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Beyond Anthrax

separator This may be the first cold and flu season you actually feel glad you've got a runny nose. It's generally not a symptom of the inhaled form of anthrax. What are the symptoms? What are the different types? What else do you need to know about potential biological or chemical attacks?


There are three types:

Cutaneous: Occurs when the anthrax bacterium enters the skin through a cut or abrasion. The infection first looks like a bump, but then becomes blister-like, with a black dot in the middle. The bump is usually painless, but people often feel feverish, tired or have swollen glands. This form is highly curable when treated with antibiotics.

Inhalational: Caused when tiny anthrax spores are breathed into the lungs and go into the middle of the chest. There, they produce a toxin that attacks tissue and causes the symptoms of the illness: mild fever, muscle aches and fatigue. The symptoms can quickly progress to respiratory failure, shock and death.

Antibiotics are the only known treatment for anthrax. Chances for survival are extremely high if treatment begins before the anthrax exposure causes symptoms. Healthcare professionals initially assumed that inhalational anthrax was nearly always fatal once symptoms appeared, but recent cases of the disease have proven otherwise. Some people who've had symptoms have taken antibiotics and recovered.

Almost all of the recent cutaneous and inhalational anthrax cases occurred when someone opened mail containing anthrax spores or was in the vicinity of someone who did. There is one exception. A woman in New York, who died of inhalational anthrax, has mystified professionals. They haven't been able to trace the source of her infection.

Gastrointestinal: Usually occurs when someone eats meat that has been contaminated with the anthrax bacterium. This has been extremely rare in the U.S., and at this point, no cases have been discovered recently. Symptoms include fever and abdominal distress, including nausea, vomiting, vomiting blood and bloody diarrhea.

At first, anthrax wasn't on healthcare providers' "radar screens." Now, organizations like the Centers for Disease Control and Prevention, the New York City Department of Health and the Infectious Disease Society of America are sending information out to medical professionals with a fair amount of frequency. As is almost always the case when an unfamiliar disease appears, some physicians did not recognize that their patients were sick with anthrax. That's unlikely to happen now.

It's important to point out that the F.B.I. still does not know who is responsible for spreading the anthrax spores that caused the recent outbreaks of the illness.

For more information about anthrax, visit the Centers for Disease Control and Prevention. (

Other Potential Threats

The difficult truth is that anthrax may not be the only disease we should be concerned about. Government officials are uneasy about the potential for an outbreak of other conditions such as plague, yellow fever, botulinim, Q fever and smallpox.

Smallpox seems to have caused particular concern. It's a virus that's known to exist in laboratories in the U.S. and Russia, but it's uncertain whether other organizations possess it, and if they do, whether they intend to try to contaminate targeted populations.

The U.S. stopped smallpox vaccinations in 1972, because the disease had been wiped out. For those who did get the vaccination, there is likely decreased protection because the vaccine may have worn off.

Symptoms of smallpox include:

  • Rash
  • Fever of 102
  • Lesions that are deep in the skin (as apposed to the chickenpox lesions, for example, which are on the surface)

Unlike anthrax, smallpox is contagious. It also has a high death rate. There is a smallpox vaccine, but it has a high rate of side effects, including possible death in a small amount of people. It's currently not recommended that the general public get smallpox vaccinations, and this isn't possible right now anyway, because there isn't enough vaccine to inoculate everybody.

In case of a smallpox outbreak, the Centers for Disease Control has trained teams of experts who would rush to contain and treat the illness. These individuals have been vaccinated.

Advice for Uncertain Times

We can't predict whether there will be more biological attacks, or if there are, where they will take place or even what they will be. But we do have a little advice:

Don't saturate yourself with television
It's understandable that the media will give us constant information any time there's an outbreak of an illness that appears to have been deliberately caused, but we don't have to let the news consume us. The wave of anthrax news has calmed down, but it's realistic to expect similar coverage if another illness is introduced. Learn what you need to and turn off the TV.

Don't take medications without the advice of your doctor
It's never a good idea to take medications unless you really need them. When large amounts of people take a specific antibiotic, for example, resistance to the drug increases, and eventually the drug loses its effectiveness.

Keep your interests alive
Instead of focusing on things that scare you, focus on things you love. You can't control what's going on in the world, but you can still enjoy life. During your get-togethers this holiday season, appreciate your time with friends and family. Pursue your interests with all the passion you can muster. Take up a new hobby if you've lost interest in the old ones.

Get treatment for anxiety, panic or depression if you need it
Mental health counselors have been busier than usual lately. It's normal and helpful to seek treatment if things are bothering you to the point where you have trouble going about your daily routine.

Centers for Disease Control and Prevention; The New York Times, 3, 6 November 2001.
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