County Lab Prepares for Bioterrorism

In Lee Borenstein’s three years as head of Los Angeles County’s bioterrorism response team, he has investigated 28 suspected outbreaks of some of the most dreaded agents of germ warfare: anthrax, pneumonic plague, tularemia and others.

The meticulously packaged samples--sometimes suspended in test tubes, sometimes packed in sand--are ushered into a windowless shoe box of a room on the 12th floor of the county Health Services Administration Building on the edge of downtown Los Angeles, where their true identities are coaxed out using a fluorescent microscope, a DNA sequence detector or a simple petri dish.

“They all turned out negative,” said Borenstein, a microbiologist and immunologist in the Public Health Laboratory’s molecular epidemiology department.

If terrorists ever succeed in mounting an attack in Los Angeles using biological weapons, Borenstein will probably be among the first to know about it.

So far, none of the potential germ warfare agents he and his four deputies have subjected to biological scrutiny has turned out to be a deadly substance--let alone one propagated with malicious intent. An additional four alerts called in from around the county were revealed to be hoaxes before samples were ever dispatched to Borenstein’s lab.

But after the Sept. 11 terrorist attacks on the World Trade Center and the Pentagon, the lab’s long-standing role as guardian of public health has taken on a new dimension.

“We have a whole new awareness of the potential threat,” said Borenstein, who normally analyzes specimens of HIV, tuberculosis and E. coli. “We will need to have more diligence and be more alert, especially since the creativity of those factions may have been underestimated.”

The lab is one of 81 facilities across the country belonging to the National Laboratory Response Network, which was formed three years ago after a spate of anthrax hoaxes in the United States and several real attacks overseas, including the 1995 sarin gas attack in the Tokyo subways by the Aum Supreme Truth cult.

The network is a partnership among the Centers for Disease Control and Prevention in Atlanta, the Assn. of Public Health Laboratories, the FBI Laboratory’s Hazardous Materials Response Unit, and other federal agencies.

After last week’s revelations that some of the suspected hijackers had shown interest in flying crop-dusting planes--perhaps to spread chemical or biological weapons--some influential members of Congress said the program should be bolstered with additional funds. A proposal by Sens. Edward M. Kennedy (D-Mass.) and Bill Frist (R-Tenn.) would earmark $1 billion to fund public health initiatives in 2002, including an increase from $10 million to $300 million for bioterrorism initiatives.

In Los Angeles County, membership in the Laboratory Response Network means an annual infusion of about $700,000 from the federal government. Of that, $220,000--or 2.8% of the Public Health Laboratory’s overall budget--is earmarked for Borenstein, his lab, and his small staff.

A threat turns up somewhere in California about once a week, said Michael S. Ascher, chief of the communicable disease branch of the state Department of Health Services. A few of the cases turn out to be hoaxes, but most of them involve patients who are sick.

That doesn’t mean they were infected through nefarious means, however. Animals carrying anthrax have occasionally passed it along to humans from animal hides on African drums and to wool sorters handling wool from infected sheep. Squirrels in the Angeles National Forest north of Pasadena are known carriers of pneumonic plague, the same contagious scourge that wiped out an estimated millions of Europeans in the Middle Ages.

Since Jan. 1, 2000, the CDC has recorded no cases of anthrax, eight verified cases of pneumonic plague and 186 cases of tularemia.

The first time Borenstein was called upon to test a suspected sample of anthrax, “I had mixed emotions,” he said.

“We went slow and steady and worked through it,” he said. By the time the third sample came his way, he had the process down to a well-honed routine. Even with the heightened sense of danger today, Borenstein feels almost blase about handling the next sample that will arrive at his lab.

Tests are performed in Borenstein’s 8-by-8-foot biosafety lab, which is protected by sliding glass doors and is restricted to authorized personnel. At least one member of the bioterrorism team is on call 24 hours a day, seven days a week.

Samples are handled inside a metal biosafety cabinet equipped with a protective glass wall and special fans to direct errant hazardous substances away from workers. The floor is designed to wash down easily, with a drain in the middle of the room and a deliberate lack of crevasses where hazardous materials could take root and grow.

Proving that a sample is in fact a dangerous substance is a far trickier task than proving that it is not. The tests conducted at hospitals can only show that a sample isn’t dangerous. Often, the ones that do get forwarded to labs such as Borenstein’s turn out to be benign as well.

Borenstein and his colleagues feel strongly that the average Angeleno is far more likely to be sickened by bad sushi than a biological weapon. The reason is that a germ attack would be extraordinarily difficult to launch. Anthrax spores are likely to be inactivated by ultraviolet light. Other germs can’t survive out in the open air.