Hospitals prepared for threat of anthrax

Posted: Sunday, October 21, 2001

Anthrax outbreaks in New York, Washington, D.C., and Florida have caused a rash of copycat pranks, paranoia of any white, powdery substances and fear even in Alaska of a disease that, according to medical experts, is not as serious as people seem to think.

"We deal with much more serious diseases on a daily basis at the hospital that are much more dangerous and have similar deadly effects if not treated," said Charlie Franz, administrator of South Peninsula Hospital in Homer. "People need to understand not to panic, it's a very manageable problem we're dealing with. People need to have some trust in us. We really are working and trying to give you straight information about what's going on."

Anthrax is an infectious disease of wild and domesticated animals, especially cattle and sheep, caused by bacteria spores that can be transmitted to people. It is considered a potential weapon in biological warfare.

Anthrax can infect people in three different ways -- by touch, by inhalation and by digestion. All three infections can be treated with antibiotics, the most popular of which is the high-powered Cipro, Franz said.

Central Peninsula General Hospital in Soldotna maintains an ample stock of antibiotics.

"We keep a couple week's supply of just about everything," said Bonnie Nichols, director of marketing and public relations at CPGH.

Alaska hospitals prepare for other kinds of disasters that could interfere with the transport of necessary items, so stocks, like antibiotics, are kept on hand, Nichols said.

South Peninsula Hospital has reserve stocks as well.

"We inventoried our antibiotics in the hospital and checked with both pharmacies in town, and we have an ample supply to treat several hundred people for two to thee days." Franz said. "I can't imagine we'd have an emergency that would involve a significant number of people on the peninsula, it's incomprehensible to me. I just don't believe that the terrorists have looked on the map and picked out the Kenai Peninsula as a place to attack."

Anthrax contracted through the skin, or cutaneous anthrax, is far less threatening than the other two varieties. Cutaneous anthrax can only be contracted by anthrax spores coming in contact with broken skin. Anthrax cannot be absorbed or contracted through healthy skin. Anyone who has touched anthrax spores or gotten it on their clothing simply needs to wash the contaminated areas and their clothes with hot water and soap, Franz said. As long as the skin is intact, anthrax will not be contracted.

If there is a break in the skin and anthrax spores enter the wound, an ulcer-looking sore with a black center will result. As uncomfortable as these sores may be, the fatality rate for cutaneous anthrax is only 20 percent, Franz said. Death from cutaneous anthrax only results secondarily, such as if sores form around the neck and create airway problems from swelling, not from the disease itself.

Gastrointestinal anthrax is more serious and has a higher fatality rate than cutaneous anthrax, but is much harder to contract. This type of contamination happens from ingesting anthrax spores, as from tainted meat.

"The chances of seeing that in this country would be pretty low," Franz said.

"You find it in developing countries where it already exists in the environment, where someone eats an infected animal and doesn't cook the meet well."

Gastrointestinal anthrax contamination brings about flu-like symptoms, including fever, vomiting, aches and pains and bloody diarrhea. This type of anthrax has a fairly high fatality rate, around 60 percent, if it is untreated, Franz said.

Inhalation anthrax is contracted by breathing anthrax spores into the lungs, where they move into the lymph nodes and cause problems with the lymphatic system.

"Inhalation anthrax is certainly the one most people are concerned about because it has the most potential for fatality," Franz said. "It causes a general systematic infection and it's pretty serious, but it is not easy to contract -- it requires a significant number of spores to be inhaled before you actually contract the disease."

As with gastrointestinal anthrax, inhalation anthrax results in flu-like symptoms, including aches and pains and a fever. Symptoms can develop in anywhere from two to 60 days.

As with all anthrax infections, inhalation anthrax can be treated with antibiotics. But since the symptoms resemble the flu, victims may not seek medical treatment immediately after symptoms develop.

"That will be one of the major problems I think we'll face with the upcoming flu season," Franz said.

"People will have the flu and think they have something else. The key thing people need to understand about anthrax is that their chances of being struck by lightning are much greater than contracting anthrax."

If someone were to come in contact with a white powder that they think may be anthrax, Franz recommends following these steps:

n Cover the item containing the powder or the powder itself with a plastic bag to prevent further contamination;

n Leave the room and close the door or somehow secure the area to keep other people from possibly disturbing the area;

n Wash hands with soap and hot water; and

n Call the authorities and report the incident;

If the suspicious powder is touched or gets on a person's clothes, they should shower and change clothing, especially before going to a hospital or other populated area where the contamination might be spread.

"It's not something that's going to kill you immediately," Franz said. "It's not an emergency situation as far as having to do something right now."

Avoiding panic is good advice in these situations, since not one of the anthrax scares in Alaska has turned out to be genuine.

"Most of the white powder that has been taken to the authorities has been exactly that -- white powder, not anthrax," Franz said. "There's a lot of sick people out there that think it's a joke or something to threaten somebody with anthrax. I think our attorney general gave good advice on that -- those people should be prosecuted to the full extent of the law."

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