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10 Dec 2002

Source: New York Times, October 27, 2001. 

The Epidemic

Anthrax Outbreak of '57 Felled a Mill but Yielded Answers


MANCHESTER, N.H., Oct. 25 It started with a scratchy throat, a parched sensation that would not go away no matter what Albert Langlois did. It was 1957 and Mr. Langlois had started a new job just two months earlier, working at the Arms Textile Mill, pulling out wool and goat hair that was too short to be made into fabric.

But one day in late October, Mr. Langlois, 33, told his wife that he did not feel well.

"For a few days he says, 'Gee my throat is so dry,' " recalled his wife, Stella, 73. "All he did was drink water. He kept drinking and drinking. We thought it was the flu or something. We didn't know what it was."

It turned out to be anthrax, and Mr. Langlois, the father of two young sons, died a few days later. He was one of nine men at the mill who were infected. Four died of inhalation anthrax in what is still the nation's only outbreak of the disease.

The mill on the banks of the Merrimack River is now gone, destroyed in what was then one of the world's largest decontamination projects ever, and most people in Manchester have forgotten about the outbreak. Nevertheless, the millworkers who died left a legacy that reverberates now as the nation confronts a battery of anthrax attacks. The episode enabled science to show that the anthrax vaccine works.

"It's the only anthrax epidemic we've had in this country," said Dr. Philip S. Brachman, an expert in anthrax epidemiology, who in 1957, the year the Arms Textile Mill workers became ill, was in the process of testing an anthrax vaccine for the Centers for Disease Control. By coincidence, he had chosen the Manchester mill as a site for his experiment. The fact that no vaccinated workers got anthrax during the epidemic, he said, "really suggested that the vaccination was effective."

Equally important, the Manchester outbreak gave scientists glimpses of how hardy and opportunistic anthrax bacteria can be. The nine victims five with inhalation anthrax and four with cutaneous anthrax became infected while working at the Arms Textile Mill here, but not in the same room or at the same time. Some worked in the carding room, some in the weaving department, and some operated the combing machines, where they removed short lengths of hair or wool called noils. The men became ill over a period of 10 weeks.

What they had in common, epidemiologists later discovered, was that at some point all had handled the fibers of a single shipment of black goat hair from Pakistan. The anthrax, Dr. Brachman said, must have been stubbornly present in that shipment.

"It was the only lot that all the workers had contact with," he said. "The hair from this one particular lot was going to machinery that all these employees were working at when they got ill. But some were at the beginning of the process, some were in the middle of the process, and some were at the end."

Cutaneous, or skin, anthrax, characterized by black lesions on the hands, was not unheard of in textile manufacturing at that time. The Arms Textile Mill, which turned goat hair and wool into lining for fashionable suits, recorded more than 100 cases of it from 1941 to 1957.

Anthrax is caused by bacteria that typically infect animals. For this reason, it was considered, in its cutaneous form, to be such an occupational hazard that it was known as wool-sorter's or ragpicker's disease. It was treatable with antibiotics.

"My guess is at some level anthrax was accepted back then," said Frederick A. Rusczek, director of the Manchester Health Department. "It was an occupational illness."

Perhaps that is why more workers did not participate in the vaccine study that Dr. Brachman was conducting. Few, if any, would have known about inhalation anthrax, rarer and more deadly than skin anthrax. The study sprang out of the cold war fear that enemies would seek to use anthrax as a biological weapon, and Dr. Brachman's task was to see if the vaccine worked.

In May 1957 he enlisted participants at three mills in Pennsylvania and at the Arms mill, one of a cluster of imposing 19th-century red brick buildings near downtown Manchester. At Arms, about 300 of the 600 employees agreed to participate in the study. Half of those received the vaccine, half a placebo.

During the epidemic, from late August to early November, four of the nine who got infected had received the placebo. Two of those infected, including Mr. Langlois, began working at the mill after the study began and therefore could not participate. The other three chose not to participate, Dr. Brachman said.

One of those was Antonio Jette, 49, who worked in the carding room, placing the goat hair, wool and fibers into machines, which straightened and aligned the strands.

Both carding and combing, Mr. Langlois's work, generate dust, and the epidemiologists found that most of the anthrax infections occurred in those two departments.

Mr. Jette's daughter, Anita Simonds, now 74, said her father never mentioned anything about the vaccination experiment.

"We never heard of that," she said. "In them days you never knew anything unless you were very intelligent and asked a lot of questions." She remembers her father became ill in September, cutting short a Labor Day trip to a state fair to come home. A few days later, he went upstairs and lay down on his bed.

"He never seemed to wake up," Mrs. Simonds said. "My God, he'd never been sick a day."

After the epidemic, Dr. Brachman's team decided to jettison the experiment and vaccinate all workers at the mill. With vaccination a condition of employment, no more millworkers became infected, but in 1966, Norbert Lemoine, a 46-year-old worker at a machine shop across the alley from the mill, died after contracting inhalation anthrax, presumably from spores that had wafted over from the building.

The nation's current supply of anthrax vaccine, derived from the experiments of 1957, was licensed in 1970 by the Food and Drug Administration to prevent the form of anthrax that afflicts the skin. The vaccine is given to military personnel and is not commercially available.

In 1968, Arms Textile went out of business and the mill was sealed while health officials figured out how to make sure that anthrax spores there could not escape.

Unlike the epidemic, which received little attention in newspapers, the mill's future was big news. "Lethal Spores Could Menace All Manchester," declared a 1970 headline in The Manchester Union Leader.

In 1971, the decontamination process began, with workers who were vaccinated and dressed in protective suits and oxygen masks and tanks spraying first a detergent solution and then concentrated formaldehyde over the mill. In 1976, faced with trying to revitalize Manchester's fading factory row, the city decided to raze the building, worried that anthrax might still be hiding in the crevices of the old timber and brick, Mr. Rusczek of the Manchester Health Department said.

As the building came down, it was sprayed with a chlorine solution, he said. The timber was incinerated, and the bricks, doused in chlorine again, were buried a half-mile away.

Today, there is no sign of the epidemic that hit this sturdy river town. The site of the mill is now a parking lot, bordered by a hip bistro called Cotton and another factory building, which is now home to high-tech firms and tae kwon do gyms.

The place where the bricks were buried is a parking lot, too, for the Singer Family Park, where ball games and concerts are held.

For those who never forgot the anthrax epidemic, today's events are a chilling reminder of their helplessness long ago.

"We're learning more about anthrax now," Mrs. Simonds said, "than we ever knew then."