Besdeshryhh.

MEMORANDUM FOR THE RECORD

September 12, 1986

SUBJECT: Discussion with Dr. Matthew Messelsen, Harvard University

Dr. Messelsen had recently (about 23 August 1986) returned from
a visit to Moscow, Ministry of Health (3 days) where he met
with four doctors all of whom were involved in treating
patients during an outbreak of anthrax in Sverdlovsk in April
1979. He was invited by and his trip was fully supported by
the USSR Ministry of Health. i

Dr. Messelsen did not visit Sverdlovsk, he was briefed only in
Moscow. He opened his discussion with the statement that
anthrax is endemic in Sverdlosk (attached papers Nos l & 4).
He further stated that over 2 million people are innoculated
against anthrax each year (mostly butchers) with a live
encapsulated strain. Immunity develops in 12 to 14 days and
lasts for 1 year but does not preclude cutaneous anthrox.

With regard to Sverdlosk, he stated that a large outbreak
occurred in the spring of 1979 with 96 cases and 64 deaths.
The first case occurred on April 4 and the last on May 18.
Eleven cases were cutaneous, six were cutaneous leading to
systefmic and all 17 survived. Of the remaining 79, all were
“gastric anthrax cases and 64 died for 81 percent fatalities.

He was told that 1979 was an unusually wet year and fodder
for animal feed was short. To increase meat production,
fodder was supplemented with meat bone flesh powder (assumed
to be bone meal by U.S.). He explained that anthrax cases
have been identified as caused by bone meal. In this case
there are about 11 producers of bone meal. One facility 16
km south of Sverdlosk produced one 29 ton lot which was
responsible for this outbreak. The lot was put on sale on 25
March and all sold by 29 March to private animal owners.
Anthrax was isolated from this lot of bone meal powders and
victims and by. capsule morphology and virulance in white mice
was ascertained to be the same mifcroorganism. Sheep and
some cows were infected and he estimated that hundreds to
thousands of people ate the contaminated meat. The animal
sites were destroyed by open air burning of the buildings.

In addition 300 street dogs were sacrificed with two dogs
infected. Chloramine was used extensively as a decontaminant.
Leaflets, dated 14 April (attachment No. 6) were distributed
warning of risk of contracting anthrax from consumption of. -
uninspected meat.
According to Dr. Messelsen all patients from this outbreak
were treated at one hospital, City Hospital No 40. The
incidence of admittance to the hospital was as follows
beginning on 4 April and ending on 18 May: 5/5/5/7/7/6/10/
9/7/5/4/4/1/0/0/1. In addition 67 percent of the cases were
male, 70 percent lived in the southern half of Sverdlosk, and
most cases (32) were between the ages of 40 to 49. No cases
-occurred in the same household, no cases involved restaurants, .
"and there was no military involvement. Thirty percent of
“cases involved workers from a ceramics factory which employed
“about 3000 workers. Between April 8 and 15 cattle carcasses
‘from private sources were received and offered for sale at
‘the factory to the workers. Only one carcass was infected
with anthr@x. He further stated that the incidence of disease
-was higher in truck and auto drivers who were thought to be
more mobile and thus able to buy meat first.

As regards symptomology, Dr. Messelson reported he was told
blockage of the intestine was the first sympton follwed by
‘chills, high fever (39°-41°), dypnesia, rapid pulse, cynosis,
and death. In some cases the temperature dropped rapidly
immediately before death. All victims reported some stomach
pain. The first diagnosis was made on April 7 and the first
laboratory test on April 10. Extensive treatment was reported,
mostly with a wide variety of broad spectrum antibiotics
which included penicillin and serum fractions. All 96 cases
were thought to be from animals who ate contaminated bone
meal. _Although he had no autopsy information he had been.
provided one photograph of a victim which he had turned over
to government officials. He was told autopsies indicated
‘-hemmorage in the intestine, swollen intestine with severe
hemmorage all over, lymph nodes hemmoraged, and lungs free of
hemmorage. Some victims died at 48 hours after onset of
illness; some lived up to 4 days. The causative organism was
reported to be a thick capsule strain of anthrax. Survivors
all felt fine two years after illness. No information was
reported on burial or treatment of bodies of victims.

He reports a list of all foreign visitors is available and
provided a trip report (attachment 7) by Prof Donald Ellis
(which has been available in the U.S. for several years).
Professor Ellis reports no unusual activity in Sverdlosk

even though he reportedly arrived on 6 or 7 April, stayed
about one month, visited Novosibirsk for one month, then
returned to Sverdlosk for another month. Dr. Messelson also
was provided in Moscow a phamphlet which was supposedly
distributed in Sverdlosk at this time (attachment 6).

Dr. Messelson is planning three actions: a follow on visit of
specialists from the U.S. to Moscow; the four doctors he had

discussions with will be brought here to lecture; and that a

scientific paper they are preparing will be translated and he
will arrange for publication in an American journal.