11 October 1999
Source: Hardcopy The New Yorker, October 18 & 25, 1999, pp.90-107.
Thanks to Richard Preston and The New Yorker.
See parallel news report: http://www.nytimes.com/library/national/regional/101199virus-track.html
See also two related articles by Richard Preston: "The Bioweaponeers" and "The Demon in the Freezer."
DISPATCH
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How did it get here? The C.I.A. would like to know.
BY RICHARD PRESTON
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Last spring, long before the outbreak, an Iraqi defector declared Saddam Hussein had told him of plans to use the virus as a bioweapon.
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SINCE the end of August, a brain virus that is now believed to be a previously unknown variant of the West Nile virus has killed at least five people around New York City and its suburbs. This has created a stir in the national news media -- and a whiff of concern within the C.I.A. that the outbreak might have been an act of bioterrorism -- but the main effect of the outbreak in humans has been quiet: thousands of New Yorkers may have had West Nile virus replicating in their brains this summer without knowing it. In most people, the West Nile illness feels like a mild flu. Humans catch it from the bite of an infected mosquito. You might get a headache and a backache and the blahs; just another summer bug. Usually, the illness lasts from three to six days, and people recover quickly, without lasting effects. But in young children, the elderly, and people with weak immune systems West Nile can turn into encephalitis -- an inflammation of the brain. The brain becomes red and puffs up inside the skull. These victims may get tremors -- their muscles may become uncontrollably weak -- and they can have seizures, fall into a coma, stop breathing, and die.
The West Nile virus was first identified by virologists in 1937, in the West Nile district of Uganda, along the Albert Nile near the border with the Congo, where it was making people sick. West Nile virus is a traveller. Mosquitoes are its main carriers and birds are its main hosts; they are its deep reservoir in nature. It has been found all over east Africa, in western India, in Australia (where one of its close relations is known as Kunjin), and in Egypt and the Middle East. About forty per cent of the people who live in the Nile Delta in Egypt have been infected with West Nile at some point in their lives. Although the virus stages occasional outbreaks in people, the real outbreaks are happening in birds, and people are bystanders caught in the crossfire -- bitten by chance by an infected mosquito. The virus also gets into ticks. From the point of view of the West Nile virus, the human species is of less consequence than a tick. In a manner of speaking, West Nile doesn't even know we exist. But when West Nile moves with the birds there is splatter damage among humans. Birds occasionally carry West Nile into Eastern Europe during their annual migrations out of Africa. Right now, there is a major outbreak of what is believed to be the West Nile virus in southern Russia, around the cities of Volgograd and Rostov-on-Don. There are reports that some six hundred people have been taken ill, and at least thirty-two have died. American scientists have been trying to persuade Russian scientists to send them samples of tissue and blood from the Russian outbreak, so that they can compare the New York strain with the Russian strain. It might show that the New York strain somehow came from Russia, perhaps travelling by airplane in the bloodstream of an infected Russian who ended up in Queens and was bitten by a mosquito there, and the mosquito then passed it to a bird. So far, the Russians haven't sent any samples.
Until this summer, the West Nile virus had never been seen in the Western Hemisphere. Some virus experts think that the leap of West Nile virus into North America -- if this is indeed what has happened -- is one of the most important biological events to occur in the world of the viruses in this century. For one thing, until now the virus has generally not been fatal to its avian hosts. For another, the outbreak reveals the mobility of viruses and their propensity to cross continents. The experts have no idea how the virus got to New York and little idea where it's going. Possibly, an infected bird somehow flew across the ocean -- or hitched a ride on a ship, or was imported legally or illegally. Or perhaps an infected mosquito got here on a plane. The virus may now be headed down the eastern seaboard of the United States for the winter, travelling inside birds. In late June or early July, the virus apparently showed up in birds in the Whitestone area of northern Queens and in the South Bronx. The birds caught it from an urban mosquito, Culex pipiens -- Latin for "chirping bug" -- commonly known as the house mosquito. This mosquito breeds all over the world in polluted water. Where the mosquitoes of New York City got the West Nile virus is unknown.
IN mid-August, Dr. Tracey McNamara, a veterinary pathologist with the Wildlife Conservation Society, at the Bronx Zoo, began hearing reports of dead birds all around New York City. Then she noticed dozens of dead and sick crows around the zoo. "I'm sitting there saying, 'It's raining crows,' " she recalls. "The sick ones were neurologic -- they couldn't fly, they had trouble balancing. They were sitting there with tremors." Dr. McNamara performed necropsies, and when she opened the birds' skulls she found that they'd had brain hemorrhages; she also found lesions on their hearts. Then, the day after Labor Day, there was a big die-off of birds at the zoo. A number of South American flamingos and cormorants died, and a bald eagle developed head tremors and died. Dr. McNamara sensed that an unknown virus was killing the birds. She already suspected it was being passed by mosquitoes, and she feared that it could be lethal to humans. She began taking extra precautions: she handled the birds only with special equipment, and opened them up in a filtered-air safety cabinet. She notified health authorities and sent them samples for analysis.
At roughly the same time, Dr. Deborah Asnis, at the Flushing Hospital Medical Center, in Queens, was treating two elderly patients who were dying of an apparent encephalitis virus, but she couldn't diagnose it. Dr. Asnis brought it to the attention of doctors at the New York City Department of Health, who sent samples of human brain tissue to a laboratory of the federal Centers for Disease Control and Prevention in Fort Collins, Colorado, where Dr. Duane Gubler, the director of the Division of Vector-Borne Infectious Diseases, made a tentative identification of St. Louis encephalitis virus. That virus lives in birds and mosquitoes in the South and Midwest, and had never been seen in New York On Friday, September 3rd, city officials learned that the C.D.C. believed that the virus was St. Louis encephalitis, and just two hours later Mayor Rudolph Giuliani ordered trucks and a helicopter to begin spraying insecticides over neighborhoods in northern Queens. The spraying eventually involved five helicopters, and was carried out all over the city and in many suburbs. The chief of the Mayor's Office of Emergency Management, Jerome Hauer, bought half a million cans and bottles of Off! and other insect repellents on behalf of New York City. He ended up cornering nearly the entire supply of insect repellent in the United States. The city handed out the bug repellent for free. Hauer also is in charge of New York City's preparations for a bioterror event. A bioterror event is the deliberate release of a biological weapon, such as anthrax or smallpox, by a terrorist a possibility that has city officials very concerned, and they've been having planning sessions and staging simulated terror exercises. It may be that their preparations for a bioterror event fortuitously speeded up the city's response to the outbreak of the brain virus.
Then two groups of scientists almost simultaneously discovered that the virus wasn't St. Louis encephalitis virus but West Nile -- or something close to West Nile. One group was led by Dr. Ian Lipkin, of the Emerging Diseases Laboratory at the University of California at Irvine, who was studying bits of brain tissue from people who had died in New York. The other group was led by Duane Gubler, of the C.D.C. lab in Colorado. Both Lipkin and Gubler were attempting to decode the DNA of the virus to determine exactly what the virus is. It might be given a new name, Lipkin told me early last week: "We could call it the Hudson River virus. We won't call it the Queens virus. People don't like to have viruses named after the places they live." Then, at the end of the week, Lipkin announced that he believed the virus was indeed a new strain, and that it is most closely related to the West Nile virus and its relative the Australian Kunjin virus.
THE mystery of how a West Nile-like virus got to New York City has been troubling the Central Intelligence Agency. At the headquarters of the C.I.A., in Langley, Virginia, there is a group of analysts and officers who concern themselves with biological weapons -- the C.I.A.'s bioweapons-analysis section. The section is run by a senior biologist who has had firsthand experience with some of the world's most dangerous viruses, including the Ebola virus. The scientist is said to be well respected by his peers, and he works with a team of analysts, mainly younger people fresh out of college. The analysts gather intelligence involving bioweapons and then try to assemble the big picture, fitting the data together with what they already know about bioweapons. After the New York diagnosis was changed to West Nile, on September 27th, the top officers in the bioweapons-analysis section suffered a lurch of uneasy recognition: they recalled a report that a self-described defector from Iraq had declared last April that Saddam Hussein was developing a strain of the West Nile virus as a biological weapon and was preparing to release it.
Someone in the analysis section apparently noticed that on April 6th a British tabloid, the Daily Mail of London, had published an excerpt from a book entitled "In the Shadow of Saddam," with a note that the account's credibility was "for the reader to judge." The author calls himself Mikhael Ramadan. That may or may not be his real name. Mikhael Ramadan is said to look a lot like Saddam Hussein. Purportedly, he served as one of Saddam's doubles, in order to help foil assassination attempts. There is a photograph, supposedly of him, on the back cover of the book, and he looks remarkably like Saddam except that he has more gray at the temples, and somehow he looks kindly. Eventually, Mikhael Ramadan managed to escape from Iraq. In his book he offers a wild-sounding account of his experiences working as Saddam's double, including such vignettes as a Kurdish rebel being lowered slowly into a vat of sulfuric acid. Mr. Ramadan also wrote, as the Daily Mail published it:
In 1997, on almost the last occasion we met, Saddam summoned me to his study. Seldom had I seen him so elated. Unlocking the top right-hand drawer of his desk, he produced a bulky, leather-bound dossier and read extracts from it.... The dossier holds details of his ultimate weapon, developed in secret laboratories outside Iraq.... Free of UN inspection, the laboratories would develop the SV1417 strain of the West Nile virus-capable of destroying 97 pc [per cent] of all life in an urban environment.... He said SV1417 was to be "operationally tested" on a Third World population centre.... The target had been selected, Saddam said, "but that is not for your innocent ears."
It sounded crazy. But why would a man presenting himself as an Iraqi defector predict that Saddam would unleash a virus just months before the same one broke out unexpectedly in New York? And, of all the thousands of viruses in the world, why West Nile? It was enough to make any bioweapons analyst at the C.I.A. feel uneasy. Adding another twist to the story, it turns out that in 1985 the Centers for Disease Control had sent samples of West Nile virus to a researcher in Iraq, which occasioned a controversy in the media five years later, on the eve of the Gulf War, when reports came out that Iraq had a biowarfare program. But the fatality rate for West Nile is not remotely near ninety-seven per cent, and "SV1417" is not a standard designation for any known strain of West Nile virus. It may be a code designation for some strain that Saddam's bioweaponeers might conceivably be working on, perhaps in a French-built virology facility near Baghdad that has been closed to inspectors from the United Nations for two years, ever since Saddam threw out all the U.N. inspectors. In the early nineteen-eighties, a French vaccine company, Institut Merieux, which is a division of the pharmaceutical giant Rhone-Poulenc, built a facility called the Foot and Mouth Vaccine Plant at a site now known as Al Manal. Institut Merieux helped the Iraqis operate Al Manal for a time, and trained the staff before departing. Al Manal was subsequently used for research into virus weapons. During the Gulf War, Al Manal and the Merieux equipment were used for making twenty thousand litres of botulinum toxin, or BTX -- one of the most lethal biotoxins known. In 1992, the United Nations tore down the buildings in which the BTX was made and destroyed that equipment, but it left standing eighty per cent of the facility, part of which was for virus research. (Some inspectors wanted the whole thing torn down.) Al Manal may be back in business developing virus weapons.
At the same time that the report about West Nile virus was being discussed in the C.I.A., Dr. Ken Alibek, the former deputy chief of research for Biopreparat, the Soviet Union's main biowarfare program -- he defected to the United States in 1992 -- spoke to various people on Capitol Hill, voicing his concern that the West Nile outbreak was suspicious. "I told them, 'It will not be possible to say whether or not it is terrorism unless we have a thorough study,' " he explained to me. "We need to take these situations with a high degree of seriousness."
Mikhael Ramadan is now apparently in hiding somewhere in Canada or the United States. At any rate, the C.I.A. people had an interest in finding him. Presumably, they would want to ask him more questions about the West Nile virus and whatever Saddam might have told him about any plans Iraq might have had for it and New York City. I don't know whether they succeeded in finding him.
Hoping to speak with Mikhael Ramadan myself, I called his publisher, a tiny outfit called GreeNZone Publishing, which has an office in the south of England. One of the firm's three directors, James Bartholomew, answered the telephone. "We don't know Mikhael Ramadan's whereabouts," he said. "We believe he was in Canada for a while. We have five employees here, and none of our people has ever met him. We were introduced to him through a third party. There was a woman, an American-Iraqi nurse, involved in bringing him forward. There was a verification meeting with him that took place in the fall of last year, in Canada, I guess. All of our communication with him has been by E-mail. His E-mail address is now defunct. His manuscript was physically delivered to us by a courier outfit. We tried to get him to change his mind and come forward for television interviews. We had inquiries from NBC and CBS. What is that show, '60 Minutes'? -- they were trying to find him. The book has sold well for a company our size. We want to pay him, but we can't find him."
"Is the book fiction?"
"We've taken his book as true, based on the evidence we have. But we don't know how much of it is true."
"What's the evidence?"
"I can't say. It would put him in danger," Mr. Bartholomew said. "True or not, it was a good story. We saw it as a commercial proposition. We weren't trying to educate the world."
I THEN spoke with the Secretary of the Navy, Richard Danzig. As early as 1993, Danzig had played a leading role in encouraging the government to plan for a possible bioterror event. He is a soft-spoken man with a thin face and spectacles, and he didn't sound alarmed. "A point I've been making to emergency planning groups is that, though we may know that a biological event has occurred, we may not know if it's an incident of bioterrorism," he said. "Even if you suspect biological terrorism, it's hard to prove. It's equally hard to disprove. This is more illuminating of my prediction that we won't necessarily know when bioterror has occurred than it is illuminating of Saddam Hussein."
I called a top scientist who advises the F.B.I., a person who has been deeply involved with bioterror planning. The F.B.I. is currently investigating more than two hundred threats, hoaxes, and attempts at bioterrorism that have occurred in the United States in just the past year -- it's got to the point where every wanna-be terrorist is threatening to unleash a bug. This scientist seemed thoughtful, and said that West Nile might be a good one. He said, "If I was planning a bioterror event, I'd do things with subtle finesse, to make it look like a natural outbreak. That would delay the response and lock up the decisionmaking process."
An Army expert on bioweapons told me that the military has known for some time that Soviet biologists working for the U.S.S.R.'s biowarfare program had evaluated the West Nile virus for use as a biological weapon. "The Russians did this kind of crap back in the seventies -- they're admitting it to us now," he said. The Soviet scientists were interested in West Nile because it can be put into mosquitoes and the mosquitoes can be released into a city, where they will bite people. "They abandoned it because it didn't work very well," he said. "How many containers of West Nile-infested insects do you need to release in Queens to make it worth a shot?"
BY Friday, October 1st, the Mikhael Ramadan story had surfaced at the Centers for Disease Control, in Atlanta. Dr. Scott Lillibridge, who is the head of the C.D.C.'s Bioterrorism Preparedness and Response Program, alerted other scientists at the C.D.C. about the allegations and asked them to evaluate the evidence. I spoke with a person at the C.D.C., who said, "We're taking it seriously. We'll see where the data takes us. It could be done. You'd have to bring in a lot of mosquitoes." If the mosquito-filled containers were made of plastic, they would not show up in a metal detector at Kennedy International Airport. He went on, "But West Nile is not a great biological weapon, because it doesn't hurt most people very much."
An expert on insect viruses named Dr. Thomas Monath, who ran the C.D.C.'s Fort Collins lab, and later worked for the Army, and is now the chief scientist at a Massachusetts biotech firm called OraVax, took a longer perspective. He thought that the appearance of West Nile in North America was one of the most exciting things that he'd ever seen in his life. "My favorite hypothesis, at the moment, is that a human accidentally brought it here," he said. He thought it was quite possible for a single infected person to have passed through Kennedy International Airport, gone into Queens, and been bitten by a house mosquito, which in turn gave it to a bird. "Unlike most of its relatives, West Nile produces a lot of virus particles in the human bloodstream," Dr. Monath said. "Some people can develop about three thousand to ten thousand particles of the virus in every millilitre of their blood." A millilitre is roughly a quarter of an eyedropper. The particles of West Nile look like golf balls when photographed in an electron microscope. A Culex pipiens mosquito could suck multitudinous golf balls of West Nile into its gut while feeding on human blood.
"West Nile already knows Culex pipiens well, because that mosquito lives all over the world," Monath said. "But now the virus is encountering a whole new ecosystem in North America. Everything else will be unfamiliar to the virus -- the weather and climate, the ticks, many of the birds -- so it's got a job ahead of it in order to become established. Winter is coming on. In order to maintain itself and reproduce, it's got to find a suitable ecosystem. And it's got to find a mechanism for surviving the winter. Humans are just getting in the way. They have nothing to do with its survival. In Africa, it migrates with the birds. Right now, the birds of eastern North America are heading south for Florida and the Caribbean, and they will be going as far as Brazil and Argentina. We could see an outbreak of West Nile in Buenos Aires. It could also persist locally in the New York area, in hibernating mosquitoes. The virus may not be successful at overwintering, but if it is it will take us years to understand the impact and spread of West Nile in the New World."
On Wednesday, October 7th, a man in his twenties from Lakewood, New Jersey, reportedly became the first suspected case of West Nile-like encephalitis south of New York City. Last week, he was in critical condition. New Jersey health officials reported that they had picked up fifty dead crows around New Jersey; fifteen of them have tested positive for the virus. Tracey McNamara, at the Bronx Zoo, said, "I'm certain that the number of birds being reported dead is a gross understatement." A woman in Hopewell, New Jersey, found five dead blue jays and crows, but threw them away before health officials could pick them up.
AT sunrise a couple of days ago, I went up on a ridge overlooking the Hopewell Valley, near where I live. I walked to the top of a field. Trees stood in field lines all around. Birds were chirping, and I heard the squawking of a grackle. The trees were smoky and tinged with yellow. Cloud decks were moving in, and the sun had not yet risen. A fingernail of moon shone through breaks in the running clouds, and I picked out the morning star, Venus, a pinpoint of light near the moon. The sun rose, and Venus was washed away in the head of dawn. The birds started lifting off, and all were flying from north to south, except for two crows, who loitered in an ash tree at the bottom of the field like hoods on a corner, flapping around and looking for crow-excitement.
Three flycatchers wove for insects, weaving always southward. Two more flycatchers came by, going south, and three finches passed, going south, and a lone bird with sharp wings beat by, going south, and then three grackles humped along, keeping the rising sun on their leftward wings. Milkweed in the field was dying, its leaves turning brown at the edges. I broke open a milkweed pod, and two shockingly red beetles tumbled into my fingers. They'd been feeding on the milkweed and probably laying eggs. I tore out the milkweed seeds and threw them in the air. A few parachutes of milkweed deployed, and the seeds drifted across the field. Everything alive understood what was coming. What was coming, for many organisms, was death. For them, death was not what we think of as death but a means of survival. You die on purpose, to give your genes their best chance to spread out into the world and remain alive. This valley in New Jersey reminded me in a strange way of Kitum Cave, on Mt. Elgon, in East Africa, a haunting place I'd seen some years ago. Kitum Cave is suspected of harboring a type of the Ebola virus called Marburg, which is thought to carry on its life cycle inside some unknown animal that visits the cave or lives there. The natural host of the Ebola virus has never been identified. The cave in Africa and the field in New Jersey were two habitats bursting with life, and in them were viruses, active but unseen, carrying on their life cycles. I could not see Ebola in Kitum Cave any more than I could see West Nile pouring through the Hopewell Valley. However this biological event began, it has become something important in nature. In discovering the New World, West Nile has killed a few humans and managed to roil the C.I.A., but now it has more important business -- to find a way, somehow, to keep making copies of itself. If the virus continues migrating south with the birds, and if it finds a place to hide this winter, the only way we will know is if it comes back next year.