'Don't panic': Anthrax threat deserves concern not overreaction - Airman Consumer

Airman, Feb, 2002 by Mike Young

Military medical experts are echoing the same warnings and reassurances as civilian medical professionals -- Don't panic!

The detection of anthrax contamination in the U.S. mail system has heightened our sensitivity and awareness associated with the use of anthrax. Most of the cases containing suspicious substances have been hoaxes, however some were not.

"The key is not to panic," said United States Air Forces in Europe medical spokesman, Lt. Col. Fred Kelsey. For example, when dealing with suspected contamination in a mailed package or letter, "panic can lead to carelessness and a potential spreading of the mailed substance."

The best way to combat the anthrax threat is to increase your knowledge of the facts then use this information to protect yourself and those around you.

The first step in this line of defense is to know what anthrax is -- a disease caused by a bacterium having the scientific name Bacillus anthracis.

"When environmental conditions are not adequate for its growth," Kelsey said, "anthrax forms a resistant spore. These spores can remain viable and infective for many years. Under favorable growth conditions, such as in infected tissues or appropriate laboratory settings, the bacteria revert to a vegetative form that reproduces and creates the products that cause tissue damage during infection."

The next step is to recognize the symptoms of infection. These generally occur within seven days of exposure, depending on how the disease was contracted, with most cases showing symptoms during the first 48 hours after exposure. However, incubation periods up to 60 days are possible.

Anthrax can be spread three ways:

* Through breathing in (inhalation) anthrax spores

* Through cutaneous (skin) contact with infected animal products, such as wool, hair, or hides, or soil contaminated by the animal

* Through ingesting contaminated, undercooked meat

"Initial symptoms of inhalation anthrax may resemble the common cold," Kelsey said. "Alter a few days, symptoms may progress to severe breathing difficulties and shock."

After the onset of symptoms, inhalation anthrax is often fatal. However, early antibiotic treatment of the disease before the onset of symptoms increases the chances for survival.

While inhalation anthrax causes flu-like symptoms, cutaneous anthrax is marked by a boil-like lesion that appears and eventually forms an ulcer with a black center.

The initial symptoms of intestinal anthrax include nausea, loss of appetite, vomiting and fever, followed several days later by abdominal pain, vomiting of blood and severe diarrhea.

As for origin, anthrax spores occur naturally in soil, especially on farms. The disease occurs most commonly in grass-eating animals, such as goats, cattle and sheep. These animals become infected while feeding in pastures where the spores naturally occur in the soil.

Naturally occurring anthrax is rare in the United States as a farm animal disease due to good vaccination programs. However, anthrax does occur regularly in farm animals in other parts of the world, such as South and Central America, southern and eastern Europe, Asia, Africa, the Caribbean and the Middle East.

When it comes to humans and anthrax, most cases are the cutaneous form. The last naturally occurring case in the United States was reported in 1992.

There are two pluses concerning anthrax: First, it's not spread from person to person, so it cannot be acquired from those who've contracted the disease. Second, the use of anthrax in a battlefield weapon system isn't a simple process," Kelsey said.

"To be effective, the anthrax spores must be very small and placed in an aerosolized form so those targeted would inhale the spores," Kelsey said. This type of preparation requires sophisticated equipment and training.

The third and final step in the anthrax education process is knowing how to increase your awareness. The following guidelines can help you:

What should I do if I receive suspicious mail or find a suspicious substance in a room?

* Do not move it; cover the mail with paper, towels, clothing, etc.

* Close windows/doors, shut off fans and have everyone leave the immediate area.

* Wash you hands with soap and water.

* Notify your supervisor; call OSI.

* If possible, collect names of everyone who had contact with the suspicious mail and who were in the room.

* As soon as possible, gently seal your clothing in a plastic bag and take a soap and water shower.

* Contact your medical clinic for appropriate assessment.

When I receive suspicious mail or find a suspicious substance, should the building be evacuated?

* Evacuate the building when forced air ventilation or fans are in use, or doors/windows are open allowing increased air movement.

* Evacuate the building if the suspicious mail has circulated through several rooms in the building.

* Always move outside into fresh air, but don't leave the immediate area.

When I receive suspicious mail or find a suspicious substance in my building, should adjacent buildings be evacuated?

* Normally it's not necessary, but it's the decision of the on-scene emergency responders.