From the ASPR Blog: From the front lines of the anthrax investigation to pre-staging our future health response

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Fifteen years ago, anthrax was used as a terrorist weapon. Dr. Jaffe, Director of Medical Countermeasures Strategy and Requirement in ASPR’s Office of Policy and Planning, provides a behind-the-scenes look at the response and talks about some of the progress that we have made to prepare the nation since those attacks. Learn More >>

From the front lines of the anthrax investigation to pre-staging our future health response

Author: Dr. Rick Jaffe, Director, Medical Countermeasures Strategy and Requirements, ASPR’s Office of Policy and Planning
Published Date: 9/29/2016 4:28:00 PM
Category: Innovations; Medical Countermeasures; Public Health Preparedness;

Fifteen years ago this month, anthrax was used as a terrorist weapon against our nation. As a microbiologist with experience in dealing with Bacillus anthracis, the bacteria that causes anthrax illness, I was called in to be on the front lines of the investigation into the attack. Today, I help ensure our nation is best prepared for and can respond to a future one.

Soon after September 11, 2001, an attacker mailed letters laced with anthrax spores causing the deaths of five people and sickening 22 others. As part of the response, I donned a hazmat suit to investigate the possible extent of spread near one of these sites. When the FBI launched an investigation to determine who perpetrated this attack, the agency looked to the company I worked for at the time; with my background, I was to be part of the investigation to identify its source.

There were many challenges in the beginning. Decisively linking the anthrax spores collected from the attack site to the laboratory of a potential suspect would be necessary to prosecute and successfully charge the perpetrator. Therefore, every step including collection, analysis, and validation of samples; quality assurance and control; reporting out; and communication of complex molecular techniques needed to be resolved so that prosecutors and potential jurors would trust and understand for any potential litigation for attribution.

The first challenge was that different strains of Bacillus anthracis are very similar to each other at the genome sequence level, which presents challenges to differentiating strains. However, an astute scientist at United States Army Medical Research Institute of Infectious Diseases noticed unique differences in the appearance and growth characteristics of the anthrax spores used in these attacks. Therefore, we needed to be able to determine at the molecular level how these anthrax spores used in the attacks were different beyond a reasonable doubt.

The next challenge was that there were no established methods for differentiating anthrax spores at the molecular level. In order to determine definitively that the source of the anthrax used in the attacks, we had to create that method. We created one the first molecular forensics assays that identified unique fingerprints of the DNA of the anthrax spores used in the attacks, and then had to validate our assay and the technicians who would be testing any samples that were suspect.

We next had to determine optimal growth conditions to standardize the repository samples so they could be accurately compared using molecular testing. We also developed a method of isolating the DNA to be tested in our unique molecular assay.

Since Bacillus anthracis is a select agent, every researcher working with anthrax in their facility is required to register with the CDC and FBI, so researchers from all across the country were provided our standard growth conditions, and they prepared samples to be sent to my laboratory for comparison as part of the FBI’s investigation into the attacks. These became known as the repository samples.

Over the span of the next nine months, we examined over 1,000 repository samples using our standard methods for growth, DNA extraction, and molecular testing and found approximately 10 samples matched those used in the anthrax attacks in 2001. Those samples came from two laboratories, and one of those labs provided anthrax to the other. So, we were able to confirm the identity of the laboratory as the original source of the Bacillus anthracis used in the attacks.

Today, we have more tools at our disposal to respond to an attack. As the Director of the Medical Countermeasures Strategy and Requirements Division at ASPR, I have been able to play an important role in anthrax preparedness. My office has developed and updated anthrax requirements that determine how many medical countermeasures, such as treatments and vaccines, we need, how many can be used and what products would look like to preserve lives following a potential future anthrax attack. We work diligently within ASPR to prepare and respond against future attacks, to focus on preparedness; building federal emergency medical operational capabilities; countermeasures research, advance development, and procurement; and grants to strengthen the capabilities of hospitals and health care systems in public health emergencies and medical disasters.

Just as I was able to be a part of an innovative approach to identifying the source of the anthrax used in the attacks 15 years ago, I have seen the dedication and ingenuity within ASPR and am proud to be part of this vital mission.