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Until last week, however, nobody had successfully used anthrax spores as weapons. Scientists' best idea of what such an attack might look like comes from a 1979 Soviet accident in Sverdlovsk. Dr. David Walker, chairman of the department of pathology at the University of Texas Medical Branch at Galveston, was part of a U.S. team that visited Russia in 1992, just before Boris Yeltsin finally acknowledged the escape of anthrax from a bioweapons plant. Confronted with the evidence of an unprecedented 77 infections and 64 deaths, Walker and the others began thinking hard about the biology of anthrax and how doctors might deal with an outbreak. When Bacillus anthracis emerges from inhaled spores, they knew, it grows and multiplies and starts secreting a powerful toxin that chews through tissue and enters the bloodstream. From there the poison spreads throughout the body to attack internal organs. Lymph nodes, meanwhile, clogged with immune-system cells that have been summoned to fight the invader, begin to press on the organs and interfere with their functioning.
This suggested, says Walker, that doctors must find better ways to drain lymph from around the organs, in order to relieve the pressure. And they need to develop an antitoxin, since even when antibiotics kill off the bacteria, the poison that the bug has emitted can still kill the patient. There is also an anthrax vaccine, made exclusively for the U.S. government by a private manufacturer named BioPort in Lansing, Mich. But in 1999 the FDA asked the company to stop shipment of its vaccine until BioPort instituted better quality-control measures. The company expects to begin shipping vaccines again by the end of the year, but even so, the side effects of the vaccine can be so unpleasant that some Gulf War soldiers risked court-martial rather than take the shot.
Until these cures and preventives can be perfected, though, antibiotics are the only reliable treatment--and they work only when they are given soon after exposure. For that reason, authorities can only hope that the difficulties involved in culturing large quantities of anthrax spores, weaponizing them and delivering them to large numbers of people will prevent a large-scale attack.
In that regard, the experience of Japan's Aum Shinrikyo cult is instructive. The group, which carried out an infamous nerve-gas attack in the Tokyo subways in 1995, had tried to work up an anthrax weapon. Aum had plenty of cash, recruited scientists into its ranks and cultivated biological-warfare experts in the former Soviet Union. But in the end, it never could pull off a successful assault using anthrax.
Terrorism experts figure that al-Qaeda might have similar problems; even if it got its supplies from a pariah like Saddam Hussein, it would have to find a way to deliver them. Officials know that hijacker Mohamed Atta asked about crop dusters before the Sept. 11 attacks. And a Delray Beach, Fla., drugstore owner says a man resembling Atta showed up at his store in late August seeking treatment for a burning sensation on his abnormally red hands. But none of this is conclusive.