An Anthrax oddity

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Bob Stevens of Florida just died from kidney failure and cardiac arrest, brought on by an inhaled form of Anthrax. The CDC has stated that there is no evidence to suggest that this was the result of terroristic activity, and I agree - there's no evidence. But today's AP story on his death brought two points to light that I'd like to post on, because they seem very odd:

1) While an Anthrax case happens every year on average within the US, a death from the inhaled form (vs then one transmitted through skin contact) is the first such case in 25 years in this country.

2) Mohamed Atta, one of the suspected hijackers, had rented planes at a flight school at Palm Beach County Park Airport. Bob Stevens house is within a mile of this airport. It could be a mad coincidence, and I agree these two facts do not constitute definite evidence of anything yet. Agree? Thoughts?

-- Bemused (and_amazed@you.people), October 06, 2001

Answers

The CDC and Tommy Thompson are on the case. The neighbors in Florida are worried. It's very much an open story, I think....

-- Bemused (and_amazed@you.people), October 06, 2001.

It's nice to see this board is just becoming another doom and gloom Mecca. What does Gray North have to say about this?...... HA!

-- grannie gadfly (get@some.duds), October 06, 2001.

Speak for yourself. I am one happy son-of-a-bitch.

-- KoFE (your@town.USSA), October 06, 2001.

I am not going to die from anthrax.

I am going to die from skin cancer.

-- (Catherine__Linton@hotmail.com), October 06, 2001.


I posted this on another thread but thought it might also be useful here to help dispel paranoia. If this is a biowar attack we'll be seeing a lot of new cases real soon. It's unlikely that this is the case.

"****** [2] Date: Fri 5 Oct 2001 12:05 PM From: Peter Turnbull

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]

-- Peter Turnbull

-- Medic (-@aool.com), October 06, 2001.



This one is a little close to home for me. The guy who died worked for American Media, publisher of the tabloid Sun for whom he was a photography editor. American Media is my client....

-- FutureShock (gray@matter.think), October 06, 2001.

The lives of many Americans have been touched by this incident. I was at Disneyworld in Orlanda only about 100 miles away while Atta was flying around up there taking lessons. If the wind was blowing a little differently, I might be with Bob Stevens in that big amusement park in the sky.

Please send donations to:

Attack On America Fund, The Sequel My Bank, My Account Number Tearwater, FL 0I812

(be generous, you might die some day too)

-- please feel sorry for me (make the world @ warm and fuzzy. place), October 06, 2001.


It's nice to see this board is just becoming another doom and gloom Mecca....

Well, you're talking right now to a very anti doom & gloom guy. I was careful to point out that the two facts I listed above don't constitute real evidence of terroristic activity.

But one of the facts is weird, and both, involving the same guy, is weirder. Part of my job is dealing with statistical probabilities of system failures, and all I'm willing to say is that this strikes me as odd.

I'm betting it will blow over, and we'll look back on this as one of the strange facts we found ourselves dealing with in this new through-the-looking-glass world.

But I'm not blind to the fact that sometimes betting == hoping.

-- Bemused (and_amazed@you.people), October 06, 2001.


But for now my suspicions are that it is not inhalation anthrax...

And to respond to "Medic" - that's what we all hope we end up hearing from the CDC. Sometimes I wonder if the CDC wants to minimize press conferences, though, just like any organization that's still wading through raw facts trying to get to truth.

-- Bemused (and_amazed@you.people), October 06, 2001.


Ant hrax, the official line

-- (Roland@hatemail.com), October 06, 2001.


From the above link~

---------------------------------

Inhalational Anthrax Inhalational anthrax follows deposition of spore-bearing particles of 1 to 5 µm into alveolar spaces.31, 32 Macrophages ingest the spores, some of which undergo lysis and destruction. Surviving spores are transported via lymphatics to mediastinal lymph nodes, where germination may occur up to 60 days later.28, 29, 33 The process responsible for the delayed transformation of spores to vegetative cells is poorly understood but well documented. In Sverdlovsk, cases occurred from 2 to 43 days after exposure.8 In experimental monkeys, fatal disease occurred up to 58 days28 and 98 days34 after exposure. Viable spores have been demonstrated in the mediastinal lymph nodes of monkeys 100 days after exposure.35

Once germination occurs, disease follows rapidly. Replicating bacteria release toxins leading to hemorrhage, edema, and necrosis.23, 36 In experimental animals, once toxin production has reached critical threshold, death occurs even if sterility of the bloodstream is achieved with antibiotics.19 Based on primate data, it has been estimated that for humans the LD 50 (lethal dose sufficient to kill 50% of persons exposed to it) is 2500 to 55,000 inhaled anthrax spores.37

The term inhalational anthrax reflects the nature of acquisition of the disease. The term anthrax pneumonia is misleading. Typical bronchopneumonia does not occur. Postmortem pathological study of patients who died because of inhalational anthrax in Sverdlovsk showed hemorrhagic thoracic lymphadenitis and hemorrhagic mediastinitis in all patients. In up to half of the patients, hemorrhagic meningitis also was seen. No patients who underwent autopsy had evidence of a bronchoalveolar pneumonic process, although 11 of 42 patients undergoing autopsy had evidence of a focal, hemorrhagic, necrotizing pneumonic lesion analogous to the Ghon complex associated with tuberculosis.38 These findings are consistent with other human case series and experimentally induced inhalational anthrax in animals.33, 39, 40

Early diagnosis of inhalational anthrax would be difficult and would require a high index of suspicion. Clinical information is available from only some of the 18 cases reported in the United States in this century and from the limited available information from Sverdlovsk. The clinical presentation has been described as a 2-stage illness. Patients first developed a spectrum of nonspecific symptoms, including fever, dyspnea, cough, headache, vomiting, chills, weakness, abdominal pain, and chest pain.8, 19 Signs of illness and laboratory studies were nonspecific. This stage of illness lasted from hours to a few days. In some patients, a brief period of apparent recovery followed. Other patients progressed directly to the second, fulminant stage of illness.2, 19, 41

This second stage developed abruptly, with sudden fever, dyspnea, diaphoresis, and shock. Massive lymphadenopathy and expansion of the mediastinum led to stridor in some cases.42, 43 A chest radiograph most often showed a widened mediastinum consistent with lymphadenopathy (Figure 2).42 Up to half of patients developed hemorrhagic meningitis with concomitant meningismus, delirium, and obtundation. In this second stage of illness, cyanosis and hypotension progress rapidly; death sometimes occurs within hours.2, 19, 41

The mortality rate of occupationally acquired cases in the United States is 89%, but the majority of cases occurred before the development of critical care units and, in some cases, before the advent of antibiotics.19 At Sverdlovsk, it is reported that 68 of the 79 patients with inhalational anthrax died, although the reliability of the diagnosis in the survivors is questionable.8 Patients who had onset of disease 30 or more days after release of organisms had a higher reported survival rate compared with those with earlier disease onset. Antibiotics, antianthrax globulin, and vaccine were used to treat some residents in the affected area some time after exposure, but which patients received these interventions and when is not known. In fatal cases, the interval between onset of symptoms and death averaged 3 days. This is similar to the disease course and case fatality rate in untreated experimental monkeys, which have developed rapidly fatal disease even after a latency as long as 58 days.28

Modern mortality rates in the setting of contemporary medical and supportive therapy might be lower than those reported historically. However, the 1979 Sverdlovsk experience is not instructive. Although antibiotics, antianthrax globulin, corticosteroids, and mechanical ventilation were used, individual clinical records have not been made public.8 It is also uncertain if the B anthracis strain to which patients were exposed was susceptible to the predominant antibiotics that were used during the outbreak.

Physiological sequelae of severe anthrax infection in animal models have been described as hypocalcemia, profound hypoglycemia, hyperkalemia, depression and paralysis of respiratory center, hypotension, anoxia, respiratory alkalosis, and terminal acidosis.44, 45 Those animal studies suggest that in addition to the rapid administration of antibiotics, survival might improve with vigilant correction of electrolyte disturbances and acid-base imbalance, glucose infusion, and early mechanical ventilation and vasopressor administration.

-- (Roland@hatemail.com), October 06, 2001.


Me too Catherine.

-- Uncle Deedah (unkeed@yahoo.com), October 07, 2001.

Given the case is airborne, there is a very high probability that Q has possession of Anthrax. It entered the U.S. through the nearby port 30 to 90 days ago. Unless this one death is the first of many, the operatives were careless and suffered an accidental release of the aerosol while unpacking or repackaging the contaminant.

Given that exposure occurred several months ago, and that the exposed individual is now dead, it will be difficult to determine the exact date, method, and disposition of the package. If there is something about the unfortunate individual's job, location, personality, habits, or acquaintances that predisposed him to contamination, then we have a chance.

-- A (A@B.com), October 07, 2001.


Unless Mohamed Atta was flying crop dusters at the flight school, and the flight instructor let him put anthrax in it, and Atta had a special strain of anthrax that would only kill people with Bob Steven's genetic make-up, I would say we don't have a lot to worry about.

-- granny gadfly (get@some.duds), October 07, 2001.

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