ANTHRAX THREAT
October 30, 2001

Health officials focus on two people with anthrax who do not routinely work with the mail. Gwen Ifill and Susan Dentzer track the latest anthrax developments. The NewsHour Health Unit is funded by a grant from The Henry J. Kaiser Family Foundation.

 

Online Special: The Bioterrorist Threat The NewsHour's Health Spotlight Oct. 26, 2001: Update on the anthrax health scare. Oct. 25, 2001: The chief postal inspector discusses the anthrax investigations at post offices. Oct. 24, 2001: Dr. Jeffrey Koplan on the anthrax threat. Oct. 23, 2001: Government response to the anthrax threat. Oct. 22, 2001: How safe is the U.S. mail system? Oct. 18, 2001: Three regional reporters on the anthrax threat. Oct. 16, 2001: The health implications of anthrax Oct. 16, 2001: Investigation: Seeking the source of anthrax Oct. 15, 2001: Sen. Bill Frist and Surgeon General David Satcher on the anthrax threat. Oct. 12, 2001: New concerns surrounding the anthrax threat Oct. 12, 2001: Examining the anthrax cases in Florida and New York. Oct. 8, 2001: How security across the U.S. is changing to address new threats Oct. 1, 2001: How great a threat is biological terrorism? Browse past NewsHour coverage of health.   Center for Disease Control and Prevention U.S. Health and Human Services United States Postal Service	GWEN IFILL: A new question today in the anthrax puzzle. In New York, the latest confirmed victim of inhaled anthrax is a hospital worker, a 61-year-old woman who works in the stockroom. Developments on the anthrax front, health officials said today, appear to be racing ahead of the known science. DR. ANTHONY FAUCI, Director, National Institute for Allergy & Infectious Disease: Up to yesterday there was no evidence at all that there could be or is an individual in which there might be the reasonable question, "Did they get infected from a piece of mail that went to their home?" That is being intensively investigated right now. As the days go by and you get more information, you make your rational decision based on the information and balancing the risk to the benefit of what you might want to do for example from a treat or not standpoint.
	Not a postal worker
	GWEN IFILL: The New York City woman was listed in critical condition today. Officials said she deteriorated quickly. MAYOR RUDOLPH GIULIANI, New York: She worked on Thursday and Friday. She was at work on Friday, although reportedly ill on Friday, her co-workers say. Then on Sunday late in the afternoon, early evening, she started to get very serious symptoms and late in the evening on Sunday, she checked herself into Lennoxville Hospital where she was in very serious condition. NEAL COHEN, New York Health Commissioner: The woman is critically ill. There is evidence that the inhalational anthrax has released a lot of toxins and done a lot of damage to her systemically, and at this point she is struggling for survival. GWEN IFILL: The case is the second diagnosis made this week in someone who is not a postal worker. Yesterday in Trenton, New Jersey, officials confirmed a woman living near a mail facility had contracted skin anthrax. Spores had been found at building, but the woman does not work there. Officials continue to wrestle with the question of how the anthrax is spreading. Postmaster General John Potter told a Senate panel today he thinks the senders are mailing the germ in a certain kind of envelope. JOHN POTTER, U.S. Postmaster General: I think that there was a different type of paper. That paper was more porous than the previous paper, and allowed the anthrax to move through the paper. That's my assumption. GWEN IFILL: Elsewhere on Capitol Hill and throughout the Washington area, anthrax spores were reported today in four more office buildings. The Hart Senate Office Building, where a letter containing the disease-causing bacteria was discovered in Senate Majority Leader Tom Daschle's office, remains closed. Daschle said today the building will be fumigated with chlorine dioxide to kill any remaining spores. That could take two weeks. Meanwhile, postal workers voiced new fears for their safety. RUDOLF WILLIAMS, Washington, DC Postal Worker: Biggest thing we want are some answers. How safe are we, and how safe are our coworkers throughout the Postal Service -- because a lot of us feel that once the first letter came through in the United States, they should have checked the postal service. GWEN IFILL: Still, senior Postal Service managers said the new contaminations are extremely limited.
	How did they come to be infected?
	GWEN IFILL: And with me now is Susan Dentzer of our health unit, a partnership with the Henry J. Kaiser family foundation. Susan, you've been talking to health officials, CDC officials to be specific. Do they have any idea about how these latest two victims; these two women who are not postal workers could have come to be infected? SUSAN DENTZER: Well, Gwen, the supposition is it was transmitted by mail. But that's because at this point there really isn't any other persuasive explanation. Nobody is ruling out some other things that could have happened here. Again the explanation seems to be at this point that there was cross-contamination by mail. The woman, the 61-year-old woman, who was hospitalized, who worked at Manhattan Ear and Throat Hospital, for example, worked in the stockroom but the stockroom apparently doubled for a certain period of time as the mailroom so she was handling mail. Connecting those dots, the officials say it looks like that was the case of mail. GWEN IFILL: When you say cross contamination, what do you mean? SUSAN DENTZER: Basically that there was an initial letter or series of letters, the letter to Senator Daschle, for example or the letter that went on to Tom Brokaw, that those letters somehow contained enough in the way of anthrax spores to seep out, to contaminate some other mail that ended up being handled by these other individuals -- either that or there are other anthrax bacteria laden letters about that people still have not been able to put their hands on. GWEN IFILL: Are health investigators any closer today to a solution or at least to be the beginning of an answer to this puzzle than they were on October 2 when we heard about the first outbreak in Florida? SUSAN DENTZER: If they're telling us, if they know that, rather, they're not telling us, at least in terms of any other explanations that don't involve these letters that we now have put our hands on and some scenario whereby spores escaped from those letters and contaminated other mail.
	Little definitive knowledge
	GWEN IFILL: It seems the bigger question here is what we don't know. What don't they know? SUSAN DENTZER: All of the above almost. For one thing they don't understand how the small amounts of anthrax bacteria that appear to have been contained in the letters that we have been able to establish existed, how those could possibly have been in sufficient abundance to have contaminated and infected as many people as possible. It does leave open this question of wasn't there some other mail. Also frankly people are overwhelmingly surprised with the degree of the infection once it's established in people. And as was said in our piece, the woman in New York is very, very seriously ill. People are not able to explain how somebody who probably inhaled only a tiny amount became so seriously ill so quickly. How many spores is necessary to infect somebody now is a major question. GWEN IFILL: That's exactly the point. When we hear about hot spots or we hear about trace amounts found or spores found in various buildings around Washington and in New Jersey especially, how do we know how significant that is? Can people go back to work, for instance at the State Department where they say there probably are spores everywhere but there are no infections? SUSAN DENTZER: Well, as Dr. Jeffrey Koplan of the CDC said today in a press briefing, officials are very confident that a few spores don't harm you. You're not at risk. They're very confident that 10,000 or more spores can harm you. What is the threshold in between at this point, nobody knows. It's probable that in the areas the postal facilities around Washington and other places where very small amounts have been found that there is very little if any risk to any individuals. But officials really are not willing to draw a bright line at this point because the truth of the matter is they don't know. Anything that we know about how spores infect people is basically derived from animal studies that are many years old. GWEN IFILL: Everything with humans is changing every day. So another CDC official said this afternoon there is still a small, tiny risk, were the words he used, that you or I or regular people who are not in the media would actually be affected by this. What is their confidence in a small tiny risk when things every day? SUSAN DENTZER: They are not trying to palm off on anybody any kind of sense of assurance at this point. And they're very careful to suggest that people who have any degree of suspicion about any mail that they receive should first of all not open it if it has... If it's not identified, not readily identified by a return address -- encase it in plastic, wash your hands immediately with hot water and lots of soap and wash them for a good period of time. That's the only degree of protection now that they feel, that they can offer to people and people can sustain for themselves.
	Using a variety of antibiotics
	GWEN IFILL: Now since October 2, tens of thousands of people have begun receiving these antibiotics. First Cipro and then Doxicyclin and who knows what else, penicillin. Is there any way of tracking what the side effects are? Now we have so many people in these medications -- any way of knowing the effects? SUSAN DENTZER: The CDC says it will try to do that because there are real side effects. They range from the relatively benign nausea and so forth to the much more serious, very serious tendon and joint injuries can arise as a consequence of Cipro usage. They're trying to track that; they're trying to do many things at once. First of all, they're trying to make sure that the people who should be taking these medications are taking them. And then they want to make sure that the people who are taking them aren't getting adverse effects from them. It's a series of complicated threads that they have to follow. The other important thing though that has happened in the last several days is that people have backed off the immediate response, which was to prescribe only the drug Ciprofloxin, because it was readily established very early on that the bacterial strains are in fact susceptible to antibiotics that probably produce fewer side effects and that we certainly have much greater basis of knowledge on because they've been around for a long time and have been used by many people like Doxicyclin and conventional penicillin. GWEN IFILL: But everyday that circle of treatment seems to get wider and wider. It's not shrinking. SUSAN DENTZER: That's right. That's one reason why people are increasingly inclined to go to these other antibiotics, which have been proven to be effective against this bacterial strain. GWEN IFILL: Susan Dentzer, thank you very much. SUSAN DENTZER: Thanks, Gwen.