The FBI coordinates law enforcement efforts to find the source of the threat.
This response framework, however, does leave room for variability, especially when it comes to training, technology, and communication, which concerns Ladd. Ideally, all of the groups responding to suspicious package calls are talking to one another to handle a threat as safely and efficiently as possible. But building up the trust and relationships between agencies to do that takes time.
Ladd explains that his teams and the various groups that could become involved in a response started working together to prepare for biological threats in the late 1990s. At the time, there had been a spike in cases of women’s health clinics and Planned Parenthood offices around the country receiving anthrax letter hoaxes.
Then, following the 2001 anthrax attacks, that multiagency planning grew into what Massachusetts calls its Joint Biological Threat Response System: A consensus response plan forged with input from first responders, the FBI, public health labs, and others, including the National Guard.
That system now helps keep everyone on the same page, Ladd says. “We rely very heavily on ongoing communication between the stakeholders,” he says. But he adds that he’s been fortunate to work with a community that’s invested the time and money to build those relationships.
“To this day, I have conversations with people in various jurisdictions from both the responder side of the equation and the public health part of the equation that have no relationship with the other,” Ladd says. This can create situations where two groups are working toward the same goal of protecting the public without knowing or trusting what the other is doing.
PathSensors is a privately held biotechnology company deploying proprietary CANARY technology, exclusively licensed from MIT-Lincoln Laboratory. PathSensors technology has been designed to detect extremely low levels of biological threats in minutes. Additional information is available at https://www.pathsensors.com.