Guest guest Posted October 7, 2001 Report Share Posted October 7, 2001 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 ---------------------- Forwarded Message: --------------------- 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) *********************************** A ProMED-mail post <http://www.promedmail.org>'>http://www.promedmail.org> ProMED-mail is a program of the International Society for Infectious Diseases <http://www.isid.org> [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 ---------------------------------- 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 *##########################################################* ProMED-mail makes every effort to verify the reports that are posted, but the accuracy and completeness of the information, and of any statements or opinions based thereon, are not guaranteed. The reader assumes all risks in using information posted or archived by ProMED-mail. ISID and its associated service providers shall not be held responsible for errors or omissions or held liable for any damages incurred as a result of use or reliance upon posted or archived material. ************************************************************ Visit ProMED-mail's web site at <http://www.promedmail.org>'>http://www.promedmail.org>. Send all items for posting to: promed@... (NOT to an individual moderator). If you do not give your full name and affiliation, it may not be posted. 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