Anthrax Treatment Must Begin Before Symptoms

October 8, 2001

Anthrax treatment must begin before symptoms show up, some of which can be confused with flu

By JOSEPH B. VERRENGIAThe Associated Press10/8/01 8:35 PM

Anthrax is an animal disease that rarely spreads to humans and almost never is transmitted from person to person. Early symptoms from inhalation anthrax, the most rare kind, begin with a cough but rapidly progress into severe breathing problems and shock. They initially can be confused with the flu. To be effective, antibiotic treatment must begin before symptoms show up -- usually within one week, but sometimes as long as two months after exposure. In Florida, co-workers of a man who died of inhaled anthrax last week are being tested and given antibiotics as a preventative measure. On Monday, officials announced that the germ was found in the nose of one of his co-workers and on a computer keyboard in their office. The Centers for Disease Control and Prevention have identified two antibiotics -- Cipro and doxycycline -- to treat anthrax. Federal officials were sending Florida 100 cases of antibiotics to back up the local supply. The antibiotics came from the federal stockpile, which holds enough to quickly treat 2 million anthrax cases. Once established, inhalation anthrax can kill within a few days, despite aggressive treatment. "You want to treat people before they show symptoms," said Bruce Clements, associate director of St. Louis University's Center for the Study of Bioterrorism and Emerging Infections. Anthrax is one of a handful of microbes turned into biological weapons designed to infect and kill large populations. Armies that have developed biological weapons have loaded anthrax into bombs and missiles; a treaty signed by 143 nations bans their use. However, terrorists would most likely spread anthrax by spraying it or releasing into a ventilation system, experts suspect. Anthrax spores are hardy and can persist for weeks indoors. They are resistant to both sunlight and disinfectant. Only 18 inhalation cases in the United States were documented in the 20th century, the most recent in 1976. About 95 percent of all cases of anthrax worldwide result from skin contact with infected animals or tissue, and ranchers and animal handlers are sometimes at risk. Two suspected cases of so-called cutaneous anthrax have been reported in Texas this year, both in ranch workers. Cutaneous anthrax often begins with a bump on the hands, arms or head that eventually turns into a sore and coal-black lesions. More severe symptoms may follow, including fever, swelling and headache. Untreated, about 20 percent of patients die. Anthrax can also be caused by eating tainted meat. No cases of digestive anthrax have ever been reported to the CDC. The worst incident with inhaled anthrax occurred in 1979, when anthrax spores were accidentally released from a former Soviet military laboratory, killing 68 people. Anthrax spores remain viable in the soil for decades. In 1942, Winston Churchill ordered germ warfare tests on Gruinard Island off the coast of Scotland. In 1986, workers removed tons of topsoil, then soaked the remaining ground in seawater spiked with large amounts of formaldehyde.

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