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October 10, 2001

Anthrax Update for October 10, 2001 #2


 (SafetyAlerts) -  Sen. Bob Graham (D FL), the chairman of the Senate Intelligence Committee, met with CDC Director Jeffrey Koplan on Monday night and said afterward, "I asked Dr. Koplan what would be the likelihood that such a disease could have occurred without human intervention. His words were, 'Nil to none.'" Graham told the Miami Herald that he is "worried" by the anthrax cases, but added that there is "no reason to suspect" they were linked to the 11 Sep 2001 terrorist attacks or the hijackers who carried them out - some of whom had lived near the newspaper offices.

A state health official added to the growing conviction that the 2 anthrax cases at American Media Inc., which left one man dead and another hospitalized, were the result of foul play. "The chances are one in a billion" that 2 such cases would occur naturally, said Dr. Landis Crockett, director of disease control for the Florida Department of Health. But Florida Health Secretary John Agwunobi told MSNBC Cable on Tuesday that the source of the bacterium remains unknown. "Our investigators aren't ruling out anything at this point," he said. He also sought to reassure the public, saying the isolated cases do not pose a public health threat.

Barbara Reynolds, a spokeswoman for the Centers for Disease Control and Prevention in Atlanta, said federal investigators have eliminated the obvious environmental sources of anthrax at the offices of AMI, the publisher of tabloid newspapers The Sun and The National Enquirer and The Globe. The FBI on Monday sealed off the AMI offices, and agents donned protective gear before going inside. "We regard this as an investigation that could become a clear criminal investigation, and we are pursuing this with all the dispatch and care that's appropriate," U.S. Attorney General John Ashcroft said. "We don't have enough information to know whether this could be related to terrorism or not."

Anthrax cannot be spread from person to person, but all 300 people who work in the building - and anyone who spent more than an hour inside since Aug. 1 - were advised to visit health officials for tests and antibiotics. The Palm Beach County Health Department tested 743 people linked to the building on Monday and expected an additional 100 people on Tuesday, said Alina Alonso, the department's director of clinical services.

A worker at the AMI offices who was treated last week for pneumonia said she had been instructed to return Tuesday for further tests. "I'm glad to have 2 tests," [a 67-year-old female employee of] the company, told the Miami Herald. "All my friends are telling me how lucky I am to have pneumonia. I don't think they believe I have it."

The anthrax scare also spread to Virginia, but a doctor on Tuesday said that initial lab tests on a patient with connections to The Sun have thus far been negative. "I just want to allay everybody's anxiety about this case because it just doesn't seem to fit the criteria," said Dr. Thomas Ryan of Price William Hospital in Manassas, VA.

Health officials initially considered [the first patient's] death as an anomaly, but concerns were heightened when anthrax was detected on his computer keyboard and a second case of anthrax exposure involving a co-worker was confirmed on Monday. The second case involved a Sun mailroom employee. Health officials said tests confirmed he had anthrax bacteria in his nasal passages, but he was not showing symptoms of the disease. [The mailroom employee] was tested for anthrax because he happened to be in a hospital for what co-workers said was an unrelated heart problem. He was in stable condition at a Miami-Dade County hospital Monday, being treated with antibiotics, according to health officials.

Though there is no evidence linking the outbreak to the 11 Sep 2001 attacks, news accounts noted that the dead photo editor, lived about a mile from an air strip where flight school owner Marian Smith said suspected hijacker Mohamed Atta rented planes. Several suspected hijackers also visited a crop-dusting business in Belle Glade, 40 miles from [the deceased patient's] home in Lantana. The Miami Herald also reported that investigators were reviewing the names of several subscribers of one tabloid whose names are similar to those of 2 hijackers.

Federal officials are sending Florida 100 cases of antibiotics to back up the local supply. The antibiotics came from a federal stockpile that holds  enough to treat 2 million cases of anthrax.

[Byline: Fredricka Whitfield]

Letter scrutinized as possible source of anthrax.

8 Oct 2001 Posted: 11:16 PM EDT (0316 GMT) Authorities are taking nose swabs and blood samples from people who worked in or visited the building. Test results from the nose swabs won't be available for several days; blood test results could take several weeks. However, health officials have not been able to reach a few individuals who worked in the building, Agwunobi said. They are being asked to call (800) 342-3557. Employees were also being told to fill out a public health department questionnaire, detailing their visits the mail room, text or photo libraries. Another question: "Since 11 Sep 2001, have you noticed any unusual occurrences at work?"

[A mailroom employee] was admitted to Cedars Medical Center in Dade County last week after feeling ill and exhibiting flu-like symptoms at work. He felt so sick that co-workers drove him home, 2 counties away. Physicians conducted tests and began treating him for pneumonia, but his case became more complex once the [confirmed case of pulmonary anthrax] came to light. FBI agents came to the hospital and questioned [the mailroom employee's] wife "for hours," a family spokesperson said. [As there is no
confirmation of anthrax lesions, it might be assumed that any chest x-ray was of an expected pneumonia. - Mod.MHJ]

At the same time, the hospital ran tests and conducted a nasal passage swab to test for anthrax exposure, discovering anthrax spores in [the man's] nose. [He] did not contract respiratory anthrax, hospital officials said, and so far has exhibited no clinical symptoms [associated with the] bacterium.

[The deceased photo editor] fell ill after a recent trip to North Carolina, but a Florida state epidemiologist said he did not believe [the man] contracted the disease during his trip. The incubation period for anthrax is between 6 and 45 days, a period which would not have included his trip. As photo editor,[the deceased] worked on a number of stories but did not leave the building, officials said.

An editorial states that with the recent anthrax exposure, the government must "shore up" its defenses, including "specific actions and a basic reorientation of defense scientists from physics to biology." The editorial suggests that the government improve its supervision of biowarfare vaccine production, particularly in light of production problems with the anthrax vaccine. Further, the editorial suggests that the government provide grants for biological defense-related research.

President Bush also should name biologists to unfilled positions at NIH and the FDA because "well-regarded biologists" can help the United States "mount a strong defense against bioweapons."

Even though the anthrax cases raise suspicion and fears of bioterrorism, there are "reasons to be reassured," an editorial states. For instance, the "event seems to be relatively small," which could mean that the "job was either botched or the goal was not mass murder but rather harm to a particular individual or 2." Another "comforting element" is the medical and public health systems' "rapid response" to the exposures, the editorial states.

Even if these anthrax exposures do not prove to be related to terrorism, "the point to keep in mind is that sooner or later" this won't be a "false terror alarm," an editorial says. The editorial suggests that the federal government improve awareness of bioterrorism among public health officials, doctors, and hospitals.

Update: Ongoing Investigation of Anthrax in Florida 8 Oct

Today public health officials in Palm Beach County Health Department began to evaluate and offer prophylactic treatment to persons who might have been exposed to _Bacillus anthracis_ (the bacterium that causes anthrax) while working or visiting America Media Inc. (AMI) in Boca Raton, Florida.

Persons known to have been in the AMI building for at least one hour since 1 Aug 2001 will be contacted if they have not already been evaluated. Those who are not currently in Florida might seek care in other jurisdictions.
Contact your local or State health department if this happens in your jurisdiction, so that the information can be relayed to CDC and the Palm Beach County Health Department. The prophylactic antibiotic treatment regimens recommended for persons potentially exposed to _B. anthracis_ at AMI are attached. Additional information about prophylactic treatment for anthrax can be found at: <>

Federal agencies and public health officials are continuing to investigate anthrax in Florida. No additional cases of anthrax have been identified.

Reminder: symptoms of inhalational anthrax include fever, muscle aches, and fatigue that rapidly progress to severe systemic illness. Workers and visitors associated with the AMI worksite in Florida who develop such symptoms should be thoroughly evaluated to exclude anthrax and be reported to the state health department.

[The thinking at this time is clearly that this is a biocrime, not bioterrorism. The former might be defined as having criminal objectives that are narrow and in a definable close relationship to the target, and thus the perpetrator would be "getting even" over something the company published or how he or she had been treated by the company. While the company will be shut down for a couple of weeks, as the FBI treats it as a crime scene, the financial cost to The Sun will be significant though it may not shut it down permanently. A wide variety of people in and out the public eye have been unwilling subjects of their publications. - Mod.MHJ].

Source: ProMed.

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