By Denene Lofland, PhD P1 Contributor

An envelope arrives in the mail. When opened, a mysterious “white substance” wafts into the air and then…panic. The recent delivery of such letters addressed to Prince Harry in London, Donald Trump Jr., and former President Obama was not only disturbing, but also a reminder of the anthrax letters sent to two senators and several news organizations in 2001, which resulted in 22 cases of anthrax and five deaths.

In the grand scheme of murder, knives and guns pale in comparison to the instruments of death that are nearly invisible to the human eye. Long before humans shaped the first stone into a weapon, viruses and bacteria silently killed both man and beast.

Nowadays, the threat of bioterrorists and biological warfare looms over our heads. A minute particle of one of these microbes can be grown and multiplied many times over. For someone committed to implementing an attack, the process is simple and the organisms obtainable, despite stringent government regulations.

Federal statutes (Title 18 U.S.C. Section 175[b] and Title 18, U.S.C. Section 2332[a]) state an individual or entity shall not possess, threaten to use, use, or transfer any Department of Health and Human Services (HHS) select agent (potentially deadly microbe or toxin) without a certificate of registration issued by the HHS Secretary. A scientist engaged in prophylactic, protective, bona fide research, or other peaceful purpose may apply for a certificate of registration. As a condition of registration, an individual must be designated as the Responsible Official, undergo a security risk assessment by the Attorney General and be approved by the HHS Secretary or Administrator.

Once cleared, the scientist is free to begin work. To do so, the microbe can be ordered from wholesale supply houses called reference laboratories. These labs maintain large inventories of some of the deadliest organisms known to man. Those materials are normally shipped as freeze-dried samples via regular U.S. mail or through a commercial shipping company from the reference labs to the scientists.

Growing and tracking cultures

The freeze-dried samples are converted into live organisms called stock cultures by placing the microbe in a nutritional environment inside an incubator. After this reanimation, the culture is then stored in a sub-zero freezer at temperatures of minus 70 degrees Fahrenheit, or in liquid nitrogen, until ready for research to begin.

An employee with ill intentions can simply use a cotton swab to scrape a minute portion of frozen culture from a vial, then start the process of multiplying the bacteria or viruses. The rogue employee/undercover terrorist could repeat the process as many times as desired. Once the organisms have grown sufficiently, terrorists could deliver them to an unsuspecting person, or an entire population.

Transport and delivery of select agents

Scientists frequently visit one another to exchange information and thoughts. It’s important for them to keep abreast of all the latest ideas, testing equipment and procedures, so it’s not uncommon for them to fly on commercial airlines to other cities to visit collaborating companies and laboratories. Potential terrorists may travel in a style called VIP, which is an acronym known in certain microbiology communities that means “Vial in Pocket.”

It is possible to travel to another lab, swab bacteria such as anthrax and place the swabbed material in a plastic vial. The vial is potentially undetectable by airport security scanners. The traveler can return home on the plane seated next to you or me with the vial in their pocket, or carry-on bag. Once the scientist is back in their own lab, they can begin the multiplication of the borrowed microbe with no one the wiser.

After reproduction, there are several ways to disseminate a biological agent. The method is dependent on characteristics of the particular microbe. Agents can be delivered by direct physical contact between the bioterrorist and the target, infection of animals, or contamination of food and water supplies. But the method most well-publicized is by aerosol, which brings us back to the delivery of a powdered form of anthrax in a letter.

What is anthrax?

Anthrax is caused by the bacterium Bacillus anthracis. According to the Centers for Disease Control (CDC), this agent is one of the most likely microbes to be used in a bioterrorism event. It occurs naturally in the soil and affects domestic and wild animals such as cattle, sheep, goats and deer. Once anthrax contaminates the soil, it can live there for years, even under conditions of extreme heat and cold.

How does the microbe survive? When it encounters harsh conditions, it converts to a dormant spore form. While the spore form does not reproduce, it can tolerate environmental extremes for long periods of time. The spores can then be placed in food, water, sprays and powders.

The “white substance” in the 2001 anthrax letters was actually thousands and thousands of the spores. When the spores are inhaled, they land in the lungs, a warm and nutritious environment. This environment prompts their conversion back to a microbial form capable of causing disease.

After inhalation the disease progresses rapidly. Once the symptoms appear, it is most likely too late to prevent a person’s death. Some symptoms of inhalation anthrax include flu-like illness (fever, chills, headache and body aches), chest discomfort, shortness of breath and coughing.

Infection usually develops within a week of exposure but may take as long as two months to appear. Inhalation anthrax is the deadliest form of the disease. People may also become infected by ingesting food or water contaminated with anthrax spores or by getting the spores in a cut or scrape.

Anthrax is not a contagious disease, which means it cannot be passed from one person to another like a cold. Anthrax is acquired through contact with the spores. Naturally occurring cases of anthrax happen when people contact infected animals, animal meat, or contaminated animal products.

Law enforcement and others exposed to anthrax spores, or who suspect they have been exposed, should seek medical attention immediately. Antibiotics may prevent the development of disease and are used to treat active infections. The microbe also produces toxins which may be inactivated through the administration of an antitoxin.

There is a vaccine for the prevention of anthrax, but it is only recommended for people who are at an increased risk of contacting anthrax spores, such as members of the U.S. military, certain laboratory workers, and some people who handle animals or animal products.

Recommendations for local responders

In the event of a suspected biological incident, the FBI-DHS-HHS/CDC Coordinated Document, Guidance on Initial Responses to a Suspicious Letter / Container With a Potential Biological Threat, provides the following recommendations for responders:

Request assistance from a certified hazardous materials (hazmat) response team. Communicate the event to appropriate local and state authorities and your designated FBI weapons of mass destruction (WMD) coordinator/Joint Terrorism Task Force. If it appears the package/letter was delivered through the U.S. Postal Service, notify the U.S. Postal Inspection Service. Do not touch or move the package/letter. If the initial threat credibility assessment performed by the FBI determines the threat is credible, notify the Department of Homeland Security and HHS/CDC. If concerned for public health exposure or environmental contamination, contact the local public health department. Treat the location as a crime scene. In coordination with the hazmat team, preserve evidence and retain suspicious material for lab analysis and forensic examination. Maintain chain of custody. Perform field safety screening to rule out explosives, radiation, flammability, corrosives and volatile organic compounds. Immediately transport in law enforcement custody to a Laboratory Response Network as coordinated with the FBI/WMD coordinator. Identify and list names and contact information for anyone who may have been exposed. In coordination with the FBI, identify a single point-of-contact for incident follow-up. Conclusion

Education and preparation are crucial for providing an appropriate and safe response to a suspected bioterrorism incident. Additional online resources from:

FEMA: Managing the Emergency Consequences of Terrorist Incidents CDC: Preparation and Planning for Bioterrorism Emergencies CDC: Biological and Chemical Terrorism: Strategic Plan for Preparedness and Response.

The Center for Domestic Preparedness offers face-to-face training for biological attacks.

About the author Denene Lofland, PhD, is a professor of microbiology in the Department of Medical and Molecular Sciences at the University of Delaware. As a former biotech company director, she supervised several biological agent projects, including government-sponsored research which required her to maintain a secret security clearance. She is a renowned scientist recognized for her expertise in bioterrorism and new drug discovery.

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