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Anthrax Teamwork Is a Struggle


WASHINGTON — After a colony of anthrax bacteria was found growing in a mail bin at the Princeton, N.J., post office last month, the FBI and public health agencies couldn't settle on which group should take environmental swabs.

So they both did. And the state's public health laboratory was forced to process two batches of samples to be reviewed by two agencies instead of one batch in a combined effort.

"We used our samples to make public health decisions," explained Dr. George T. DiFerdinando Jr., the state's acting health and senior services commissioner. "They can hold onto their samples if they need to go to court."

Critics say it was just another day in the national anthrax probe, with public safety and public health officials proceeding down separate tracks, unable or unwilling to collaborate on basic tasks.

The five-week investigation has been "a bureaucratic snafu of the first order," said Sen. Max Cleland (D-Ga.). "Any time you have two government agencies, it's like two pretty sisters--you always compete."

In this case, however, the usual bureaucratic competition has been heightened by a clash of cultures between law enforcement and public health. The two sides often approach their jobs in opposite--or at least very different--ways. Each has distinct habits and styles.

The FBI, police and prosecutors tend to keep information secret to win a conviction at trial. Public health authorities, by contrast, tend to share every detail they know, hoping to prevent diseases from spreading and treat people already infected.

Publicly, the sides say they are getting along remarkably well as they scramble to investigate 17 anthrax infections, four of them fatal.

"I think it's working out better and we're working to improve it," Health and Human Services Secretary Tommy G. Thompson said last week, calling the reported differences between health and law enforcement officials "completely blown out of proportion."

But several instances in the last five weeks show a tenuous relationship marked by duplication of effort, delays, communication breakdowns and missed opportunities.


* The FBI sent virulent anthrax samples taken from the office of Senate Majority Leader Tom Daschle (D-S.D.) last month to a military lab in Maryland rather than to the Centers for Disease Control and Prevention's lab in Atlanta. As a result, public health officials learned of the results later than criminal investigators. Confusion over the meaning of the results led to further delays.

Two postal workers employed at the Brentwood mail processing facility, which handles most of the federal government's mail in Washington, died of inhalation anthrax before they could be treated. If officials had moved more quickly and prescribed antibiotics to the Brentwood employees, the two men might have been saved, critics of the operation say.

"You can see where the Postal Service and the postal workers fell through the bureaucratic cracks here," Cleland said.

* The New Jersey health department was forced to take its own environmental swabs at a post office in Ewing, N.J., because the military lab hadn't processed the FBI samples from the same location after two weeks. The swabs came back negative.

* The FBI didn't notify New York City health officials of a suspicious letter sent to NBC News until after the city learned of a network employee's possible anthrax skin infection from a private doctor.

* District of Columbia health officials learned from the news media about anthrax spores found in the mail rooms of several federal agencies.

"Had law enforcement and medical epidemiology been connected, I think we would have been in a better position to anticipate a problem," said Dr. Larry Siegel, senior deputy director of the District of Columbia Department of Health.

"If you're talking about information sharing, there is a disconnect. . . . I don't think we've had the kind of coordinated response to this that should be in place."

* When the FBI took over the investigation of the first anthrax death, in Florida, press briefings by public health officials halted. The law enforcement agency, seeking to protect the integrity of its investigation, urged health officials to keep mum, which stopped the flow of information about anthrax precautions and risks to a worried public, Cleland said.

"When it took the criminal bent and FBI took over, there really was no public health message out there," said Dr. Jean Malecki, director of the Palm Beach County health department. Without assessing blame, she said: "The public health message has got to be No. 1, no matter what bent an investigation takes."

FBI officials say they are not free to share all the information they collect, but they do pass along anything that may have a bearing on public health, including the results of anthrax swabbing.

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