Medical Detectives Tracking Anthrax Cases

Rare disease hits two at Florida newspaper; FBI enters investigation

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HealthDay Reporter

MONDAY, Oct. 8, 2001 (HealthDayNews) -- One place of business, two men exposed to an extremely rare strain of anthrax. Do those numbers add up to terrorism? The world of medical science may only be able to provide part of the answer.

The disease itself doesn't leave a calling card to let doctors know where it came from, said Dr. Martin Hugh-Jones, a professor at Louisiana State University and a leading anthrax expert. Instead, the clues lie in the circumstances.

"Basically, what gives these things away is the wrong thing happening in the wrong place at the wrong time," Hugh-Jones said.

Until last week, only 18 cases of inhaled anthrax had been diagnosed in the country in the last 100 years, most recently in 1976. But now -- less than a month after the Sept. 11 attacks -- one man is dead from inhaled anthrax and anthrax bacteria has been found in the nasal passages of one of his co-workers and in the Florida newspaper building where they both worked.

U.S. Attorney General John Ashcroft announced today that the FBI is investigating the incidents to see if terrorism was behind them.

The scare began last week when Bob Stevens, a 63-year-old photo editor at the supermarket tabloid, The Sun, became ill from an inhaled strain of anthrax. He died on Friday.

At the time, the U.S. Centers for Disease Control and Prevention said the case could simply be an isolated incident. But health officials announced today that they had detected anthrax in another Sun employee.

The co-worker, who had been hospitalized for pneumonia, apparently hasn't developed the disease. According to news reports, he is 73 and expected to survive.

A company official told the Associated Press that the latest victim worked in the company mailroom.

Officials also found anthrax bacteria on a computer keyboard in the tabloid newspaper's building in Boca Raton. The building, which houses American Media Inc., the parent company of The Sun and five other supermarket tabloids, has been shut down.

The anthrax cases are unprecedented, and the investigation will be too, experts said. One of the first steps will be to determine what the two victims have in common.

"You take these clues, and you track like mad," said Dr. Philip Brachman, a professor at Emory University. "You [test] those environmental areas where these two people would have had contact with each other. I'm sure they're looking at the office where they worked very carefully."

Although the strain of anthrax in question is inhaled, it is not considered to be contagious, said Brachman, who helped develop an anthrax vaccine in the 1950s and 1960s. The anthrax bacteria bypass the lungs -- meaning they cannot be exhaled through respiration or coughing -- and instead attack the lymph nodes around the lungs, Brachman said.

Victims of inhaled anthrax develop the disease within days or weeks of infection. Then, within a day or two after developing initial symptoms, they may begin to have breathing problems and bleeding. The death rate is unclear but was very high in the days before antibiotics were common. In 1979, 79 people inhaled the bacteria in an accident at a Soviet military facility, and 68 died.

Employees at the tabloid newspaper in Boca Raton are being tested for anthrax, and officials are advising them to begin antibiotic treatment.

Normally, tests for anthrax are fairly quick and take only six to eight hours, said Hugh-Jones. The U.S. Navy has developed a test that is even faster; it takes just five minutes, he said.

If investigators do determine that humans are behind the anthrax outbreak, they will have to consider possibilities other than international terrorism, experts said.

"Is there someone else with a motive to contaminate them or the building? It doesn't have to come from Osama bin Laden or Saddam Hussein," said Samuel Watson, director of the BioMedical Security Institute at the University of Pittsburgh and a former national security official in the vice presidential administration of George H.W. Bush, the president's father.

Watson said he also wondered why a terrorist would choose South Florida for an attack instead of New York City or Washington, D.C. "It could be someone developed this stuff and wanted to see if what they have grown actually worked. It's just a real mystery."

Although the past will be helpful in determining the cause of the anthrax cases, the future may settle the issue for good.

"If it's terrorism, one would think that there'd be more cases," Brachman said.

What To Do

A vaccine against anthrax exists, but supplies are limited to military personnel right now. Further, the only maker of the vaccine has had its share of problems with quality control.

To find out more about anthrax, visit the Centers for Disease Control and Prevention.

To learn more about bioterrorism preparedness and defense, check out information from the Center for Civilian Biodefense Studies.

SOURCES: Interviews with Philip Brachman, M.D., professor of public health, Emory University School of Public Health, Atlanta; Martin Hugh-Jones, Vet. M.B., MPH, Ph.D., professor of pathbiological pathology, Louisiana State University, Baton Rouge; Samuel Watson, director, BioMedical Security Institute, joint program of University of Pittsburgh and Carnegie-Mellon University, Pittsburgh.

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