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06 May 2003

Source: Washington Post, May 6, 2003

The Front Lines of Biowarfare

Today's Anti-Terrorism Effort Casts Early Test Subjects in New Light

By David Snyder, Washington Post Staff Writer

The Army convoy rumbled across the vast Utah desert just before twilight, as the July heat waned and the searing wind settled across the barren salt flats. Deep inside Dugway Proving Ground, a desolate 800,000-acre government weapons range, 30 young draftees dressed in olive-drab fatigues dismounted from 21/2-ton trucks and took their positions.

Just breathe normally, Merlin Neff remembers his commanding officer saying. Sitting on crude wooden benches jutting incongruously from the sand, and surrounded by caged rhesus monkeys and guinea pigs, the soldiers sat still and waited.

Then the whir of air-sampling devices indicated that the air they were breathing had been intentionally contaminated by the release of microbes that cause Q fever, a debilitating illness that could lay an army low for days. Within days, Neff and his fellow volunteers were racked with fever, chills and bone-shaking aches.

"You were really miserable for two, three days," said Neff, who was 23 then and now is a 70-year-old doctor living in California. "I really have never been any sicker than that."

It was July 1955, and Operation Whitecoat was underway.

Over the next 18 years, about 2,300 military draftees -- most of them stationed at Frederick's Fort Detrick and most Seventh-day Adventists whose beliefs discouraged combat duty -- volunteered for the Whitecoat program. They agreed to subject themselves to a broad range of potentially deadly pathogens -- tularemia, Venezuelan equine encephalitis, sand-fly fever -- in the name of protecting the United States from the growing Soviet arsenal of biological weapons.

Their exploits, secret for years, became public knowledge in the 1970s -- and then were largely forgotten after the end of the Cold War. Now they are gaining more attention, and even respect, as the threat of biological terrorism has grown. Frank Damazo, a 70-year-old surgeon and Adventist who hosted some of the volunteers in his Frederick home in the 1950s and '60s, is organizing a reunion this fall to commemorate the 30th anniversary of the program's conclusion.

National anxiety over future terrorist attacks has invigorated two long-dormant attitudes that made Whitecoat possible: trust in the government and tolerance of extreme means to ensure security, said Jonathan Moreno, director of the Center of Biomedical Ethics at the University of Virginia.

"Before 9/11, people went nuts if they heard about the Whitecoat experiments," Moreno said. "Now I think many people are more comfortable with the idea... . We've come full circle, in a way."

Many of the vaccines and devices that protect against biological agents -- critical elements of the $6 billion Project BioShield proposed by President Bush in his State of the Union message -- were tried first on Whitecoat volunteers, who made up one of the largest human testing programs in the nation's history. None of the Whitecoat volunteers is known to have died as a result of testing.

At the same time, Army officials acknowledge that little is known about 1,000 former Whitecoat test subjects, and little has been done to find out whether the diseases to which they were exposed have had long-term effects.

"It is not clear at all that these people were given the full range of information, either about what they were being exposed to or what the long-terms effects would be," said Leonard A. Cole, an adjunct professor of political science at Rutgers University in Newark and author of "Clouds of Secrecy," a book detailing the government's tests during the biological weapons program. "In the 1950s and '60s, we were at the height of the Cold War. In general, the culture allowed for less questioning of authority, and it was more likely to be understood at both ends -- leadership and the general citizens -- that you could trust the government."

Facing the 'Eight Ball'

The Whitecoat program began in 1954 as U.S. intelligence was gathering information on the development of biological arsenals by Cold War enemies. The nation's biological weapons program was based at Fort Detrick, and all of the testing, except for the Dugway experiment, was conducted in Maryland, where military scientists produced anthrax and a host of other deadly agents.

Many of the Detrick tests involved the million-liter steel sphere known as the "eight ball," where scientists would aerosolize biological agents, sending them in a swirling cloud through the sphere's interior.

Wearing face masks attached to portals in the sphere, Whitecoat volunteers would inhale. Afterward, they were quarantined and treated for any symptoms. Some Whitecoat volunteers went through an entire two-year tour of duty without undergoing a test. Some experienced as many as five "projects."

Recovery could be agonizing.

"Some of the guys said that first they were afraid to die, and then some of them were afraid they wouldn't die," said Richard O. Stenbakken, director of Adventist Chaplaincy Ministries at the General Conference of Seventh-day Adventists and chairman of the board of the recently founded Whitecoat Foundation.

The Adventists were deeply involved in Operation Whitecoat. The church had a long tradition of supporting military service, but not the use of church members for explicitly offensive military actions. That posture made the draft problematic for church members, and the Army offered an option other than serving as a medic: Allow drafted church members to volunteer for Whitecoat.

The young church members offered a nearly ideal group of test subjects -- healthy and, on average, better educated than the typical draftee, and therefore more likely to understand the significance of the experiments .

"Some of the men, myself included, thought that we would prefer doing that, as opposed to going to Vietnam," said Warren Martin, 60, of Myersville, a Whitecoat volunteer from 1963-'65 although he was never called for an experiment. "I don't think anyone in their right mind wishes they would be sick, but given the options, I'm glad that I did it."

Hundreds, if not thousands, of participants became violently ill. But Army officials say nobody died in the course of 153 tests from 1955 to 1973, when the last class of Whitecoat draftees left the sprawling Detrick compound in the city of Frederick. Operation Whitecoat continued for four years after President Richard M. Nixon called an end to the nation's biological weapons program in 1969, but it ended after the military stopped drafting young men in 1973.

Informed Consent

During its time, Whitecoat was a model of sound medical ethics, Moreno and others said. The volunteers signed forms acknowledging that they understood that the tests could have serious health consequences.

They were told that they could back out of the test at any point before it began. By all accounts, the Army does not appear to have reneged on that promise, though some former participants have described a subtle, implicit coercion -- turn down too many tests and you could be sent to Vietnam.

Unlike the infamous Tuskegee syphilis tests, when the government deliberately did not treat black men with syphilis from 1932 to 1972, Whitecoat operated under a doctrine of informed consent that was uncommon, if not unheard of, at the time, Moreno said.

"They were way ahead of their time," he said. "It was very public, very transparent, and the Whitecoaters seemed really to be volunteers. . . . In terms of follow-up, in terms of voluntariness, in terms of efficacy, it was a highly ethical program."

Even supporters acknowledge that the program was extremely risky. The Q fever tests conducted at Dugway in 1955 were not repeated, in part because of concerns that the amount of pathogens the soldiers were exposed to could not be controlled. Caused by a microbe called Coxiella burnetii, Q fever results in fever, chills and muscle aches and can lead to pneumonia. In rare cases, it can be fatal. The military was concerned that the disease, if weaponized, could incapacitate thousands of soldiers.

Fifty years after the program began, the Army has addresses for 1,000 of the 2,300 people known to have volunteered, said Lt. Col. Phillip Pittman, senior medical scientist at the U.S. Army's Medical Research Institute of Infectious Diseases.

About 500 have responded to his inquiry about their health, and at least a handful have claimed lingering health effects. Pittman said there may be more former volunteers the Army does not know about.

One is Gene W. Crosby of Stevensville, Mont.

Crosby, 61, said that for decades, he has been racked with back pain and heart ailments caused by the autoimmune disease ankylosing spondylitis. Crosby said he believes that the disease is the result of a 1965 Whitecoat test. The Army has told him there is no clear connection.

"We've been getting stonewalled by the military," said Milt Datsopolous, Crosby's attorney. "[Whitecoat volunteers] were not adequately or appropriately advised of the potential medical complications or long-term consequences and were never fully advised upon discharge to look for any symptoms that would develop in the future."

As knowledge about the Whitecoat program has spread and volunteers have shared their stories, members of the group are increasingly aware of the importance of their work, said Damazo, the doctor who hosted volunteers at his house in Frederick.

The Whitecoat Foundation was formed last year to spread word about its history. Some members hope to publish narrative accounts of their experiences.

Today, Damazo, the reunion organizer, acts as the central clearinghouse for information on Operation Whitecoat and has boxes and boxes of files and photographs of the volunteers.

"From [the Whitecoat program], the whole country and the whole world learned a lot of valuable information about these diseases," Damazo said. "This is important, because at some point, there's going to be another biological event somewhere in this country."

Staff researcher Bobbye Pratt contributed to this report.