As the number of incidents of anthrax continues to grow, so does the public concern about biological terrorism from enemies who attack with germs instead of guns. Public health departments find themselves flooded with calls and questions about the threat. State and local health officials are facing the twin tasks of identifying the threat and calming an alarmed public.
The fight against bioterrorism is a war against an unseen and potentially deadly enemy.
Dennis Perrotta, chief epidemiologist at the Texas Department of Health, says public health officials who once labored in obscurity are suddenly finding themselves frontline soldiers in that war. "Public health plays an especially important role in bioterroism because we have epidemiologists on board, and those are the medical experts, if you will, the medical detectives that first detect it," he said. "Obviously that's a bit different than an explosion or a chemical release, where its impacts are obvious. And so public health ends up playing a leadership role in the response to bioterrorism."
The federal Centers for Disease Control gets a great deal of media attention, but has no enforcement powers. State and local health authorities, on the other hand, have broad powers to enforce health laws.
Nearly one-dozen state and local health officials interviewed say they have been swamped with work as they answer questions from an alarmed public and at the same time try to identify possible outbreaks of infectious agents.
Mr. Perrotta says the volume of calls and level of concern fluctuate daily. "It is an up-and-down cycle what I have noticed," said Dennis Perotta. "Some days people who call are calm and have just a few questions. And we can help them out and they can go about their way without very much problem. And then other parts of the day we will get panicked calls. And so there is a mixture of it. Everybody is looking for information, and it almost depends on the time of day, or perhaps what is going on in the media, that spurs the difference between mature concern and full-blown panic."
In addition to answering e-mails or phoned in questions, public health officials are holding frequent media briefings to inform and calm the public.
New York State Department of Health spokeswoman Christine Smith says public concern is fed by the steady diet of alarming headlines. "I think there is a feeling, a concern, especially in some individuals who are experiencing "anthrax overload." It is in every newscast, it is talked about all the time on the radio, on television, on the cable stations, in the newspapers," she said. "They are seeing it everywhere, and they may have the perception that it is everywhere. But it is not."
Officials point out that the anthrax attacks, if they are proven to be such, appear to be confined to selected federal officials and high-profile media personalities.
But Joe Mallonee, chief of the Acute Disease Service at the Okalahoma Department of Health says bioterrorism by mail makes people extremely nervous, even if they are thousands of miles away from Washington or New York. "I think that everyone recognizes that we are just as vulnerable as the next letter that comes," he said. "While what we have seen so far, most of this has been targeted against high-profile people on the East Coast, but everyone is wary of that."
All the departments contacted say they have been testing hundreds of samples of white powder for possible anthrax. Most turn out to be false alarms or even outright hoaxes.
Alarm bells sounded in Texas when white powder was found in an envelope of stamps sent in the mail. It turned out the sender a stamp collector routinely uses talcum powder to keep the stamps from sticking together.
Most states are putting bioterrorism response plans into place. Mr. Perrotta, in Texas, was way ahead of them; he established one in his department in 1997. But it languished for lack of funding and interest.
Now, his department and others are finding money flowing and official interest high. Ms. Smith reports that during a recent visit to the state health department, New York governor George Pataki pledged an immediate $1 million in additional funding for more staff and equipment without even being asked.