The Washington Post reported yesterday that small amounts of a bacterium that causes “rabbit fever” were found on Washington’s National Mall on the weekend of Sept. 24-25, 2005 — the same weekend that thousands of protesters marched against the Iraq War. But U.S. health authorities did not announce it until Saturday, Oct. 1 — a week later.
The Centers for Disease Control and Prevention said several government environmental air monitors in the Mall area detected low levels of Francisella tularensis, a bacterium that causes tularemia, commonly known as rabbit fever. Public health agencies have had no reports of any related human or animal illnesses caused by the bacteria.
The CDC said it issued an alert on Friday night, Sept. 30, 2005, as a precaution so medical personnel were aware of the situation and could report any suspected cases. Tularemia does not transmit from person to person and can be effectively treated with readily available medicines, the CDC said. Symptoms usually appear three to five days after exposure, but in rare cases can take up to two weeks.
Symptoms of the disease include sudden fever, chills, headaches, conjunctivitis, diarrhea, muscle aches, joint pain, dry cough and progressive weakness. District of Columbia health officials told local radio station WTOP on Saturday, Oct. 1, that the detected bacteria was not harmful and probably occurred naturally.
The CDC waited a week to notify city officials of the detected
bacteria because it took that long to test the samples at labs and confirm its presence, the radio station reported.
According to the CDC’s website, people can get tularemia by being bitten by a infected tick, deerfly or other insect, handling infected animal carcasses, eating or drinking contaminated food or water or breathing in the organisms. The CDC also said the bacterium can be used as a weapon if made into an aerosol that could be inhaled.
Although not many human cases are reported in the USA each year and the disease is primarily endemic in the middle USA, as well as Martha’s Vineyard, an island off the coast of Massachusetts, almost every state has reported cases — see refs. below. Since the bacterium is ubiquitous, unlike plague,
the BioWatch system may detect its nucleic acid if, for instance, material containing the organism is aerosolized by landscaping or yard work.
Area health officials were not notified for five days that sensors on the National Mall had detected a potentially dangerous
bacterium there last month because subsequent tests were not conclusively positive, a federal official said Tuesday.
The Department of Homeland Security delayed in alerting the federal CDC for the same reason, said Richard Besser, who directs the CDC’s coordinating office for terrorism preparedness and emergency response. More than half a dozen sensors showed the presence of tularemia bacteria the morning of Sept. 24, after thousands of people gathered on the Mall for a book festival and antiwar rally, yet the CDC was not contacted for at least 72 hours.
Testing never identified all the definitive markers for which
scientists were looking, and officials were wary of issuing a false alarm, Besser said. He called the entire incident “highly unusual,” but he acknowledged that it would prompt the two agencies to review their protocol and the timeliness of their response “to make sure the system doesn’t have any flaws in it. It really will cause us to look at the system and say, ‘Should things have been different?'” Besser said in a phone interview.
In letters Rep. Thomas M. Davis III (R-Va.) sent on Monday, Oct. 3, to Homeland Security Secretary Michael Chertoff and CDC Director Julie Gerberding, he called the notification time frame “alarming” and asked for an accounting of the procedures triggered when the government’s “BioWatch network” senses a biological agent. His questions focused on what each agency knew and when it knew it, as well as which local and state officials were called and when. “Why weren’t these officials notified immediately following the detection?” Davis wrote.
D.C. Health Director Gregg A. Pane, who learned of the situation in a conference call on Friday, Sept. 30, morning, said he would have liked to have been involved sooner. Hours after being alerted by the CDC, he and his counterparts across the Washington region put out an announcement for the public. “I wish they’d bring us in earlier,” he said Tuesday. “There’s got to be a level of trust and communication” among the entities and layers of government, he said.
As of Tuesday, local and federal health officials said they had confirmed no cases of tularemia from the Mall gathering and, through medical surveillance, had not found any spikes in possible symptoms. Although the germ that causes tularemia is highly infectious, the disease itself is not passed from person to person and can be easily treated with antibiotics. Left untreated, it can be fatal.
Besser said that if the initial evaluation had revealed true
positives, the laboratory would have immediately contacted Homeland Security, which would have immediately brought CDC and local health agencies into the discussion.
Instead, as late as Thursday, Sept. 29, CDC officials expected final testing to disprove the presence of the bacteria. “So we didn’t really think there was a need to alert area public health officials,” he said.
In his letter, Davis requested specifics about the bacteria levels
ultimately detected and the government’s plan to inform the public of risk. “How do you monitor the thousands of people who visited the affected areas?” he asked.