Doctors, health system facing new challenges from anthrax

Physicians must maintain a balance between alert and alarm.

By Stephanie Stapleton, AMNews staff. Nov. 5, 2001.

Washington -- Early last month, it happened.

It, of course, is a bioterrorist event -- the purposeful release of a dreaded biological agent to wreak havoc on the American psyche and leave behind it a trail of illness and death.

In this case, the agent was anthrax delivered via the mail. And the role of physicians and public health officials as the first line of defense against it became immediately clear.

At press time, the toll of those affected was growing. But documented cases from Florida, New York, New Jersey and Washington, D.C., all proved susceptible to a panel of antibiotics -- a finding heralded as good news by disease detectives. But questions continue both in terms of what has been done and what other steps should and could be taken.

"This is new territory for everybody," said Ivan Walks, MD, a top D.C. public health official. "The response is a work in progress."

Anthrax presents a medical conundrum because experience with it is limited. In recent history, there have only been a handful of naturally occurring cases. And regarding its weaponized form, almost all of what is known stems from 1979, when aerosolized anthrax spores were released from a military microbiology facility in the former Soviet Union.

Thus, doctors' priority in their response should be surveillance.

"The most important thing physicians can do now is become familiar with the signs and symptoms of anthrax and other bioterrorism agents and be vigilant in reporting possible cases to their local public health department immediately," said AMA Chair Timothy Flaherty, MD. [...]