Anthrax a year later: Biothreat wariness now an exam room reality

Physicians are keeping their eyes open to the possibility of bioterrorism while continuing to treat routine cases.

By Susan J. Landers, amednews staff. Oct. 7, 2002.

Washington -- Just over a year ago, a Centers for Disease Control and Prevention public health message confirmed the diagnosis of anthrax in a 63-year-old Florida man.

With this, the reality of bioterrorism began to emerge. Until then, the use of biological weapons to cause illness and death among civilian populations was more the subject of novels than the practice of medicine. But suddenly, physicians found themselves playing a key role in public safety, as well as public health.

"The learning curve a few weeks after the anthrax outbreak was straight up, not only for the profession but also for the public," said AMA Trustee Timothy Flaherty, MD, who is a member of Health and Human Services Secretary Tommy Thompson's Council on Public Health Preparedness.

Twelve months later, the response is evident. National smallpox vaccination guidelines have been developed. Communication between physicians and public health departments has been improved. And doctors across the country have stepped up their knowledge of biological weapons and report an awareness that things are not always as simple as they seem.

"When we see rashes, we look a little more closely to make sure they are not consistent with smallpox," said internist Frances Durocher, MD, of Fairfax, Va., a Washington, D.C. suburb.

But they also maintain their perspective. "If someone comes in with a fever, cough and chest pain, you're not going to think first of anthrax," said Alan Pocinki, MD, a Washington internist whose office is six blocks from the White House. A number of other more plausible diagnoses would be appropriate, he noted. [...]

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