Public health agencies learned to work together after Sept. 11, anthrax attacks


Pam Tucker remembers people undressing outside businesses and being sprayed down with firehoses.


“Not to take any chances of course, measures were taken to decontaminate people who may have been contaminated with anthrax,” she said. “We just didn’t know.”

The fearful and sometimes chaotic response to those anthrax letters in October 2001 across the country, and what public health has learned since then, is the subject of a new report out today from Trust for America’s Health.

Remembering 9/11 and Anthrax: Public Health’s Vital Role in National Defense includes reports from those involved then in first responding to the terrorist attacks and then to letters filled with anthrax mailed to media figures and the U.S. Senate that sickened 22 people and killed five. Suspicion centered on the U.S. Army Medical Research Institute of Infectious Diseases, where the Ames strain of anthrax used in the letters was housed. The focus first fell on one scientist until it was determined he did not have access to the specific batch of spores used to create the anthrax in the letters, according to the report. The Department of Justice now believes it was likely the work of Dr. Bruce Ivins, who committed suicide in 2008 as officials were seeking to indict him in the attacks, according to the report.

The anthrax letters had a profound effect on a public still reeling from 9/11, Tucker said. Between Oct. 14 and Oct. 24, she documented 19 calls about suspicious powders or pieces of mail, some as vague as “Suspicious package; resident was not expecting package; no strange markings” or “Unknown green substance on envelope,” according to Tucker’s notes.

“Some of it was just a smear,” she said. “Some of it was purple. And people would be frightened. It was right after 9/11 and everybody was on edge, as we all were at the time.”

Policies and sometimes tests had to be created on the fly, officials at the Centers for Disease Control and Prevention wrote in the report.

The CDC has since adopted the incident command system, where operation centers like the one at East Central Health District can be activated in a time of disaster or incident to help speed communication between agencies. The center was activated in 2005 during the Graniteville train disaster, which killed nine people, to coordinate information coming from the hospitals, said Jonathan Adriano, director of the Office of Bio-Terrorism/Emergency Preparedness for the health district. There are now lines of communication between agencies that hardly existed before 9/11 and the anthrax incidents, he said.

“A lot of times we work in silos,” Adriano said. “But after 9/11, we realized we can’t do that anymore.”

Columbia County now has a hazardous materials team and there are more sophisticated ways of handling decontamination, such as mobile units that can be set up to treat people more quickly and more privately, Tucker said.

“Right now, trust me, our methods have improved tremendously if we were to have this same kind of thing happen again,” she said.

There is now a written protocol in Georgia between public health and agencies like the Federal Bureau of Investigation that outlines how a suspicious package or powder is to be handled, Adriano said.

“That is a huge help because before that, when you had a suspicious powder incident, there were a lot of questions about testing, who determines what gets tested, credibility of the threat and all of that,” he said. “Now we have a clear-cut understanding that if the FBI doesn’t support this being tested, it won’t be tested by the Georgia public health lab.”

There are also 730 volunteers with the district’s Medical Reserve Corps that can help out in a crisis, such as distributing drugs from the Strategic National Stockpile if it is needed to respond to an incident, said coordinator Preston Harpe,

“Without them, I seriously doubt we could do it,” he said.