Seeing Anthrax Saved Us, and other
lessons from the 2001 biological
attack on the U.S. Capitol
Office of U.S. Senate Majority Leader,
Tom Daschle on October 15, 2001
Setting the Scene
• September 11, 2001
• Emergency and contingency planning sees
• Press stories about smallpox and bioweapons
• Robert Stevens was admitted to the ER at 2am on 10/2/01 with fever, nausea and
“was disoriented to person, place or time.” He worked at AMI as a photo editor.
• Gram stain +, spinal fluid cloudy – diagnosis meningitis
• Bacillus in spinal fluid
• Testing revealed bacteria that were large, nonmotile (not capable of spontaneous
movement) and nonhemolytic (didn’t destroy red blood cells)
• Bacteria had a capsule (a thick outer coating)
• Bacteria had a particular polysaccharide in the spore wall
• Gamma phage test was positive (type of virus that rapidly reproduce and cause
bacterial cell to open).
• 8:15am on Thursday October 4, test conclude infection is bacillus anthracis
• Huge press conference at hospital (CDC, FBI, Florida health officials)
• Friday, October 5, 2001 – late afternoon -- Robert Stevens dies in Florida
• Cause of death is inhalation anthrax – first such death in US in 25 years.
• First known bioterrorism fatality in the USA
• October 1, 2001 (day before Mr. Stevens), Ernesto
Blanco was admitted to the hospital with flu-like
symptoms and diagnosed with pneumonia.
• He worked in the AMI mailroom.
• When Robert Stevens died, AMI was notified of the
anthrax diagnosis and called the hospital treating Mr.
• His doctor began treating him with massive IV Cipro
• He went home 22 days later
• Sunday, October 7, lab tests confirmed anthrax in
several locations in the AMI building.
• The building was closed.
• Anyone who had been in the building since August 1
was instructed to report to the health department
for a nasal swab and 10 days of cipro.
• One additional person had exposure confirmed via
nasal swab but was already on cipro.
Week of October 7-12
• Anthrax, bioterror stories running 24/7
• Operation Enduring Freedom began on Sunday,
• Guidance on mail opening in Senators offices
developed, with meeting on Friday, October 12 to
present it and the new security procedures to all 100
• Capitol Police begin responding to a suspicious mail
or suspicious package calls – more than once a day.
• She’d visited her doctor on October 1 with an
ulcerative lesion on her chest, and she was feeling
weak and tired.
• The health department tested her biopsy and it was
negative for anthrax.
• When the news broke about the AMI exposures
through the mailroom, she remembered a letter with
• She visited a dermatologist who sent a skin sample
and the letter to CDC.
October 12, 2001
• CDC confirmed that a skin biopsy on an NBC
employee was positive for anthrax.
• It was all over the news that Tom Brokaw’s assistant
had opened a letter addressed to him containing
• The letter postmarked September 18 mailed from
Trenton NJ tested positive for anthrax
Friday, October 12
• We’d stopped opening mail in Senator
• Managers attended the briefing including one
for “cleared employees only”
• Daschle managers met with staff who opened
mail and explained new procedures.
• Mail opening was to resume Monday.
• On top of the pile of unopened mail was a
letter from the 4th
Grade, Greendale School,
Franklin Park, New Jersey.
• Postmarked Trenton NJ on October 9
• An identical letter with an identical postmark
would be found weeks later addressed to
• It sat in the office all weekend
Monday, October 15, 2001
• The letter was opened about 9:45am
• Intern who opened it sat motionless and held
the letter shut
• Capitol Police responded swiftly, ours was the
third call about “white powder” that morning.
• Capitol Police conducted the a rapid “field
test”. The initial test was positive for anthrax
• Incredulous, they performed a second test.
The Initial Response
• 13 people present when the letter was opened on 6th
Floor of the Hart Building.
• They were taken into the hallway and nasal
swabbed, then taken to the large conference room
on the 9th
floor of Hart
• Nasal and clothing swabs were taken
• Staff were sent back to the office with a 3 day supply
• Nobody was decontaminated
• 25 people were on the 5th
Floor when the
letter was opened
• We were locked in the office for 5 hours –
• Our colleagues from the 6th
floor rejoined us
for a pizza lunch (delivery man got 60 days of
Floor staff waged a battle to received nasal
swabs. We were told to walk to the Capitol
to get them.
• The power was “floaty”, it could be seen in the air
when the police opened the letter
• HVAC system was difficult to shut off - took an hour
• People kept coming in and out of the back door
(some in bio hazard suits/most were not)
• Office was sealed with duct tape and plastic
• Southeast quadrant of Hart all floor was sealed off.
• Did I mention that we were sent home in our clothes
on metro and by foot and car.
Tuesday, October 16
• Massive lines form for nasal swabs (in Hart)
• Southeast quadrant of Hart (all floors) closed
• FBI arrives in Trenton NJ Postal facility.
• Senate and House in session
• Dr. Greg Martin stopped by the Bethesda lab
to check the blood agar culture plates of our
nasal swabs. Less than 12 hours after plating,
anthrax was covering about a dozen plates.
The day keeps getting worse…
• The bacteria is growing – some of us will likely test
positive – but it’s not responding to antibiotics
• Word came back that a woman in Daschle’s Capitol
Office had tested positive (raising possibility of
• In the military protocol was post-exposure anthrax
vaccine – but we are not eligible; CDC maintains a
civilian stockpile and Secretary of HHS Thompson
assures Daschle “whatever you need, Senator, you’ll
Wednesday, October 17 - Results
• Our swabs began showing a response to antibiotics
• All 13 people on the 6th
floor tested positive.
• 7 people on the 5th
floor also tested positive. This
result meant that all 38 people in the office were
presumed exposed and put on cipro.
• Members of Senator Feingold’s staff tested positive
along with first responders.
• False positive on environmental sample of Capitol
staff (no secondary exposure)
• Navy – “Just because you tested positive for
exposure does not mean you will develop anthrax.”
• USAMRIID– General Parker “Sample is highly
concentrated” “Pure Spores”
• CDC – “We have seen hundreds of cases of anthrax”
• Psych Team – “Stop watching television and reading
• The FBI asked us to bring in the clothes we’d
been wearing on Monday
• So ever dutiful, we complied resulting in a
panic in the Capitol.
• The FBI decided they didn’t want these after
all, and our clothing journeyed through
multiple government agencies and returned
to us, heavily sampled, about six months later.
“Garden Variety Anthrax”
• Anthrax spores normally exist in soil and are
durable lasting years in soil
• Grazing animals may become infected by
ingesting or breathing the bacteria
• Human anthrax infection almost always come
from contact with infected animals or it’s
wool or hide. “Woolgathers disease”
• Cutaneous anthrax (spores enter skin through
cuts or openings) is treatable with antibiotics.
• During WWII, allied scientists performed anthrax
experiments on this isle off Scotland
• They exploded devices containing anthrax spores and
tethered sheep at various intervals to measure
• The animals died and their remains incinerated.
island grasses burned to kill any remaining spores
• From 1943-1990, the island’s soil was tested and the
spore count undiminished. No humans allowed.
• It was finally decontaminated in 1990.
• 1979, a worker in an anthrax lab forgot to
replace a filter and approximately 2 grams of
“aerosolized” anthrax spores was released.
• According to official reports, hundreds of
animals and more than 60 people died
• 2 grams over an entire city
More Cutaneous Anthrax
• Case #2 - Monday, October 15, NY health
department announces a second case of
cutaneous anthrax (in an infant who visited
his mom at ABC news)
• Case #3 – An assistant to Dan Rather at CBS
news. She’d been on antibiotics since early
• Case #4 – NY Post Employee. Her symptoms
began Sept 22. Her diagnosis was made Oct
• Letter to NY Post containing anthrax was not
opened. It was in a bin of suspicious mail.
• Postmark was September 18 from Trenton, NJ
• At the end of year, 7 people in NYC had been
diagnosed and recovered from cutaneous