Senators said the Centers for Disease Control and Prevention, whose doctors are the nation's front line against bioterror, was too slow to test workers at a Washington postal station that handled an anthrax-laced letter sent to Senate Majority Leader Tom Daschle.
"I am very concerned about what CDC is doing and how they are operating," said Sen. Tom Harkin, D-Iowa, at a bioterror hearing. "Maybe I'm wrong, but it just seems to me that something broke down here. People are getting sick and people are dying."
CDC director Dr. Jeffrey Koplan defended the agency, saying its doctors were acting on the best information they had in an investigation that was unheard of just weeks ago.
"We are health officials," he told a Senate hearing. "These are tragedies for us as well and not something we take lightly. But you've got to know about cases to take action."
Two Washington postal workers died of inhalation anthrax Monday, one week after the anthrax-laced letter arrived in Daschle's office. At least three other postal workers one in New Jersey are hospitalized with inhalation anthrax.
All worked in centers that handle mail sent to Congress, but none of those workers were immediately called in for anthrax testing or given preventive antibiotics.
"They closed the House building down while we were in there inhaling it," said Abraham Odom, a package sorter at the Brentwood Road center. "That's not right. That's not fair. This stuff is supposed to be deadly."
The CDC's Dr. Rima Khabbaz, an infectious disease specialist, said the agency was "on a steep curve of learning" and was re-evaluating its response.
Officials said that early testing at some sites led them to believe there was little risk to postal workers, and the anthrax cases in recent weeks had involved skin infections, less dangerous than the inhaled form.
Although Tuesday's hearing produced the sharpest criticism of the Atlanta-based agency, questions about the CDC's response to bioterror had been mounting since the first anthrax death in Florida on Oct. 5.
Public health experts outside the government said the agency was slow to alert doctors to the threat of other bioterror agents and didn't do enough to calm a jittery nation ill-informed on the particulars of anthrax.
CDC was publicly silent as the investigation began in Florida, deferring questions to state and local health officials.
"The only people who can bring order to this is people like CDC," said Dr. Alfred Sommer, dean of public health at Johns Hopkins University. "This is a national crisis. This should be their day."
He questioned why in Florida CDC didn't hold daily briefings to help sort out conflicting information and inspire national confidence that the scare was in the hands of medical expers.
Presenting the image that health workers are directing the response not politicians or investigators is a key part of CDC's mission, said Dr. Gregg Wilkinson, epidemiology chairman at the University of North Texas' public health school.
"I think that there's a bit of an overreaction on the part of many members of the public. People are not using their heads," he said. "That's where CDC and public health agencies need to calm people's fears."
CDC spokesmen say they were initially restricted by the parent agency, the Department of Health and Human Services, and the FBI investigation and federal emergency laws.
Georgia's Sen. Max Cleland came to CDC's defense: "The only time they've been throttled back is for national security. They're the best in the business, and thank God we have them."
Established in 1946 to promote Americans' health by preventing disease and injury, the CDC is accustomed to doing its most dangerous work behind the scenes. It covers everything from tracking the flu to stopping gun violence. It rarely discusses the research it performs in high-security labs on the world's deadliest pathogens.
Soon after anthrax appeared in Florida, the CDC's disease detectives were dispatched to investigate. At its Atlanta headquarters, officials set up a crisis center, with dozens of scientists processing tests.
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"We're working around the clock," said Dr. Julie Gerberding, acting deputy director of CDC's infectious disease branch. "Our capacity to address the emerging threats is one that is evolving as the threat situation evolves."
"No one doubts the urgency of this," said Dr. John Ward, editor of a weekly CDC bulletin. "It's very reminiscent of CDC's response to the early days of the AIDS epidemic."
But even as criticism of the agency was unleashed, congressional leaders were moving toward pouring hundreds of millions of dollars into the agency, which still has some operations in World War II-era buildings.
To justify the spending, some lawmakers point to another failure early in the anthrax scare: Bad wiring caused a power outage at CDC that delayed by 15 hours the agency's ability to identify the anthrax case at NBC News.
"We have a crisis in America today, and CDC is at the point of the spear," said Rep. Saxby Chambliss, R-Ga., chair of the House terrorism subcommittee. "These folks are doing a great job. But they need to have the resources to do a better job."
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