Earlier this month, it was almost unheard of. Now, it's part of our everyday vocabulary: anthrax.
So far, 17 people have contracted it. Four have died. Tens of thousands believed at risk have been put on antibiotics.
Government officials have seemed sometimes as baffled and confused as the rest of us. With each new diagnosis, concern has given way to worry; worry has given way to fear.
Richard Morgano, a New Jersey postal worker who scratched his arm on the job as early as September 20, was among the earliest victims.
"The arm got infected and it was hot, feverish, and it swelled up about two to three times its size," Morgano tells 60 Minutes II correspondent Vicki Mabrey. Now, a month later, the wound is healing, but it is still large.
The 39-year-old Morgano repairs machines at the Hamilton, New Jersey, post office, where at least three anthrax-laced letters were processed. But his symptoms appeared long before anyone was talking about anthrax.
At first, he says, it looked "like two bug bites, a mosquito bite or something. And then it turned black in the center and it began to, began to blister around the center."
On September 30, about a week after he cut his arm and 5 days before anybody knew about anthrax, he became concerned and went to the hospital emergency room.
"The emergency room doctor took a look at it and she didn't know what it was and she seemed like she wanted to stand back from me," Morgano says. " She looked scared. And she gave me a prescription for an antibiotic and a couple of gauze pads to wipe up what was leaking and then she wrapped the arm and said, 'See your doctor tomorrow, immediately.' "
The next day, when he saw his doctor, the doctor immediately thought it was anthrax.
"And then he began to ask me how did this come about, and he said, 'Were you around any animals? Were you around any farms? Were you around any pelts? Did you have anything to do with any wool? Anything like that.' All the answers were no," Morgano explains. " I had no idea how I could possibly have ever come in contact with anthrax in any way."
The doctor placed him on heavy antibiotics and monitored him closely. But 2 weeks later, when the anthrax-tainted letter to NBC's Tom Brokaw was discovered, the doctor's suspicions were confirmed.
"He said, 'You have to notify the postal service that I believe 99% that you had anthrax because the letter that came through the post office was postmarked in Trenton,'" Morgano says.
Morgano called the post office, and the FBI was brought in. He was tested for anthrax, and the FBI told him to keep quiet. But because he had already been on antibiotics for 2 weeks, his initial tests were inconclusive--and authorities decided to keep Morgano's post office open.
"They're saying that the building is safe, and I'm saying there's no way the building is safe. I know there's anthrax in here," Morgano says.
By October 14, when the FBspoke to him, the rest of us had learned about letters to a Florida newspaper office, NBC in New York, and the office of Senate Majority Leader Tom Daschle in Washington, DC. At the time, it seemed no one in authority thought about postal workers, because they didn't think anthrax could leak out of envelopes.
William Patrick may know more about anthrax than anyone in the country. In the 1960s, he was part of America's top-secret program to develop biological weapons. Now a CBS News consultant, Patrick says the post office was an unexpected but surprisingly efficient way of delivering anthrax, and he demonstrated how that could happen.
After the anthrax-laced letter is dropped in the mailbox, he says, "it's picked up by a very high energy system that moves the mail through high levels of energy, and that rapid mail equipment is essentially a very efficient munition. It's a very efficient munition . . . and that's why the postal workers are at such a grave, grave risk.
Tht was a risk that no one focused on. In the days after an anthrax letter arrived in Senator Daschle's office, Senate staffers were tested for exposure and congressional offices were closed. Even after it became clear that New Jersey postal workers were infected and their post office was closed on October 18, no one thought to close Washington's Brentwood facility, where all government mail is sorted.
That's where 47-year-old Joe Curseen worked. A 15-year veteran of the DC postal service who had never missed a day of work, Curseen began to feel ill the week the Daschle letter arrived. According to his sister, Joan Jackson, he was so sick he went to the emergency room.
Jackson said she became concerned when her sister-in-law told her Curseen, a man who drinks at least eight glasses of water a day, went to the hospital and was told he was dehydrated.
"I knew Joe worked at Brentwood," she says. "It was my understanding that all government mail comes through Brentwood and I was getting a deep concern within me for him."
Tragically, she was the only one concerned about anthrax. When Curseen went to the emergency room, doctors and nurses never asked where he worked and he never told him. They diagnosed the flu and sent him home. One day later, because inhalation anthrax causes respiratory failure, brain inflammation, and septic shock, he died. That day, the Brentwood postal facility finally was closed.
Jackson thinks things could have been handled better. "I don't personally point the blame," she says. "I feel, however, strongly, that whoever was in charge should have honed in on the Brentwood facility a lot faster, a lot faster. And perhaps this tragedy could have been avoided."
In this war with many fronts, the surprise anthrax attack has been difficult to define, each day bringing new details and new instructions from federal officials. This has led to widespread criticism that postal workers were left unprotected even after the threat was nown.
"As far as I'm concerned," says Morgano, "the moment I called them and told them, told them that I'm 99% sure I had anthrax, they should've shut that building down." That would have been October 13, a full 5 days before it was closed.
"I'm positive that anybody in maintenance was exposed and most of everybody that was working on the floor in that building was exposed," says Morgano.
In fact, three of Morgano's co-workers have been hospitalized with suspected cases of anthrax--two with the more dangerous inhalation form.
Morgano is angry at the Centers for Disease Control [the CDC] and the department of health. "We're paying these people to look into this type of thing," he says. "This should be a part of their protocol. If there were a bomb threat, they would have closed that facility in 5 minutes. They would have emptied that building, okay? But because it was an anthrax threat and they weren't really sure--well, let's wait a couple of days."
As soon as he learned of the first postal infection, Patrick says, he realized that the letters are sufficiently contaminated with anthrax spores so that when the energy of the mail-sorting process is applied to the envelopes, they create a deadly aerosol.
Instead of closing the Capitol, he says, authorities should have closed the post office.
Patrick believes there are more letters out there, a scary prospect, since according to Patrick, the 2 grams of anthrax found in the Daschle letter--if dispersed in a more effective way--is enough to infect, and possibly kill, millions of people.
Although Patrick knows as much about anthrax as anyone else in the country, he had not been contacted by the CDC, the Department of Health and Human Services, or the Office of Homeland Security.
Knowledge seems to be in short supply these days but there's plenty of confusion, from top officials in government all the way down to the physicians working on the front lines.
"The firsrule in medicine, really, is you see what you know and you know what you see," says Dr. Alan Zelicoff, an immunologist and biophysicist at Sandia National Laboratory in New Mexico. "And if you haven't seen a case of anthrax before, a case of smallpox, you're not likely to recognize it or make the diagnosis. When you think about the hundreds of things that physicians have to rule in and rule out in their everyday experience, it's really asking a little bit too much of most physicians to recognize exotic diseases that are rarely ever reported in the United States."
Zelicoff has devised a solution to that problem and is testifying about it in front of Congress Thursday. It's an early warning system where doctors can input suspicious symptoms so that public health officials can track potential outbreaks.
"For example, if I clicked in an 18-30-year-old male with an influenza-like illness and an abnormal chest X-ray with a wide mediastinum, your doctor doesn't know this in general, bt the public health officials know that this is anthrax until proven otherwise. And if the system finds that, it automatically faxes, emails, and pages the state epidemiologist on call in every jurisdiction in the country."
They call the doctor immediately and warn him not to let the patient go.
Catching the first signs of an outbreak, Zelicoff says, can mean the difference between a few casualties or thousands.
"Were there to be an outdoor aerosol release of anthrax in a major metropolitan area," he says, "the difference between losing and saving a large segment of the population that's been exposed--60, 70, 80% of that population--really comes down to making the diagnosis within a few hours. Because the logistics of getting to all of those people, getting them the drugs they need, doing the testing that needs to be done, is already a problem. And you want to narrow the diagnosis time as much as you possibly can. So hours can make an enormous difference."
Patrick agrees that an early warning system will help but hopes that government agencies could handle an even bigger test.
While this anthrax attack caused widespread fear, stopped the mail service, and disrupted American life, Patrick says, it was, from the standpoint of biological warfare, a very mild attack. He doesn't believe the country can deal with a major attack, although it is gearing up for it:
"You know," he says, "Americans only respond to critical situations, and therefore we have a history of this. We have to be hit in the head by a two-by-four before we start to gear up. And we've been hit by a two-by-four, and now I think we're going to do something about it."
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