Last Updated

27 Nov 2002

Source: Wall Street Journal, December 21, 2001.

SPECIAL REPORT: AFTERMATH OF TERROR

U.S. Response to Anthrax Mailings Becomes Even More Complicated

By SARAH LUECK, Staff Reporter of THE WALL STREET JOURNAL

WASHINGTON -- The government's confused public-health response to this fall's anthrax mailings got more complicated.

Federal health officials Thursday said contamination of the Brentwood postal facility here is more widespread than previously thought, dumping uncertainty on yet a larger group of workers who now will have to decide whether they want to opt for an experimental post-exposure vaccine.

The Centers for Disease Control and Prevention, already under fire for its muddled initial response to the anthrax mailings, this week told thousands of potentially exposed workers it wasn't sure whether they should be vaccinated or continue taking antibiotics. So the agency said they would have to decide for themselves.

Using the anthrax vaccine in post-exposure instances is experimental and carries uncertain but potentially dangerous health risks. Allergic reactions happen fewer than once in every 100,000 doses. Some people have reported serious muscle and joint diseases, miscarriages and infertility after getting the vaccine. But data indicate that people getting the vaccine suffer those maladies at the same rate as the general population.

The lack of clear advice is prompting a growing chorus of complaints. "In the first go-round, we tried to exercise some patience as the experts found their way; this time, there is no excuse," said New Jersey Rep. Chris Smith, whose constituents include postal workers from the Trenton area, where several anthrax-laced letters originated.

The CDC says research indicates that the deadly inhalation form of the disease is unlikely more than 60 days after exposure. Nobody who finished the 60-day course of antibiotics has caught the disease, nor have any of those who stopped taking the drugs earlier. But the agency says there is a minor chance of infection after 60 days, based on studies that found spore traces in animal lungs as many as 100 days after exposure. The CDC says this isn't cause for great concern, however, because anthrax infections caught early respond to antibiotics.

Given all that, the agency urged exposed workers -- believed to number as many as 3,000 congressional, postal and media employees in Florida, New York, New Jersey and the Washington area -- to carefully monitor their health and do one of three things: Finish the 60-day treatment; take antibiotics for an additional 40 days; take the extra 40-day treatment and get inoculated with a vaccine under an experimental program.

But the agency's experts said they don't know who is most at risk. CDC Director Jeffrey Koplan did little to clear up the matter, saying only that people who came in contact with an anthrax letter, who worked in an area where someone caught anthrax or who were in areas known to be "heavily contaminated" likely had "some greater amount of exposure."

Thursday's disclosure about the contamination at the Brentwood facility further complicated matters. Health officials said machinery and airflow in the cavernous facility scattered anthrax to the building's far corners, making it difficult to identify who might have been exposed to high quantities.

"We fully understand it's frustrating for those who've been exposed that government can't make a strong recommendation about who should have the vaccine," Dr. Koplan said.

The result is a patchwork of advice. Washington officials recommended against the vaccine. But Congress's physician suggested the vaccine for about 70 people; some received the first of three injections Thursday. In New Jersey, the state Department of Health and Senior Services doesn't yet know what to tell its residents. "At this point we've just received the plan and we look forward to reviewing it," a spokeswoman said.

In Connecticut, where cross-contaminated mail is suspected of killing a elderly woman, the state Department of Public Health has no plans to issue a local recommendation. In Florida, where American Media Inc.'s building was contaminated, the company says it won't make any recommendations but has scheduled a meeting Friday between its employees and local health officials. A spokesman for the Florida Department of Health said "at this time, no decision has been made," about issuing a local recommendation.

Patricia Johnson, president of the American Postal Workers Union's Washington local, said her organization isn't advising workers to continue taking antibiotics or to get vaccinated because "there's just not enough information." The U.S. Postal Service said it isn't sure what to tell its employees and pressured the CDC to provide "specific criteria" on who should be vaccinated, based on such factors as proximity to equipment that processed anthrax letters and individual health histories. But the CDC has declined to do so.

Dr. Koplan said the CDC plans to send teams of experts to Florida, New York, Washington, New Jersey and Connecticut, including some postal facilities, to help answer questions from people who may have been exposed.

-- Kathy Chen in Washington, Eleena Delisser in New York and Chad Terhune in Atlanta contributed to this article.