¶ … Anthrax as a Weapon of Mass Destruction In 2001, a handful of anthrax letters wreaked havoc. What impact might a sackful have? -- Donald Donahue, 2011

Just one week following the deadly terrorist attacks of September 11, 2001, three dozen envelopes were mailed through the U.S. Postal Service, including one to Senate majority leader Tom Daschle's office and others to news media containing anthrax that killed five people and injured more than a dozen others. These events, falling hard on the heels of the most destructive domestic terrorist attack in U.S. history, had many already-nervous Americans wondering if their own mailboxes would also come under attack. Since that time, though, concerns over new anthrax attacks have diminished but some observers caution that the threat remains as serious as in the past. To determine the facts, this paper reviews the relevant literature to determine the impacts of anthrax when used as a weapon of mass destruction and its overall biothreat followed by a summary of the research and important findings concerning weaponized anthrax in the conclusion.

Review and Analysis

On October 15, 2001, a letter postmarked October 9, 2001 containing anthrax spores was received in the offices of Senate Majority Leader Tom Daschle (Brookmeyer & Blades, 2003). The letter had been processed by the Hamilton, New Jersey post office and forwarded to the Brentwood post office in the District of Columbia on October 12, 2001 (Brookmeyer & Blades, 2003). A picture of the envelope and letter received by Senator Daschle's office is provided in Figures 1 and 2 below.

Figure 1. Anthrax-containing envelope addressed to Senate Majority Leader Tom Daschle

Source: https://www.fbi.gov/about-us/history/famous-cases/anthrax-amerithrax/image/1b.jpg

Figure 2. Letter addressed to Senate Majority Leader Tom Daschle

Source: https://www.fbi.gov/about-us/history/famous-cases/anthrax-amerithrax/image/3a.jpg

Besides the letters to two senators, other anthrax-laced letters were mailed to news media, including NBC Nightly News, the New York Post and the National Enquirer (Zelizer & Start, 2003). After the anthrax was discovered in Senator Daschle's mail, the Hart Office Building was quarantined and everyone in the building was provided with antimicrobial prophylaxis (Brookmeyer & Blades, 2003). Two postal workers were among the five fatalities that resulted from the 2001 anthrax mail attacks (McElhatton, 2011). Shortly thereafter, all of the postal workers employed in these two post offices were also treated prophylactically (Brookmeyer & Blades, 2003). None of the people who were treated in this fashion experienced any adverse effects (Brookmeyer & Blades, 2003).

The 2001 anthrax mail attacks were codenamed "Amerithrax" by the FBI (Ake, 2011). According to Ake (2011), "It was the worst biological attack in U.S. history. The most likely biothreat comes from nature, but the most significant threat is from a bioterrorism attack" (p. 38). According to the FBI's Web site, the Amerithrax Task Force spared no expense in their efforts to identify the perpetrator of the 2001 anthrax mail attacks. The task force was comprised of between 25 and 30 full-time investigators who invested hundreds of thousands of hours in investigating this case, including interviewing in excess of 10,000 witnesses around the world as well as 80 searches that yielded more than 6,000 items that were regarded as potential evidence in this case (Amerithrax, 2015).

The Federal Bureau of Investigation (FBI) concluded its investigation into the 2001 anthrax mail attacks on February 19, 2010, stating that based on their analysis of circumstantial evidence, Dr. Bruce Ivins at the U.S. Army Medical Research Institute of Infectious Diseases at Fort Detrick, Maryland, was responsible (Ayotte, 2011). In July 2008, Dr. Ivins committed suicide using an overdose of codeine-laced Tylenol (Review panel faults FBI anthrax probe, 2011), purportedly as a result of the enormous pressure he received during the FBI's investigation, but there has been no conclusive evidence that this individual was responsible or whether he acted alone (Ayotte, 2011).

Moreover, subsequent research showed that although the anthrax strain used in the mail attacks shared some genetic markers with the strains used in Dr. Ivins' laboratory, there were sufficient differences to rule out this individual as the source (Review panel faults FBI on anthrax probe, 2011). Many authorities, though, continue to assign responsibility to Dr. Ivins despite this evidence to the contrary. While the real perpetrator of the 2001 anthrax mail attacks remains unknown, the event served to highlight the nation's vulnerability...

As Donahue points out, "This was an extensive and coordinated incident, even if perpetrated by a lone, disturbed individual. It highlights an aspect of preparedness that is underserved" (2011, p. 4). The impacts of the 2001 anthrax mail attacks were also heightened by the general state of the American public at the time, just one week after the September 11, 2001 terrorist attacks. In this regard, Zelizer and Stuart (2003) report that, " In a country still reeling from the September 11 attacks, the letters and the death of a photo editor renewed a sense of panic" (p. 210).
It is important to note, though, that the 2001 anthrax attacks were not the first of their kind, but were rather a continuation of a series of similar attacks that occurred during the years leading up to 2001. For instance, Gegax and Hosenball (1999) note that during 1998, more than 100 anthrax scares were perpetrated in the United States, primarily against abortion clinics and women's health centers. The letters used in these incidents included a computer-generated sheet that simply said, "Anthrax. Have a nice death" (cited in Gegax & Hosenball, 1999, p. 36). Likewise, Johnstone (2008) points out that the potential use of anthrax by Iraq during the 1991 Persian Gulf War resulted in about 150,000 military personnel being vaccinated and renewed concerns in 1998 resulted in all U.S. military personnel being vaccinated against anthrax (Johnstone, 2008). In addition, more than 100,000 American civilians were recommended to receive a 60-day antibiotic regimen to protect them following the 2001 mailed anthrax incidents (Brookmeyer & Blades, 2003).

These precautions were deemed justifiable at the time given the more powerful strains of anthrax that have been developed in recent years (Anthrax, 2003). For example, a report from the Centers for Disease Control (CDC) emphasized that, "The recent cases of anthrax that occurred after B. anthracis spores were distributed through the U.S. mail have further underscored the potential dangers of this organism as a bioterrorism threat" (Anthrax, 2003, p. 42). There have been some other impacts as a result of the 2001 attacks as well. For instance, in response to the 2001 anthrax mail attacks, the U.S. Army was tasked with developing response teams to handle any future domestic bioterrorist threats (Magnuson & Tadjded, 2014). In 2001, there were just 10 such units available to respond to bioterrorist attacks but since that time, an additional 47 response teams have been deployed across the country (Magnuson & Tadjded, 2014).

Likewise, the U.S. Postal Service has implemented a number of costly bioterrorism countermeasures to the tune of $150 million a year in response to the 2001 anthrax mail attacks and mail carriers are being considered as potential distributors of antibiotics by the CDC in the event of future widespread anthrax attacks (McElhatton, 2011). Since the 2001 attacks, the U.S. postal service has investigated more than 50,000 suspicious pieces of mail and all of the mail processing facilities in the United States have been equipped with air-sampling early warning detectors (McElhatton, 2011).

A study by Blendon, Benson, DesRoches and Pollard (2002) specifically analyzed the American public's local and national response to the 2001 anthrax mail attacks. These researchers randomly surveyed households telephonically in three cities (Boca Raton, Trenton/Princeton and the District of Columbia). Based on their findings, Blendon et al. (2002) report that, "Residents of those three areas and people there who were affected by the incidents expressed a higher level of concern and took more precautions handling their mail" (p. 37). In addition, Blendon and his associates (2002) identified heightened levels of anxiety among these populations and a corresponding increase in health care services utilization.

Although additional anthrax attacks of significance have not recurred, the potential for such terrorist activities remains salient today and it is this threat that has been the most powerful legacy of the 2001 incidents. In this regard, Marlantes (2001) reports that, "As a weapon of mass destruction, anthrax has so far proved to be less than effective - with just [a few] fatalities and a handful of illnesses resulting from the spate of recent cases. But as a form of psychological warfare, it's having a profound impact" (p. 1). This point is also made by Ayotte (2011) who suggests that the adverse impact of the 2001 anthrax mail attacks was amplified by the terrorist attacks on September 11 to the point where a near panic ensued. For example, Ayotte reports that, "Following the 2001 anthrax mail attacks, tens of thousands of people took ciprofloxacin prophylactically, given the occurrence of five deaths out of a total 22 infections [and] [t]he anthrax attacks caused a national reaction out of proportion to the event itself" (p. 2).

Indeed, Ayotte (2011) and like-minded analysts argue that the official response to the 2001 anthrax mail attacks was a classic case of…