This column is about healthy aging. Never did anyone ever think that in the 21st century we would once again be concerned with such potential scourges of health as small pox, plague, anthrax and botulism. However, the morning that this column is being written, the US House of Representatives is closed for business, there are postal workers in the hospital with anthrax, hundreds of public figures and their staff are being tested for exposure to anthrax and countless numbers of threats and hoaxes are being reported. This all seems remote from Seabrook, and it is. Nevertheless, Seabrookers need to know the facts about our new public health threat represented by bioterrorism.
Microbes used in War Listed in Table 1 below are the organisms that are most commonly mentioned in any discussion of bioterrorism or biologic war. Seabrookers should not fear these weapons since it is most unlikely that we will be targets, but as an informed an intelligent citizenry it is important for us to know the facts about these diseases.
Anthrax is a disease that is caused by the bacterium B. anthracis generally found in animals in South America and the Middle East. It is not spread from human to human, and therefore in the usual sense of the word is not a human spread disease. Humans can contract the disease from ingesting it, inhaling it and getting the organism on the skin. The reason it is creating such fear is that the organism can live without being in or on a host animal or human - i.e. it can be found in soil and in powders that can be sent through the mail. To be most effective in causing death and human disease anthrax for weapon use is formulated in some form of inhalation delivery system so that humans breathe the small spores into their lungs and then contract the potentially (if untreated) disease. For greatest effect on the largest number of people the spores would have to be sprayed in small enough particles for mass inhalation or delivered in some air handling equipment in buildings or planes.
Botulism is a food-borne disease, generally found in spoiled canned foods. It is caused by the botulism bacterium that once absorbed into the blood after ingestion forms a toxin that attaches to the nerves and impairs such things as vision, swallowing, weakness and even breathing. Botulism results from a large dose of the bacteria and it is unlikely that this could be delivered in any mass form by terrorists. Plague is a bacterial disease caused by the yersinia pestis bacteria and usually transmitted by infected fleas. The airborne variant of the disease is called pneumonic plague and is the most deadly form of the disease that can be spread from human to human once it is established. Terrorists could spread this with an aerosol device. Small pox is the final weapon generally considered in bioterrorism.
It is a viral illness unlike the three bacterial ones just discussed. It is caused by the variola virus. This is a contagious disease passed from human to human either by cough or by contact of skin lesions.
Diagnosis and Treatment One of the terrorism aspects of these biological weapons is that unlike bombs and guns, these weapons cannot be seen. They present a diagnosis difficulty because unless there is known exposure, the symptoms are identical to many other bacteria and viruses and would not necessarily be high on a doctor's list of possible causes. The lists of common symptoms is in the table. Note that there is nothing specific about the symptoms and the diagnosis depends on culture of the organism from the victim. For this to occur the physician must have a high index of suspicion. Treatment for anthrax is specific and if begun early enough should prove life-saving. The treatment is penicillin or one of the more modern antibiotics.
Anthrax/Bioterrorism Questions and Answers
Q: Is general information available about bioterrorism? A: Education is your best weapon against bioterrorism. The public can check out the CDC's web site at www.cdc.gov, or contact local public health agencies, to find out the status of preparations at different levels of government.
Q: What are federal health officials doing about the threat of bioterrorism?
A: The CDC has been working with state and local health departments, law enforcement officials, and other local and federal agencies to investigate possible anthrax exposures in the United States. Response teams of specialists have been formed by the CDC and have been dispatched to Florida, New York City, Washington, D.C., and other areas. In Atlanta, CDC officials continue to work from a 24-hour Operations Center. The Operations Center also is responding to calls each day from the public. More than 50 CDC laboratories have processed hundreds of specimens. The CDC also has offered extra training for physicians and other health care professionals in diagnosing and treating anthrax.
The treatment of botulism must be prompt and consists of an Botulism antitoxin. Plaque is treated with anti-microbials and small pox is best prevented by prior vaccination. The key to all of the treatments is early detection and prompt medical attention. The American concern now is that we have a stockpile of appropriate drugs to treat the area that might be attacked with these new weapons. Like all terrorism, the diseases caused by these tactics are local to a particular building or site and for the most part cannot be spread from human to human.
If one is exposed to a potential biological exposure there are 4 things that one is instructed to do:
1) Remove clothing and place them in a plastic bag that is sealed. 2) Shower thoroughly with soap and copious water. 3) Clean any contaminated surface with a cleaning solution (1 part bleach to 9 parts water -1 cup bleach to 1 gallon). 4) Contact your physician. If one is at a site of attack the entire rescue process should be initiated by dialing 911.
Summary The effectiveness of biological warfare is more from its terror than actual physical harm. Most of the microbes have medicines or antidotes that are effective if given early after exposure. The fear comes from two main factors, one cannot see, hear or smell the weapon - therefore its invisibility makes it a potential danger anywhere. The second cause for fear is our not so subtle realization that this is a new kind of weapon and it is potentially delivered relatively easily within our country by any one who has access to the weapons and a knowledge of how to use them. As countless newspeople have pointed out including your columnist, the chances of Seabrookers having to deal with this is very very remote, but the fact that some of our fellow Americans will is most terrifying.
Additional Online Resources outside MUSCHealth.com: (MedlinePlus, is an excellent source of health information from the world's largest medical library, the National Library of Medicine. Health professionals and consumers alike can depend on it for information that is authoritative and up to date. MedlinePlus has extensive information from the National Institutes of Health and other trusted sources on over 650 diseases and conditions.)
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