In 1950s, N.H. mill was hot zone in anthrax fight

By Beth Daley a Nd Gareth Cook, Globe Staff, 10/21/2001

MANCHESTER, N.H. - Antonio Jette's daughter was certain her father had a cold when he went home early from the Rutland Fair one Sunday 44 years ago. A cough. Maybe a slight fever.

Four days later, the 49-year-old Nashua father of seven, who cleaned wool-picking machines, was dead - a victim of this nation's deadliest anthrax outbreak. In all, four men died and five others fell ill, starting on a hot August day in 1957 in the No. 9 mill of Arms Textile Co., where wool was pieced into coat linings for some of the country's most fashionable designers.

''We didn't even know what he died of until after he passed away and they told us anthrax. We didn't know what the word `anthrax' meant,'' said Anita Simonds, 75, his daughter. Simonds and her 95-year-old mother, Anna, still regularly attend Mass in Jette's name. ''He just got in the gate at the fair and had to go home. He died so quick. Later, they told us other people died of the same thing.''

As Americans grapple with the worst bioterror attack in US history, specialists say the lessons learned at the old Arms Textile Mill are a major reason the current outbreak isn't even more frightening. Here, nestled against the Merrimack River, the mill was a crucial turning point in the battle against this ancient enemy, a testing ground for decontamination methods and an experimental vaccine that turned out to be a powerful lifesaver.

''They had an idea that the vaccine worked, but this gave them the opportunity to test it,'' said Eric Croddy, senior research associate with the Monterey Institute of International Studies in California. ''It is a fascinating story.''

But the epidemic is also a cautionary tale about how difficult it is to get rid of anthrax once a place has been contaminated. Anthrax spores can live in the ground for years, and they are so tiny that they can easily escape detection. In Manchester, the contaminated mill was soaked in detergent, sprayed with heated formaldehyde, torn down, incinerated, and the remaining bricks in it buried. It's now an asphalt parking lot.

The epidemic started innocuously enough, with coughs and skin lesions among a handful of employees who worked near anthrax-tainted animal hair at the mill. But as events unfolded in the late summer and fall of 1957, health workers began to realize that the tiny Bacillus anthracis had two deadly coconspirators: fear and confusion. A third of the more than 600 workers at the plant refused to participate in the government's vaccine-testing program, which would have protected at least some of them. And medical detectives trying to piece together clues from the sprawling plant were never certain of the outbreak's ultimate source, though they strongly suspected that the culprit was a seemingly routine shipment of goat hair from Pakistan.

Before the epidemic, anthrax was an annoying, but treatable, occupational hazard of weavers and wool pickers in textile mills. Since biblical times, anthrax has been reported, most often the less dangerous skin form of the disease. Its symptoms were black lesions on cheeks, arms, and necks of textile workers; the ugly blisters were even dubbed signs of ''woolpickers disease.'' There were no signs anyone at the Manchester mill had ever contracted inhalation anthrax, a far more lethal form that results when the spores are breathed into the lungs, where they release toxins.

By 1955, however, anthrax was much more than an annoyance to biological warfare scientists toiling at Ft. Detrick, Maryland. Anthrax, a naturally occurring bacteria known to decimate cattle, sheep, and other livestock herds, was being perfected as a key biological weapon - long-living, hardy, and often 90 percent deadly to humans if they inhaled enough spores. Realizing that enemies might be working on the same project, scientists rushed to create a vaccine to protect against all forms of anthrax, and they were desperate to test it on humans.

The vaccine had worked in animals, but it wasn't known whether it was effective in humans, according to Philip Brachman, who was asked to test the vaccine while working at the national Centers for Disease Control and has been an anthrax specialist for more than four decades.

The only way to test it, he said, was to look for volunteers in a population that was regularly exposed to the disease.

Four mills were picked, including the Arms mill. Many workers, however, chose not to participate in the two-year experiment because they distrusted the vaccines.

Jette never mentioned the vaccine experiment, Simonds said, although records indicate he refused to participate in the trial. ''We never even knew about it,'' she said. According to records, three of the nine men who contracted anthrax had refused inoculation, four had received either a placebo or an ineffective version of the shot, and two were so new to their job they didn't have an opportunity to be asked.

Doctors were keeping such close watch on the patients in the study that they were able to spot the outbreak quickly. After nine men contracted skin or inhalation anthrax, scientists threw away the research and vaccinated everyone. By the time the last victim, a 61-year-old worker, died on Nov. 5, the epidemic was over. The vaccination program proved to be more than 92 percent effective. (Some vaccinated workers at other mills in the experiment fell ill, but none in Manchester.) And the results served as the foundation for the drug's approval by the Food and Drug Administration in 1970. Arms began vaccinating all of its employees.

''This is where we demonstrated that the vaccine is effective,'' said Brachman, who directed the field test and is now a professor at the Rollins School of Public Health at Emory University. ''This was the first epidemic in the United States of inhalation anthrax.''

After the 1957 outbreak, there were no more reported inhalation anthrax deaths at Arms, although a 46-year-old man in a next-door metal fabrication shop died in 1966 after authorities believe he inhaled some spores that drifted over from the textile plant.

The Arms Co. went out of business in 1968 and the building was sealed until 1971 when one of the world's biggest decontamination efforts began in hopes of rehabilitating the structure. Hundreds of mill workers in surrounding buildings were vaccinated and workers with oxygen masks and bright orange nylon and rubber suits began hosing down the walls with a powerful formaldehyde solution. But scientists still worried: Maybe microscopic spores could be hiding in nooks and crannies.

''In the end, they decided to dismantle the building and build an incinerator on site,'' said Rich DiPentima, deputy health director for the Manchester Health Department who has studied the case. ''The feeling was you couldn't be too careful.''

Bricks and other material that couldn't be burned were soaked again in a chemical solution, removed, and sprayed down once more before being buried close together so no rats could get between them. The several-month process worked: Tests years later showed no anthrax in any tests on the old mill site or where the bricks were buried.

Working off that experience - and the decontamination of an island off Scotland once used for anthrax bomb testing - specialists have come up with a nontoxic detergent made of shampoo ingredients to invade the germ's protective spore and kill it. The decontaminants are delivered by foam or fog that don't harm keyboards or phones.

While it's difficult to flag and kill every single spore that could be hiding behind a wall or under a desk, officials say application of the antianthrax treatment would reduce the number of spores in a particular area far below the 8,000 to 10,000 spores needed to infect someone.

''If you have an anthrax spore left behind, that is going to be the difficult part,'' said Brian Kalamanka of Modec Inc. in Denver, one of the companies licensed to sell the antianthrax formula.

The hardest job in the current anthrax scare is likely to be persuading workers in anthrax-tainted buildings to return to them. Dozens of employees of American Media Inc. in Boca Raton, Fla., the first building to be contaminated, say they doubt they will ever feel safe in the recently rehabbed building.

''The trouble is going to be convincing people the buildings are clean,'' said Michael A. Wartell, chemistry professor and chancellor of Indiana University-Purdue University Fort Wayne, who serves on the Army Science Board. ''In order to contract this, you need a reasonable dose. But perception is incredibly important in this case. That is going to be the hardest part.''

In Manchester, where few people today have heard of the outbreak, the parking lot where the mill once stood is used every day. In fact, it's where the city holds its annual Riverfest that draws thousands, most unaware of the story beneath the pavement.



-- Anonymous, October 21, 2001