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Downed plane, Florida anthrax case raise new fears
By ALISA ULFERTS and DAVID BALLINGRUD
© St. Petersburg Times, published October 5, 2001
CDC, FBI investigate Lantana case
Florida's first confirmed case of anthrax in 27 years surfaced Thursday in Palm Beach County, prompting an intense investigation by federal and state health officials and assurances that the isolated case had no link to last month's terrorist attacks.
"There's no need for people to fear they are at risk," said Dr. Jeffrey P. Koplan, director of the Centers for Disease Control and Prevention in Atlanta.
But he said a deliberate release of the germ by terrorists is one of several possibilities under investigation. "We have that on the list," he said.
Bob Stevens, a 63-year-old Lantana man and photographer for Boca Raton-based American Media Inc., checked himself into a Palm Beach County hospital Tuesday after a trip with his wife to North Carolina, where he had become ill.
The initial diagnosis was meningitis, but then doctors took a closer look. What they found -- a deadly bacteria that occurs naturally but also is said to be favored as a tool of biological warfare -- has alarmed officials even as they appealed for calm.
"The disease is not contagious. It does not spread from one individual to another," said Florida Department of Health Secretary John Agwunobi.
"At this point there are no indications that anyone else has contracted this disease. We have not found any other cases," Agwunobi said.
But officials are searching.
"We are actively looking for people who have these symptoms. But hospitals haven't reported any (more)," said CDC spokeswoman Barbara Reynolds.
Dr. Steve Wiersma, an epidemiologist with the Florida Health Department, said that based on the disease's incubation period of up to 60 days, authorities are certain Stevens contracted anthrax in Florida.
Yet federal Health and Human Services Secretary Tommy Thompson noted that Stevens, described as an avid outdoorsman, apparently drank from a stream while in North Carolina, a state known for hog farming and its associated waste.
Public health offices across the country have been on alert for possible biological attack ever since federal officials warned that several of the Sept. 11 hijackers had asked about renting crop dusters. That level of alert led doctors to diagnose Stevens so quickly, officials said.
Officials repeatedly stress Stevens' case is not linked to the terrorist attack, but it does have one striking coincidence: One of the hijackers, suspected ringleader Mohamed Atta, rented a four-seat Piper airplane from the Palm Beach Airport in Lantana, the same town where Stevens lives. Atta and several other men suspected in the attacks asked about renting crop dusters in nearby Belle Glade.
Reynolds wouldn't say whether her agency will look at the airport, but did say they plan to track Stevens' movements.
"We will go wherever this person has been," Reynolds said.
While her agency is investigating every possible source of the bacteria, Reynolds stressed again that the case appears to be isolated and poses no threat. The agency would be looking at a possible deliberate release as one of many possibilities even if the country hadn't recently been attacked by terrorists, she added.
Anthrax typically affects one of three areas: the skin, the intestinal tract and the pulmonary tract. Agwunobi said Stevens appears to have the third and most serious kind, in which the victim inhales the bacteria spores. Such cases have a high fatality rate, he said.
The most recent previous U.S. case of anthrax was this year in Texas. But that was the more common skin form, not inhalation anthrax. During the 20th century, only 18 cases of inhaled anthrax were reported in the U.S, the most recent in 1976.
Anthrax causes pneumonia, and patients are treated with antibiotics. A vaccine can prevent the spread of the disease, but it is not available to the public. The vaccine involves a series of six shots administered over 18 months, Reynolds said.
CDC investigators have been dispatched to both Florida and North Carolina, since Stevens was said to have visited Duke University in Durham, N.C., about a week ago. The FBI also is investigating.
Anthrax is an occupational disease, contracted almost exclusively by people who handle animal hides or skins -- farmers, butchers, veterinarians or wool handlers, for example.
But the bacteria has appeal as a weapon, too. The former Soviet Union produced hundreds of tons of weapons-grade anthrax spores, and terrorists have been drawn to it because it is invisible and lacks taste and odor. It can also be stored for long periods.
And it is lethal.
According to an estimate by the Congressional Office of Technology Assessment, 100 kilograms of anthrax, released from a low-flying aircraft over a large city on a clear, calm night, could kill 1-million to 3-million people.
Some experts on bioterrorism say its value as a weapon is overrated, however, pointing to a failed 1993 anthrax attack in Japan. The doomsday cult Aum Shinrikyo tried twice to dispense anthrax from the roof of an eight-story building in Tokyo, using an industrial sprayer and a large fan. The clumsy delivery system and a weak strain of anthrax had no effect.
The Russians have some experience with its lethality.
In April and May 1979, an unusual anthrax epidemic occurred in Sverdlovsk, USSR. Soviet officials attributed it to consumption of contaminated meat, but U.S. agencies blamed it on inhalation of spores accidentally released at a military microbiology facility.
Florida's most recent case of anthrax occurred in 1974, when a 22-year-old woman contracted the skin kind after buying a bongo set in Haiti that was made with contaminated goat skin. News reports at the time said she survived with just minor scarring.
Two years later, state health officials confiscated wool contaminated with the spores from several craft stores in St. Petersburg and Clearwater. The wool had been imported from Pakistan.
-- Times staff writer Steve Bousquet and Times researchers Kitty Bennett, Deirdre Morrow and Cathy Wos contributed to this report, which includes information from the Associated Press.
Anthrax is an animal disease that rarely spreads to humans and almost never is transmitted from person to person. It most commonly occurs in cattle, sheep, goats, camels and other herbivores, but can occur in humans when they are exposed to infected animals or their tissue. Its spores -- a bacterium's inactive state -- can live in the soil for years.
Infection can occur in three forms: skin, inhalation and gastrointestinal. Inhalation is the most serious. Symptoms typically start within seven days of breathing in spores but can develop six to eight weeks later. Only 18 U.S. inhalation cases were documented in the 20th century.
First symptoms of inhalation anthrax may resemble a cold, with cough and fever, but the disease progresses to severe breathing problems and shock. Once symptoms begin, the disease often responds poorly to antibiotics. Without treatment, 90 percent of victims die within a few days.
Skin anthrax often begins with a bump on the hands, arms or head that turns into a sore. More severe symptoms may follow, including fever, swelling and headache. The infection can be cured with antibiotics. But when untreated, about 20 percent of patients die.
Person-to-person spread of anthrax is extremely unlikely. There is no need to immunize or treat friends, relatives or co-workers of people ill with anthrax, unless they were exposed to the same source.
Infection in people exposed to anthrax can be prevented with antibiotics. The vaccine is not recommended to the public and is not available.
-- Source: Centers for Disease Control and Prevention