[.ca] The Anthrax Letters: A Medical Detective Story (ISBN 030908881X)

Very informative book.:
I'm actually just finishing up the book now. I'm really enjoying it. The author did some excellent research and provided a lot of descriptive information on the subject. I had never heard many of these facts before. Some of the standouts in this book include the author's ability to help us get to know the victims of the Antrhrax attacks. He humanizes them well. I have to admit that some of the early medical jargin in the first chapter was a little over my head. The average person, with no medical background, may find it a little overwhelming. However, I understand that this information was important and needed to be described. The rest of the book concentrates on the victims and the investigation. A very fascinating and enlightening book. At the time of these attacks, I never felt as though the public was getting the entire story, as far as detail. This book answers a lot of questions.

Solid presentation; useful detail; a valuable contribution:
I'm grateful to Mr. Cole for researching and writing this book. I work for the U.S. Postal Service and happened to find myself in the thick of this whole business in October 2001 in Boca Raton. Mr. Cole assembles the facts in a clear and logical way, provides useful digressions and details, and sheds light on many things that I did not understand before. This is very good work and, though some will undoubtedly question this detail or that, I think his book contains many valuable "lessons learned" which will assist those who have to deal with similar emergencies in the future.

In-depth report that questions the FBI profile:
This is the second book I've read on the anthrax attack. The first, The Killer Strain: Anthrax and a Government Exposed (2003) by Washington Post journalist Marilyn W. Thompson is a good book (with a different emphasis), but this is a better one. Written by Rutgers University Professor Leonard A. Cole, who is an expert on bioterrorism, The Anthrax Letters is both more extensive and goes into greater depth than Thompson's book. Perhaps the most important thing (from my point of view) that Professor Cole does is argue convincingly against the FBI's disaffected loner theory of who did it. Instead Cole presents a lot of evidence that strongly suggests that Al Qaeda may indeed have been responsible. First of all, the leading suspect, Attorney General John Ashcroft's "person of interest," Steven Hatfill, actually had an alibi. He was working in another state at the time some of the letters were mailed in Trenton, New Jersey. More importantly though, Cole sees a link between Iraq's known bioweapons program and Al Qaeda; he believes that the Ames anthrax strain in the Daschle letter was possibly purified and concentrated by "the Iraqi BW team." (p. 201) Furthermore the fact that there were at least two types of "weapons" sent by mail suggests more than a lone perpetrator. Additionally, the mystery of why the tabloid people in Florida were targeted (and indeed how they became targets) is explained when one learns that two of the suspected 9/11 hijackers rented an apartment from Gloria Irish, the wife of Mike Irish, editor of the Sun tabloid, an American Media Inc. publication. One of the men, Marwan Akl-Shehhi, told her that he was a pilot and was taking flying lessons. (p. 42) And it is not to be forgotten that the Al Qaeda suspects were interested in learning to fly crop dusters. That alone makes it clear that they expected to have access to and intended to use either chemical or biological weapons. Finally, there is the unsettling fact that one of the hijackers was actually treated for a black lesion on his leg that could very well have been cutaneous anthrax. Cole also suggests that it was no coincidence that the anthrax attacks began less than a month after September 11, 2001. To all of this I would add the fact that the Bush administration has become entirely mute on this question, which may suggest that they know who did it but for reasons unknown to us are not telling. What could those reasons be? Originally I thought it was because the FBI had bungled the evidence and didn't have enough left to stand up in court, or that something about the perp or information he or she had would be embarrassing to the government. Now I think it is possible that Al Qaeda was indeed responsible but the Bush administration won't acknowledge that because it would have to reveal secret information about our counter-terrorism program, and also possibly because such information may work into the hands of Al Qaeda's desire to psychologically terrorize the US population. Another interesting point that Cole brings up is the question of exactly how many cases of anthrax illness were caused by the mailed spores. He reports that there were eleven confirmed cases with five deaths. However, as noted in the final chapter, there is a twelfth case that the CDC would not confirm, that of postal inspector William Paliscak who had inhaled dust in which there were spores, and who had anthrax spores on his clothing and in his car. The problem is that the CDC was not able to culture anthrax from blood samples taken from Paliscak. Cole speculates that Paliscak and possibly others at the Brentwood postal facility did indeed contract anthrax, asking, "Could bacilli have been embedded in the brains of Bill Paliscak and others who were exposed to spores...?" He adds that there were eight deaths at Brentwood in the year following the anthrax attack when usually there are only two a year. Four of the people who died had inexplicably enlarged hearts. (p. 237) Also significant is Cole's point that what we learned from the attacks is that we are not nearly as well prepared as we thought, and that the use of the postal service as a means of disseminating a bioterrorist weapon was greatly underrated. What was not realized prior to these attacks was that anthrax spores in the size of about three microns would easily slip through the 20-micron pores in a typical envelope resulting in cross-contamination of the mail. The two women, Kathy Nguyen and Ottilie Lundgren, who died of inhalation anthrax even though spores were never found in their homes or in their mailboxes, were probably the victims of cross-contamination. Cole posits that by the time the mailboxes were swabbed the spores had dissipated. In support of this idea Cole quotes Harvard microbiologist Matthew Meselson as saying, "a single organism \oof anthrax\c has a chance of initiating infection." (p.110) This raises the question of how many other people died because of their exposure to the bacterium, cases that were either not reported or unrecognized as anthrax killings. This leaves me with an idea. Cole reports that how the perps got the very, very fine and slippery weapons-grade anthrax spores into the envelops without getting some into the air and eventually into their lungs is not known. With Al Qaeda's complete disregard for human life, they may not have warned their operatives of the dangers. Perhaps the FBI ought to look for some dead Al Qaeda operatives in the US and double-check the cause of death.

First Rate:
A first rate, well-written history.

An Outside the Box Insightful Account of Bioterrorism:
To date there have been eleven reviews of this book on Amazon, with an overall, deserved average of five stars. Unfortunately, Amazon has not provided a SEARCH INSIDE option which otherwise might allow the reader to view additional opinions (that include Richard (The Hot Zone) Preston's ".. a masterful piece of reporting ...", or a peek at the skills Dr. Cole has employed in making this a most delicious read. Cole is a gifted professional whose narrative ranks with the late Berton Roueche, the man who invented "medical detective" stories in The New Yorker over fifty years ago. Cole has the ability to accurately capture complex scientific facts, to personalize the many individual tragedies surrounding the anthrax letters, and to bring original insight over and above the plodding prose of newspaper accounts. Cole can even make an encounter with a mailbox an exciting adventure! For those people who enjoy the books by Oliver ( viz. Awakenings) Sacks of people challenged with neurological disease, or Robert S.(viz. New Guinea Tapeworms and Jewish Grandmothers) Desowitz's whimsical tales of parasitic infections, or Arlo (viz. Man and Microbes) Karlen's fascinating explorations of infectious disease history, Cole's most recent book certainly ranks with these authors. I hope that he continues to provide us with additional narratives of medical detection, given his proven scientific knowledge, demonstrated humanity, and Holmesian gift of assiduous investigation.