Taking a Germ Bullet

Dressed in battle fatigues and wrapped in an Army blanket, Lloyd Long slept on the sand in the barren Utah desert. Monkeys and guinea pigs sat placidly in cages beside him. A siren blared, telling Long to wake up and climb onto a stool. He faced into the wind and breathed the night air.

Two weeks later, the 18-year-old soldier fell as sick as he’d ever been. Fever. Headache. Blurred vision. The desert wind had carried a waft of the debilitating disease known as Q fever, unleashed by Army scientists.

And Long, a human guinea pig by his own consent, had helped prove that Americans were vulnerable to a new type of weapon: the germ.

That was more than 46 years ago. Long was part of Operation Whitecoat, a set of 153 Army tests from 1954 to 1973 that mark an extraordinary chapter in medical research history, one that probably could not be repeated today. The Whitecoat experiments exposed hundreds of healthy young men to debilitating diseases that might be used in biological warfare. And the experiments were conducted on soldiers recruited from a single religious group: the Seventh-day Adventist Church.

Now the Whitecoats, who have received little public attention over the years, are being lauded as heroes. By offering the first details of how biological weapons move through the environment and affect the human body, their experiments laid out many of the scientific insights that officials need as they boost U.S. defenses against bioterrorism and investigate the anthrax attacks that have killed at least four Americans.

“I firmly believe that if those experiments had not shown our vulnerability to biological warfare, there would be no biological defense program today,” said Col. Arthur Anderson, an Army immunologist. “As a result, the services provided during this outbreak of anthrax would be completely in the Dark Age.”

But ethical concerns probably would rule out Operation Whitecoat today, because the experiments would put volunteers at undue risk, said Jonathan Moreno, a University of Virginia bioethics researcher.

Should those standards now be relaxed?

“Before Sept. 11, would we have found these tests more objectionable than we do now? I think we would,” Moreno said. “We might be willing to live with more ambiguities and moral compromises now, in the harsh realities of the 21st century.”

No test subjects died during Operation Whitecoat, Army officials say. The Army only now is conducting a study of possible long-term effects on those exposed, asking the 1,000 or so volunteers who could be located to fill out health questionnaires.

Like today, the nation was trying to grapple with the new and frightening threat of biological warfare at the time Operation Whitecoat was created.

After World War II, Americans learned that Japan had conducted extensive germ attacks and experiments on humans, mostly in Japanese-occupied areas of China. By some accounts, more than 10,000 people were infected.

But to U.S. scientists, biowarfare was an unproven threat. Once released, biological agents seemed hard to control in battle. And it was unclear how many casualties might result. Little was known about the number of germs it took to harm someone, and whether they could be released broadly, through an aerosol.

“We needed to fully understand the nature of aerosols and infectivity in man,” said William C. Patrick III, a former official in the U.S. bioweapon program. “You could only get so much information from an animal model.”

And so, in 1954, the Army approached Adventist leaders about forming a partnership.

Adventists had a special niche in the armed forces. Following the commandment “Thou shalt not kill,” many sought status as conscientious objectors and became medics. That often put them on the battlefield, but in life-saving roles.

Army scientists thought the well-educated Adventists, with their natural interest in health matters, would make good test subjects. Moreover, Adventists--at least those who followed church rules--did not smoke, or drink alcohol or coffee.

“They were a cleaner piece of paper on which to work an experiment,” said Richard O. Stenbakken, who supervises Adventist clergy in the armed forces. When testing an experimental drug or disease agent, “you didn’t have to ask if their reaction was because they were drunk as a skunk on Saturday night.”

In all, more than 2,100 young Adventist soldiers made the trip from Ft. Sam Houston in Texas, where the Army conducted medic training, to serve their tours of duty at the Army’s biological warfare program at Ft. Detrick, Md. Many would have ended up in Korea or Vietnam. Once at Ft. Detrick, they were expected to volunteer for at least one experiment while holding clerical, motor pool or other military jobs. But some took part in more than one and a few participated in none.

“They gave us pretty good duty,” said Lou Bitzer, 64, an auto mechanic in St. Charles, Mo., who as a Whitecoat inhaled bacteria that cause tularemia, a plague-like disease. “I never sat down to a table where there wasn’t a tablecloth or a flower on there.”

Soon, Whitecoat experiments began laying out the details of biological weaponry, the type of information that is becoming a staple today of news reports about the anthrax attacks on the East Coast.

For example, tests such as the 1955 Q fever release in Utah established that germs could be spread effectively through an aerosol.

Moreover, early tests showed that germs embedded into tiny particles are most dangerous. Where large particles settle quickly to the ground, small particles float invisibly on air currents, and they can be inhaled deeply into a victim’s lungs.

This lesson apparently was well considered by whoever mailed anthrax bacteria to the Washington office of Senate Majority Leader Tom Daschle. Anthrax spores in the letter were so small that they found their way over the air currents to the nostrils of 28 people.

Operation Whitecoat also helped scientists use animals as proxies for people in biological tests. The researchers exposed rhesus monkeys, guinea pigs and Whitecoat volunteers to a nonlethal disease, such as Q fever or tularemia. The tests showed how many more germs were needed to make a person sick than each type of animal.

Scientists could then test lethal agents such as smallpox and plague on animals, and make projections about what dose would be lethal for humans. “This was a very, very important development,” Patrick said.

Although other methods were used to determine the lethal dose of anthrax, the Whitecoat techniques laid out some of the principles that made those calculations possible.

The data helped scientists understand how the agents would function as weapons. Even after President Nixon renounced offensive biological weapons in 1969, the same type of information was needed to develop vaccines and medicines that defend against biological attack.

“This was the first work done of its kind,” said Dr. C.J. Peters, a former Army disease researcher who now leads the Center for Biodefense at the University of Texas Medical Branch at Galveston. “We’d still be arguing about these things if they hadn’t done the work.”

Safety equipment also was developed during the Whitecoat experiments that scientists still use when working with dangerous bacteria and viruses, Anderson said. This includes biohazard suits and containment chambers that control germs with air flows.

A central feature of the Whitecoat program was the “Eight Ball,” a huge, spherical chamber at Ft. Detrick, more than two stories tall. Scientists would discharge bacteria or viruses into the chamber, while volunteers wore breathing apparatus that allowed them to draw the infected air.

Army officials say the Utah experiment in 1955, at the Army’s Dugway Proving Ground, was the only one in which germs were released in the open air.

Long, now 65 and retired from the insurance business, recalled that he and about 29 other volunteers were taken to a remote section of the desert and stationed about a tenth of a mile from one another. At night, they slept on the ground. Occasionally, a siren would blow, signaling another release of the Q fever bacteria. The men were to wake up and face into the breeze, breathing naturally.

But for the first five nights, a siren soon blared a second time, indicating that the test was a scratch. Wind conditions were not right, or something else had gone wrong.

On the sixth night, Long knew that the release had worked, even though he never saw or felt the germs. Instead of a second siren blast, soldiers drove up in gas masks to take the volunteers back to base. The men showered, then stood under ultraviolet lights to kill any remaining pathogens, then showered again. Quickly, they boarded a plane and were flown to Ft. Detrick, where they were quarantined in a hospital.

Long worked as a lab assistant for the rest of his two years of duty. Though he now is battling malignant melanoma and colon cancer, he does not believe his Whitecoat participation is responsible.

“I don’t know anybody who went in who felt later on that they had been bamboozled,” said Long, of Bullhead City, Ariz.

Whitecoat volunteers participated in a range of other experiments. Instead of a likely tour of duty in Vietnam, Dean Rogers tested an Eastern encephalitis vaccine in the early 1970s. Jonah Kumalae was part of a study about how the body reacts to sand fly fever, a mosquito-borne illness that bedeviled U.S. troops overseas.

In possibly the strangest experiment, in 1970, Gary Swanson and four other men were placed in hospital beds, each separated by a curtain. On each bed was an electronic console, covered with dials and lights.

When some of the lights stopped blinking, the men were to turn the dials to get them flashing again. When other lights blinked, the men would turn them off by adjusting other dials. A distracting white noise filled the room.

The effect was something like trying to keep an aircraft running over the roar of the engines.

Then the men were injected with sand fly fever and fell ill. Still, they were asked to keep working, said Swanson, 55, of Silver Spring, Md.

Many soldiers were exposed to serious diseases, officials say, but none were infected with anthrax or other life-threatening illnesses.

The Army and the church also say Operation Whitecoat was a model of the proper use of gaining consent from volunteers in medical research. Volunteers were asked to give consent to participate at several stages--before they joined the program, and then twice each time they volunteered for an experiment.

“The procedures were state of the art then and would be today,” said Anderson, who leads the medical research review board for Army experiments at Ft. Detrick. He offered one exception: “I don’t think they would do aerosol studies today. The lung is a fragile organ. So many conditions can trigger respiratory distress.”

The program ended along with the military draft in 1973. The church still is proud of its involvement, saying it led to vaccines and treatments that have saved thousands of lives.

Anderson called the Whitecoats “real heroes” for taking on the risks of the experiments.

Arthur Caplan, a bioethicist at the University of Pennsylvania, said the Whitecoat tests would not meet current standards for medical research, including those set by the Food and Drug Administration. And he does not believe current fears about bioterrorism justify changing those guidelines.

“We do not expose people to conditions that could be lethal or have high risk,” Caplan said. “We do the best we can with animals. . . . To bend the rules would make it almost impossible to distinguish between what we’re for and what the other guys are for.”

Caplan also questioned the Whitecoat recruitment procedures, on grounds that there is an element of coercion in any offer from an officer to a soldier to volunteer for research.

Still, many of the Whitecoats were grateful for the chance to join.

“Those of us who went into the program were very fortunate,” said Rogers, now 54 and living in Silver Spring. “We wanted to serve our country. But some of the friends who went to Vietnam didn’t come back. The friends I had in the Whitecoats are still around.”