Ten Years After Deadly Anthrax Mailings, AAAS Event Explores Lingering Questions

A decade after anthrax sent by mail left five dead and put America on edge, questions continue to be raised about the adequacy of the science used to identify a suspect and on the ability to prevent such bioterrorism, specialists said at a AAAS retrospective on the attacks.

Agencies and institutions must take steps to enhance the screening of those who work with dangerous pathogens, they said, while also assuring the public that the criminal justice process, in the event of any future attacks, will work and work well.

Jeanne Guillemin, a medical anthropologist and senior fellow in the Security Studies Program at the Massachusetts Institute of Technology, called for a commission of experts on the microbiology of anthrax and the development of biological weapons to review the scientific underpinnings of the long and often contentious hunt for the perpetrator of the 2001 anthrax attacks.

A Dialogue on American Anthrax

Although the FBI concluded last year that Bruce Edward Ivins, a scientist at the U.S. Army Medical Research Institute of Infectious Diseases (USAMRIID) at Fort Detrick, Maryland, carried out the attacks, recent media accounts have suggested weaknesses in the case against him. Ivins committed suicide in July 2008 before charges could be filed.

Guillemin told the 20 October meeting at AAAS, organized by the AAAS Center for Science, Technology and Security Policy, that the credibility of major U.S. institutions, including the Justice Department, the FBI, the U.S. Army, and the news media, is at stake. While she expressed confidence in the forensic science used during the anthrax investigation, Guillemin said it is important for the public to know what was done in order to dispel what she called a general “crisis of legitimacy” for government institutions.

With no confession from Ivins and no airing of the evidence in a trial, the legal process was short-circuited, Guillemin said, and that can lead to distrust and alternative explanations. “I think it is important that there be convened an independent commission,” she said, to assess the science—much of it newly developed—used during the anthrax investigation.

Guillemin stressed that she was not criticizing a National Academy of Sciences panel of microbiologists, chemists, physicians, jurists, and others that issued a report in February on the scientific approaches used in the case. That panel found that spores in the attack letters shared a number of genetic similarities with those from a batch of anthrax from Ivins’ lab. But it also said the data “did not definitively demonstrate” a link.

Guillemin said there remains a need for a “Team A” review of the science by specialists who “really understand the microbiology of anthrax” and its development as a weapon. The review panel should have access to classified materials about the case which were not reviewed by the Academy panel, she said.

Guillemin also discussed the potential impact of the current budget crisis on biodefense and how changing threat perceptions have influenced investment in defensive research against select pathogens over the years.

Anthrax spores mailed to political offices and news organizations killed five people in 2001.

Anthrax spores mailed to political offices and news organizations killed five people in 2001.

After President Richard Nixon ended the U.S. offensive bioweapons program in 1969, she said, developing defenses for troops against anthrax became a relatively low priority. A 1979 anthrax outbreak in the former Soviet Union revived interest in anthrax vaccine research by USAMRIID (Bruce Ivins, among others, was hired at that time.) And after the Cold War, concerns about “rogue states” such as Saddam Hussein’s Iraq ratcheted up worries about bioterrorism. The worries became a fixation in the wake of the anthrax attacks, with USAMRIID finding itself in competition with university and industry research centers for billions of new federal dollars to improve biodefense.

Now, Guillemin said, anticipated cuts in the current biodefense budget could have a destabilizing effect on those research centers, forcing them to downsize. Policy-makers will have to grapple with continued concerns about bioterrorism, she said, while also adequately funding other programs important to national health such as chronic disease prevention, childhood immunization, and occupational safety.

“The question,” Guillemin said, “is what do we want the biodefense enterprise to look like in five or 10 years, so that the nation can be truly safe.”

An effective defense effort will require measures to enhance the reliability of those who do research on dangerous pathogens, according to Dr. Ronald Schouten, director of the Law & Psychiatry Service at Massachusetts General Hospital. Schouten served on a panel that posthumously reviewed Ivins’ psychiatric record at the request of U.S. District Judge Royce Lamberth. He said the scientist’s behavior certainly should have raised concerns.

Bruce Ivins

Bruce Ivins

Ivins had “a long history of behaviors prior to 2011 that should have excluded him from a security clearance and working with anthrax,” Schouten said, including stalking behavior, vandalism, and stealing a colleague’s laboratory notebook. There were mechanisms available for Ivins’ superiors to discover his history of substance abuse, mental illness, and threatening behaviors, he added, noting that Ivins had allowed full access to his clinical treatment records as part of his employment agreement.

“There were multiple instances throughout Bruce Ivins’ career when colleagues and supervisors did not respond to behaviors and statements on his part that were, in hindsight, red flags for serious problems,” Schouten said. The panel’s psychological assessment of Ivins concluded that he was “psychologically disposed to undertake the [anthrax] mailings” and that he had the means and motivation for carrying them out.

Still, as Schouten noted, “there is no absolute certainty. There is always ambiguity. In science there is always a margin of error. In law, proof beyond a reasonable doubt does not mean 100%” and therefore the door is always left open to those who have doubts about a case.

But no matter who carried out the anthrax attacks, Schouten said, the case offers lessons for how to prevent such episodes in the future. Federal agencies, including the Department of Defense, the Centers for Disease Control and Prevention, and the Department of Health and Human Services, have been changing their approach to biosecurity to address some of the major issues raised by the attacks, Schouten said.

The Pentagon has made changes to its Personnel Reliability Program (PRP), a program of psychological evaluation and other screening measures first instituted during the Cold War to help ensure that only the most trustworthy individuals have access to nuclear, chemical and biological weapons. Certain other federal agencies and facilities also have PRPs. There was no formal PRP for the Army’s biological facilities prior to the anthrax attacks.

In any assessment of an employee’s reliability, Schouten said, agencies must balance the risk of allowing an insider threat to slip through versus the cost of excluding talented individuals who have skills the government needs. The focus needs to be on behaviors of concern, as in the Ivins case, he said, and not whether someone has an illness. To do otherwise risks excluding qualified individuals from important work in the absence of any real threat to security or safety, Schouten said.

A significant challenge going forward, Schouten said, is to develop appropriate biosecurity programs—with goals similar to PRPs?for academic institutions and companies without having a chilling effect on the conduct of life sciences research. The National Science Advisory Board for Biosecurity recommended in April 2009 against a formal, national personnel reliability program for all researchers using select agents such as anthrax. Instead, it supported enhancement of existing measures and a culture of responsibility and accountability within institutions conducting select agent research.

For a security program to be effective, Schouten said, employees under stress must feel free to seek counseling and treatment if they need it—without fears that disclosure will damage their careers or personal lives.

Schouten also cautioned that a diagnosis of mental illness, in and of itself, “does not indicate an increased risk of violence or insider threat.” But substance abuse and anti-social behavior in combination with a mental disorder, particularly personality disorders such as malignant narcissism, psychopathy, or borderline personality, are warning signs for potential problems, he said.

He also noted that treating clinicians, while essential sources of information in biosafety and biosecurity assessments, tend to be advocates for their patients and are not always objective in their assessments of risk.

While psychological screening tools are imperfect instruments, Schouten said, it is possible to incorporate them into a security system that does work to deter insider threats. In building such systems for the future, Schouten said, it is important that those being screened for employment be offered full confidentiality in return for release of information about their past medical history. He proposed that agencies and institutions establish review panels with three representatives—one each from the human resources department, the medical/behavioral health department, and the security office.

Each would do an independent evaluation of the candidate and then confer on whether the person should be hired, declined, or accepted with provision for monitoring. The final decision would be conveyed to the appropriate supervisors without getting into specific diagnoses or clinical details.

In the end, he said, the best results from screening systems and personnel reliability programs depend on employees and supervisors who place an emphasis on occupational health and wellness. They take responsibility for their own safety and security, he said, and demand that any “fitness for duty” issues be addressed promptly and effectively.

Learn more about the AAAS Center for Science, Technology and Security Policy.