The 2000 National Republican Convention was in full swing, and
Philadelphia was crowded with delegates from every state in the
union. Gift shops were selling out of Beanie Baby elephants. Press
tents surrounded the convention hall like bustling, brightly lit
cities, complete with mess halls and Internet access and temporary
studios for stations from CNN to MTV.
The New York Times had set up an entire newsroom, with
reporters typing madly into laptops to meet deadline. Columnist
Maureen Dowd wandered in, looking casually elegant and in her element.
I, on the other hand, was completely outside mine. For once, I wasn’t
a journalist hanging out in the pressroom and scribbling down quotes
No, I was at the convention as a member of the Centers for Disease
Control and Prevention’s antibioterrorism team, monitoring
area hospitals for early signs that anthrax or smallpox or botulism
had been quietly seeded into these unsuspecting crowds.
As one of six Knight public health journalism fellows at the CDC
that summer, I had just completed a month of training with the agency’s
new Epidemic Intelligence Service (EIS) officers—the elite
“disease detectives” sent to investigate outbreaks around
the world. We could now accompany public health officers into the
field, although we were prohibited from reporting or writing about
the agency’s investigations for the duration of the fellowship.
I was eager to go out as part of an investigative team and volunteered
as soon as I heard about the Philadelphia assignment. I had just
attended a workshop on the increasing threat of bioterrorism—strictly
defined as the deliberate use by an individual, group or government
of a virus, bacteria, fungi, toxin or chemical to produce death
or disease for ideological, political or financial gain—and
was curious to see what could be done to reduce the risk.
The convention was a prime potential target since most of the delegates
would have returned to their home states by the first onset of symptoms,
creating a devastatingly effective mode of dissemination. Delegates—like
mosquitoes, birds or fleas—made perfect vectors for infectious
diseases; the spread would be rapid and exponential.
As I walked into the small room at the back of the Philadelphia
Department of Public Health (where the CDC team was set up), I wasn’t
sure what to expect. A biohazard lab with petri dishes and centrifuge?
A decon unit with portable showers and bleach? A team of doctors
and nurses ready to head to hot spots?
Here’s what I found: a bank of computers, a stack of forms
to distribute to area emergency rooms, and a statistician on Rollerblades.
“I can make it to all the inner-city hospitals in 20 minutes,”
The computers were running data-analysis programs that would automatically
sound an alarm if the information fed to them from Philadelphia
ERs matched illnesses that could have been caused by bioterrorism
agents. The problem is that early symptoms of bioterrorism are identical
to early symptoms for just about any illness: lethargy, low-grade
fever, cough, body aches, diarrhea.
Perhaps this was why, in the center of all the high-tech hardware,
sat a bright red Santeria candle purchased from a nearby shop, labeled:
“Protection from plague and pestilence.”
I asked one of the epidemiologists about the candle, and he grinned
and shrugged. “We believe in incorporating local culture into
our investigations,” he said.
After entering some numbers into the computers, we walked to lunch
at one of the shrines of epidemiology—the hotel where Legionnaire’s
disease had been discovered. It was now (and I am not making this
up) a mall food court.
Over fries and cheesesteaks, I got to know the members of the team,
which was led by a young but widely respected doctor with experience
in combating everything from meningococcal disease on airlines to
malaria in Third World countries. He could also make very cool whale
sonar sounds by holding a pair of government-issue walkie-talkie
cell phones upside down next to each other, a skill for which he
held a certain notoriety among the first-year EIS officers.
After lunch, we made hospital rounds. As public health workers,
you always end up asking really busy people to do one more extra
task, and all you can offer in return is that they will be contributing
to the greater good of society.
Having once been an ER physician, our team leader knew we were doomed
to low compliance on the forms we were asking the staff to fill
out on every patient admitted. If we didn’t win them over,
they’d see our green checklist as just one more piece of troublesome
paperwork, and Patient Zero could slip right through the hospital
So, at one of the busiest hospitals, our team leader had taken along
a platter of canolis when he gave the stack of forms to the nurses.
So far, compliance from that ER had been the highest yet. “Never
underestimate bribing with food,’’ he said.
This was the same hospital to which 87-year-old Gerald Ford had
been rushed when he had taken ill the night before at the convention.
Later, we would see the green form that had been filled out on Ford,
with “former president’’ listed for profession.
The press was calling the hospital, waiting for word on his condition,
which ended up to have been a mild stroke.
As part of the CDC team, I walked right in. But I wasn’t there
for a news scoop. We were touring the decontamination unit, where
several police officers had been stripped and showered earlier in
the day after being sprayed with a colorful, strong-smelling solution
by protestors outside the convention hall. It turned out to be paint
and paint-thinner, but we were able to see how the decon system
had worked in an emergency. The showers were set up for privacy,
and baby shampoo was used instead of bleach.
“We were scrubbing people raw with bleach, when baby shampoo
is just as effective for most contaminants,” one expert said.
Over the four-day rally, where George W. Bush was projecting his
platform of “prosperity with a purpose’’ and vowing
to “leave no American behind’’ to 45,000 party
faithful, the CDC team never got near the convention hall.
That’s the irony of bioterrorism: it starts out silent and
slow, so there’s little hope of blocking it at the source
other than taking the same security precautions already in place
at any large, VIP-filled gathering. But by the time it’s apparent
that there has been an attack, hundreds of thousands of people may
have been exposed.
Catching the subtle signs, the earliest cases, is vital, especially
when the agent is infectious and spreads person to person like smallpox
or the plague, instead of through direct contact, like anthrax or
I visited the convention for an hour one evening and was dazzled
by the stadium seating, bright lights and cheering crowds. Although
I sat in a press seat with a badge secured from a former colleague,
I felt distant from the throng of reporters. They were looking for
sound bites and anecdotal color; I was looking for viral hemorrhagic
Long a CDC groupie, I relished my foray into this fascinating world
where a ballpoint pen fitted with a vial of deadly germs could be
a virulent weapon. But I was pretty sure we wouldn’t find
After all, these were the halcyon days, before the difference between
pulmonary anthrax and cutaneous anthrax was common knowledge in
most American households. On this humid evening, just two Augusts
ago, the threat of bioterrorism seemed as remote and unlikely as
a tie in a presidential election.