Javed Ali: Connecticut anthrax source not likely to be natural
CNN's Bioterrorism Analyst Javed Ali has written extensively for various publications, including Jane's Defense Weekly, and is the principal author of Jane's U.S. Chemical Biological Defense Guidebook. He is expert in the analysis of weapons of mass destruction, terrorism, counter-terrorism, and Middle Eastern and Asian security and political dynamics.
CNN: Thank you for joining us today, Javed Ali, and welcome.
JAVED ALI: Hello there, everyone in the CNN chat room.
CNN: What's your analysis of the case involving a 94-year-old Connecticut woman that died of inhalation anthrax?
ALI: This case is certainly unusual and puzzling, just as the death of Kathy Nguyen in New York, because both of these women did not fit into the target profile that we've seen in the other anthrax incidents in Washington and Florida.
CHAT PARTICIPANT: What was different about this case and the other deaths?
ALI: The difference between the deaths of Miss Nguyen in New York and Miss Lundgren in Connecticut, and the other anthrax incidents is the fact that the investigators still have not determined conclusively how they were exposed to an obvious inhalation challenge of anthrax materials. It does not appear that either of these two had any contact with the mail or postal facilities or media outlets or in ways that served as explanations for the other incidents. However, I assess that both of these deaths cannot be attributed to a natural source of the disease.
CHAT PARTICIPANT: Do you suppose that anthrax has always been here and caused deaths but we just labeled it as something else because we didn't know what we were looking for?
ALI: There are public health experts who have come forward with that as one potential explanation, but I have a different assessment or opinion of that, in that pulmonary anthrax cases are so rare in nature, that to have this many of them is indicative of an intentional use of the disease, rather than a natural occurrence.
CNN: Is there any evidence now leading us to think this is more a domestic case, rather than being linked to the events of September 11?
ALI: The FBI put out a profile of the possible perpetrator, and that profile was based on their assessment of the evidence they have collected to date. Those of us on the outside of the investigation are not privy to those investigative results, and therefore we can only make informed opinions about possible perpetrators, rather than examining actual evidence. So, in a nutshell, the domestic perpetrator theory holds great credibility, but it's still not conclusively proven, either.
CHAT PARTICIPANT: Javed, what was incidence of anthrax before September 11?
ALI: The disease is endemic to at least 80 countries around the world, and in some of those countries, there are dozens, if not hundreds of cases of either gastro-intestinal or cutaneous forms of the disease. What is not prevalent in nature is the pulmonary form of the disease, so that's why the 18 cases we've had here in the United States over the last two months are indicative of a criminal or terrorist act.
CHAT PARTICIPANT: Javed, is there any indication that the FBI has looked at the relatives of the women who died in New York and Connecticut?
ALI: I'm sure the federal investigators are trying to explore every possible investigative avenue to identify the perpetrators. I'm not sure, however, if this particular line is one of those things they're looking into. Interesting theory.
CHAT PARTICIPANT: What are the possible ways that they can infect us, besides with powder?
ALI: One of the intriguing aspects of these incidents is that the perpetrators have chosen not to use a more effective means of delivery for what appears to be a fairly high-quality grade of anthrax material. That dynamic in and of itself is puzzling because in theory, the high quality of the material could lend itself to some type of effective aerosolization, thereby exposing many more people.
CHAT PARTICIPANT: Which countries have the capability of this biological warfare?
ALI: According to publicly available U.S. government threat assessments, there are between ten to twelve nations that have current offensive biological weapons programs. The three countries we know the most about are the United States (which terminated its offensive program in 1969), the former Soviet Union program, and the Iraqi program. Now, there's never been greater identification of who those other countries are, within that 10-12 nation range, although just last week, a senior Bush administration official publicly stated that the U.S. government was concerned about biological warfare activities in Iraq, Iran, North Korea, Syria, and possibly the Sudan.
CNN: If she was not tested for anthrax until more than 24 hours after she'd shown symptoms of the disease, doesn't it raise the question that more people should be tested for anthrax as soon as they show flu- or pneumonia-like symptoms?
ALI: That's going to be a difficult question for federal, state and local public health and medical authorities to wrestle with. In treating dangerous biological agents like anthrax, the more rapid the identification of the disease, and the sooner appropriate treatment is provided, the better the chance for the infected person to overcome the effects of that disease. With respect to anthrax, the medical data that had been established prior to September 11 indicated that if antibiotic treatment was provided up to 18 to 24 hours after someone was symptomatic, they had a very good chance of surviving the pulmonary form of the disease, which is the most lethal. This dilemma for the public health and medical community may unfortunately play out in the upcoming flu season. We're trying to differentiate between cases of the flu, and possible pulmonary anthrax cases, which will be quite difficult when a person initially presents to a health care provider.
CNN: Do you have any closing comments to share with us today?
ALI: One thing people have to understand about how people are getting exposed to the anthrax material is that if there has been cross-contamination with mail, letters, packages, objects, then that material that may be on the outside of those objects does not pose a threat in the pulmonary form of the disease, unless there is another energy source to lift that material up and render it airborne where it can be inhaled.
CNN: Thank you for joining us today
ALI: Good bye!
Javed Ali joined the CNN.com chat room by telephone and CNN provided a typist. This is an edited transcript of the interview which took place on Friday, November 23, 2001.
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