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Anthrax & Bioterrorism / The Bioterrorism Threat: Interview with Dr. Sue Bailey
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submitted by Dr. Gary Farr - Contact the author here.
Last Updated November, 19, 2001
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DR. IAN SMITH:
We've heard about the threats with the agents and the treatments, so now the question is how worried should we really be? Joining me is Dr. Sue Bailey. She's the former Assistant Secretary of Defense for Health Affairs. Hello, Sue.
DR. SUE BAILEY:
Hello.
DR. IAN SMITH:
One question right of the top is, we haven't had a case of inhalational Anthrax for more than 20 years, and the question now with the cases of the inhalational Anthrax and the cutaneous Anthrax, how big of a concern is this in the broad perspective?
DR. SUE BAILEY:
Well, I don't think it's any concern for any particular American. I think their risk is almost zero. As we've seen, however, even though they're not really spreading disease with these—mail carried—Anthrax spores they are in fact spreading terror.
DR. IAN SMITH:
One of the concerns, of course, is people are asking, "Should I go get tested if I exhibit flu-like symptoms," or if they know someone who has worked in an area in which there's been exposure. How do you answer those concerns?
DR. SUE BAILEY:
Well, as we know, Anthrax is not contagious person to person. If you've been somewhere where there was a known exposure—you probably—you certainly should be tested, and you probably should be on Cipro. At this point, you know, the fact is that we're not seeing these exposures on, on any large scale, and that's the good news.
DR. IAN SMITH:
One of the concerns also is this rush on Cipro over the last couple of weeks. In fact, many pharmacies here in New York City are reporting shortages. How do you allay the fears of consumers and regular citizens that there will be Cipro available if, in fact, a large attack does occur?
DR. SUE BAILEY:
Well, we have a national pharmaceutical stockpile that can make available within hours, all of the Cipro we would need. So I don't think that's the concern, and I would really want to caution people about running out to buy it, and certainly want to tell them don't give it to children. This is not something that is benign in and of itself. You only need Cipro when there is known exposure, and all of us are more sensitized now. We're gonna notice if there's a powder that comes into the air or that is on our hands after we've opened mail.
DR. IAN SMITH:
Someone just asked me, in fact, what happens if you were in the exposed area and some of the spores got onto your clothing, and you accidentally brought those spores home on your clothes. What do you do in that case?
DR. SUE BAILEY:
Well, spores live for a long time. They can live in the soil for 40 years, and some say maybe even for 100 years. But the fact of the matter is that to develop the really dangerous inhalation Anthrax, which as we know is, you know, over 90 percent deadly, the fact is you have to take in a lot of spores. It's 8,000 to 10,000 probably minimally, and maybe up to 50,000 to develop inhalation Anthrax. So, carrying a few spores—or even finding those spores that we're seeing on the nasal swabs of those who are nearby when a letter is open—does not indicate disease, and the chances of it causing disease are pretty low.
DR. IAN SMITH:
One of the major concerns that people have is the testing. How is it that a lot of the these tests come back negative to begin with, and then all of the sudden they convert to positive?
DR. SUE BAILEY:
Well, first of all people should understand we don't have a lot of clinical experience, you know, the case where you're gonna see a patient who actually has the disease. So we're not really as prepared as we will be very quickly to do the kinds of tests that would let us know someone has the disease or to recognize the symptoms of the disease itself.
DR. IAN SMITH:
Now, but the actual test, how does a test turn up twice negative and then positive? What happens? Is it too complicated of a test?
DR. SUE BAILEY:
Well, first we do the swab test where that's done with a nasal swab on an individual, or you swab an area to see if, in fact, spores are around. That's gonna detect the spores themselves. You may also do what's called a Gram Stain (PH) because the Anthrax bacteria has a characteristic way of absorbing a purple stain. So we would see the actual rod shapes that we've all now seen on T.V.
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