The anthrax scare has captured the nation's attention the past few weeks. There have been a handful of confirmed cases, including several deaths, but a much greater number of false reports and hoaxes, which serve to increase our fear but not our understanding of anthrax. That's where Michael Donnenberg, M.D. -- the head of the Division of Infectious Diseases at the University of Maryland School of Medicine and the University of Maryland Medical Center -- comes in. Dr. Donnenberg, a professor of medicine, microbiology and immunology at the University of Maryland School of Medicine, answers some frequently asked questions to help you make sense of this dangerous disease.
Much attention has been focused on anthrax threats being sent through the mail. Below are some guidelines compiled from the FBI, U.S. Postal Service and Centers for Disease Control on how to spot and deal with suspicious mail.
What constitutes a suspicious letter or package?
What should you do if you receive a suspicious letter or package?
Q. What is anthrax?
A. Anthrax is an infection caused by a spore-forming bacterium called Bacillus anthracis, and it's an infection principally of herbivores - grass and plant eating animals -- like goat, sheep, cattle and horses, in developing countries. Humans are very rarely infected in developed countries. When people get this infection, other than due to criminal activity, it's usually due to coming into close contact with the meat or the hide of an animal that died of anthrax or was heavily infected.
Q. How is anthrax transmitted?
A. You can get anthrax in three ways:
Q. Is anthrax contagious?
A. No, and that's a very important thing for people to know. You can't get anthrax from someone who has anthrax.
Q. What are the most common symptoms?
A. With cutaneous anthrax, or anthrax of the skin, it begins as a red bump that is itchy and looks like a bug bite. But unlike a bug bite, it progresses and gets replaced by fluid-filled blisters, which break open and form a black scab or lesion at the site where the spore got into your body. You can also get swollen lymph nodes. People can get quite ill with fever, aches and feel very sick. Left untreated, about 20 percent of people would die from cutaneous anthrax. With proper treatment, people should recover fully.
With the inhalation/respiratory form a person might start out with nonspecific symptoms, like a fever or general ill feeling, then may have a few days where they're not so sick. This is usually followed by a very abrupt onset of respiratory problems, such as difficulty breathing, which makes someone extremely ill as the toxin is released in large amounts in the body. This form of anthrax is usually fatal.
Q. How are anthrax cases treated?
A. When someone has been exposed to anthrax, or has a very credible threat that they may have been, they are put on antibiotics to prevent them from getting the disease.
Q. Since certain antibiotics can prevent anthrax, is it a good idea for concerned people to ask their doctor for them?
A. That is one of the worst things we can do. This will deplete the supply of antibiotics, make the antibiotics less useful by increasing the amount of resistance to them, and divert them from people who really need them. People taking antibiotics they don't need can end up with the side effects, because a certain percentage of people get side effects from any medication.
Q. Are there steps people can take to reduce their risk of contracting anthrax?
A. I don't think they have to reduce their risk, because their risk is miniscule. The general public has not been exposed to this yet, and hopefully won't be. People should keep in mind that every white powder they see is not anthrax. There are white powders all around us, and the odds that any of them are anthrax is very small.
Q. When should people contact a doctor or the police about anthrax-related symptoms or concerns?
A. People should see a doctor when they have symptoms severe enough that would ordinarily prompt them to go to a doctor, or if they had some kind of very suspicious exposure [to anthrax]. For example, if you opened an envelope that had a threat in it and a white powder, then you should contact 911 immediately and minimize the handling of that envelope. By that I mean leave it where it is, wash your hands and wait for help to arrive. But if you're not somebody who's been in a room with a suspicious envelope, than you really shouldn't worry that whatever cold symptom you have is due to a biological weapon. It's not going to be; it's going to be due to a cold.
Q. How much should people worry about contracting anthrax?
A. It's an unconscionable act to deliberately make someone ill from an infectious disease, especially such a deadly one, so it's big news. But this is a country of 280 million people and only a handful have the disease. The chances that you or I are going to get it is much lower then the chances that we're going to get killed in a car accident on our way home from work, so you shouldn't worry too much.