Source: Los Angeles Times, October 20, 2001.

Soviets' Silent Hysteria

A 1979 anthrax outbreak killed dozens. But unlike in the current scare, there was little sign that anything was wrong. That's because officials covered it up.

By MAURA REYNOLDS, Times Staff Writer

MOSCOW -- The deadliest anthrax outbreak on record began in silence and killed quietly--both literally and figuratively.

Sometime on April 2, 1979, millions of anthrax spores began to spread across southern sections of the Ural Mountains city known at the time as Sverdlovsk. A meat-plant worker named Vasily Ivanov was out walking his dog. The day shift at a ceramics factory was grinding sand and clay. In a little more than a week, Ivanov was dead. So were 18 ceramics workers.

Rumors spread quickly of a deadly disease that wasted healthy men in a matter of days. But there were no articles in the newspapers, no breathless television reports, no government leaders urging calm. Except for workers who suddenly started hosing down roofs and disinfecting streets, there was little outward sign of trouble.

But in the privacy of their homes, residents were terror-stricken.

"The authorities may have believed they could prevent people from panicking by not telling the truth," Ivanov's 42-year-old daughter, Alevtina Nekrasova, recalled this week by telephone from her home in the city, which has been renamed Yekaterinburg. "But people were in a panic anyway. Everyone sat at home, with windows and doors shut tight, shivering with fear and waiting for the first symptoms . . . to develop. We all thought we were going to die."

Alevtina Nekrasova vists the grave of her father, Vasily Ivanov , who was one of the first victims of the 1979 anthrax outbreak in the Soviet city of Sverdlovsk.  At least 64 people were killed. 

In many ways, the Sverdlovsk anthrax outbreak--which killed at least 64 people and perhaps dozens more--was a looking-glass version of the current anthrax scare around the world. The death toll was far higher, but the public hysteria was lower. And it was futile to look to the federal government for help because the malevolent force behind the outbreak was the government itself.

"We lived next to a top-secret military compound," Nekrasova said. "Common logic suggests that it could not have been anything but a biological weapon. What other explanation can there be?"

The Sverdlovsk outbreak has been called a "biological Chernobyl," and just like the more well-known 1986 nuclear disaster in Ukraine, Soviet officials' first instinct was to cover it up. They managed to do just that, with varying degrees of success, until after the Soviet Union collapsed in 1991.

They probably assumed that a cover-up would be easy. After all, Sverdlovsk was a grim, closed military city at the time, and a significant proportion of its cautious and hard-working population was employed in defense-related industries.

In its most common form, anthrax is primarily a disease of farm animals. And for more than a decade, the official government explanation was that Sverdlovsk residents had been sickened by eating meat from infected animals.

Officials apparently were unconcerned by the fact that it is fairly rare to contract anthrax by eating tainted animal products. Most people who catch the disease are farm or textile workers who absorb the bacteria through cuts in the skin. Less commonly, a person can contract pulmonary anthrax by inhaling the bacteria's spores.

All forms of anthrax are treatable with antibiotics such as penicillin if caught in the earliest stages.

The Soviet government concocted the tainted-meat story to conceal what the West already suspected: The Soviets were violating the 1972 Biological Weapons Convention by producing anthrax. Indeed, they were manufacturing it around the clock inside a top-secret facility in southern Sverdlovsk known as Compound No. 19.

Boris N. Yeltsin, who was Sverdlovsk's Communist Party chief at the time of the outbreak, acknowledged the truth in 1992, when he was Russia's president: The anthrax had escaped from Compound No. 19. But he never explained how.

In a 1999 book on the Soviet biological weapons program, "Biohazard," Ken Alibek, the program's former deputy chief, recounts the explanation he heard: A missing air filter was to blame. A clogged filter had been removed during one shift, and workers had left a note for the incoming shift to replace it, Alibek was told. The note went either missing or unheeded for several hours before the mistake was caught.

The military didn't notify civilian authorities, much less the public. Hospital officials were told only to be prepared for an outbreak of some kind of infectious disease. For the most part, it was left for local public health officials to figure out what to do.

One of those health officials was Faina Abramova. The morning that Vasily Ivanov died, Abramova, the recently retired chief pathologist at City Clinic No. 40, was called to examine the body of a man whose symptoms had confounded her colleagues.

"All the soft brain tissues were permeated with blood," Abramova, 80, recalled this week. "The pathologists who performed the initial autopsy suggested it might have been some sort of a viral infection, like a form of influenza. But in more than 30 years of work, I had never seen anything of the kind happen to flu patients. What I was looking at was utterly different."

Abramova had to consult a medical school textbook to come up with the answer. "There were a lot of doctors in the autopsy room watching me work--among them experts on infections," she said. "So I asked them bluntly . . . 'Have any cases of anthrax been reported in Sverdlovsk?' "

The other doctors hemmed and hawed. "And all of a sudden, the administrator of the infections ward admitted they had been ordered to allocate a special ward for people with highly virulent diseases. Possibly anthrax."

Abramova and her colleagues immediately suspected a biological weapons leak. None of the patients had skin lesions associated with cutaneous anthrax. All of them had the pulmonary form of the disease. And all lived in the same southeastern district of the city, which on April 2, 1979, was downwind of Compound No. 19.

In the ensuing weeks, Abramova performed autopsies on 42 people who died of anthrax. But her findings were not passed on to the families. Instead, relatives received death certificates that listed diseases such as pneumonia or influenza as the causes of death. Ivanov's certificate said he died of an "unidentified poison."

Abramova doubted that tainted meat could have caused so many cases of anthrax. But she was warned to keep her conclusions to herself.

The Soviet Union's top sanitary physician was part of a commission that arrived from Moscow. Abramova said he told her: "Whatever you find and whatever conclusion you draw, remember--the official version is 'meat.' " Shortly thereafter, plainclothes men arrived at the hospital and confiscated Abramova's reports and other materials relating to the outbreak.

"We do not know exactly who they were," she said, "but it's rather easy to guess."

Meanwhile, doctors and nurses spread out in the district downwind of the plant and started giving shots and antibiotics. Sometimes they were accompanied by police. No one could offer an explanation.

After the deaths of the 18 workers at the ceramics factory less than two miles from the compound, doctors showed up there with needles and pills.

"We were not told it was anthrax," recalled Nikolai Shigapov, chairman of the factory trade union. "Doctors also prescribed tetracycline to all of us as a precaution--they told us to swallow these pills by the pack: three times a day, six pills at a time. No wonder a lot of people who never got anthrax got kidney and liver problems instead. I, for instance, got a serious liver problem that has remained uncured for the rest of my life."

He also came down with an illness; it took three weeks for him to recover. He now believes that it was anthrax. "Doctors told me I must have gotten an infection from meat," he said. "No one was diagnosed as having anthrax."

Everyone in the district was treated. Soon, the number of those falling ill dropped off. In June 1979, Abramova autopsied her last victim.

It is still not clear how many people fell ill or died. The official count of 64 deaths is widely believed to be a bare minimum. Other victims may have been improperly diagnosed before Abramova completed the first autopsy.

Jeanne Guillemin, a sociology professor at Boston College whose book "Anthrax" investigates the Sverdlovsk outbreak, believes that the military's attempt to ignore the incident raised the death toll considerably. She notes that it was only after Abramova's first autopsy -- nine days after the emission--that public officials had an inkling of what was wrong.

"If someone had taken responsibility and acknowledged there had been an accident, they could have saved a good number of people," Guillemin said.

Some researchers suspect that the death toll was higher. They suggest that employees at Compound No. 19, which had its own hospital, may have died without their deaths being reported. In his book, Alibek says he was told that the toll was 105.

The Sverdlovsk outbreak remains the only case of inhaled anthrax on record in which multiple victims died of a weapons-quality strain. Biological weapons experts who have studied the accident say it demonstrates some of anthrax's strengths as a weapon. A small amount of anthrax--perhaps as little as a gram--killed dozens. It also traveled far in Sverdlovsk, killing farm animals more than 30 miles away.

But experts say it also demonstrates some of anthrax's limitations. The killing power depends on wind speed and direction, as well as other factors. For instance, the wind that morning in 1979 was brisk and blowing steadily to the southeast, away from the city center. Those exposed were in a fairly straight and narrow corridor. If the wind had been blowing in the opposite direction, or more slowly to disperse the spores over a wider area, many more might have died.

Considering that the city's population was 1.2 million, that thousands were exposed and that the anthrax was weapons-grade, even 100 deaths might seem fortunate.

Another lesson is that children appear to have some kind of higher immunity to airborne anthrax, Guillemin says. For still unexplained reasons, no children died in the outbreak even though many were outside playing when the plume passed over. Also, curiously, only two of the known victims were women.

Finally, the Sverdlovsk case suggests that once confirmed, anthrax outbreaks can be contained. Martin Hugh-Jones, an anthrax expert at Louisiana State University who has investigated the accident, says that although the public health effort doesn't get high marks for openness, the Soviets did most things right medically.

Regardless, it was not the facts of the case that kept a lid on public hysteria in Sverdlovsk -- it was political repression.

Information and emotion refract differently through a society ruled by a repressive government and one saturated with instantaneous and sometimes premature news reports. And terrorism thrives not on the number of deaths, but on the public reaction.

"As a result of the anthrax mail campaign in the United States, there will be only a few who actually contract anthrax and die," said Lev Grinberg, chief pathologist of the now-renamed city. "But the main objective has already been achieved--whoever sent those letters out has managed to strike primordial fear into people's hearts."

Alexei V. Kuznetsov of The Times' Moscow Bureau contributed to this report.