Sunday, April 26, 2015

Psychological Warfare In Reverse: "I Feel So Cared For!"

How can something be "known to have no diagnostic value" as a tool, on the one hand, while also being the method by which 33 people were diagnosed with "exposure" to anthrax?

You can't tell me that almost 11,000 nose swabs were sent out to a laboratory for culturing in a blind, numbered study, and they happened to pick out the two tabloid mailroom workers in Florida, and the group from Daschle and Feingold's offices (And three in New York? Erin O'Connor was "diagnosed" by the head man at the CDC an hour before the fact, if not her name, went flashing around the zipper at Rockefeller Center. The woman at the New York Post had a lesion on her middle finger, which she defiantly saluted to Saddam-Osama in a full, front-page photo in the newspaper. This was their value.

Ernesto Blanco was originally reported to have been found with a single--that means one--spore in his nose, at a time when only a "trace" of anthrax was found on Robert Steven's computer. There are many other references in the record to testing finding one spore, which is a medically and legally defensible position. Call it monosporic reality. Can anyone prove it's not there?



In October, 2001:
When the Amerithrax event occurred, the extent of contamination was difficult to ascertain, especially before the source and route of the bacterium was known. Samples were taken to discover the extent of exposure, including dry and wet swab samples and nasal swabs.

At least 10,775 nasal swabs were taken; 33 came back positive: 2 in Florida, 3 in New York, and 28 on Capitol Hill. Among those exposed were at least 9 people who directly handled contaminated letters as well as people who were in immediate or adjacent proximity to where letters were handled or opened.30,31 Environmental samples were also collected by the CDC, EPA, and USPS and included the sampling of 286 postal facilities.32 Nationwide, approximately 120,000 samples were taken, placing great strain on many laboratories’ ability to process the samples.32

In 2005:
In addition to the large number of samples taken on Capitol Hill, the comparatively quick turnaround, 24/7 cleanup schedule, media quotes, and public addresses assuring the public that they were safe, as well as the act of taking nasal swabs from anyone in the region who requested one, all demonstrate that more effort went toward remediating the Capitol Hill buildings."4,"12 Nasal swabs are a particularly good indication that extra care was taken on Capitol Hill, primarily because they were already known to have no diagnostic value and their function in the Capitol Hill cleanup was largely to "...convey[ed] the message that the hazard that building occupants might face was being taken seriously."12(p68) Comments made by a Capitol Police spokesman illustrate the prevailing sentiment: "It cost what it cost. The bottom line is we have to ensure the public safety."22

From:

2012, Biosecurity and Bioterrorism: Biodefense Strategy, Practice, and Science, Volume 10, Number 1, 2012, Mary Ann Liebert, Inc. DOI: 10.1089/bsp.2010.0053, Total Decontamination Cost of the Anthrax Letter Attacks, Ketra Schmitt and Nicholas A. Zacchia,


Sources:

30. Pennsylvania Department of Health. Health Alert #17. October 25, 2001.

31. U.S. Centers for Disease Control and Prevention. Update: investigation of anthrax associated with intentional exposure and interim public health guidelines, October 2001. MMWR Morb Mortal Wkly Rep. 2001 Oct 19;50(41):889-893. http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5041a1.htm.


12. Committee on Standards and Policies for Decontaminating Public Facilities Affected by Exposure to Harmful Biological Agents: How Clean is Safe? National Research Council. Reopening Public Facilities After a Biological Attack: A Decision-Making Framework. Washington, DC: National Academies Press; 2005

22. Kenen J. Hart Senate Building reopens, anthrax-free. Reuters January 22, 2002.





Reuters, January 22, 2002.

Hart Senate Building Reopens, Anthrax-Free

By Joanne Kenen
WASHINGTON (Reuters) - The Hart Senate Office Building reopened on Tuesday after a technically challenging three-month anthrax cleanup that cost at least $14 million after a potent anthrax-laced letter was sent to Senate Majority Leader Tom Daschle.
"I feel completely safe,'' said Daschle, who entered the building at midday after the cleanup involving fumigation with a powerful gas, high-tech vacuums, foam and liquid cleansers.
"I think we have done everything possible to remediate this building.''
The letter opened in his office Oct. 15 contained highly potent powdered anthrax. It was part of a spate of anthrax-tainted letters sent to government officials and media outlets in Washington, Florida and New York. Five people died and about a dozen others were treated for inhalation anthrax or the less serious skin version.
Coming just after the Sept. 11 attacks on America, U.S. officials had feared a foreign bioterror attack, but investigators now believe it was probably a domestic source. No suspect or motive has been publicly identified.
TOTAL COST UNKNOWN
Authorities said they are confident that the nine-story Hart building, which is part of the U.S. Capitol complex, is safe after the cleanup and the examination of more than 5,000 environmental samples.
"It's good to be back,'' said Daschle, a South Dakota Democrat. "It's good to be confident that we can return to normalcy.''
Authorities said the final cost could be well beyond the $14 million the Environmental Protection Agency (EPA) has estimated, once additional costs from the Defense Department, the Capitol Police and Congress itself are tallied.
"It cost what it cost,'' said Capitol Police spokesman Lt. Dan Nichols. "The bottom line is we have to ensure the public safety.''
The building was still quiet Tuesday, as people drifted back from makeshift offices a day before Congress reconvenes for its 2002 session. Many staffers used luggage carts to bring back files and materials that had accumulated since October.
Carrying boxes back in Sen. Craig Thomas, a Wyoming Republican, put the inconvenience in perspective. "If you consider what might have happened, it wasn't so bad,'' he said.
"They gave me a laptop and I've been working at home -- and I liked it,'' said Reed Garfield, a staffer at the Joint Economic Committee. "The only real problem I had was that I had left Library of Congress books in Hart, and the library kept canceling my account because they were overdue.''
Daschle was one of two senators who received anthrax letters. A letter to Vermont Democrat Patrick Leahy, chairman of the Judiciary Committee, was discovered before doing any harm and was sent to a military research lab in hopes that it could help trace the source of the anthrax.
All mail to Congress is now irradiated and screened for bioterror threats or explosives, Nichols said.
Although the contamination was concentrated in Daschle's suite, traces of anthrax were found elsewhere in Hart so the entire building was sealed off.
Less extensive anthrax contamination was found in several other House and Senate office buildings, but those "hot spots'' were easier to decontaminate.
Thousands of people who had been in Hart were given antibiotics for at least a few days, and those who had been in or near Daschle's office were then placed on a 60-day drug regimen. Some were later offered an anthrax vaccine and another 30 days of antibiotics.
No one became ill in Congress but several postal workers got sick and two died before experts realized the anthrax had been so finely milled it had seeped through the envelope.
Daschle's suite, the epicenter of the contamination, was stripped down to bare walls and floors and his staff will work in a temporary Hart office while it is refurbished. As majority leader, Daschle also has offices in the Capitol building.
Supervised by the EPA, government cleanup experts and private contractors used chlorine dioxide gas to fumigate Daschle's office and related heating and ventilation systems. They have also used liquid and foam decontaminants.





Nonfumigated Buildings

Table 2 shows all nonfumigated buildings: 21 USPS buildings, 6 Capitol Hill buildings, 5 corporate office buildings, and 3 government mail facilities. Existing data on nonfumigated buildings includes $15 million for the Morgan PDC and a total cost of $2.1 million for 6 Capitol Hill buildings. Since the entire facilities were not decontaminated, considering data on a per square foot basis does not make sense. For these buildings, per square foot costs are $7.14 and $3.10, respectively. The high variance between these can be explained by several factors; most significant is the lack of knowledge about the actual area decontaminated.

Capitol Hill Buildings

Collectively the cost of remediating the buildings on Capitol Hill was about $27 million.4 These buildings are discussed separately from all others for a number of reasons. First, detailed contractual information is available for these buildings. More important, the cleanup cost for Capitol Hill buildings is likely significantly higher than it was for other comparable sites. The National Academies Board on Life Sciences conjectured that ‘‘[t]he high-profile users of the buildings undoubtedly created pressure to reopen the buildings quickly, yet a conservative definition of ‘clean’
was adopted by EPA. More important, there was a lack of a standard protocol to drive remediation, which in some cases led to repeated decontamination.’’12(p66) Office buildings on Capitol Hill were reopened in a matter of 3 months, whereas some large USPS PDCs stayed closed for years. The standard for anthrax removal was initially considered to be ‘‘no detectable, viable anthrax
spores.’’4(p8) As this is not possible to demonstrate, the EPA set the standard as ‘‘zero B. anthracis growth on any samples taken’’ and ‘‘[t]o ensure credibility, EPA took a large number of samples,’’ more than 9,000.12(p67) By comparison, USPS took about 10,000 samples in total for its 23
contaminated buildings as well as the 286 other buildings it sampled.21 This difference demonstrates an exacting standard of cleanup exercised on Capitol Hill.

In addition to the large number of samples taken on Capitol Hill, the comparatively quick turnaround, 24/7 cleanup schedule, media quotes, and public addresses assuring the public that they were safe, as well as the act of taking nasal swabs from anyone in the region who requested one, all demonstrate that more effort went toward remediating the Capitol Hill buildings.4,12 Nasal swabs are a particularly good indication that extra care was taken on Capitol Hill, primarily because they were already known to have no diagnostic value and their function in the Capitol Hill cleanup was largely to ‘‘.convey[ed] the message that the hazard that building occupants might face was being taken seriously.’’12(p68) Comments made by a Capitol Police spokesman illustrate the prevailing sentiment: ‘‘It cost what it cost. The bottom line is we have to ensure the public safety.’’22

The only Capitol Hill facility fumigated was the Hart Senate Office Building, costing at least $14.3 million, approximately half of the $27 million Capitol Hill cleanup.4,22 Therefore, each of the remaining 6 Capitol Hill sites cost about $2.1 million to decontaminate. At the Capitol Hill sites, technical contracts accounted for over 26% of total costs for nonfumigated buildings, while "technical contracts typically account for about 10 percent of total contract costs at a cleanup site."4(p15)

Corporate Office Buildings

Corporate buildings affected by the Amerithrax attack included the offices of NBC Nightly News, CBS News, ABC News, the New York Post, and American Media, Inc., as well as an office building on Kuser Road, exposed through cross-contamination.18 Of these buildings, the American Media, Inc., building, which housed the National Enquirer newspaper office, was the most contaminated. The owners of the building decided simply to move and sold the building for $40,000 to Sabre Technical Services, a company that was involved in remediation at USPS facilities.23 According to a Sabre spokesperson, the building cost "significantly less than 5 million dollars" to decontaminate and they were able to sell it in 2007 for $9.3 million.12,24 Details about the remediation done at this building were not released, and it is important to remember that Sabre Technical Services was the only stakeholder in this operation, likely expediting the decontamination effort. However, from this we can say that it is at least feasible to decontaminate a building like this for under $5 million. This value results in a fumigation cost of $7.70 per cubic foot. This is lower than the $9 to $10 per cubic foot for the Trenton and Brentwood PDCs and validates the idea that remediation (at least in theory) became easier and cheaper over time.

The offices of NBC Nightly News, CBS News, ABC News, and the New York Post were all contaminated; however, little public information is available on the extent of contamination or the cost of cleanup. Inquiries into the subject received no response. None of these sites showed evidence of aerosolized anthrax, nor were there any cases of inhalation anthrax associated with these sites. However, contamination seems not to have been localized. At NBC there were 3 areas contaminated
by anthrax spores. They included the set of NBC Nightly News, a security room, and the mail room.12 Ensuring the safety of employees and earning their confidence seemed important at least to NBC, whose ‘‘management went overboard’’ with the standards they set themselves.12(p65) The office building on Kuser Road was the site of one case of cutaneous anthrax. After extensive environmental sampling, the only area to produce a positive result was a mail bin that had likely contained a cross-contaminated letter. At this site remediation was restricted to cleaning the area around where the positive sample was taken.18

USPS Buildings

The greatest amount of remediation was done at USPS sites. Contaminated letters passed through a number of post offices and PDCs, which use high-speed mail sorting machines. Anthrax spores were often spread when letters passed through these machines. USPS had to do major remediation at 5 main sites as well as 18 other buildings.

Major decontamination efforts took place at 3 PDCs: Trenton, Brentwood, and Morgan. The 2 largest sites were the Trenton and Brentwood PDCs located in New Jersey and Washington, DC, respectively. At both sites there was evidence of widespread aerosolizing of anthrax spores,25
and mail workers at both facilities developed inhalation anthrax.25 The decision was made to do complete fumigations of both buildings with chlorine dioxide. The complete remediation, including fumigation, took over 2 years and, for both buildings, cost $200 million.2,26 In addition to fumigation and decontamination costs, remediation at these sites included miscellaneous costs. For
example, $4.5 million was spent busing postal employees from their usual Brentwood or Trenton workplaces to other locations while cleanup was happening.27 Additionally, after the fumigation, USPS spent $10.8 million renovating the Trenton PDC to refurbish the facility.28 We assume
these expenses are included in the overall remediation costs of these sites.

The other large PDC to be significantly contaminated was the Morgan PDC in New York City, which occupies 2.1 million square feet.27 The cleanup at this facility involved closing only a section of the facility for about 2 weeks while decontamination was going on 24 hours a day at a cost of about $15 million.29

There were 20 other USPS facililities that produced positive environmental samples.13 Contamination at these sites was generally low and usually thought to have occurred through direct physical contact of cross-contaminated letters. Many sites produced just 1 or 2 positive samples, and
in some cases remediation involved cleaning the area of the room around the positive sample. In some cases, potentially contaminated items were disposed of.13 According to the Vice President of Engineering for USPS, ‘‘.15 location  had very small amounts of contamination. Cleanup procedures
were very limited; closing was generally a 24 to 48 hour time period. Again, no employees at these locations ever became infected.’’10(p114) Given the extremely low level of decontamination necessary in these buildings, we construct a lower bound estimate on cost by assuming that no
additional cost was incurred decontaminating these buildings (eg, current staff and resources were used to decontaminate).

However, we present the data here to illustrate. For these buildings, per square foot costs are $5.70, $7.14, and $3.10, respectively. The high variance between these estimates can be explained by several factors; most significant is the lack of knowledge about the actual area decontaminated.
In addition, the Department of Justice Mail Facility was partially fumigated and thus would be expected to have higher costs.

Cost of Sampling

When the Amerithrax event occurred, the extent of contamination was difficult to ascertain, especially before the source and route of the bacterium was known. Samples were taken to discover the extent of exposure, including dry and wet swab samples and nasal swabs.

At least 10,775 nasal swabs were taken; 33 came back positive: 2 in Florida, 3 in New York, and 28 on Capitol Hill. Among those exposed were at least 9 people who directly handled contaminated letters as well as people who were in immediate or adjacent proximity to where letters were handled or opened.30,31 Environmental samples were also collected by the CDC, EPA, and USPS and included the sampling of 286 postal facilities.32 Nationwide, approximately 120,000 samples were taken, placing great strain on many laboratories’ ability to process the samples.32

Environmental samples included both dry and wet wipes or swabs, HEPA vacuum samples, air quality samples, and other samples that included control samples used to ensure the efficacy of fumigation. At the DOJ Mail Facility, dry samples cost approximately $40 each, while wet samples were $85 each.5 We assume that HEPA vacuum and air quality samples as well as ‘‘other’’ type samples also cost $85 each. Sampling performed at 23 USPS sites shows that about 28% of samples were of the dry type.32 Generalizing this distribution and multiplying by the respective costs yields a value of about $8.7 million.

For the purposes of our model, we consider these to be unique costs and add them to the overall decontamination costs.

Cost Estimates for Unknown Buildings

No cost estimate could be obtained for 29 contaminated buildings. First, we consider the case of GSA 410. The other 4 completely fumigated buildings showed relatively consistent costs on a per unit volume basis. GSA 410 has similar dimensions to and was remediated in the same manner as Department of State Annex 32. Therefore, we assume identical decontamination costs ($9 million) for the 2 buildings.

Very little data was available for nonfumigated buildings. In order to better inform policy decisions, we created an....
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April 11, 2003, New York Times, Anthrax Cleanup to Close Mail Center a Year More, by Iver Peterson,

HAMILTON, N.J., April 10— It has been 18 months since the big mail-sorting plant here was contaminated by anthrax spores and closed. But it will be at least a year more before it is safe for its scattered workers to go back inside.

The Postal Service announced today that the final step in cleaning out the anthrax that once had Trenton-area residents wearing rubber gloves to open their letters and bills would not begin until this fall. And it said that final cleanup -- a fumigation with chlorine gas -- and installation of new equipment would probably not be finished until next April.

At separate briefings for local officials, the news media and local residents, the Postal Service's top engineer said that machinery to produce the chlorine gas had not yet been disassembled from the sorting plant outside Washington, where anthrax decontamination was recently completed.

The centers there and in this Trenton suburb were contaminated in the letter-borne anthrax attacks in September 2001 in which five people, including two postal workers, died. The crimes are unsolved.

The news of further delay disappointed the Hamilton center's 500 workers, who now have to commute farther, to a temporary center north of here, just off the New Jersey Turnpike in Monroe Township. But Thomas G. Day, vice president for engineering for the Postal Service, said he would rather be safe than sorry.

''I wish we could have had this done by now, but we have not,'' Mr. Day said at a news conference in Princeton. ''Our unofficial motto has been, 'Do it right, not fast,' and it's still going to take time to get this done the right way.''

Bill Lewis, president of the Trenton-area local of the postal workers' union, expressed disappointment but not surprise. ''It's really depressing that we're not going back for so long,'' he said. ''You've got to understand that these people have been out of that facility for 18 months now.''

The temporary center, a former warehouse, not only is farther from the workers' homes, Mr. Lewis said, but also lacks proper heating and ventilation and has too few toilets.

The change in sorting centers has not affected mail service in central New Jersey, but the inconvenienced postal workers have long been a strong voice in local politics, and elected officials in both parties, including Glen D. Gilmore, the mayor of Hamilton, have taken up their campaign for a swift return to their old work site.

''I'm disappointed that it has taken so long, but I realize at the same time that they are dealing with something here that no one has had to deal with before,'' Mayor Gilmore, a Democrat, said today.

While the fumigating gas, chlorine dioxide, has long been used in water and sewer treatment plants, its use for killing anthrax spores has not been approved before, Mr. Day said, so special permits had to be obtained for the Washington sites. They are the Hart Senate Office Building, where anthrax-laden letters were mailed to Senators Tom Daschle of South Dakota and Patrick J. Leahy of Vermont in 2001, and the 14.2-million-cubic-foot Curseen-Morris mail distribution system in suburban Washington. Both have now been cleaned using the gas.

Although Mr. Lewis complained that Trenton was put last in line for a cleanup, Mr. Day said the experimental gassing of anthrax spores was tried first in Washington because the Hart building was relatively small and easier to use for a first try. After that, it made sense to keep the machinery in Washington for the big suburban center.

In each case, the Postal Service and its contractors had to design and build machinery, resembling a small chemical plant, that turned the building into a gas chamber for the living anthrax spores.

The Washington cleanup cost about $105 million, and the Hamilton work is expected to cost an additional $65 million.

Photo: During the 2001 outbreak, a temporary post office was set up in the parking lot. (Keith Meyers/The New York Times)
_________________________________________________________________________________


October 21, 2003, The Philadelphia Inquirer, Postal center cleanup to begin; The Hamilton Twp. building infected by anthrax in 2001 will be cleaned with chlorine dioxide gas. Officials assure safety, y Troy Graham, Inquiring Staff Writer,

TRENTON — Engineers will begin fumigating the anthrax-infected mail-processing center in Mercer County this weekend, clearing the way to reopen the long-shuttered building next fall.

State and federal environmental agencies gave final approval yesterday to begin the cleanup, and engineers plan to start the decontamination Friday afternoon.

The 282,000-square-foot Trenton Processing and Distribution Center in Hamilton Township is the last of three buildings infected in the 2001 anthrax attacks to be cleaned. The center, which had nearly 700 employees sorting mail for 51 post offices, has been closed for two years.


Crews will set the temperature inside the building at 75 degrees and raise the humidity to 75 percent. Then they will begin pumping in chlorine dioxide gas.

The gas must remain in the building, at the same temperature and humidity levels, for 12 hours to kill the anthrax spores. The gas is then sucked out of the building through filters that turn the gas into a saltwater solution.

Postal officials said there would be no effect on the surrounding community, other than a slight smell of chlorine in the air. All roads around the building, including Route 130, will remain open.

"It would not be unusual, depending on where you're standing and wind direction, to get some whiff of some level of chlorine," said Tom Day, engineering vice president for the postal service.

If there is a significant gas leak, surrounding residents are warned to remain indoors. They are not required to evacuate. Chlorine dioxide dissipates safely in the air, Day said.

Officials plan to begin the work around 4 p.m. Friday, after schools release their students for the weekend. They plan to finish before Sunday morning, when Hamilton Township will host a road race.

In October 2001, the Hamilton center processed anthrax-contaminated letters mailed from Trenton to the New York Post, NBC News anchor Tom Brokaw, and U.S. Sens. Tom Daschle (D., S.D.) and Patrick J. Leahy (D., Vt.). Three Hamilton employees and a West Trenton letter carrier were infected with anthrax. All four survived.

No one has been arrested in the anthrax attacks.

The letters also contaminated the Brentwood postal center in Washington, causing the death of two employees, and the Hart Senate Office Building. Both of those buildings were cleaned with chlorine dioxide, which is commonly used to treat water and sewage, to bleach wood pulp, and to sterilize medical equipment.

The price for cleaning both postal facilities will top $200 million, Day said.

During the Washington cleanup there were six minor leaks of gas, but none raised any health concerns, officials said.

Engineers tested the process earlier this month in Mercer County, pumping in a small amount of gas and finding no leaks, Day said.

Sensors at the processing center will monitor for leaks, and federal environmental officials will drive around the area in a modified bus taking samples of the air.

After the decontamination is completed, officials will take samples from inside the building, culture them, and check for anthrax spore growth.

"Our standard for success . . . is to gather samples and achieve a no-growth objective," Day said.

An independent commission of environmental officials and academics will review the findings to determine if the building is safe, Day said. That process will take about two months.

After that, it will take six to eight months to refurbish the building. Because the cleaning process is corrosive, equipment, ceiling tiles, carpet and some walls will need to be replaced, Day said.

The facility's 700 employees were shuttled around to different sites before settling in a warehouse the postal service has been leasing in Monroe Township, Middlesex County. Most of the employees have said they are eager to return to their old site.

Contact staff writer Troy Graham at 856-779-3893 or tgraham@phillynews.com.

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October 21, 2001, USA Today, FBI baffled by anthrax letters' link to town, by Traci Watson,

Updated 10:37 PM ET

EWING, N.J. — Federal investigators on Sunday continued to comb a mail route in this town outside Trenton for leads to who might have sent a rash of envelopes bearing lethal anthrax spores. Anthrax-tainted letters addressed to NBC anchor Tom Brokaw, the New York Post, and Senate Majority Leader Tom Daschle, all went through a mail-processing center in nearby Hamilton. And the Brokaw letter appears to have been mailed from somewhere on the route of a Ewing postal carrier who has come down with cutaneous, or skin, anthrax.

Investigators have few solid leads about the culprit. More than 100 FBI agents here have interviewed hundreds of people, but no search warrants have been issued. And postal inspectors will only say they have seized one or more drop boxes, the large, free-standing receptacles for outgoing mail.

Privately, FBI agents admit to being baffled as to the connection between Ewing — described by more than one resident as a place where nothing ever happens — and the taunting, tainted letters.

The handwriting on all three envelopes is similar. The strain of anthrax sent to Brokaw matched the strain sent to Daschle and to a supermarket tabloid, the Star, in Florida. The strain sent to the Post is not yet known.

What is known is that the letters to the Post, NBC and Daschle all passed through a large mail center in Hamilton, a town some 20 miles northeast of Ewing that processes mail from nearly 50 post offices in the surrounding area.

Two workers at the plant have contracted anthrax. One is an unidentified 35-year-old man from Levittown, Pa., who has a confirmed case of cutaneous anthrax. Officials said he handles packages; co-workers said he handles letters, magazines and large envelopes.

Another worker at the facility, Rich Morgano of Hamilton, also has cutaneous anthrax, according to his girlfriend, Dianne Abbott. Morgano maintains mail-processing machinery at the facility.

The processing facility remained closed Sunday as investigators conducted tests for anthrax spores. New Jersey health officials said Sunday that 13 of 23 samples taken from the facility showed evidence of anthrax. The plant could be closed for up to 4 weeks.

The FBI referred inquiries about the case to the New Jersey health department, which said that federal investigators are reporting a "suspect case" of anthrax in an employee of the Hamilton center.

Among the mail processed by the postal center in Hamilton is that from the West Trenton post office, which is in Ewing. A West Trenton letter carrier identified by The (Newark, N.J.) Star-Ledger as Teresa Heller came down with cutaneous anthrax but is recovering, health officials say. It's her route that FBI agents and postal inspectors have zeroed in on.

Postal employees are increasingly concerned about their safety now that they know they are the method of delivery for the nation's anthrax scare.

A postal worker in Washington, D.C., was in serious condition with the more deadly type of infection, inhalation anthrax, on Sunday. His diagnosis prompted the testing of about 2,000 postal workers in the nation's capital. Inhalation anthrax occurs when the bacteria moves deep into a person's lungs.

"As the postal machinery and sometimes the workers compress it, the anthrax then can come out," Sen. John Kerry, D-Mass., said Sunday on CBS' Face the Nation. "Most of the envelopes were sealed all around, and the theory is that it came out in a burst of air, and that's how it's inhaled."

Heller, the postal carrier in Ewing, delivers mail to more than 500 houses, apartments and businesses and picks up outgoing mail from home and business mail boxes, co-workers say. But she doesn't collect mail from drop boxes.

Complicating the trail, postal officials say, Heller did not work Sept. 18, the day the letters to Brokaw and the Post were postmarked. The letter to Daschle was postmarked Oct. 8 or 9. Co-workers say carriers have little contact with mail other than what they deliver or pick up from private mailboxes.

"I'll pick up one of these buckets, maybe half a bucket" of mail, said West Trenton letter carrier Sean McSherry of Levittown, Pa., pointing to a plastic crate stamped "United States Postal Service."

"That bucket of mail goes into another bin that goes onto a truck and goes away," McSherry said. He said it's a mystery to him how Heller could have become infected.

It's even more of a mystery to the residents of Ewing, a tranquil, middle-class suburb of 37,000, known for neatly kept front yards and Italian restaurants. It's a place where many people spend their lives and where the closest thing to a town center is an intersection that has two gas stations and a convenience store.

"This is really a first, in having Ewing Township the focal point of international concern," Mayor Al Bridges says. "You can't slip into Ewing. If a group of terrorists bought a house in Ewing, people would notice."

Especially if those terrorists were Middle Eastern, because Ewing is nearly 80% white, mostly Italian-American. African-Americans and Latinos live here, but there are "no tensions," says Bridges, who is African-American.

Fernwood, the neighborhood that includes much of Heller's route, is like the rest of Ewing: tranquil, stable and mostly white. Full of small houses decorated for Halloween, it seems an unlikely breeding ground for terrorism.

"There's never anything going on here," says Ala Trzewik, a high school student who lives along Heller's route. Pressed to recall any kind of unusual incident, she ponders and says, "Some of my neighbors screamed or something."

"It's not anybody from this neighborhood," Fernwood resident Carl Ayre says.

Ayre grew up here and is now raising his own family here, like many others who live here. Besides, he says, "There are enough old biddies on the block that stay abreast of everything."

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