New York Anthrax Scare

Yesterday, for about an hour, many in New York thought there had been another terrorist attack when news of a Brooklyn man infected with inhalation anthrax spread like gossipy spores in the street. When it was later discovered the man was likely self-infected by his working with untanned goat skins to make handmade drums, the City actually paused for a public moment to catch its breath before we all returned to our inner lives. 

Anthrax is ancient and organic — some scholars believe the plague in Thebes that destroyed the land and animals and King Oedipus
was anthrax — and while not always deadly in small organic quantities,
anthrax has an historic relationship with ordinary life on farms with
animals. Other than the militarized anthrax scare during the 9/11
crises, the last time an anthrax infection was reported in America
happened in 1976.

The key word in that last sentence is “reported” because if you spend
any time at all on a farm, anthrax is always a threat lingering in the
air and on the skin even if your entire herd is immunized because your
animals are exposed to other animals in the wild open and while your
animals may not get infected they can, in turn, infect you through
their hides or hoofs. Most farm families understand the anthrax threat
and they deal with it as the expected price of farming and see no need
to make an official “report” to government agencies for investigation
and absolution.

If you get a cut on your arm while farming and it turns nasty and won’t
heal, you don’t call the Centers for Disease Control and Prevention to
report an anthrax poisoning, you suspect your infection is probably
anthrax and you just take the salve you made from your
great-grandmother’s recipe and lather it on the hurt spot and in a few
days your skin clears up. You’ll have a scar where your skin puckered
with anthrax but it won’t kill you.

If you still feel sick, you head
into town to see the doctor to get on a pill regimen to clean you out
from the inside.
Inhalation anthrax doesn’t happen as much as skin tainting on farms
because the anthrax spores are generally embedded in dirt or in feces
and the spores are not small enough or light enough to find purchase in
the wind and into your lungs.

The key to wiping the anthrax out of your
skin is speed in suspicion, identification and remedy.
It is the very lack of speed and suspicion and identification and
remedy in the New York case that gives cause for great common good
concern.
New York City mayor Bloomberg held a press conference yesterday at
3:30pm to calm all lingering fears about another terrorist anthrax
strike.

The press conference was informative and knowing and, from a
Public Health/Public Relations perspective it was a smashing success.
However, the murky undertone of the anthrax event lurking just below
the unspoken surface is unnerving when you take a moment to consider
the timeline for the discovery of the anthrax infection as reported in
today’s New York Times:

February 15

The man is believed to be infected by the goat hides in his workspace in Brooklyn.

February 16

The man collapses after a performance in Pennsylvania and is hospitalized in that state.

February 17

The man’s blood is tested for infection.

February 18

The man is transferred to a more sophisticated Pennsylvania hospital 60 miles away.

February 19

The man’s blood continues to be tested.

February 20

The man’s blood “begins” to show signs of anthrax infection. Blood
samples are sent to the Pennsylvania Department of Health for more
tests.

February 21
The presence of anthrax in his blood is
confirmed by the Pennsylvania Department of Health. A Public Health
investigation is initiated and the New York City Department of Health
are notified as well as the CDC and the FBI. The CDC are given blood
samples for their own analysis.

February 22
The CDC confirms the anthrax infection and
the man’s workplace and apartment are quarantined. Four people who
interacted with the infected man are provided antibiotics.
Do you see the terror in the non-terrorist timeline of anthrax
infection and detection?
It took seven days from suspected infection to diagnosis confirmation
to public notification.
That kind of delay is deadly.
The infected man is currently in “Fair” condition in the hospital and
he is cooperating with the investigation but what if he had been unable
to speak?

What if he had been unable to tell his goat hide story? What
if he had been a terrorist stricken with his own anthrax and refused to
cooperate at all? How fast would the quarantine process been initiated
in that case?

If this had been a dedicated terrorist dispersal of militarized anthrax
the toxic end result would have happened faster and been far deadlier
for many more people.
There needs to be a faster process for testing blood for anthrax — as
well as other bio-terror hazards — and an immediate response from
city, state and federal officials must be forthcoming from the first
moment of suspicion.

The public’s right to know — even if the news is bad or malformed –
must trump the government’s desire to be cautious and needlenosed.
The infected man’s workplace and apartment should have been sealed upon
the first suspicion of anthrax on February 20 and not two days later.

That incredible delay allowed the possibility of anthrax exposure to
thousands of people in Brooklyn where the man worked and in the West
Village where the infected man lived.
Today we must assume by default that any slight indication of anthrax
poisoning is terrorism first and incidental exposure second and those
pledged to protect our public welfare must take quick action to isolate
areas and quarantine individuals — we can always ramp down from that
point of high concern when it is discovered the inhalation anthrax
poisoning was accidental and not purposeful.

To parlay the reverse is to play a deadly waiting game where a test
result, instead of common sense, sets Public Health policy for millions
of vulnerable and unsuspecting people.