How easy is it to get anthrax, plague, Ebola samples?
It turns out, not that difficult. Prior to the 1990–91 “first” Gulf War (Operation Desert Storm), the United States suspected that Iraq had a robust biological warfare program. After the war Iraq admitted to weaponizing 10,000 liters of botulinum toxin and 6,500 liters of anthrax. The country wasn’t fooling around.
The big surprise, though, was that Iraq obtained one of its seed strains to make anthrax and botulinum toxins through legal means from a culture collection in the United States, a microbe “warehouse” for legitimate research and medical purposes.1 Similar microbe collections exist around the world that ship and sell deadly pathogens, including the Chessmen. How Iraq got them is now apparent, but it showed that a determined adversary could obtain the top six threat agents at will.
Move ahead to 1995. Microbiologist and former white supremacist Larry Wayne Harris was caught with Yersinia pestis, the bacteria that causes plague, in his glove compartment.
Question: where did he get it?
Answer: from the same U.S. culture collection as Iraq.
The laws for bioterrorism were in their infancy, so he was convicted, not for possessing plague but for mail fraud, because he had misrepresented himself on paperwork when ordering it.
Since then the laws have tightened significantly. Now anyone who wants to work with the Chessmen and any other select agents in the United States must register with the CDC. Shipments of the pathogens are tracked closely, with much more stringent procedures and in some cases require an armed escort. Select agents are pathogens determined by the government to have the “potential to pose a severe threat to both human and animal health, to plant health, or to animal and plant products.”2 As a result there are specific requirements for handling, storing, and shipping them.
During the year I served as USAMRIID’s deputy commander, we were constantly pedaling to keep up with the changing government rules on managing select agents.3
Throughout USAMRIID we had seventy thousand vials of select agents, scattered across nearly six hundred freezers and refrigerators in the BSL-2, BSL-3, and BSL-4 labs. Each minus-eighty-degree freezer has four to five drawers or cabinets caked with one-half-inch-thick frost, which could easily hide a stray vial. The vials are tiny, less than an inch to perhaps two inches tall, and are kept inside multiple individual boxes. The number of vials was a constant moving target, because with each experiment, new vials of organisms or tissue might be created or destroyed.
Every batch of select agents in the institute had to be under the authority of a single scientist or technician who kept track of how much he or she had in storage at all times. In the past it wasn’t a major issue. The agents were kept in storage in freezers inside the containment labs. The high hurdles, multiple barriers, and lengthy training time it took to gain lab access provided a strong firewall against anyone intent on stealing agents. But as the rules changed, the individual accountability for owning and tracking the agents became more onerous and riskier.
The army instituted a new program called the Personnel Reliability Program (PRP) to investigate and scrutinize people before they entered a containment lab to ensure that they weren’t criminals, didn’t use drugs, or have a disqualifying medical issue. Personnel had to report any changes in their health status, prescription medications, and dental treatments. We probably had the largest number of people in a single institute working on these agents on the planet, at over two hundred individuals. In the aftermath of Bruce Ivins’s death, we were under intense pressure by the army inspector general (IG) to comply with the new rules. In 2007, in true Army fashion, we were given only a couple of months to get 100 percent of the workers enrolled in the PRP; otherwise the army surgeon general would shut us down.
At any given time, we were preparing for an inspection, being inspected, or responding to inspection findings from multiple organizations. Rather than killing us with one thousand little cuts, it felt more like multiple body blows. At one point we felt so pummeled that we started wondering whether there was a conspiracy to shut us down. Our operations team was drowning in paperwork responding to the inspections, and our scientists were frustrated by all the delays the inspections caused in keeping their essential research on track. One inspection was particularly galling. At the end of a CDC evaluation, during their outbrief the inspectors said that we should expect only about a dozen “findings” to address. We briefed our commanding general on the good news. But when the report came out, the CDC listed ninety-three findings. It had cited the same finding repeatedly for each one of our containment laboratories, thus multiplying the findings eightfold. We felt betrayed.
Our lead for operations, Lieutenant Colonel Dave Shoemaker, oversaw our agent accountability and inspection responses. Although Dave had a softer side, and he loved nothing more than hanging out on his sailboat, his shaved head and ramrod military bearing jibed with his meticulous compulsiveness. He had the right personality for the job, and I trusted him implicitly. Dave was particularly incensed by the CDC’s bait and switch. When he finally finished addressing all the findings, as a subtle way to express his displeasure, Dave sent the CDC a shipment of nineteen three-ring binders, which included three versions of the relevant documents: the original version, versions showing tracked changes, and new, revised documents. Years later when he learned that the CDC’s lead inspector was angry to receive such a voluminous response, Dave smiled to himself.
The PRP extended to agent accountability. Someone who didn’t manage his or her inventory properly could be deemed “unreliable” and blocked from lab entry. Not surprisingly some scientists preferred to avoid taking on that risk.
In 2008 one long-term USAMRIID scientist left the institute for a job elsewhere, so another scientist had to pick up his agents. The receiving investigator compared the agent list she inherited with the actual vials in the lab freezers.
One afternoon I learned that three vials of VEE on the list were missing. Oh shit! I thought. What happened to them? In natural outbreaks in Central and South America, mosquitoes spread VEE among horses, which kills them. But VEE can also infect through the air. It is considered a “reliable” weapon because it sickens nearly 100 percent of the people who inhale it. Most other viruses aren’t as efficient. The virus grows and replicates in the brain and surrounding fluids, causing high fevers, body aches, and an excruciating headache. Victims don’t usually die, but they might wish they were dead; they may stay in bed for a week or two. The risk to a military operation is obvious because it’s hard to drive a tank or dig a foxhole if you feel like you’ve been run over by a truck. A terrorist could spray enough of it over a city to knock down hundreds to thousands of people.
When we queried the departing investigator about the inventory mismatch, he believed that the missing vials had been used up and discarded after experiments by someone else years ago, but the paperwork had failed to catch up. He had never even worked on VEE and probably inherited the list of vials from someone else. Our internal assessment concurred. We sent the requisite EXSUM up the chain, stating, “A thorough internal USAMRIID investigation concluded that past accounting errors of this large inventory was responsible for this discrepancy.” In the past this would have been the end of it—but not in the current climate.
The army uses SIRs to notify the Pentagon about major disasters, like a soldier’s death or a helicopter crash. A missing vial qualified as an SIR, which Dave Shoemaker dutifully fired off. This triggered alarm bells around the Washington, DC Beltway. The Criminal Investigation Division (CID), the military version of the FBI, paid us a visit. You don’t want to tangle with these people—they have no sense of humor.
Before launching their investigation, the lead CID investigator sat down with Dave Shoemaker to agree on some ground rules “for nonconfrontational conversation, not heavy hitting,” Dave said. “Questioning of RIID folks was not going to be a hardcore ‘good cop/bad cop’ type scenario, but simply information gathering.”
That’s not what happened, however. If you are a hammer, everything is a nail. If you are a CID investigator, everyone is a criminal, even when none exist. When the CID started interviewing USAMRIID staff, “It was totally the opposite of what I had been led to believe,” Dave said. At least a half dozen people came to him upset—some on the verge of tears, feeling “like they were criminal suspects.” This was particularly frightening for the workers in the post-anthrax investigation climate. This “lit my fuse,” Dave related, and he had some heated exchanges with the CID.
Nonetheless, the investigation continued for five months . . . involving thirty special agents conducting over five hundred interviews and documenting 1,250 man-hours on a wild-goose chase over five continents at a cost of $500,000. The CID concluded that it was probably a clerical error left over from decades prior. Hmm. Didn’t we conclude that five months earlier . . . for free? I shared Dave’s concern that “this was an incredible waste of time, money, and resources.” The departing scientist felt that after years of dedicated service, he was an easy target for blame, because he had already left the institute. It all seemed a bit of overkill, but after 9/11 and the anthrax attacks, the environment was heavily charged.
Dave considered the VEE investigation “growing pains,” as we transitioned our mind-set away from the days when a scientist could carry a “VIP” (vial in pocket) of a disease agent or a patient sample when returning from a foreign country. The take-home lesson for me was that scientists could now go to jail merely for a clerical error.
That was the fate of Dr. Tom Butler, a Vietnam veteran, highly respected plague expert, and infectious disease professor in Texas. In 2003 he reported a discrepancy in his plague sample numbers, as would be required under the new rules. Instead of being applauded, he was accused of bioterrorism. He was eventually exonerated for bioterrorism, but the investigation dug up financial irregularities from his research grants. He spent two years in a penitentiary and lost his medical license, despite outcries from respected medical societies and colleagues.4 We were in a new world order.
Inventory scrutiny dogged us like a toothache with the occasional root canal. Dave says, “I lost more nights’ sleep for that than anything else.” At one point the USAMRIID commander confided to him that he wrote in his daily log book, “I will get fired today,” after a tough meeting with our commanding general. Dave subsequently told me that the inventory issues might be enough for the Pentagon’s anthrax response task force to shut down the institute or to relieve the commander. I told Dave, “If the commander goes, I’m going with him.” Dave said he would too. Dave went home that evening and broke down, feeling guilty that an inventory error could sack “the best commander [he] had ever served under.”
We were already reeling from the emotional toll of constant scrutiny.
Then the next shoe dropped.
On February 4, 2009, I walked into Dave’s office next to the USAMRIID headquarters. Given his job responsibilities, Dave usually had a humorless demeanor, but I could occasionally get him to crack a smile—not today. Dave was with one of his Operations Section chiefs. They told me that an army inspector that day had inventoried a list of sixteen vials of VEE in the freezer.
They found twenty vials instead—another inventory mismatch.
Damn. Feeling a familiar punch in the gut, I had to sit down. I understood the implications immediately. Not only was this on the heels of the missing VEE vials, but over a year earlier, the previous commander had certified that we had 100 percent accountability of our agent stocks. The disconnect? When the institute conducted the prior inventory, it started with the list and compared it with the vials, not the other way around. This was a self-inflicted wound.
The army previously required an SIR for any “underage” (i.e., missing vials), which made sense, because a vial could have been stolen. But just days before, as part of the new post-Ivins rules, it had decided to do one better than all other research labs and added a new rule, requiring an SIR for any “overage” (i.e., extra vials found that were not in the database).5
The army had painted us into a corner. I knew immediately that we had no choice but to shut down the entire institute and conduct a full inventory. The four vials called into question our entire inventory database.
After a brief discussion of an action plan but feeling the weight of the news we would bring him, the three of us slumped silently, like condemned prisoners, over to the commander’s office. He took the information in stride and agreed on the only path forward: shut down operations and conduct the inventory.
How did we get there? Had we just been blowing off the regulations?
Prior to 2001 USAMRIID did not have an institute-wide database with a line-by-line inventory. There were no such requirements. Instead, investigators kept spreadsheets of their agents in the freezers and tracked their daily work in their laboratory notebooks as “working stock.” However, after 2001 the institute made a concerted effort to develop an institute-wide inventory database.6 During the transition from paper records to an electronic database in 2005, all vials may not have been entered because it was built with data from active researchers, not samples in deep storage no longer used, but whenever an unaccounted vial was found, the scientist entered it into the database.7
As one scientist noted angrily, “You had a situation at USAMRIID where you had decades of stuff in freezers that had never been formally inventoried, because business was not done that way back in the day—and then all of a sudden some bureaucrat bean counters try to implement some new unproven inventory system in a really short period of time. It was destined to fail from the start.”
Shutting down for the inventory would bring our $125 million research mission to a standstill. We braced for the backlash from unhappy research funders, the army’s chain of command, and disgruntled scientists, who viewed the shut down as punishment.
Dave fired off another SIR up the chain, and that afternoon the commander emailed the institute explaining the situation: The institute must certify “that the full contents of each freezer and refrigerator have been evaluated and that all BSAT [Biological Select Agents and Toxins] are included in our inventory.”8
Unfortunately, he didn’t anticipate that one of our own would forward his email to the press. Once again we found ourselves in the media spotlight, gracing the front pages of the Washington Post, which painted a big target on us.
It might seem simple on the surface, but this would be a massive operation—to assess nearly six hundred freezers and fridges institute-wide, with over two hundred in the containment labs.
The commander tasked me to get the ball rolling. In some ways this would be my final leadership “exam.”
During my years at USAMRIID, I had worked to protect the soldiers, the lab workers, the president, and ultimately, the nation. We had even managed to weather the Bruce Ivins anthrax crisis. Now I felt the weight of the institute’s future on my shoulders. We had to get this right for USAMRIID to survive.
So, where to begin? I knew I needed someone to take my guidance and to “run point” for me who could interface with the lab scientists every day.
Colonel Terry Besch was a veterinarian with wide-ranging experience who had worked in the containment labs. She had impressed me with her insightful comments at meetings and by her candor in private. Tall, with short chestnut-colored hair, she had the right no-nonsense attitude. Although she ran a large support division for the institute, she had some good leaders working for her, so I thought she had some flexibility. I brought Terry into my office and asked her to run this to ground. Surprisingly, she seemed enthusiastic to take it on.
I wanted every freezer and refrigerator in the institute emptied and all contents moved into an empty freezer or fridge—on the hot side, gray side, and cold side (i.e., no “stone” would be left unturned). We needed a standardized, defensible process, and I didn’t want to ever have to repeat this. We also needed to protect the commander, whom the army could punish as the fall guy at any time.
We developed the inventory process from scratch, with a strong sense of urgency and common sense. BSL-3 procedures came first, followed by BSL-4, then BSL-2. Before beginning we assessed what research absolutely could not be shut down, due to significant costs or if animals had already been infected with an agent. We did not want to harm animals unnecessarily. We emphasized accuracy over speed, but we couldn’t risk having the virus and bacteria samples thaw during the transfers, or we might lose valuable historical samples.
Picking Terry to head the effort and giving her the authority to make decisions turned out to be one of the best decisions I had ever made. Terry laid out a large institute floor plan on my conference table. She numbered and tracked the locations of all the refrigerators and freezers and organized them according to which division would oversee the inventory in a specific area. Terry color-coded a freezer map, which looked like a Christmas display, showing “Green (complete), Yellow (in progress), and Red (pending start),” for lab rooms across the institute.
It has been said that no battle plan ever survives first contact with the enemy.9 Every laboratory had its own idiosyncrasies that had to be accommodated, so Terry and I met regularly to adjust as issues came up during the execution of our “battle plan.”
Until we rolled up our sleeves, we had no idea how long it would take.
At the start, we were hampered by the lack of empty freezers, even though we always kept a couple on hand, ready to go. It takes several hours to bring a freezer down to the proper temperature of minus eighty degrees Celsius, and just moving an eight-hundred-pound freezer into containment is a challenge that could take an hour or longer. After moving one into an airlock, the individual then changes and enters the lab, pulls the freezer in from the airlock, and searches for an available electrical outlet.
I placed an urgent priority 8 (critical) order with the contracting officer for twelve more freezers. She put in the order that day, but the government contract rules for mandatory competition kicked in. We waited . . . and waited. The freezers arrived over six weeks later. By then we had improvised without them.
Terry made a rule that every freezer had to be thawed and cleared with a squeegee to verify that every drawer was empty. Most researchers didn’t like that. One researcher was particularly vocal, until one day, while using a squeegee in BSL-4, a vial popped out and hit the visor of her space suit. After that the complaints stopped.
Investigators are natural pack rats. The process was like cleaning out the attic. There was no telling what treasures we might find. During the inventory we “rediscovered” one set of valuable serum samples from Korean War veterans who had been infected with Korean hemorrhagic fever in the 1950s. Such samples, if destroyed, could never be replaced. The challenge is predicting which ones will be needed for future outbreaks or research.
The commander received constant pressure from up the chain of command: When will this end? He avoided making promises, but the pressure mounted. Terry and I authorized research operations in the containment suites to resume on a rolling basis as soon as we completed and validated each inventory.
One of Terry’s update reports noted, “The amount of paperwork generated is extraordinary. Morale is low. People are frustrated.” As the weeks went by, Terry’s map showed the sea of red slowly transition to yellow, then green. Thankfully, the army surgeon general was our best supporter. I was occasionally copied on his messages to the vice chief of staff of the army, and I admired how quickly he understood our challenges and defended us. The USAMRIID commander extracted a huge concession during the inventory: if we noted any missing vials, we would send up an SIR immediately, but we could wait to report newly found inventoried vials in a single SIR at the end of the inventory. We could have been tied up in knots sending SIRs otherwise.
The commander’s leaked email about the inventory forced us to engage with the media. The commander was under a lot of pressure, so Caree, our public affairs officer, asked me to serve as the media spokesperson instead. We had worked together previously on several interviews and press releases, so I knew she would keep me out of trouble, and she knew I wouldn’t say anything stupid.
I looked forward to telling our side of the story and explaining its enormous challenges. I also believed that by serving as the spokesperson, I might take the “fall” if the army needed a scapegoat, rather than the commander.
Caree, Dave Shoemaker, and I sat around my conference table for a phone interview with a reporter from Science magazine. I took the “hot seat” and did most of the talking. The interview went well, and the reporter gave us a fair shake in his article for identifying a problem and addressing it, noting, “Researchers affected by the new rules are understandably unhappy, says Kortepeter, but they ‘realize the importance’ of carrying out the inventory.”10
Four months after we began the inventory, we had counted and recorded over 70,000 vials and tissue samples of infectious pathogens. Among these, 9,220 vials had not previously been listed in the database. There were zero missing vials.
We weren’t surprised to find some vials, but that number shocked even us. It is easy to ask, “how could this happen,” but the changing rules added to the complexity—for example, genomic DNA for certain viruses was new on the inventory list, and many of the vials “found” were working stock. When a scientist pulled a vial out of the freezer, he or she could make additional samples from that vial and use those samples for experiments for up to thirty days before entering them in the database. It is easy to understand how a sample might be put back into the freezer and later forgotten without being entered into the database. The number of vials was constantly changing as a result.
The inventory was an incredible undertaking of time and resource allocation to complete, transfer all the agents between freezers, and update the computer catalog and agent storage after over forty years of collection. Terry tracked the effort, which required 223 people (~27 percent of the institute employees), and over 6,600 personnel hours at a cost of nearly $400,000, which was most likely an underestimate. The less tangible but larger opportunity cost was delaying our research mission by about one calendar quarter, which included damage to our credibility in the eyes of the country, the scientific community, the research funders, the army; disgruntled employees; and potential damage to critical frozen agent stocks.
As the inventory wound down, the media came calling again. We had to engage, but I worried that this time that things could get bloody.
Caree and I decided that I would lead the call again, but we pulled in a couple of others for backup. Once again we sat around my conference table: Caree, Terry Besch, Dave Shoemaker, and Sam Edwin, who was our lead on select agent inventories.11 We spoke with reporters from the Associated Press, the Frederick News Post, the Washington Post, Science, and Science Times. As the call commenced, Dave later told me that he was thinking, God, I’m glad it’s Colonel Kortepeter, not me! This time the USAMRIID commander sat on the periphery in my office during the discussion.
I emphasized that we had recognized a problem and addressed it head on. The news reports, however, didn’t see it that way. The next day our 9,220-vial inventory discrepancy hit the major news outlets like a stink bomb. The sheer number of vials led to fresh scrutiny, and some reports made it sound as if we were trying to skirt the rules, which was not the case.12
The commander never said anything to me about how I handled the media call, but I wondered if I should write my own “I will get fired today” note in my daily notebook.
The inventory mismatch forced us to address something that should have been done several years earlier, but it also allowed us to catch the institute up with the new army rules. We were in a no-win situation, though, with strong disincentive previously to cease operations because the funding stream for USAMRIID had become tenuous, and if USAMRIID was not operational and couldn’t do the work, funders would go elsewhere.13
The inventory results also reflected negatively on the CDC’s laboratory inspection unit, the DSAT (Division of Select Agents and Toxins). As one article noted: “USAMRIID’s case raises questions about lab inspections conducted by federal agencies to ensure compliance with select-agent rules. At least in USAMRIID’s case, a CDC inspection in September 2008 failed to identify the problem of unlisted samples.”14
Not surprisingly the CDC sent us a memo shortly thereafter, warning of another inspection. From that day on, the punishment continued. The CDC, as well as other agencies, including our parent command, the Department of the Army Inspector General’s office, and others, have conducted nonstop inspections.
In the aftermath, the deputy to the army inspector general (DTIG), a two-star general from the Pentagon, visited us for a briefing on the situation. When an army unit does target practice, the DTIG noted, they check weapons out to the soldiers and issue bullets at the rifle range. At the end of the training, everything is returned and counted. The DTIG chastised us, saying that counting vials should be like counting bullets.
I disagreed, which probably didn’t earn me any points with him or our chain of command, but he had a fundamental misunderstanding of the problem because he had never set foot inside a laboratory. “Bullets don’t reproduce,” I explained. Live agents do. Therefore, the focus on counting vials is misguided.
Under the right conditions, 2 bacteria dividing exponentially every twenty minutes could increase to over 65,000 in four hours. Viruses infect cells and produce millions of offspring. We can count all the vials we want, but a criminal who knows what he is doing doesn’t have to steal a vial to produce thousands of vials of organisms. He or she only had to steal some ice crystals in the vial that contain organisms. The vial and the fluid level inside it would remain intact. Therefore, we should focus instead on what agents are used or stored in the lab and ensure that we have redundant measures to prevent the wrong people from getting near them.
In the meeting, one of my virology colleagues, Gene Olinger, displayed a diagram to illustrate an even bigger challenge for the DTIG. Like a New York City subway map, numerous colored lines crossed and spread out in all directions showing where numerous blood, tissue, or other body-fluid samples from infected animals went after a single experiment: to the diagnostics lab, pathology, the genomics lab, electron microscopy, and multiple refrigerators and freezers throughout the institute. Should every one of those pieces be counted, weighed, and tracked? Every scientist would need a full-time cadre following him or her around like a swarm of bees around honey, writing down everything the scientist was doing and entering it into a database. Such a protocol is not only very expensive, it is also dangerous because having more people in the containment lab just to gawk increases the safety risk for everyone. Under such circumstances it isn’t long until research shuts down.
So in the long run, our rules risk shackling us, and we become less secure because we don’t have the flexibility to respond quickly to a new outbreak, because we’re so worried about watching our backs.
The DTIG was unmoved, saying, “I understand it’s hard, but you need to find a way to do it.”
I was proud that USAMRIID weathered the storm and resumed operations, but we had dodged a bullet. We witnessed what could have happened if we had failed: the army surgeon general shuttered the Armed Forces Institute of Pathology’s (AFIP) decades-old biodefense program, and it had to transfer most of its pathogens to USAMRIID. The transfer of AFIP’s samples demonstrated the army’s renewed confidence in our ability to manage the inventory going forward.
The army and the navy also operate research institutes overseas in collaboration with foreign governments and militaries. One lab in Bangkok, Thailand, the Armed Forces Research Institute of Medical Sciences (AFRIMS), has served as a hub for infectious disease research throughout Asia for over fifty years. It faced the same challenges that we had dealing with select agents. When a team from the army inspector general paid the lab a visit, they found vials of Bacillus anthracis (anthrax) and Yersinia pestis (plague) bacteria and Crimean Congo hemorrhagic fever virus in the freezers. Their largest cache of select agents consisted of over three thousand Japanese encephalitis virus (JEV) isolates and animal tissue samples. Even though JEV is not usually considered a bioweapons threat, it had been classified as a select agent back in 2005.
JEV occurs throughout East Asia (Japan, China, Indonesia, India), generally in rural areas where pigs live close to humans, because pigs generate virus like a factory and the mosquitoes that spread the virus breed in the rice paddies nearby. JEV causes an infection of the brain leading to death or severe brain damage. Fortunately, not everyone who gets infected gets sick, and there is a vaccine to prevent it.
Colonel Fernando Guerena was an athletic Mexican American with black hair and a heavy accent who would later come to USAMRIID to take my old job as Medicine Division chief. Fernando was a veteran of the Iraq and Somalia operations and knew how to get things done. As the army officer put in charge of developing a program to handle the select agents at AFRIMS, he went about establishing the appropriate security and getting people enrolled in the PRP while the institute started to build a new BSL-3 containment laboratory. He told his personnel, “We can do this,” noting, “It was a great exercise, because one day we’ll have the real thing.”
Despite Fernando’s heroic efforts, when the new army requirements came out, overnight samples of JEV that had been stored inside AFRIMS freezers, probably for decades, were suddenly deemed unsafe. He recalls getting a memo on Cinco de Mayo from his commanding general directing AFRIMS to secure all the select agents immediately. A later memo directed him to destroy the samples. The staff searched the freezers and refrigerators and gathered all the samples of B. anthracis, Y. pestis, and Crimean Congo hemorrhagic fever virus that had been collected over decades, placed them in an autoclave, and threw the switch that summarily destroyed them. Only the JEV samples would be spared.
Kurt Schaecher, another future USAMRIID colleague, was working at AFRIMS at the time on malaria countermeasures as the deputy chief of immunology and medicine. A man with short, graying hair and a robust sense of humor, he recalls getting the notification that AFRIMS needed to secure the JEV samples, package them up, and ship them out to USAMRIID. “We got caught with our pants down having it there,” Kurt says. The notion that a terrorist would break into the lab and steal JEV samples that could be found easily in the local region seemed ridiculous. Nevertheless, the army officers saluted and did what they were told. The new army rules required someone to have “eyes on” the samples 24/7. Because the lab didn’t have a video monitoring system, the institute consolidated all the JEV samples into two freezers in a room with glass doors. Kurt, Fernando, and their medical and scientific army colleagues had to keep guard on the samples 24/7. Kurt says, “I had to take a chair and sit in front of the room and just sit there.” Fernando said it was like being on call. Some soldiers had the overnight shift and brought in their sleeping bags, teddy bears, and books during their guard shifts.
The lab was ordered to ship the JEV specimens from Thailand, a country where JEV already “lived” in nature, to USAMRIID in a country free of the disease (but harboring the mosquitoes that spread it), just to “check a box.” When West Nile virus first landed in New York City in 1999, it took only a few years for mosquitoes to spread it across the entire country. If JEV got out, those same mosquitoes could sweep it across the country like a jetliner. It seemed foolish to risk a repeat of that with JEV. I objected. I lost the battle. Sometimes our rules get ahead of common sense.
When the Royal Thai Army Medical Department learned about the plan to ship the JEV specimens, it put the brakes on the operation, claiming ownership of the samples for Thailand, where they had been collected. Pathogen samples can have significant commercial value. The AFRIMS team kept the U.S. ambassador informed, but the two countries could not agree on ownership. They essentially agreed to disagree. Eventually, the Thai army allowed AFRIMS to move the samples temporarily to the United States, with the promise that they would be returned when the AFRIMS lab could meet all the new army rules.
Before shipping the samples, because of their presumed dangerous nature, a huge paperwork exercise ensued, including the need to complete endangered species importation paperwork because the samples included JEV-infected monkey tissues. Additionally, the samples had to fly using an airline “white glove” service that came with a special fee. Just getting the samples to the airport required armed guards. Each of the armed guards and anyone else who would transport the samples had to be drug tested, but there was no U.S. drug testing facility in Thailand. Fernando eventually managed to get them tested by none other than the antidoping agency from the Olympic committee stationed in Bangkok.
One evening Dave Shoemaker, my operations chief, brought me two sealed boxes, each about the size of a large sheet cake, containing the JEV samples that had arrived by courier from Thailand. I told him I didn’t want anyone opening the boxes, let alone touching the samples inside. It was late in the day. Reminiscent of the final scene of Indiana Jones inside the vast warehouse full of stacked wooden crates, we carried those boxes down the institute’s dark hallways to a lonely narrow side corridor behind a locked metal-mesh door. We unlocked one of the freezers and shoved the unopened boxes into an empty bottom drawer; then we locked it back up.
Years later they were shipped back to Thailand.
JEV would be removed from the select agents list three years later, in 2012.
I shudder to think how many irreplaceable historical specimens had to be destroyed, in haste, in the name of security. Which ones might be needed as a reference in future natural or bioterrorist outbreaks? We have no idea what samples our adversaries might be hiding in their freezers.
The military wasn’t the only agency caught in the crossfire of new regulations. Years later I watched with empathy and understanding in 2014 as my colleagues at the NIH and the CDC also struggled with inventory and select agent issues. The NIH discovered twelve boxes with 327 vials holding a variety of pathogens, including smallpox and Q fever, a lesser-known potential bioweapon agent. This occurred around the same time that the CDC director had to testify before Congress about its mishandling of live anthrax and avian influenza samples.15
In August 2009 I concluded a tumultuous year as USAMRIID’s deputy commander—a year where USAMRIID was shaken to its core by the Ivins and inventory challenges. I like to think I made a difference in helping to save this vital national resource from ruin.
During my next assignment, at the Uniformed Services University, the entire world would struggle with a new and unexpected disaster.