PRO/AH/EDR> Anthrax, human - USA (Florida) (03) (fwd)

[Guest guest]

Some very interesting questions are raised by Dr.

Turnball in regards to where this anthrax came from and

whether it could be terrorist related.

e

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From: ProMED-mail <promed@...>

promed-ahead-edr@...

Subject: PRO/AH/EDR> Anthrax, human - USA (Florida) (03)

Date: Fri, 5 Oct 2001 23:14:38 -0400 (EDT)

ANTHRAX, HUMAN - USA (FLORIDA) (03)

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[see also:

Anthrax, human - USA (Florida) 20011004.2407

Anthrax, human - USA (Florida) (02) 20011004.2408]

[1]

From: ProMED-mail <promed@...>

Date: 4 Oct 2001

Source: ABCNews.com [edited]

<http://abcnews.go.com/sections/us/DailyNews/anthraxvictim011005.html>

Florida Anthrax Victim Dies

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Lantana, FL, Oct 5: A 63-year-old Florida man died today after contracting

the inhaled form of anthrax, an extremely rare and lethal disease that

could be a weapon in the hands of terrorists. [However] investigators have

said there is no evidence he was the victim of a terrorist attack. Dr. Jean

Malecki said the man failed to respond to the antibiotics he had been given

and died at 4 p.m. the first anthrax death in the United States in a

quarter century. Dr. Larry Bush, an infectious disease specialist, said his

patient suffered kidney failure and then cardiac arrest and could not be

resuscitated. " It was not unexpected, " Bush said.

Barbara Reynolds, a spokeswoman for the Centers for Disease Control and

Prevention in Atlanta, and Tim O'Conner, a spokesman for the Florida

Department of Health's Palm Beach County operation, both said today that no

other cases of anthrax have been reported. " [CDC investigators] are not

looking at any pending cases, " Reynolds said. " They have been scanning the

hospitals, but we don't have anything. " O'Conner said several ill people

visited doctors and called public health clinics today, fearing they might

have anthrax. 3 people warranted additional tests, but all were negative.

" We have ruled them out, " he said.

There has been concern because anthrax has been developed by some countries

as a possible biological weapon, though U.S. officials have said there was

no evidence the Florida case was the victim of terrorism.

The disease, which is not contagious can be contracted naturally, often

from livestock or soil [if you are a cow... MHJ], and the deceased man did

visit North Carolina last week. Officials said the deceased man was an avid

outdoorsman, and the CDC said today it is continuing to investigate where

he may have caught the disease. Only 18 inhalation cases in the United

States were documented in the 20th century, the most recent in 1976 in

California. The last anthrax death in Florida occurred in 1974, according

to the state health department.

Dr. tti, a professor at the University of Florida's College of

Veterinary Medicine, said anthrax is not normally found among wildlife or

livestock in Florida. " There has not been a case here [among animals] in

years, " he said. He said anthrax occasionally appears among animals in

Texas, Louisiana, New Mexico, Arkansas, and parts of Midwest, though he

wasn't sure about North Carolina. " It will be interesting to see where this

came from, " he said.

FBI, CDC and state health and agriculture investigators sealed off the

deceased man's house and searched it for about 2 hours today. When they

left, they removed the yellow crime scene tape they had placed around the

house. They were also searching his workplace.

FBI spokeswoman Judy Orihuela said that was routine procedure and it does

not indicate any belief by agents that the anthrax was released by

terrorists. Dr. Wiersma, a state epidemiologist, said investigators

took a number of items from the man's home, including pesticide sprays and

fertilizer bottles, to see if they were contaminated. " We don't expect any

of these to turn out positive, but those are prudent to check, " he said.

Some in Lantana have been concerned because Mohamed Atta, one of the

suspected hijackers who crashed airliners into the World Trade Center on 11

Sep 2001, rented planes at a flight school at Palm Beach County Park

Airport. The home of the deceased man is within a mile of the airport.

Shortly after the terrorist attack, n , owner of Palm Beach

Flight Training, said Atta had rented a plane four times in August.

Employees at the flight school declined comment today. Atta also visited an

airfield in Belle Glade, about 40 miles inland from Lantana, and asked

workers there questions about their cropdusters, but never flew one. Some

of the suspected hijackers had lived in an apartment complex in Boynton

Beach, about 10 miles south of Lantana.

" I'm starting to get a little scared, " said Louis Selitti Jr., 33, who

lives across the street from the home of the deceased man in a neighborhood

of modest, single-story homes. " To get something in our lungs, you have to

breathe it in. Hopefully it wasn't around here. "

Orihuela said agents have not revisited the airport or the apartment

complex since the Florida man became ill, and she was not aware of any

plans to do so. She said the agency is monitoring the CDC's investigation,

" but they're in charge. "

Croddy, a bioterrorism expert at California's Monterey Institute, said

that everything so far leads him to believe that the government is right,

that the Florida man caught the disease naturally and that it is an

isolated case. " He's an unfortunate, unlucky fellow, " Croddy said. He said

that there likely have been a small number of other cases of the disease

since the 1970s, but because the disease is so rare in this country it was

misdiagnosed. " But now every doctor knows of it and is looking for it, " he said

******

[2]

Date: Fri 5 Oct 2001 12:05 PM

From: Turnbull <peterturnbull@...>

It seems a little premature to me to call this pulmonary anthrax. That term

is generally reserved for anthrax acquired by inhaling the spores. I

understand this person had meningeal symptoms, which as you know can be a

sequel to any form of the disease. By the time he was being X-rayed, I

suspect he had generalized edema and this, in the chest region, may have

been regarded as pulmonary symptomatology. It will be interesting to see

what CDC can trace in the way of infection source and route. But for now my

suspicions are that it is not inhalation anthrax.

[ProMED-mail wishes to thank Dr. Turnbull, truly one of the world's leading

authorities on anthrax, for his comments. - Man. Ed. DS]

--

Turnbull

<peterturnbull@...>

[but if it was not primarily pneumonic, which itself sets up problems of

how did he get it, what was the primary lesion the meningitis infection

followed? So far there are no reports of any other lesions. I suppose if he

sniffed hard at some contaminated wool or picked his nose after handling

some contaminated Haitian goat skins, for example, it would go almost

straight to the brain via a lesion in his nasal turbinates, and if no one

has looked up his nasal passages, any lesion there would be missed. Also

drainage from a primary nasal lesion would be into the trachea and lungs.

The autopsy will reveal more information.

Otherwise, the only other relevant information I have from various sources

is that he had an obvious positive blood culture at the time of his

positive lumbar tap on Tuesday. The organism was sensitive to 4 common

antibiotics tested, including penicillin and ciprofloxacin. The careful

initial positive identification was confirmed by CDC. The patient's care

was certainly outstanding to have kept him going for so long. - Mod.MHJ]

.........................mhj/pg/ds

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