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.

9 Comments

  1. It wasn’t anthrax that is causing a scare in Chicago. Instead what would seem like a routine, but deadly, car-truck crash on a major expressway might be connected to something more sinister.
    The headline on the local television news’ website screams: “FBI Terrorism Task Force Investigating I-55 Crash.”
    http://cbs2chicago.com/topstories/local_story_053224434.html
    “CBS 2 has learned that members of the FBI Terrorist Task Force are among those involved in the investigation originally though just to be a huge traffic nightmare, but could end up being a whole lot more,” according to the report.
    A million dollar check, unused credit cards, checks and large sums of cash were in the car of one of the victims.
    Continues the report in the last paragraph:
    “Sources caution against reading too much into the presence of the terrorist task force, which has a number of financial crimes specialists. They hint that the investigation could just as likely lead to a major counterfeiting operation as it could terrorism or terrorist financing. A lot will depend on the identy of the victim, which they already know.”
    There seems to be no delay in reporting the facts that the FBI’s task force is combing through the evidence in this case. I wonder if the authorities have learned that delay causes more fear, rumors and potential panic than early and full disclosure?
    Or, could it be that someone killed in a car wreck is less of a threat than the possibility of thousands of people flooding hospitals fearing they’ve been exposed to a biological agent?

  2. I fall on the side that more disclosure is better than less.
    News coverage or lack thereof is always interesting to follow.
    Sometimes news is out there that is never fully covered for whatever reason. Maybe there’s a political motive — newspaper editors and political leaders don’t want to scare people.
    The person I know who was killed recently is a case in point. The story about her death appeared in one local newspaper in certain zones, but not in all of the newspaper’s zones. The other major newspaper in the area failed to report the news at all. I had hadn’t stumbled across the story while looking at the electronic version of the paper, I would have missed it because it wasn’t in my print version.
    Another story about a popular high school senior with a promising future killed in a car accident had major coverage, pictures, and quotes from family and friends. The contrast was striking because the car accident killed someone from an affluent area whereas the person I knew was poor, black, single, female, and lived in Gary.
    It might be a matter of a reporter dropping the ball and failing to stop by the police department to read through the reports that are available for public inspection. The police aren’t necessarily being secretive: I spoke to one of the detectives and he told me they have some leads. Anyone could call the station and make an appointment to speak to the detectives.
    The only reason I could think that the news wouldn’t be more widely reported is that the “powers that be” don’t want to reinforce the idea of Gary as the “Murder Capital.” There is millions of dollars at stake if people decide to not invest in rebuilding Gary or the residents who are there continue to bail out.
    The same thing probably happened with the anthrax scare. The “powers that be” probably didn’t want to scare people away from New York or running into hospitals thinking they were going to die.
    However, as the rumors show, the news still gets out. People hear exaggerations and parts of the truth. Often, the bad information gets a foot hold in the public’s mind and when the official information is released, it is often too late.
    Trying to cover things up or delay their reporting does a great disservice. Even if the news is bad, the public deserves to hear it so they can be fully informed. Democracy is threatened when the voters lack all of the information they need to make decisions.

  3. The culture of “need to know” brings to mind medical experiments that were conducted without the subjects’ informed consent.
    I’m always amazed when I hear about medical experiments conducted on subjects who never gave consent. The Tuskegee Experiment comes to mind as one notorious example.
    http://www.npr.org/programs/morning/features/2002/jul/tuskegee/
    Also, radiation experiments conducted on humans are another example.
    http://www.eh.doe.gov/ohre/
    And, let’s not forget MK Ultra, the CIA’s testing program:
    http://en.wikipedia.org/wiki/MKULTRA
    When the door to open discussion is slammed shut and people are told only part of the story, the results can be tragic.