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The Anthrax Threat: Dr. Jeffrey Koplan, Director of the CDC

Jim Lehrer talks with Dr. Jeffrey Koplan, director of the Centers for Disease Control and Prevention.

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  • JIM LEHRER:

    Now to a newsmaker interview with the director of the Centers for Disease Control and Prevention, Dr. Jeffrey Koplan. Doctor, welcome.

    DR. JEFFREY KOPLAN, Director, Centers for Disease Control and Prevention: Thank you.

  • JIM LEHRER:

    Just for the record, have there been any new confirmed cases of anthrax in the United States today?

  • DR. JEFFREY KOPLAN:

    Well, we've been dealing with 11 known cases, and several suspect that we're investigating, I'm not sure what the final determination out of those are during the course of the day. But we're dealing with roughly a dozen and a few more under suspicion.

  • JIM LEHRER:

    These are the postal workers here in Washington?

  • DR. JEFFREY KOPLAN:

    No, this is a mixture of all the cases we've seen, Florida, New York, New Jersey and Washington.

  • JIM LEHRER:

    Okay. But the postal workers that were announced this afternoon — when will we know about them, do you think?

  • DR. JEFFREY KOPLAN:

    I think specimens are being taken and they're being examined and considered clinically in the hospital. But, again, we're trying to keep it very low sensitivity, or high sensitivity for people to come forth with any kind of illness particularly if they're postal workers. And so we're hoping that many of these people or all of these people have other diseases, but it still is prudent to be careful and look and see if we can find more cases.

  • JIM LEHRER:

    In a very general way, Dr. Koplan, how would characterize the overall threat from anthrax right now in this country?

  • DR. JEFFREY KOPLAN:

    I characterize it as both relatively contained currently, but unpredictable — that what we've seen, again in Florida with two cases there, one other person exposed, and located in one building; several instances of work sites namely related to the media in New York City; some spread and a very troubling spread in postal facilities — are still relatively circumscribed as a disease. I think a key feature of anthrax is it is not communicable person to person. So of course that has not occurred. I'm not in any way diminishing the seriousness of this. We take this extremely seriously and have put huge resources and heavy amount of activity towards this. But it remains something that is located in a few sites with a few cases, all of them we take with great concern.

  • JIM LEHRER:

    You told Congress yesterday that a lot of the premises on which you were operating at the CDC when this first began a couple weeks ago have changed. What — for instance you just said it's not a communicable disease from one person to another. Are you still sure of that?

  • DR. JEFFREY KOPLAN:

    Yes. We knew that at the beginning and we know that now. There are certain facts about this organism and this illness that we have known and have not changed. In the course of an investigation such as this, an epidemic or an outbreak investigation, one learns new things every day in the course of the investigation. That's the nature. You wouldn't be doing an investigation if you knew everything up front. So decisions that you might make on day 10 or day 14 are not the same ones you'd make at day 5 or day 6.

    In addition, this is not a routine investigation — if there's such a thing — there is no such thing as a routine investigation. It's also an attack, it is a malicious attack, so that we're dealing with something that's really quite different from anything we've dealt with before.

  • JIM LEHRER:

    What is the premise now, what does the CDC believe about how these postal workers here at the Brentwood facility contracted anthrax? What happened at the Brentwood facility that caused them to contract anthrax?

  • DR. JEFFREY KOPLAN:

    Well, we only have pieces of the information, so I can't, again, maybe in a few days we'll have some more information. But the best we can, the best way we can put this together is that mail has come through the facility — one, or some larger number of letters — which has contained anthrax in a form that permits it to permeate the letter or escape through the letter in some way, whether it's through openings in the letter, through the paper. And that that in turn has gotten into the air that people breathe who work in some parts of the facility.

    We're in the process of analyzing information that looks at environmental — looks around the facility, interviewing people and seeing what their jobs are and where they were. But previous suppositions we had based on our experience in Florida and New York and New Jersey are certainly very different in this Washington facility.

  • JIM LEHRER:

    Because you believe that that couldn't have happened before, right?

  • DR. JEFFREY KOPLAN:

    Well, before we had either people open the mail or were exposed to open mail when they got ill. Or there was the possibility that mail might have been torn in the course of handling or perforated in some way. In this instance that appears very unlikely, and it appears that we're dealing with something different.

  • JIM LEHRER:

    Now, in tracking back where this anthrax came from — is… does anthrax have the equivalent to fingerprints on it where you can actually track back all of this anthrax came from this particular source or from one source or whatever?

  • DR. JEFFREY KOPLAN:

    We can't. I think that around the world there are different strains of anthrax that are characterized for different places, and that many laboratories use some standardized-type strains for work. And keep in mind that it's used in veterinary work and for trying to improve treatment and exposure to farmers and veterinarians and others that get exposed to anthrax as part of their livelihood. So there are labs that legitimately use this as part of their research or other procedures.

    What we can do is with this particular organisms that we've seen is we test for antibiotic sensitivity, which from a health perspective is very important to determine quickly, and have determined that the specimens we've looked at are sensitive to a number of antibiotics. We can also characterize it by certain genetic markers and see how it looks there. But there are many other features of the organism that require further study.

  • JIM LEHRER:

    So you don't know now whether all this anthrax came from the same place?

  • DR. JEFFREY KOPLAN:

    I can't tell you whether it all came from the same place.

  • JIM LEHRER:

    What about as an investigative matter, is it possible for a human being to put this kind of anthrax into an envelope and mail it, as clearly happened in this case, without infecting themselves?

  • DR. JEFFREY KOPLAN:

    Well, I pretend to no expertise on the criminal investigation side. But on a health side, if someone were to put this into an envelope, as you say, unless they were to do it under very controlled bio safety level three conditions, which are safety hoods and negative air throw, et cetera, they would have to take some extraordinary protective measures for themselves, and whether that means special ventilation equipment, masks, they also could possibly be somehow either immunized against it themselves or be on antibiotics. But it certainly would pose a threat to people that didn't take extraordinary precautions.

  • JIM LEHRER:

    Does that say to you just from a health point of view, not necessarily from an investigative point of view, that whoever did this knew what they were doing and when it came to anthrax, I mean, these people were experts or had access to experts in doing this?

  • DR. JEFFREY KOPLAN:

    I think that whoever did this is displaying some level of sophistication in everything from microbiology to psychology and sociology and a range of other issues.

  • JIM LEHRER:

    And is this kind of knowledge commonly held by a lot of people in this country?

  • DR. JEFFREY KOPLAN:

    Well, or around the world.

  • JIM LEHRER:

    Or around the world?

  • DR. JEFFREY KOPLAN:

    My understanding is it does take some level of sophistication and knowledge to be able to make this stuff and produce it in certain ways and do things with it. This is not stuff that's going to win anyone a Nobel Prize. But it is something that probably over the course of a year or two of study in microbiology if your intent was to learn how to do this, in a number of laboratories and universities around the world one could learn these techniques.

  • JIM LEHRER:

    Okay. Doctor, thank you very much.

  • DR. JEFFREY KOPLAN:

    Thank you.

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