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02 Jan 2003

Source: Washington Post, November 5, 2001.

Anthrax Has Inspired Dread and Breakthroughs

By Guy Gugliotta, Washington Post Staff Writer

Anthrax is one of the world's oldest afflictions, a scourge known throughout history for its ability to cripple and kill -- an old and hated enemy, as horrifying in ancient times as it is today in the age of bioterrorism.

When Pharoah refused to free the Israelites, the Bible tells us, Egypt was attacked with 10 plagues. Number five was a "grievous murrain" that killed cattle, and number six, "a boil breaking forth with blains upon man and upon beast throughout the land."

Homer, at the beginning of the "Iliad," described a "burning wind of plague" that attacked "pack animals first, and dogs, but soldiers too." And Virgil's "Georgics" record an epidemic so grotesque that "in the very stalls" animal carcasses were "rotting with putrid foulness."

The primitive dread that accompanies an anthrax outbreak is something the world has felt for thousands of years. But anthrax also triggered one of the most important breakthroughs of science -- development of the "germ theory" of disease and the beginnings of modern microbiology.

The usefulness of vaccines has "been verified so many times in the past year . . . that it is not necessary to demonstrate again," Louis Pasteur told a skeptical publisher in 1882 after showing that a weakened, or "attenuated," anthrax bacterium could immunize animals from the disease. "It belongs to science."

Anthrax is perhaps 11,000 years old, dating to the prehistoric beginnings of animal domestication. The bacterium and its various strains can be traced to specific parts of the world where their presence has spanned millennia.

"It is only because of the close relationship between domesticated livestock and human beings that anthrax is even an issue," said Susan Jones, a veterinarian and medical historian at the University of Colorado. "It is a very mappable disease because it is endemic to livestock."

In the United States, Jones said, live anthrax spores can still be found along the cattle trails of the Old West. "The practice was to let the animals die and leave them behind," she said. "The animal becomes an incubator, and the bacteria survive in spore form for decades and decades in soil."

It is the hardiness of the spores and their lingering virulence that make anthrax a preferred weapon of modern biological warfare, and while the ancients did not understand what germs were and why they did what they did, they were well aware of how germs could work in their favor.

The Romans learned the value of fouling a water supply by dumping the rotting corpses of people and animals in a city's wells. History does not say whether anthrax was the hoped-for affliction, but it was one possibility.

Medieval and early modern history are rife with stories and legends of how lethal pathogens shaped events. The Huns described how anthrax slew their horses and cattle as they swept across Eurasia in 80 A.D.

Mongols besieging the Crimean city of Kaffa in 1346 catapulted the cadavers of comrades slain by bubonic plague inside the town walls, driving the inhabitants to escape by sea, and purportedly spread the "Black Death" that eventually killed one-third of Europe's population.

In 1763, the British decimated their Native American enemies during the French and Indian War by giving them a "peace offering" of blankets taken from a clinic where British soldiers were being treated for smallpox.

In Santo Domingo in 1770, about 15,000 people are reported to have died from intestinal anthrax -- a form of the disease seldom seen today and contracted from eating tainted meat.

The stories of early bioterror are given scant credence by historian Alfred W. Crosby, an expert in how disease shaped world history. "People always want heroes, heroines and villains, but it was much less deliberate than that," Crosby said.

"Four hundred years ago, disease was someone who was sick and how do you aim that person," he added. "Yet if you tried to use the person [as a weapon], you ran a serious risk of infecting yourself."

Still, he said, there is no doubt that disease could be decisive in wars and that European diseases decimated indigenous New World populations. "By the time you were 10 in Europe, you had either survived smallpox or you were dead," Crosby said. "The effects on locals [in the Americas] were devastating."

By the 19th century, scientists understood that humans could contract anthrax by handling tainted animals, by eating their meat or by breathing dust from their hides or fur. Pulmonary anthrax was extremely rare, but almost always lethal.

Still, farmers regarded the disease with what today would be considered appalling offhandedness. One 19th-century veterinarian described a Brighton, Mass., farmer who fed the entrails of a dead steer to his pigs, "which were speedily attacked with anthrax, and as speedily killed to save their bacon."

In 1876, however, German physician Robert Koch published a paper identifying the bacterium bacillus anthracis as the cause of anthrax. It was the first microorganism ever linked specifically to a disease.

Then, in a dramatic experiment five years later, Pasteur immunized 25 sheep with a weakened form of the bacterium, then injected those sheep and 25 others with anthrax. The 25 immunized sheep lived and the untreated sheep died.

The first attempt to use anthrax as a biological warfare agent occurred in World War I, when Norwegian police arrested a German agent carrying two vials of the bacteria to be used to infect reindeer ferrying supplies to allied forces in Europe. The spores were still viable when scientists analyzed them in 1998.

By World War II, however, almost every combatant had a biological warfare program that included anthrax. Britain needed 36 years to clean up a tiny island whose soil had been poisoned by anthrax testing in 1942.

Japan, however, was the only combatant that actually used biological agents during the war. In testing between 1932 and 1945, Japanese researchers fed typhoid-laced dumplings to Chinese prisoners of war, dumped typhus rickettsia, cholera bacteria and plague-infested fleas on parts of China, and lab-tested more than a dozen biological agents, including anthrax, on humans. More than 10,000 people died in those experiments.

After the war, both the United States and Soviet Union amassed huge stockpiles of biological agents, an arms race finally called off in 1969 when President Richard M. Nixon unilaterally banned offensive use of biological weapons and ordered U.S. supplies destroyed.

But in 1979, a leak from a biological weapons plant in the Soviet city of Sverdlovsk caused at least 66 deaths, the largest known number of fatalities to date from pulmonary anthrax. And by the end of the Persian Gulf War in 1991, Iraq had produced more than 2,200 gallons of concentrated anthrax bacteria.

"Until modern science, if you lay siege to a town, the townies would have six months' worth of food and nice dry houses, while the invading army lived in the mud and started dying of dysentery," Crosby said. "Things have changed. Today, disease comes out of a bottle."