Index

Page numbers refer to the print edition.

Acinetobacter, 118

Adamovicz, Jeff: and anthrax letter analysis, 40, 43, 198; and FBI investigation, 185–88; and hallway contamination, 89–90; thoughts on Bruce Ivins, 180, 200, 202

Aeromedical Isolation Team (AIT), USAMRIID, xxv, 222, 253n3

AFEB. See Armed Forces Epidemiologic Board

AFIP. See Armed Forces Institute of Pathology

Aflatoxin, 101

AFRIMS. See Armed Forces Research Institute of Medical Sciences

agar: for anthrax growth, 26, 40–42, 177; as a bacterial growth medium, 255n8

air detectors, 61, 63

AIT. See Aeromedical Isolation Team

Aldis, John, 131–33

Al Eskan disease, 125, 128, 259n2

Alibek, Ken, 10, 235

Alves, Derron (Tony), 229–32

America’s medical school. See Uniformed Services University (USU)

Amherst, Sir Jeffrey, 24

Anderson, Arthur, 34–37, 258–59n4, 260n1

Anderson, Ed, 258n4, 260n1

The Andromeda Strain (book, Crichton), xxi, 253n1

The Andromeda Strain (movie, Wise), 49, 225

anthrax: altered morphology in letters, 41–42, 177, 199; attack victim Erin O’Connor, 35–38, 45–46, 285n1; attack victim Robert Stevens, 30–33, 38, 201; Aum Shirinkyo dispersal attempts of, 65; as a biothreat agent, 13, 15, 26–27, 30–32, 68–70, 72, 101, 103, 240; and B’nai B’rith hoax, 68; and Daschle letter, 39–43, 45, 51, 88, 177; hallway contamination, 79–90; impact on USAMRIID, 191–92, 194–96, 202, 204–8; Iraqi production of, 201; laboratory exposure to, 86–90; letter attacks, xiv, 29–46, 235; letter decontamination testing, 44; and North Korean arsenal, 234; USAMRIID research on, xx, 243; vaccine, 73, 74, 176–77, 185, 197

ark of the covenant, 254n6

Armed Forces Epidemiology Board (AFEB), 95

Armed Forces Infectious Disease Society, 259n3

Armed Forces Institute of Pathology (AFIP), 215

Armed Forces Research Institute of Medical Sciences (AFRIMS), 216–18

Ashcroft, John, 62

Aum Shinrikyo, 21, 65–66

Bacillus anthracis. See anthrax

Baghwan Shree Rajneesh, 66–67

BARDA. See Biomedical Advanced Research and Development Authority

Bartlett, Roscoe, 86, 257n3

Bassett, Anthony, 261–62n1

Bassett, Jennifer, 261–62n1

bats, 20, 70

Bavari, Sina, 154, 254n5, 260nn1–2

Belfer Center (Harvard University), 234, 265n1

be on the lookout (BOLO) message, 183–84, 186

Besch, Terry, 210–13

Bible: and anthrax 26; and plague, 22, 254n6

biological select agents and toxins (BSAT). See select agents

biological warfare. See biological weapon(s)

biological weapon(s): and Biological Weapons Convention, 101; detectors for, 61, 63; history of, 12–13; ongoing threat from, 234–37, 239–41; potential uses of, 65–68; properties of, 12–27, 68–70; USAMRIID’s defensive role against, xiv–xv, 16, 47–48, 56–58, 73–75, 97–98, 143–45, 172, 175, 243–44

biological weapons program: in Canada, 13, 38–39; in Germany, 13; in Iraq, xiv, 13, 17, 93, 101–2, 110–11, 260; in Iran, 13; in Japan, 13, 23; in Libya, 13; in North Korea, 13, 234; in Russia, 235; in the Soviet Union, xiii, 13, 17, 19, 21, 65, 74, 198, 235; in Syria, 13; in the United Kingdom, 13, 26; in the United States (defensive), xiii, 47, 74–75; in the United States (offensive), xiii, 13–14, 17, 19, 47, 198

Biomedical Advanced Research and Development Authority (BARDA), 236

Biosafety Level 3 (BSL-3) lab: accessories of, 80–81; Daschle letter analysis in, 39, 78–79; entry procedures, 80–81, 255–56n5; occupational exposures in, xxiii; pathogen inventory procedures in, 210–11; requirements for designation as, 49; USAMRIID’s research project ward, 44

Biosafety Level 4 (BSL-4) lab: Ebola exposure in, xviii–xx, xxii–xxiv, 148, 164; entry procedures, xvii–xviii, 167–68, 261n2; model for the Slammer, xxi, 225; Nancy Jaax and, 162; and new labs, 163–64, 243; pathogen inventory procedures in, 210–11; pathology work in, 229–30; requirements for designation as, 49–50

biosurety, 263n3

bioterrorism: and B’nai B’rith hoax, 68; and Dianne Thompson outbreak, 67–68, 240; and Thomas Butler, 207, 263n4; and Larry Wayne Harris, 203; and plague scare in New York City, 23–24; future preparedness for, 235–37, 240–41, 243–44

Black Death, 22–24, 175, 253n2, 254n5. See also plague

Blackhawk helicopters, 99, 112, 116, 117–19

Blair, Tony, 112

Blazes, David, 264–65n2

blue suit. See “space” suit

B’nai B’rith incident, 68

BOLO. See be on the lookout (BOLO) message

Bond, James, 65

botulinum antitoxin: available at USAMRIID, 56–58; mechanism of action, 53; production of, 56–57, 75; treatment with, 55–57, 69; use in Operation Iraqi Freedom, 102–4, 108, 112, 114, 119–20

botulinum toxin: Aum Shinrikyo use of, 65–66; bioweapon threat from, 15–18, 51–52, 57–58, 102–3, 203; detection and testing for, 61–62; Japan’s unit 731 and, 23; new countermeasures against, 104, 120; paralytic effects of, 17, 52, 70, 102–3; response to presumed White House attack, 51–63; and Rheinhardt Heydrich, 18; serotypes of, 56; vaccine against, 104–5, 113–14, 116

botulism. See botulinum toxin

Boudreau, Ellen: and anthrax hallway contamination, 257n1; and anthrax lab exposure, 87, 90; and botulinum attack, 54; and Ebola exposure, xxiii–xxiv, 254n5, 260n1; and FBI anthrax investigation, 185–87; and Liberia outbreak, 130–33, 135; and SMART-IND team, 258–59n4

Boyer, Julie, 159

Brantley, Kent, 224–25, 265n6

Bray, Mike, 260–61n1

Brett-Major, David, 264–65n2, 265n4

Brokaw, Tom, 34–38, 43, 45–47, 239

Brooke Army Medical Center (San Antonio, Texas), 133–34

Brosch, Laura, 258–59n4

Brown, David, 259n1

BSAT. See select agents

BSL-3. See Biosafety Level 3

BSL-4. See Biosafety Level 4

bubo. See plague, bubonic

Bulgarian Secret Service, 65

“Bullethead,” 110–11, 113, 116

Burgess, Tim, 136–39

Bush, George W.: and anthrax attacks, 88; and botulinum toxin exposure, 55, 57, 61–62; and Operation Iraqi Freedom, 112

Butler, Tom, 207, 263n4

Camp Doha (Kuwait), 100–101, 108–10, 112, 115–17, 119

Camp Udairi (Kuwait), 109–11, 113–15

Carlin, Jackie, 114, 258n4

Casals, Jordi, 135–36

category A threat agents: 14–15, 234. See also anthrax; botulinum toxin; Ebola virus; Lassa fever virus; Marburg virus; plague; smallpox; tularemia; viral hemorrhagic fevers

CCHF. See Crimean Congo hemorrhagic fever

CDC. See Centers for Disease Control and Prevention

Centers for Disease Control and Prevention (CDC): botulinum antitoxins available at, 56, 62; category A threat list, 15; and discovery of Heartland virus, 240–41; and discovery of Lassa virus, 130, 136; Ebola discovery and, 19–20; and Ebola-infected dogs, 230–32; Erin O’Conner skin biopsy, 37; response to anthrax attacks, 31, 33, 73–74, 88; response to Ebola exposure, 151, 154, 160; response to positive air samplers, 63; select agents and, 203–5, 214, 218–19; September 11, 2001, and, 29; smallpox repository at, 71, 92; and smallpox vaccination, 93, 96; and West Africa Ebola outbreak response, 221, 223, 225–27

chain of command, USAMRIID, 258n3

chemical weapons: 12–13, 17, 70, 100–102, 119; Aum Shinrikyo use of, 65–66; and B’nai B’rith hoax, 68; properties of, 70–72, 256n4; “SLUDGE” nerve agent effects of, 258n2. See also mustard blister agent; sarin nerve agent; Soman nerve agent; Tabun nerve agent; VX nerve agent

Cheney, Richard “Dick”: and botulinum exposures, 62; and smallpox preparedness, 93, 95, 98; and SMART-IND team, 105

Chessmen, 14–27. See also anthrax; botulism; Ebola virus; Lassa fever virus; Marburg virus; plague; smallpox; tularemia; viral hemorrhagic fevers

chikungunya, 143, 260n1

Christie, Chris, 228

CID. See criminal investigation division

Cieslak, Ted, 10, 27

Clizbe, Denise, xxiii, 39–40, 162–63

Clostridium botulinum. See botulinum toxin

“cold” side, xvii, 80, 167, 198, 210

combat support hospital (CSH): Eighty-Sixth CSH, 111–14; Twenty-Eighth CSH, 123–24

Comfort hospital ship, 117–19

Conger, Nick, 264–65n2

Cook, Robin, 34

Coyne, Phil, 258n4

Crichton, Michael: The Andromeda Strain (book), xxi, 253n1

Crimean Congo hemorrhagic fever (CCHF) virus, 216–17

criminal investigation division (CID), 206–7

CSH. See combat support hospital

Cummings, James “Jim,” 258–59n4, 264–65nn1–2

Dallas Presbyterian Hospital, 227, 231

Daschle, Tom, 39–43, 45, 51, 88, 177

Dasey, Chuck, 160, 257n5

Defense Threat Reduction Agency (DTRA), 264n13

Defraites, Bob, 125–26, 138

Demmin, Gretchen, 176–77

Department of Defense Ebola working group, 221–23

desert pneumonia, 122–28

Deye, Greg, 134–35, 137

Doctors Without Borders. See Médecins Sans Frontières (MSF)

DTRA. See Defense Threat Reduction Agency

Dugway Proving Ground, 199, 262n3

Duncan, Thomas, 227, 231

dunk tank, 81

eastern equine encephalitis virus, 75, 257n3

Eastwood, Clint, 80

Ebola virus: biocontainment care for, 226–27; as a biological weapon, 15, 19–21, 69–70; as a BSL-4 pathogen, 49; clinical features of, xix, xxiv, 19, 69, 130, 148–49, 158–59; dog infection with, 229–32; false alarm, 28; fear of infection from, 21, 68; future research on, 172, 236, 308; history of discovery, 19–20, 154; in The Hot Zone book, xiii, 154, 253n3; Kelly Warfield work on, xvii–xix; mouse adapted, 264n6; outbreak preparation, 235; pathophysiology studies on, 165–72; Slammer aftermath from, 164; soldier quarantine for, 228–29; USAMRIID response to lab exposure from, xx–xxvi, 146–64; West Africa outbreak of, 12, 129, 142, 145, 220–29

Edwin, Sam, 213, 264n11

Ehrlichia, 240

8 Ball, 144

Emory University, 163, 226

Endy, Tim, 123–24, 138, 258–59n4

EPICON team. See epidemiologic consult team

epidemiologic consult team (EPICON), 125–28

epidemiologic triangle, 124, 220

Esham, Keith, 260–61n1

executive summary (EXSUM), 148, 184, 206

EXSUM. See executive summary

Ezzell, John: and anthrax letters, 30, 34, 36, 39–40, 44–45, 51, 255n5; and Ivins eulogy, 261–62n1; and Parkinson’s disease, 255n2

Fauci, Anthony “Tony,” 155

FBI. See Federal Bureau of Investigation

FDA. See Food and Drug Administration

Federal Bureau of Investigation (FBI): and anthrax lab investigation, 78–79, 88, 184–88; and the Daschle letter, 39–40, 42–43; impact on USAMRIID, 194–95, 263n3; investigation of Bruce Ivins, 90, 178–81, 183, 186, 191, 193, 197–200; investigation of Steven Hatfill, 88, 177–78, 180, 200; and letter decontamination, 44; and Robert Stevens investigation, 30–34; seeking USAMRIID consultation, 47, 50; and Ted Cieslak lecture, 27; treatment of USAMRIID personnel, 185–88

Feingold, Russ, 39

Feldmann, Heinz, 154, 260n1

Fellows, Pat, 261n1

15–6 investigation, 86, 89, 258n6

filovirus, xxi, 19–21. See also Marburg virus; Ebola virus

fleas, 22–24, 70, 125, 174

Flynn, Sandra, 260n1

Fogtman, Bev, 52–53, 58–60

Folk, Scott, 240–41

Food and Drug Administration (FDA): animal rule, 145; and biodefense countermeasures, 143–45; and botulinum response, 54–56, 62; emergency IND through the, 139–40, 155; and protocols for bioweapon threats, 73–75; ribavirin protocol and, 139; and smallpox vaccine, 95–99; SMART-IND team challenges with, 103–5, 111–12, 114, 120, 258n3; wife’s work at, 174

Fort Detrick (Maryland): Ivins memorial service on, 192–93; new laboratories on, 153, 243; 9/11 response at, 29, 88–89, 199; police at, 60, 62, 183–84, 186, 188–89; relationship with Frederick, 86, 88; SMART-IND team at, 103–4, 111; USAMRIID location on, xiii, xvii, 48, 54, 57, 258n3; U.S. bioweapons program at, 13, 47, 255n5, 256n2; White Coat Program at, 143–44, 257n3

Fort Sill (Oklahoma), 8–9

“4M Disaster,” 129–42, 228

Francisella tularensis. See tularemia

Franz, David, 34

French and Indian War, 24

Frost, Robert: “The Road Not Taken,” 10

Geisbert, Tom, 153–54, 254n5, 260n1

Gere, Jeff, 258n4

Giuliani, Rudy, 37

Grabenstein, John, 94, 97–99, 103

Gram’s stain, 4

“gray” side. See “warm” side

Guerena, Fernando, 216–18

Gulf War (Operation Desert Shield/Storm): xiii, 17, 57, 93, 101, 110

Gulf War Syndrome, 96–97, 103–4, 201

Hall, Sergeant, 254n4

hantavirus pulmonary syndrome, 126

Harper, Isaiah “Ike,” 258n4

Harris, Larry Wayne, 203

Hart Senate Office Building, 39, 88

Harvard University: education, 3–4; Belfer Center, 234–35

Hatfill, Steven, 88, 177–78, 180, 200

Hawaii, 6–8

Heartland virus, 240–41

Heine, Henry “Hank”: and anthrax letter analysis, 40–42; and FBI investigation, 177–79, 185–88; and hallway contamination, 89–90; thoughts on Bruce Ivins, 178–80, 192, 197–99, 202

Henchal, Eric, 260n1

Henderson, D. A., 10, 98

Henderson, Sergeant, 254n4

Hensley, Lisa, xx, 153, 160–61, 223, 260–61n1

Hepburn, Matt, 260–61n1

Heppner, Donald “Gray,” 107–8, 113–15, 258–59n4

Heydrich, Rheinhard, 18

HIV, 5, 8, 20, 48, 68

Hobart, Peter, 189

Hoffman, Dustin, 244

Hoke, Charles: and desert pneumonia, 125; and marines in Liberia, 133, 134, 141; and Select Agents Response Task Force (SARTF), 93–94, 96–98, 103

Honko, Anna, 260–61n1

“hot” side, xvii, 80, 165, 167–68, 210, 261n2, 261n4

The Hot Zone (Preston), xiii, xxi, 21, 154, 195, 253n3

Huggins, John, 258–59n4

Hussein, Saddam, 57, 90, 93, 102, 113, 119

influenza: as a cause of fever, 152; and CDC errors, 119; Charles Hoke research on, 93; and Soviet bioweapons, 13; and Wendy Sammons-Jackson fever, 237–39

internship (medical), 6–7

investigational new drug (IND): for anthrax vaccine, 73–75; and botulinum antitoxins, 51, 53, 55–58, 62; ribavirin for Lassa, 135, 139–40; and smallpox vaccine, 95–99; and SMART-IND products, 103–4, 113–14; for tier 2 biothreat pathogens, 75–76

Ishii, Shiro, 23

Ivins, Bruce: accusation as anthrax perpetrator, 191–202; and anthrax hallway contamination, 79, 86, 89–90; be on the lookout (BOLO) message, 183–84; death and aftermath, 189–97; eulogy, 261–62n1; FBI investigation and, 175–81, 183–86, 188–89

Jaax, Nancy, 162

Jahrling, Peter, 10, 150, 153, 155, 260n1

Japanese encephalitis virus (JEV), 216–18

Jenner, Edward, 91, 92, 95

JEV. See Japanese encephalitis virus

Johnson, Joshua, 260–61n1

Johnson, Karl, 19, 154, 172, 260n1

Johnson-Winegar, Anna, 76–77

judge advocate general (JAG), 188

Junin virus, 19

Justice Department, 192, 195, 201

Kanesa-thasan, Niranjan, 258n4

Kemp, Paul F., 200

Kennedy, John F., 189, 201

Kester, Kent, 258–59n4

KGB, 65

Kim Jong Nam, 17

Kim Jong Un, 17, 234

Korean hemorrhagic fever, 211

Korean war, 211

Kortepeter, Cindy, 7, 8, 106–7, 112, 121, 174

Kortepeter, Daniel, 107, 121, 174

Kortepeter, Luke, 8, 106, 121, 173–74

Kortepeter, Sean, 9, 106–7, 121, 174

Kostov, Vladmir, 65

Kuschner, Robert, 107, 109, 111, 118, 258n4

Landstuhl Regional Medical Center (Germany): and desert pneumonia, 122–24, 126, 128; and marine outbreak, 132, 134–35, 137, 140

Lassa fever virus: and marine outbreak in Liberia, 130–40; as a viral hemorrhagic fever, 19, 21, 49; and West Africa Ebola outbreak, 227–28

Lawler, James, 260–61n1, 264–65n2, 265n4

The Lawrenceville School, 2

Leahy, Patrick, 45, 88, 201

Lepler, Larry, 260n1

leptospirosis, 8, 138

Liberia: Ebola outbreak in, 220, 223–24; Ebola patient from, 227, 231; marine fever outbreak in, 129–32, 135, 142

Lindquist, Carl, 54–55, 57–60

Littrell, Tony, 260n1

Ludwig, George, 254n5

lyophilizer, 198

MacArthur, Douglas, 140

Machupo virus, 19, 255n5

Magill, Alan, 104–7, 258–59n4

Majidi, Vahid, 201

malaria: differential diagnosis of desert pneumonia, 125–26; marine outbreak of, 129, 131–35, 137, 140–42; as a military scourge, 131–32, 140–42; as a tropical disease, 8–9, 20, 138; in West Africa, 142, 228–29

Manhattan Project, 103

Marble Palace, 112

Marburg virus, 19, 21, 49, 69, 165, 227

Markov, Georgi, 64–65

Martin, Greg, 134–35, 138, 140

Martin, James (Jim), xxii, 151, 153, 155–56, 159, 162, 253n3, 254n5, 260n1

Martinez, Colleen, 258n4

Martinez-Lopez, Lester, 258–59n4

M*A*S*H, 3, 114, 118, 244

McKee, Kelly, 254n1, 257n1

measles, 12, 20

Médecins Sans Frontières (MSF), 221

medical school training, 4–6

mefloquine, 129, 134, 139–41

Meschede hospital (Germany), 25

Middle East respiratory syndrome (MERS-CoV), 235

Monath, Tom, 10

Morris-Magee, Mishelle, 258n4

MSF. See Médecins Sans Frontières

Mueller, Robert, 201

Murtha, John, 140

mustard blister agent, 71, 256n4

National Ebola Training and Education Center (NETEC), 246

National Institute of Allergy and Infectious Diseases (NIAID), 155, 244, 265n13

National Institutes of Health (NIH): and anthrax spore characterization, 177; biocontainment unit, 226; Ebola research, 223, 229; field laboratory, 223–24; pathogen containment, 218–19; vaccines, 144, 155

National Naval Medical Center (NNMC) (Bethesda, Maryland), 134, 136–39

NATO. See North Atlantic Treaty Organization

Negley, Dianne: and Slammer admission, xvii, xx, 152, 156, 159–62; on biosafety, 196

North Atlantic Treaty Organization (NATO), 221

Novichok nerve agent, 235

Obama, Barack, 230

Ockenhouse, Chris, 107, 112, 258–59n4

O’Connor, Erin, 35–38, 45–46, 285n1

Odierno, Raymond, 228

O’Guinn, Monica, 261–62n1

Olinger, Gene, 215, 260–61n1

Operation Glove Box, 253n3

Ouamouno, Emile, 220

Outbreak (movie, Peterson), 21, 244

Owen, Wilfred: “Dulce et decorum est,” 100, 116

Pace-Templeton, Judy, 55–56, 58, 61–62, 258–59n4

pass-box, 81–82

Patrick, William “Bill,” 10, 19, 47, 234–35

Patriot missiles, 113

Pentagon: and Ebola outbreak response, 221–23, 225–26, 264–65n2; lab inventory and, 206, 208, 214; 9/11 and, 29; response to Ivins investigation, 184, 195–97; Slammer admission and, 157; war preparations at, 76–77, 93–96, 98–99, 103, 104–6

Perkins, Christian, 147, 158, 163

Perkins, Jeremy, xxiii–xxiv, 147, 156, 163

Personnel Reliability Program (PRP), 204–5, 216, 263n3

Peters, C. J., 154, 260n1

Peterson, Kyle, 118

Peterson, Wolfgang: Outbreak (movie), 21, 244

Petitt, Patricia, 257n1, 258–59n4

Petrucelli, Bruno, 125, 127, 259n1

Pham, Nina, 231–32

Phipps, James, 91, 95

Pierce, Benjamin Franklin “Hawkeye,” 3, 6, 244. See also M*A*S*H

Pierson, Jerry, 258–59n4

Pinneo, Penny, 130, 135

Pittman, Philip, 257n1, 258–59n4

plague: as a bioweapon agent, 13, 15, 21–24, 68, 234, 240; bubonic, 22–23, 35, 174, 254n6; containment of, 49; death from, 16, 18, 22–23, 69–70, 254n5; illegal purchase of, 203; lab inventory, 207, 216; and marine fever outbreak, 126; pneumonic, 23–24, 174–75; USAMRIID research on, xx, 175, 243; vaccine, 174–76, 179

Presnyakova, Antonina, 164

Preston, Richard: The Hot Zone, xiii, xxi, 21, 154, 195, 253n3

Purcell, Bret: and Ivins eulogy, 194, 261–62n1; and Ivins investigation, 175–76, 179, 183–84; monkey study, 260n1; and Slammer admission, 260–61n1; and SMART-IND team, 258–59n4

Q (Query) fever, 13, 47, 49, 75, 143–44, 219, 256n1, 257n3, 260n1

Quamman, David: Spillover: Animal Infections and the Next Human Pandemic, 254n7

quarantine: definition of, 253n2; of dog during Ebola outbreak, 230–32; for Lassa exposure, 138, 140; with Slammer admission, xxii, xxv, 147, 149–64; of U.S. service members, 227–29

Rajneesh Purim, 66, 72

Ramon, Juan, 136

Ranadive, Manmohan, 257n1, 258–59n4

Reference Material Record-1029 (RMR-1029), 177–78, 193, 198–99

residency (internal medicine), 7–8

ribavirin, 135, 139

Rice, Condoleezza, 62

ricin toxin, 64–65, 69, 127, 243, 260n1

Ridge, Tom, 62

Rift Valley fever virus, 50, 58, 143, 260n1

ring-around-the-rosie, 16, 22, 254n5

Rivard, Robert, 260–61n1

RMR-1029. See Reference Material Record-1029

Rocky Mountain spotted fever, 240

Rollin, Pierre, 154, 260n1

Rusnak, Janice, 122–24, 128, 259n1

Russell, Phillip, 98

rye stem rust, 14

salmonella, 18, 48, 66–67, 72

Sammons-Jackson, Wendy, 237–39

sarin nerve agent, 17, 66, 71–72

SARTF. See Select Agents Response Task Force

Sawyer, Diane, 34

Schaecher, Kurt, 217, 223–24

Schenker, Marc, 254n4

Schmaljohn, Alan, 254n5, 260n1

Schoepp, Randy, 223–24

SCUD missile, 100, 103, 112–13, 116, 119

SEB: See Staphylococcal enterotoxin B

select agents (biological select agents and toxins-BSAT): and Armed Forces Research Institute of Medical Sciences, 216–18; CDC and NIH challenges with, 218–19, 264n15; CDC as the lead, 203–5, 214, 264n11; regulations, 263nn2–4; USAMRIID challenges and inventory of, 204–15, 264nn5–10, 264nn12–14

Select Agents Response Task Force (SARTF), 93–98, 103

September 11, 2001, attacks, xiv, 29; impact on USAMRIID, 195–96, 207, 263nn3–4; Ivins activities after, 198–99; USAMRIID response after, 63, 72–75

serious incident report (SIR), 184, 206, 208–9, 212

severe acute respiratory syndrome (SARS), 124–26, 235

Shanks, Dennis, 137

Shaw, Charlotte, 130

Shigella dysenteriae biocrime, 67–68

“shock and awe” campaign, 100, 113, 115

Shoemaker, David, 205–9, 212–13, 218

siege of Quebec, 24

SIR. See serious incident report

Slammer: admission decision, xxiv–xxvi, 146–47, 149–51; capabilities, xxi–xxii, 50, 151–52, 222, 225–27; Diane Sawyer interview in, 34; Ebola admission, 146–64; marines with presumed Lassa, 132–33; supervision of, xxii, 79, 253n3

Slim, William, 129, 141

smallpox: as a bioweapon agent, 13, 15, 23–26, 68, 93, 234; clinical features, 24–25, 91; global eradication of, 10, 25, 70–71, 92; historical outbreaks, 12, 24–25, 92; lab breach and, 218–19; mechanisms of spread, 24–26, 68; war preparations, 74, 90, 93–99, 102–3, 111, 113

SMART-IND. See Special Medical Augmentation and Response Team for Investigational New Drugs

Smith, Dale, 141

Soman nerve agent, 71

Soviet Union: anthrax in Sverdlovsk, 74; bioweapons program, xiii–xiv, 10, 13, 17, 19, 21, 198, 235; and Georgi Markov death, 65; smallpox and, 92

Sowers, Michelle, 261–62n1

“space” suit, xvii–viii, xxii, xxv, 31, 49–50, 146, 151–52, 167, 170–71, 173

Special Immunizations Program (SIP), 144, 148, 260n1, 263n3

Special Medical Augmentation and Response Team for Investigational New Drugs (SMART-IND): desert mission, 100–121; origin of, 99; team members, 107, 258–59n4

Spillover: Animal Infections and the Next Human Pandemic (Quamman), 254n7

Stanek, Scott: and anthrax attacks, 29, 38, 39; and anthrax hallway contamination,79–80, 84, 257n1; and Slammer admission, xxii, 153, 253n1, 254n5, 260n1

Staphylococcal enterotoxin B (SEB), 143, 260n1

Starbucks, 115, 149, 151–52, 157

Stephanopoulos, George, 62

Stevens, Robert, 30–33, 38, 201

Streptococcus pneumoniae, 4–5

Sudan, 19–20

Sverdlovsk, Soviet Union, 74

Swearengen, Jim, 254n5

Tabun nerve agent, 71

Tasker, Sybil, 134, 136, 140

task force (Pentagon), 196–97, 208

Thomas, Stephen, 228–29, 264–65nn1–2

Thompson, Dianne, 67–68, 240

Thompson, Tommy, 18, 30

Tripler Army Medical Center (Hawaii), 7–9

Trump administration, 234

tuberculosis, 20, 35, 49

tularemia: airborne alert, 63; as a bioweapon agent, 13, 15, 18–19, 70, 240, 243; clinical features of, 18, 35; lab-acquired infection from, 47, 237–39, 256n1; and marine fever outbreak, 125; source in nature, 70; USAMRIID research on, xx, 143–44, 243; war preparation for, 75

typhoid, 20, 25, 66

typhus, 35, 126

Uniformed Services University (USU), 141, 219, 221, 246

Unit 731, 23

United States Army Medical Unit (USAMU), 47, 143

University of Nebraska Medical Center and College of Public Health, 163–64, 226–27, 246

University of Texas, 244, 260

USS Iwo Jima Amphibious Ready Group, 129–31, 133–34

Vander Linden, Caree, 150, 160, 191, 193, 212–13

variolation, 24, 91–92

variola virus. See smallpox

Vaxicools, 108, 109, 112

Venezuelan equine encephalitis (VEE), 206–8, 256n1, 264n7

vice president. See Cheney, Richard “Dick”

Vicker’s unit, 225

violin, 2, 106, 174

viral hemorrhagic fevers, 15, 19–21, 68, 225. See also Ebola virus; hantavirus pulmonary syndrome; Junin virus; Lassa fever virus; Machupo virus; Marburg; Rift Valley fever virus

Von Moltke, Helmut, 264n9

VX nerve agent, 17, 71, 102, 234

Walter Reed Army Institute of Research (WRAIR), 9, 86, 97

Walter Reed Army Medical Center, 118, 124, 156–57, 165, 226

Warfield, Kelly: Ebola exposure, xvii–xviii, xix–xx, xxii–xxiv, 145; Slammer admission decision, xxiv–xxvi; Slammer quarantine, 146–64, 254n7

“warm” side, xvii, xx, 167

western equine encephalitis virus, 75, 257n3

West Nile virus, 50, 217

wheat stem rust, 14

White Coat Program, 143, 144, 257n3

White House: anthrax attack and, 88; biodefense needs, 50, 237; botulinum toxin attack and, 51–63; Iraq war and, 75, 93, 98

WHO. See World Health Organization

Willman, David, 192

Wine, Laura, 130

Winkenwerder, William, 74, 76–78, 105–6

Wise, Robert: The Andromeda Strain (movie), 49, 225

Wolcott, Mark, 231–32

Woods, Ben, 260n1

World Health Organization (WHO), 25, 92, 221

World Trade Center, 29, 33

Worsham, Pat: aftermath of Ivins death, 192, 194, 202; anthrax spore characterization and, 42, 198–99; FBI investigation and, 178–81, 185, 187–88; and Ivins arrest, 176–77; Ivins eulogy by, 261–62n1

Wyeth Pharmaceuticals, 94, 98, 103

Yale University, 130, 135–36

Yersinia pestis. See plague

Zaire, xxiv, 19–21, 154, 254n6

Zika virus, 12, 145, 235

ZMapp, 224, 229, 265n7