A THREAT
My assistant entered the office, handed me a letter, and said, “You had better read this before you do anything else.” The writer informed me that he or she could deposit, undetected, botulinum toxin in a city water supply. This toxin is one of the most lethal agents known: a single teaspoon can kill millions of people. This was serious business. The writer provided sufficient detail to indicate he knew the subject well. He would be willing to negotiate if I would put an ad in the personals section of the New York Times with the message provided by the writer. I called the Federal Bureau of Investigation (FBI).
This threatening letter was one of many letters addressed to the director of the Centers for Disease Control (CDC) and received every day in the CDC front office. If left to me, it might have taken days before I would have opened it. But we had a system: my assistant, Carol Walters, opened every letter and logged them in to be sure they received attention and got answered. Carol had taken this letter from the pile and brought it to me. She was alarmed.
Botulinum toxin, an extremely toxic protein, is produced by a bacterium called Clostridium botulinum. The bacterium stays viable for long periods by encapsulating into a spore. It can grow only in an oxygen-deprived environment. Food poisoning, long feared in home-canned products, results from inadequate heating after jars are sealed, which allows spores to begin to grow in the canned food. The bacterium then produces a toxin, which has a devastating effect on the person eating that food. The toxin blocks the release of acetylcholine in muscles, which prevents the muscles from contracting. People die because they cannot breathe when the chest muscles become paralyzed.
We may have lost some of the fear of this toxin for two reasons. Home-canned food is less common now. Moreover, we use a diluted injectable form of botulinum toxin, or BOTOX, as a cosmetic aid that paralyzes small muscles that cause the wrinkles of aging. (When diluted, botulinum toxin’s toxicity can be restricted to certain muscles.) It’s easy to forget how toxic the substance can be.
The FBI questioned CDC botulism experts, out of prudence, but also to determine the letter writer’s level of expertise. Some of the letter’s language included recent findings, an indication that the writer was an expert in the field or at least aware of recent literature. The FBI took the threat seriously. Federal agents took the letter for analysis. As with any homicide investigation, detectives must first rule out those closest to the victim. We had to ask whether any of our experts could be involved. After our suspicions were allayed, the FBI arranged to place the classified ad as instructed by the letter writer.
A second letter followed the classified ad’s publication; it contained additional details of the writer’s plan and a request for a second classified ad in the New York Times. The FBI continued their analyses and began to focus on an area in Florida as the source of the letters. The agency had been able to determine the brand of typewriter used and had hopes of finding the writer. Another letter might provide the breakthrough the FBI needed.
But suddenly things changed. The FBI called me one morning to say that a journalist had gotten wind of the investigation and was about to file a report. The journalist would be contacting me for details, and I was urged to get the journalist to delay reporting the incident.
The reporter did call me. I begged him to wait for the FBI to have a chance to apprehend the individual. We could provide the journalist with an exclusive report at that time. He refused, the report was published, and we never heard from the letter writer again. What kept the person from carrying out the threat? How many other people have similar interests? How do we balance the need for transparency, freedom of the press, and protecting the public?
This serious episode led the CDC to develop a defensive bioterrorism strategy in the early 1980s. The program, headed by Stuart Kingma, public health advisor at the CDC, involved a review of every organism that the CDC staff felt could be used for warfare or terrorism and the development of counterterrorism steps that could be taken. Stuart Kingma was the right person for this assignment. Tall, fit, and thoughtful, he brought a Dutch attention to detail to everything he did. From hunting to building boats and telescopes to making ceramics, he researched everything and insisted on perfection. He eventually had a person in charge of every organism determined to be a potential risk, and a program was developed with the FBI so that someone would always be on call if CDC assistance were needed. Secure communications were installed, and a secure conference room was developed at the CDC.
When the defense plan was complete, I naively thought we could classify it. However, I found, to my dismay, that the CDC had no way to classify documents. As a result, this plan would have to be released if requested under the Freedom of Information Act. Our work with the FBI revealed that concerns regarding bioterrorism were shared in many parts of government. The largest body of expertise was probably in the US Department of Defense, which indicated a readiness to hear about the CDC assessment. I took a copy of the plan to my contact at the Defense Department. As he read through the plan, he looked up to ask me why it wasn’t classified. I told him that the CDC lacked that authority. He then did what I had hoped for. He said, “Well, I have that authority,” and he stamped it “classified.”
Twenty years later, when anthrax spores were transmitted through the US mail in 2001, the CDC no longer had a bioterrorism program. Why? After being briefed on the program in the 1980s, a CDC manager concluded, “that will never happen,” and dismantled the CDC biodefense program!