Isegoria

The first recorded outbreak of the virus we now call the Marburg virus occurred in 1967, Ken Alibek explains (in Biohazard), at the Behring pharmaceutical works in Marburg, an old university town seventy miles north of Frankfurt:

An animal keeper died two weeks after he contracted a mysterious illness from green monkeys sent to the Behring lab from central Africa. The lab was culturing vaccines in kidney cells extracted from the monkeys. Other workers soon fell sick, and similar cases were reported at laboratories in Frankfurt and Belgrade, both of which had received shiploads of green monkeys from central Africa at the same time.

Twenty-four lab technicians came down with the unknown disease, along with six of the nurses caring for them. Of the thirty-one people infected, seven died. This kind of undiagnosed outbreak would be alarming enough, but it was the horror of their deaths that caught the attention of biologists and tropical disease specialists around the world.

The mysterious virus appeared to liquefy body organs. One of the survivors went mad after the organism chewed away his brain cells. Before the victims died, every inch of their bodies was wet with blood.

Following tradition, the virus was named after the place where it was first identified. It would alter forever the image of a city that has been a center of European philosophy, science, and religion for centuries.

Some of the world’s greatest bacteriologists and biochemists have studied at Marburg—including Albrecht Kossel, whose research laid the groundwork for the discovery of DNA, and Alexandre Yersin, a codiscoverer of the plague bacterium (named Yersinia pestis after him). The lab in which Marburg was first smeared on a glass slide was itself named after the man credited with founding the science of immunology—Emil von Behring.

A similar virus surfaced nine years later on the banks of the Ebola River in Zaire, now the Democratic Republic of Congo. By the time that epidemic died out, 430 people were dead in Zaire and nearby Sudan.

[…]

Under an electron microscope, both organisms seemed to proliferate by shooting out tiny filament-like threads, like the lines cast by fishermen, from the cells they had already scoured for the food they needed to grow. The threads were often bent at the top, like fishing hooks, and as they prepared to invade a new cell they curled into rings, like microscopic Cheerios. Marburg and Ebola were deemed to belong to a new family of viral organisms. They were called filoviruses.

[…]

Ebola’s mortality rate is between 70 and 90 percent.

Naturally the Soviets developed weaponized versions:

A strain of Marburg arrived in the Soviet Union a decade after it was first isolated, during one of our periodic global searches for promising material. It wasn’t clear from the records whether we obtained it from the United States or directly from Germany, but it was immediately added to our growing collection of viral warfare agents. We were already investigating a number of microorganisms that weaken blood vessels and cause hemorrhagic fevers, such as Junin from Argentina and Machupo from Bolivia.

And, naturally, accidents occurred:

Ustinov had been conducting a series of experiments with guinea pigs and rabbits to monitor the effects of increasingly higher concentrations of Marburg. The injection of such a highly concentrated dose directly into his thumb meant that he now had hundreds, perhaps thousands of times more particles of the virus coursing through his body than any of the victims in Germany. I thought his chances of survival were near zero.

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This was less than two years after Chernobyl; the Soviet Union was in no mood for a new disaster.

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No technician should have worked long hours with such a contagious organism. People tired easily in the heavy protective suits required for Zone Three. Their reflexes slowed down, and it was easy to become careless. Adding to our problems, Marburg research had begun at Vector before a supply of antiserum was on hand.

Ustinov’s illness lasted nearly three weeks. Throughout that time, none of his colleagues was allowed to stop working.

[…]

Ustinov had been injecting Marburg into guinea pigs with the help of a lab technician, working through a glove box. He was not in a full space suit and was wearing two thin layers of rubber gloves instead of the thick mitts normally required for such work in Zone Three. The gloves provided the flexibility to control the laboratory animals, who will otherwise squirm and try to wriggle out of a technician’s grip.

Our rules required that animals targeted for injection be strapped to a wooden board to hold them securely in place. That day, Ustinov wasn’t following procedure. He decided to steady the guinea pigs with his gloved hand. Perhaps he thought it would help calm them. Or perhaps he was in too much of a hurry.

The technician became distracted and nudged him accidentally. Ustinov’s hand slipped just as he was pressing down on the syringe. The needle went through the guinea pig and punctured his thumb, drawing blood.

The needle went in no farther than half a centimeter, but the faint spot of blood indicated that liquid Marburg had entered his bloodstream. As soon as he realized what had happened, Ustinov called the duty supervisor from the telephone inside the lab.

From then on, the procedures established for such emergencies were followed to the letter. Doctors and nurses dressed in protective suits were waiting for him as he emerged from the disinfectant shower. They rushed him to the small hospital in the Vector compound, a twenty-bed isolation facility sealed off from the outside with thick walls and pressure-locked doors.

[…]

Within a couple of days he was complaining of a severe headache and nausea. Gradually, he became passive and uncommunicative, as his features froze in toxic shock. On the fourth day his eyes turned red and tiny bruises appeared all over his body: capillaries close to his skin had begun to hemorrhage.

Ustinov twitched silently in his bed while the virus multiplied in his system. Too tired to speak, or to turn over, or to eat, he would drift in and out of consciousness, staring for long periods of time at nothing. Occasionally, lucidity would return. He called for paper during those brief moments to record the progress of the virus as it foraged through his body. Sometimes he burst into tears.

On the tenth day, his fever subsided and he stopped retching. As brilliant a scientist as he was, Ustinov began to entertain the delusion that he was improving. He started smiling again and asked about his family.

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By the fifteenth day, the tiny bruises on Ustinov’s body had turned dark blue, and his skin was as thin as parchment. The blood pooling underneath began oozing through. It streamed from his nose, mouth, and genitals. Through a mechanism that is still poorly understood, the virus prevents normal coagulation: the platelets responsible for clotting blood are destroyed. As the virus spreads, the body’s internal organs literally begin to melt away.

Shuddering bouts of diarrhea left rivers of black liquid on his sheets. The scraps of paper on which he had been scribbling his symptoms and which the nurses had gingerly carried out to transcribe each day no longer littered the floor. There was nothing more to write.

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Each viral particle, or virion, forms a brick that pushes against the cell walls until they burst. The cells then sprout wavering hair-like antennae that home in on their next target, where the process of foraging and destruction blindly repeats itself.

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The doctors from the Ministry of Health arrived early in the first week with the antiserum. To no one’s surprise, it proved useless. Antiviral drugs such as ribavirin and interferon were also tried. Hemorrhagic fevers can sometimes be treated with whole-body blood transfusions, but the medical team concluded that it would in this case be ineffective.

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I don’t know how the senior levels of our bureaucracy reacted to Ustinov’s death, but no condolence letter was ever sent to his widow. Sandakchiev asked us for ten thousand rubles as special compensation for his family in addition to the normal pension survivors were entitled to. It was a princely sum in those days, and Kalinin balked at first, but he finally approved the request.

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The risk of contagion made normal interment impossible, so his corpse was covered with chloramine disinfectant and wrapped in plastic sheeting. The remains were placed inside a metal box, welded shut, and fitted into a wooden coffin. Only then was it safe to lay him in the ground.

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The small group of mourners included Ustinov’s immediate family, his closest colleagues, and a cordon of KGB agents who had worked frantically to keep the circumstances of his illness secret. No one came from Moscow.

Regulations prohibited the circulation of any reports about accidents, fatal or otherwise, but news of the tragedy spread quickly through The System.

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A virus grown in laboratory conditions is liable to become more virulent when it passes through the live incubator of a human or an animal body. Few were surprised, therefore, when samples of Marburg taken from Ustinov’s organs after his autopsy differed slightly from the original strain. Further testing showed that the new variation was much more powerful and stable.

No one needed to debate the next step. Orders went out immediately to replace the old strain with the new, which was called, in a move that the wry Ustinov might have appreciated, “Variant U.”

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After testing the weapon in explosive chambers, we applied it to the monkeys. Every one of the twelve monkeys contracted the virus. They were all dead within three weeks.

In early 1990, Marburg Variant U was ready for approval by the Ministry of Defense.

Our scientist had found it more difficult to cultivate Ebola than Marburg—they were not able to reach the necessary concentration—but by the end of 1990, the long-term problem of cultivation had been solved and we were close to developing a new Ebola weapon. Meanwhile, at Zagorsk (Sergiyev Posad) military scientists were putting the finishing touches on new Lassa fever and monkey pox biological weapons.

Of all the diseases that have tormented mankind, Ken Alibek explains (in Biohazard), smallpox has left the oldest and the deepest scars:

Recorded as early as 1122 B.C. in China, it altered the course of history, ravaging eighteenth-century Europe and decimating the native populations of North America. Smallpox comes from the pox family of viruses, which assault the upper respiratory tract. Variola major, the scientific name by which the smallpox virus is known, is patient and systematic. It will begin by insinuating itself into cells close to the surface of the skin and in the neural system. The smallpox virus sheds its shell as soon as it enters a live cell, and quickly begins to multiply. Viral transcription begins almost immediately, inhibiting DNA synthesis and thereby preventing the cell from activating its defense mechanisms. Once the virus has inserted its genetic information into the host cell, proteins and enzymes are created to help it mature and develop. The progress of the virus can be mapped by the spread of tiny pink spots from the face and arms to the lower regions of the body.

Smallpox symptoms were once familiar to every doctor. After a quiet incubation period of five to ten days, the virus manifests itself suddenly. The first stage of the disease brings high fever, vomiting, headache, and a strange stiffness. This can last from two to four days. Within less than a week, small spots will begin to develop, forming a rash around the face. As the rash spreads over the following week these spots will develop into painful blisters. In the normal course of the illness, the blisters form scabs that linger for several weeks until they dry and fall off, leaving scars. More severe forms of black or red pox can lead to death within three to four days.

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On May 8, 1980, the World Health Organization announced that smallpox had been eradicated from the planet. The last naturally occurring case was reported in Somalia in 1977, and no new cases had been detected in three years. The WHO recommended the discontinuation of smallpox immunization programs, observing that there was no longer any need to subject people to even the negligible risk connected with vaccination.

The international agency simultaneously adopted a resolution restricting the world’s stocks of smallpox to four sites, where limited quantities would be available for research purposes. A few years later, the sites were narrowed down to two: the Centers for Disease Control in Atlanta and the Ivanovsky Institute of Virology in Moscow.

The conquest of smallpox generated a special feeling of accomplishment in the Soviet Union: the worldwide crusade against smallpox had been a Soviet initiative. Moscow first proposed the campaign at a World Health Organization meeting in 1958, and its sponsorship of vaccination programs in the third world won it admirers everywhere. Russia had suffered its share of smallpox outbreaks over the centuries, finally managing to eliminate the disease in 1936, after a decade-long immunization program sponsored by the fledgling Bolshevik government.

Soon after the WHO announcement, smallpox was included in a list of viral and bacterial weapons targeted for improvement in the 1981–85 Five-Year-Plan.

Where other governments saw a medical victory, the Kremlin perceived a military opportunity. A world no longer protected from smallpox was a world newly vulnerable to the disease.

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In 1947, the Soviet Union established its first smallpox weapons factory just outside the ancient cathedral town of Zagorsk, forty minutes’ drive northwest of Moscow. Zagorsk (now Sergiyev Posad) is the site of the

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A few miles away, in another walled compound, Soviet army scientists at the Virological Center of the Ministry of Defense devoutly cultivated smallpox, Q fever, and Venezuelan equine encephalitis in the embryos of chicken eggs.

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Using tiny syringes, laboratory workers injected microscopic amounts of smallpox virus into eggs and sealed each egg with paraffin. The eggs were placed inside thermostatic ovens for several days while the embryo host cells stirred the virus into life. As it monopolized the cells’ normal growth mechanisms, the virus spawned successive replications of itself until the host was engulfed or destroyed. The eggs were then punctured and the liquid inside poured into special vats and mixed with stabilizing materials. The resulting weapon could remain potent in refrigerated conditions for at least a year.

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Under a state-controlled agricultural system it was easy to conceal the purpose of hijacking so many eggs from the marketplace.

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In 1959, a traveler from India infected forty-six Muscovites with smallpox before authorities realized what had happened. The traveler had been vaccinated, but smallpox vaccinations lose their effectiveness over time, and while his weakened immunity was enough to protect him from suffering the symptoms of the disease, he could still pass it on to others. The strain of Variola major in his system was so virulent that an epidemic was only narrowly averted. Partly in response to this incident, the Soviet government sent a special medical team to India to help purge the virus from the subcontinent.

KGB agents went with them.

They returned to Russia with a strain of Indian smallpox excellently suited to weapons production.

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In the 1970s, smallpox was considered so important to our biological arsenal that the Soviet military command issued an order to maintain an annual stockpile of twenty tons. The weapons were stored at army facilities in Zagorsk. Annual quotas of smallpox were required as it decayed over time.

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The smallpox virus is so hardy that it can remain infectious for long periods, even in the soiled linen of those who have been infected. Smallpox victims are infectious from the moment of their first symptoms until the healing of the last scar, two to three weeks later, and they can transmit the disease to others with as little as a cough.

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Humans are the virus’s only natural hosts. There is no way, therefore, for the disease to propagate in nature.

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There are no therapeutic measures currently available to treat smallpox once symptoms develop.

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Smallpox kills between 30 and 50 percent of unvaccinated victims, a low mortality rate, but its morbidity rate ranges from 60 to 90 percent. For many people, contracting smallpox amounts to a life sentence. Some victims are permanently blinded. Others will bear scars as long as they live.

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Schoolchildren in the United States, Russia, and elsewhere around the world are not vaccinated against the disease, and international travelers are no longer required to show proof of smallpox immunity.

Today there are twelve million doses of smallpox vaccine on hand in the United States—of which only seven million are fully reliable, according to the Centers for Disease Control in Atlanta—a portion of the roughly two hundred million doses available in the world. This sounds like a comfortable amount to meet an emergency, until you consider the damage a smallpox attack would do in a densely populated commuter city like New York.

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During World War II the Western allies explored the possibility of weaponizing several viral diseases, including Venezuelan equine encephalitis and smallpox. American, Canadian, and British scientists found to their frustration that viruses were far more difficult to manipulate than bacteria.

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Aerosols were still in the early stages of development in the 1940s, and most of the approaches considered by the Allies for weaponizing smallpox seem strange today. One method involved grinding an Asian strain of smallpox into a fine powder to dust over letters. By the time the war ended, the Allies had largely given up on weaponizing viruses.

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Fewer than five viral particles of smallpox were sufficient to infect 50 percent of the animals exposed to aerosols in our testing labs. To infect the same percentage of humans with anthrax would require ten thousand to twenty thousand spores. For plague, the comparable figure is fifteen hundred cells. The differences in quantity are too minute to be discernible to the naked eye, but they are significant if you are planning attacks on a large scale. Smallpox requires almost no concentration process.

While we had clung to our egg-and-conveyor-belt method of making smallpox, Western pharmaceutical labs were manufacturing vaccines in special reactors from cultures grown in tissue cells obtained from animals or humans. This technique required expertise.

The word virus, Ken Alibek explains (in Biohazard), comes from the Latin term for poison:

Viruses are invisible under most microscopes and hundreds of thousands of times smaller than a grain of sand. Their existence was unsuspected until Dmitry Ivanovsky, a Russian microbiologist, discovered them in the late nineteenth century while investigating an outbreak of mosaic disease in tobacco plants. Ivanovsky found that the mysterious agent responsible for this disease was able to pass through filters that otherwise blocked bacteria. Over half a century would pass before the first virus was seen and identified under an electron microscope, but Ivanovsky’s discovery launched a new field of research into infectious diseases.

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The immune system works on many levels at once, like an army with scouts and infantrymen, naval and air power, a sophisticated information network, and a carefully delineated command structure. Some cells are responsible for surveillance, others for coordinating information; some focus on local maneuvers while still others direct more general attacks. Immunologists distinguish between specific and nonspecific immunological reactions. Specific or acquired immune responses depend on memory cells, which store information about previous invaders and thus play a significant role in conferring immunity.

Among the most important agents in the immune system are T cells. They act as scouts, circulating through the bloodstream and moving into lymph nodes, on the lookout for foreign substances. As soon as a virus enters the bloodstream and infects its first cell, it will be recognized by T cells, which immediately activate, replicating themselves and sending out signals, calling for the formation of antibodies and attracting them to the site of infection. Antibodies are like ground troops. They are particularly effective at attacking viruses and bacteria that are still coursing through the system, before they have infiltrated target cells.

Within seconds of infection, defensive proteins and inflammatory agents are released, which activate natural killer cells and lead them to the site of infection. Interferon, one of the most powerful antiviral agents, degrades viral RNA, slows down protein synthesis, and inhibits viral reproduction in infected cells.

By the end of the first week or the beginning of the second, the body will in many cases have developed virus-specific antibodies, which sometimes seek to neutralize the virus by binding to its surface and preventing it from penetrating into new cells. But viruses are adept and mutate quickly. Countless are now capable of inhibiting and neutralizing the body’s natural defenses, rendering their resistance ineffective.

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More than one hundred different viruses have been identified as causes of the common cold.

By 1986, Ken Alibek explains (in Biohazard), they had over 900 people at the bioweapons plant, and more were coming every month:

There were one or two accidents every week.

Once Gennady Lepyoshkin, the chief of our biosafety directorate, reported that a technician had been infected with anthrax in a lab that was supposed to be sterile. He had an abrasion on his neck, one of the most dangerous places in the body through which to contract cutaneous anthrax. When the neck swells, it interferes with breathing.

At first we treated him with streptomycin and penicillin, the most effective antibiotics for use against cutaneous anthrax, but a painful swelling erupted on his chest and spread over his body, making it increasingly difficult for him to breathe. Within three days, death seemed inevitable. A gloomy message was being prepared for Moscow when, in a final attempt to save his life, we gave him an abnormally high dose of anthrax antiserum. The shock dose worked: he began to recover.

The technician’s narrow escape drove home the potency of our new weapon. Our powdered and liquid formulations of anthrax were three times as strong as the weapons that had been manufactured at Sverdlovsk. It would take only five kilograms of the Anthrax 836 developed at the Kazakhstan base to infect half the people living in a square kilometer of territory; the Sverdlovsk weapon needed at least fifteen kilograms to achieve the same impact.

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Our factory could turn out two tons of anthrax a day in a process as reliable and efficient as producing tanks, trucks, cars, or Coca-Cola.

Ken Alibek explains (in Biohazard) the Sverdlovsk anthrax leak of 1979:

The story went public a few months later—in a way. In November 1979, a Russian magazine published by anti-Soviet émigrés in what was then West Germany reported that an explosion in a military facility in the southwest section of Sverdlovsk had released a cloud of deadly bacteria the previous April. It claimed that as many as a thousand people had died. Western news agencies picked up the story, quoting U.S. intelligence officials who claimed that the accident was clear evidence of Soviet violation of the 1972 Biological Weapons Convention.

Moscow denied the reports. On June 12, 1980, a statement published by the official Soviet news agency TASS declared that there had only been a “natural outbreak of anthrax among domestic animals” in the Sverdlovsk region.

“Cases of skin and intestinal forms of anthrax were reported in people, because dressing of animals was sometimes conducted without observing rules established by veterinary inspections,” the statement said, adding that all of the patients had been treated successfully in local hospitals.

This was a lie, of course.

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I learned the truth by talking to people who had been at the plant when the accident happened, and to army officers who had been in charge of the cleanup.

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As I rose higher in The System, I applied some of the lessons of Sverdlovsk to the plants under my control.

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On the last Friday of March 1979, a technician in the anthrax drying plant at Compound 19, the biological arms production facility in Sverdlovsk, scribbled a quick note for his supervisor before going home. “Filter clogged so I’ve removed it. Replacement necessary,” the note said.

[…]

The fermented anthrax cultures had to be separated from their liquid base and dried before they could be ground into a fine powder for use in an aerosol form, and there were always spores floating in the air. Workers were given regular vaccinations, but the large filters clamped over the exhaust pipes were all that stood between the anthrax dust and the outside world.

After each shift, the big drying machines were shut down briefly for maintenance checks. A clogged air filter was not an unusual occurrence, but it had to be replaced immediately.

Lieutenant Colonel Nikolai Chernyshov, supervisor of the afternoon shift that day, was in as much of a hurry to get home as his workers. Under the army’s rules, he should have recorded the information about the defective filter in the logbook for the next shift, but perhaps the importance of the technician’s note didn’t register in his mind, or perhaps he was simply overtired.

When the night shift manager came on duty, he scanned the logbook. Finding nothing unusual, he gave the command to start the machines up again. A fine dust containing anthrax spores and chemical additives swept through the exhaust pipes into the night air.

Several hours passed before a worker noticed that the filter was missing. The shift supervisor shut the machines down at once and ordered a new filter installed. Several senior officers were informed, but no one alerted city officials or Ministry of Defense headquarters in Moscow.

In the next few days, all the workers on the night shift of a ceramic-making plant across the street from the facility fell ill. The plant had been directly in the path of the wind that night. Within a week, nearly all of them were dead.

By then hospitals were admitting dozens of patients from other areas of town who had worked in the plant’s vicinity. Curiously, there were few women or children among the victims. Years later, some Western analysts wondered if the Soviets had developed a “gender weapon” capable of attacking only adult males. But women seldom worked night shifts in production plants, and few children would have been playing in the streets late on a Friday night.

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That it happened on a Friday night helps explain why the workers were so anxious to get home and why so many people had passed by that evening, heading for a drink at a nearby bar.

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The Soviet Union later claimed that 96 people were stricken with the disease and 66 died. The scientist who was working in the Sverdlovsk facility at the time told me the death toll was 105, but we will probably never know for sure.

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Sverdlovsk residents were informed that the deaths were caused by a truckload of contaminated meat sold on the black market. Printed fliers advised people to stay away from “unofficial” food vendors. More than one hundred stray dogs were rounded up and killed, on the grounds that they represented a danger to public health after having been seen scavenging near markets where the meat was sold. Meanwhile, military sentries were posted in the immediate neighborhood of the plant to keep intruders away, and KGB officers pretending to be doctors visited the homes of victims’ families with falsified death certificates.

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A Northwestern University physics professor named Donald E. Ellis, who was in Sverdlovsk at the time on an exchange program, reported that he noticed nothing unusual in the city. “I don’t exclude the possibility that something may have occurred,” he told The New York Times years later, “but I think either I or my wife would have sensed some effort to protect us from it. We … were not aware of any restrictions.”

[…]

“We couldn’t understand why people continued to die,” a general who was there told me much later. “We assumed that this was a quick, one-time exposure and that our mopping-up would be completed in a few days, but there were deaths for a month and a half after the release.”

The coverup was responsible for turning what began as a medical emergency into a small epidemic.

The local Communist Party boss, who was apparently told that there had been a leak of hazardous material from the plant, ordered city workers to scrub and trim trees, spray roads, and hose down roofs. This spread the spores further through “secondary aerosols”—spores that had settled after the initial release and were stirred up again by the cleanup blitz. Anthrax dust drifted through the city, and new victims arrived at the hospitals with black ulcerous swellings on their skin.

The cutaneous form of anthrax, contracted when spores enter the body through a cut or abrasion on the surface of the skin, occurs naturally in rural areas around the world, especially those with large herds of domestic cattle, sheep, and goats. It is the most common form of anthrax and is rarely lethal when treated with antibiotics such as penicillin. Russians refer to it as the “Siberian ulcer,” as it manifests itself through the formation of small and localized lesions on the surface of the skin. An outbreak of cutaneous anthrax in the region was credible, but it wouldn’t explain why so many factory workers, who could have had no contact with animals, were suddenly sick, or why so many died.

Anthrax spores can survive for years—even decades—in a dormant state. Animals will become infected while foraging for food. The spores germinate in a matter of hours and multiply in their hosts, returning to spore form when they die or on contact with oxygen. Men and women who work with infected animals—butchers, tanners, farmers, and workers in textile mills—become infected in turn through abrasions, by inhaling spores or drinking contaminated water, or, in rare cases, by eating contaminated meat.

[…]

Inhalational anthrax was first identified in the early nineteenth century when workers in a textile mill were exposed to spores released into the air by the new industrial processes developed to make wool. It is often called wool sorters’ disease.

As soon as an anthrax spore enters the body it germinates and begins to multiply. A few days will pass before the anthrax bacteria produce toxins which, in the simplest terms, bind to the protective membranes of target cells and cripple the ability of white blood cells to fight off disease. It is the toxin, and not the bacterium itself, that ravages the body and is responsible for death. If an anthrax victim is treated with high doses of penicillin injected into the bloodstream at short intervals for a week to ten days before the first toxins are released, chances of survival are almost 100 percent. But antibiotics can do little to fight the anthrax toxin. Combinations of penicillin and streptomycin have been used at this stage, but the prognosis is grim.

The headlong trajectory of pulmonary anthrax can be blocked if penicillin is administered before the first symptoms appear. I was told that thousands of Sverdlovsk residents were given antibiotics and vaccinated immediately after the first cases were reported, but it was too late to save the victims who had already begun to suffer from the fever, shortness of breath, and distinctive dark swellings along their chest and neck that mark the onset of pulmonary anthrax.

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I was told by army personnel involved in the cleanup that the corpses of the victims were bathed in chemical disinfectants and that much of the documentary evidence, including hospital records and pathologists’ reports, was destroyed. To add verisimilitude to the cover story, several black-market vendors in Sverdlovsk were imprisoned on charges of selling contaminated meat.

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The Communist Party chairman of Sverdlovsk at the time of the accident was Boris Yeltsin, the first leader of post-Soviet Russia.

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In 1981, Brezhnev signed a secret decree ordering the relocation of all biological weapons-making equipment and materials from Sverdlovsk to Stepnogorsk, a small biological research facility operated by Biopreparat in the remote deserts of northern Kazakhstan.

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For the good of our biological warfare program, Chernyshov’s mistake had to be kept quiet. A thorough investigation of what had happened in Compound 19 would raise too many awkward questions even inside our own government about our activities. This was further proof that secrecy was valued above all else in our system—even if it endangered our own safety. In the West, an accident of such magnitude would have been investigated ad nauseam and its lessons distributed, however quietly, to those working in similar areas. Our coverup virtually guaranteed further disasters.

A few months later I ran into another veteran of Sverdlovsk, Lieutenant Colonel Boris Kozhevnikov. In the year following the accident, he told me, a work crew was ordered to take a boxload of 250-liter containers filled with dried anthrax to storage bunkers inside Compound 19. Kozhevnikov had been assigned to escort the workers as they rolled the containers on carts toward the bunker a few hundred feet away. One cart hit a bump, and a container fell open. I was aghast.

“What did you do?” I asked him.

“I just closed it.” He shrugged.

Hastily, he added that he had ordered disinfectant poured everywhere. No one had fallen sick. And, of course, his superiors were not informed.

Ken Alibek describes (in Biohazard) a time he was called into the lab to handle a problem:

I stripped my clothes off and stuffed them into one of the lockers lining the walls. Then I walked into a second room, where a young nurse sat behind a desk. I had a nodding acquaintance with her outside the lab, having seen her walking her large dog, and was embarrassed at first to appear before her naked. But she always maintained a businesslike air as she wordlessly stuck a thermometer under my armpit and examined every inch of my body, including my teeth and gums. Any sign of bleeding from a cut or bruise, even from a nick while shaving, was grounds for barring further entry.

The buzz of the ventilators grew louder as I passed through the next rooms, picking up the separate items of my anti-plague suit: white socks and long johns, hood and cotton smock, respirator, goggles, boots, and gloves. The entire procedure was reversed on the way out, although the gloves were always the last to come off. Even with long practice, I never managed to complete the process in under fifteen minutes. That night, I was faster than usual.

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The air pressure in the pipeline feeding one of the tularemia rooms had begun to drop precipitously. A technician had been working there an hour or so before, but she had gone home. She may have forgotten to reset the valves.

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I opened the door and took a few steps inside. It was pitch black. I reached back, groping in the darkness for the light switch. When I finally hit the switch and looked down, I found I was standing in a puddle of liquid tularemia.

It was milky brown—the highest possible concentration. The puddle at my feet was only a few centimeters deep, but there was enough tularemia on the floor to infect the entire population of the Soviet Union.

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I was only two feet or so from the doorway, but I was trapped. If I tried to back out I would bring the disease with me into the corridor—and, potentially, into the rest of the zone.

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I poured the solution over my boots. He handed me more bottles as I moved backward, tiny step by tiny step, pouring all the time.

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The change in air pressure must have caused the culture to escape through the filter system.

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I tried to imagine what might have happened if I had lost my footing on the slippery floor.

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When we regrouped in Zone One, I advised Nazil and the others to take the antibiotics we had on hand for emergencies.

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It didn’t occur to me that such a minor mishap would need to be relayed up the chain of command, but the KGB chief in Kirov had called his bosses in Moscow, who called Kalinin early that morning.

By then, the story had become hopelessly mangled.

[…]

I had told Nazil and the others to take antibiotics, but for some inexplicable reason I hadn’t taken any myself.

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By the time I’d left Building 107 that night, I had been completely disinfected. I must have caught the disease in a matter of seconds, between leaving the sanitary passageway and entering the shower. But how? Then it came to me. I must have brushed my face while taking off my mask and hood. A hundred cells, an amount smaller than a speck of dust, would have been enough to infect me through an imperceptible cut or scratch.

[…]

Tularemia can be inhaled or ingested or contracted through bites or scratches. It rarely passes directly from person to person, but it can be carried by fleas, ticks, rats, and other rodents and can enter the bloodstream through minor abrasions. The disease is marked by a sudden onset of fever and chills, often followed by an incapacitating headache. As soon as it enters the body, the bacteria will begin to multiply locally, gradually spreading to lymph nodes and distant organs, including the liver and spleen.

Even after successful antibiotics were developed in the 1940s, tularemia was considered an ideal weapon for the battlefield due to the speed with which it could overwhelm an opponent’s medical resources, leaving hospitals and physicians unable to cope with a flood of patients in need of constant treatment.

If taken immediately, antibiotics can contain the spread of the disease and kill invading bacteria in a matter of days. The later the drugs are administered, the longer a victim will suffer. Particularly acute cases have been known to linger for months.

Tetracycline was thought to be the best antidote for tularemia, but I had no way of knowing how well it would work against the strain we had produced in our lab. In exceptional cases, certain highly virulent strains are capable of overcoming ordinary antibiotic treatment and can be fatal.

I called a friend’s wife, a physician at the local hospital, and told her I needed tetracycline urgently. Under normal circumstances I would have required a prescription, but in a small town it was easy to cut corners.

“How much?” she asked, without registering the least surprise.

Calculating quickly, I asked for three times the customary dose. There were advantages to Soviet secrecy. I would have had a hard time getting that amount of tetracycline in the United States without a good explanation. I told her not to tell anyone.

I wanted a high-impact, crash dose. If it didn’t work, I’d have to check myself into the hospital. Self-treatment had its limitations.

[…]

By the end of the day, my fever had begun to drop. I stayed home the next day, after calling in with a cold. By Wednesday or Thursday, three days after my exposure, I was better, although I continued to take high doses of tetracycline for the next ten days. I was able to return to work the following Monday.