-- Anthrax-laced letters that killed five people, targeted U.S. senators and paralyzed post offices a decade ago have reshaped the nation's biodefenses.
While confidence is higher that the United States is better protected, there are continuing worries about potential threats in the coming era of "synthetic biology," man-made designer microbes.
Nationwide, subways and airports now have germ-sniffing sensors, new federal biodefense labs have been erected and specially trained FBI teams stand ready to investigate bioterrorist attacks, all absent in 2001.
"We are certainly better prepared for another anthrax attack," says former FBI scientist Bruce Budowle, now of the University of North Texas Health Science Center at Fort Worth. "But we still don't know everything else that is out there in the environment, and 'synthetic biology' is a whole new concern."
On Oct. 6, 2001, photo editor Robert Stevens, 63, died from inhalation of anthrax spores. It was the first death in what would become a nine-year investigation that would conduct 10,000 witness interviews in six countries and collect 5,730 suspected anthrax samples.
The case formally ended on Feb. 19, 2010, a year and a half after the suicide of Bruce Ivins, a researcher with the U.S. Army Medical Research Institute of Infectious Diseases. Ivins, 62, had been named by investigators as the likely suspect.
In 2001, at least five letters containing finely powdered anthrax spores were mailed to media and political targets, including NBC's Tom Brokaw and then-senator Tom Daschle, D-S.D.
"Anthrax is still a threat here in the U.S., but there are others" raised as potential bioterror agents, such as plague and smallpox, says microbiologist Jason Bannon, of the FBI Laboratory in Quantico, Va.
"Synthetic biology actually is one of the FBI's priorities," he says, noting a main fear is a "nefarious" microbiologist augmenting a known disease microbe with genes from another that could make a microbe more toxic.
While few FBI investigators were inoculated against anthrax in 2001, each field office now has dedicated personnel to investigate biological attacks, and the bureau has an entire directorate devoted to biological, chemical and radiological counterterrorism.
In the 2001 investigation, academic researchers performed genetic tests for investigators; today, there are dedicated federal labs at Fort Detrick, Md., and elsewhere, to run such analysis.
"We are certainly better prepared now, than we were ten years ago," says physician Eric Toner of the Center for Biosecurity of the University of Pittsburgh Medical Center. "But there is still a lot of work to be done."
Toner says that a good, fast test for anthrax exposure still eludes investigators. "We need one," he says, to identify an attack and treat victims quickly.
Cuts to state and local public health offices are "the big threat today," Toner says.
The National Association of County & City Health Officials reported 29,000 lost jobs at local health departments since 2008.
"That will leave a big gap in disease surveillance," Toner says.
At the same time, the genetic analysis performed in the case, "has now become mainstream," says microbiologist Paul Keim of Northern Arizona University in Flagstaff, whose lab held a repository of anthrax samples collected in the 2001 investigation.
The samples were used to find genetic clues to the source, which proved to be the "Ames" strain of anthrax then used by biodefense labs to test vaccines.
"Hundreds of labs can do analyses for thousands of dollars today, that we spent millions on 10 years ago," Keim says.
During Germany's E. coli outbreak this year, a genetic sequence of the outbreak bug was completed within three days, and research conducted by Keim and others linked the cholera outbreak in Haiti to Nepalese peacekeepers. These cases illustrate the growth of the field of "microbial forensics."
Strict policy also bolsters the biodefense strategy. Microbiologists once swapped bugs like baseball cards, carrying them in briefcases on passenger flights; today, scientists working with dangerous microbes have to register their inventories and follow rules governing their transfer between labs, says Keim, chairman of the White House National Science Advisory Board for Biosecurity.
"We call it a 'culture of responsibility' that has to be the rule for researchers."
If another bioterrorism attack happened, "there would still be a period of confusion getting organized," Budowle says. "Each case is going to be unique."
Even with the rapid gene sequencing in Germany's E. coli outbreak, which killed 50 people, Budowle says, investigators still misidentified its source several times, before old-fashioned investigating tied it to a German farm's bean sprouts.
And at least one other thing hasn't changed since 2001, Bannon says:
"We still get a lot of white-powder letters."