Last Updated

03 Jan 2003

Source: Baltimore Sun, March 8, 2002.

Anthrax toll could have been far worse, study finds

JHU team gives credit to quick antibiotic use

By Scott Shane, Sun Staff

Last fall's anthrax attacks would have claimed at least twice as many victims had postal and media workers not been placed quickly on antibiotics, a John Hopkins University study concludes.

Ron Brookmeyer, a biostatistician at the Hopkins Bloomberg School of Public Health, and Natalie Blades, a graduate student, applied statistical analysis to three clusters of cases of the most serious form of the disease, inhalation anthrax: postal workers in New Jersey and Washington and employees of a tabloid publishing company in Florida.

Eight cases of inhalation anthrax occurred among the three groups. But the study, published today in Science magazine, found that without antibiotic treatment, the total would most likely have been 17 cases and possibly as many as 50.

Their study did not include workers at the Hart Senate Office Building, many of whom were exposed to anthrax after a letter to Senate Majority Leader Tom Daschle was opened.

About 340 people who had been in the Hart building were given antibiotics, which might have prevented even more cases of the often deadly disease, Brookmeyer said.

But because no actual cases occurred among Hart workers, the statistical model could not be applied to that group, he said.

"Our study underscores the importance of public health surveillance," Brookmeyer said.

Rapid identification of a bioterrorist attack - as occurred when an alert physician in Florida recognized anthrax in his patient - is necessary to allow treatment that can prevent illnesses and deaths, he said.

An estimated 10,000 people took antibiotics because they feared they had been exposed to anthrax, including about 5,000 in the groups Brookmeyer studied.

The anthrax-laced letters addressed to media outlets and to Sens. Daschle and Patrick J. Leahy were blamed for five deaths and 13 illnesses. A national FBI investigation has not found the perpetrator.

Notes in the anthrax letters warned recipients that they had been exposed and advised them to take penicillin. The warnings are cited by some analysts as evidence that the sender did not necessarily want to kill people but possibly to raise awareness of the threat from bioterrorism.

But anthrax spores leaked from the envelopes as they passed through postal facilities, infecting postal workers who never saw the warnings. Nor did the warnings reach a New York woman and a Connecticut woman who died of anthrax and who might have been infected by cross-contaminated mail.