Escaping the Grip of Anthrax

Va. Man Reflects on Deadly Struggle and Faces a Changed Life

By Michael Laris and Jennifer Lenhart, Washington Post Staff Writers

WINCHESTER, Va. -- When describing his last seven weeks -- the uncontrollable shivers, the searing joints and muscles and chest, the moments when death felt near -- David Hose (case 20) doesn't have much use for the words "anthrax" or "disease." He refers to his adversary with a combination of reverence and derision.

"This thing," he calls it, or "that stuff."

Hose, 59, is one of 11 Americans, from Florida to Connecticut, who contracted the inhaled form of anthrax after a spate of terrorist mailings to politicians and media outlets. Five people died. Six were treated and survived.

Investigators believe that Hose, now recuperating at home in this Shenandoah Valley city, may have inhaled anthrax spores from a letter addressed to Sen. Patrick J. Leahy (D-Vt.) that was accidentally routed to the State Department diplomatic mail facility in Sterling where Hose has worked for 11 years.

Hose remains mystified that he was the only one to get sick after dozens of colleagues spent the same long hours he did in the company of the whirring sorting machinery.

"All I can say is, I took a breath at the wrong time," Hose said.

It was a breath that tested Hose's physicians, his family and his faith. It pitted him against a formidable illness that is still puzzling the nation's top doctors, who are scouring the details of his case to aid future victims.

He knew there was a problem on Monday, Oct. 22, when he was driving home from Wal-Mart and suddenly was drenched in sweat. "It just hit all at once," Hose remembered. His body was sounding a terrorism alert, but he wasn't quite ready to hear it.

Hose went back to work the next day. But by day's end, a spiking fever had locked on, haunting him through a brutal, sleepless night. "By Wednesday, I know: This is insane. This can't be anything normal."

It was anything but normal. It was a disease that came in the mail, issued from the mind and laboratory of someone with a point to make.

"Here's a guy who got sick not by the normal biological process," said Sunil Sharma, the emergency physician who saw Hose first. "It was someone out there forcing people to be exposed. It was no different than taking a gun and shooting people."

Sharma examined Hose, took blood to test for anthrax, watched as the gravely ill man swallowed a dose of Cipro, and sent him home with a prescription for more antibiotics and a bottle of cough syrup, for another agonizing night.

By 7 the next morning, a hospital microbiologist had read the lab results and scrambled to tell doctors. They called Hose in just as he was getting ready to dial 911. He had anthrax.

Over the following two weeks, as a war raged in Hose's body, his room in Winchester's 400-bed regional hospital was filled with infectious-disease specialists, family members and a pastor from his daughter's church.

His doctor, infectious-disease specialist Mark Galbraith, consulted almost daily with physicians at the Centers for Disease Control and Prevention in Atlanta.

"We were info-gathering. We were trying to learn as much as we could about this disease as quickly as possible," said CDC epidemiologist John Jernigan, who heads the clinical investigation of the 11 inhalation anthrax victims.

Hose was delirious, his skin so lifeless and gray his family wouldn't give him a mirror. He contracted pneumonia, and doctors drained a pint and a half of fluid from around his lungs with a needle through his back. His heart rate shot well above 160 beats per minute, twice its normal level.

"It attacks everything in your body, as far as I could tell," Hose said. "It hits at every little spot."

His doctors concur.

His lymph nodes swelled with anthrax spores. The bacteria multiplied and produced toxins that affected his entire body and likely caused an irregular heartbeat that Hose developed in the hospital, Galbraith said.

Despite his bedside troops, the battle was often a lonely psychological standoff.

"Many nights in there, I was just really wrestling with a lot of insecurity -- not so much insecurity as much as [being] just plain out of it, just extremely tired of fighting," Hose said.

One such moment came when doctors placed him on a pad of circulating coolant to reduce the dangerously high body temperature -- at times over 103 degrees.

"I thought I was out there by myself then. My body was just at the limit where it just couldn't take it anymore. I passed out during the shaking and just sort of lost it," he said.

Hose's wife of 27 years, Connie, said the family felt helpless. "We were all scared he wouldn't make it. We really weren't sure," she said.

Eventually, David Hose emerged. "I guess you live through it if God wants you to live through it -- or you don't," he said, adding that he thinks prayer groups organized on his behalf helped him.

The treatment regimen also eventually did its job. He finally could walk. His fever dipped. His vital signs stabilized. And he felt well enough to take a phone call from Secretary of State Colin L. Powell.

Galbraith said, "I had to wake him up and say: 'You're going to get a phone call from the secretary of state. This is not a prank. Don't blow him off.' "

When they rolled him out the hospital door after 16 hellish days, Hose said, he remained "weak as a kitten." The pain is gone now, but he is still exhausted, still has some alarming bouts of sweating.

"It's a little unclear what's going on there, frankly," Galbraith said. "It may be a drug reaction. It's not the anthrax. That's basically gone."

Hose has begun physical therapy to rebuild atrophied muscles. He is still taking heart medicine, though doctors are tapering off the doses. Now, top national specialists are studying Hose's case to prepare for the uncertain future of bioterrorism.

"We don't know what 'typical' is when we've only seen 11 cases of inhalation anthrax," Jernigan said. "His experience certainly was consistent with the other patients and what's been classically described in the literature, with the exception that he survived."

Hose, a native of Manhattan, Kan., has ambitious plans for the life he's reclaimed. The former counselor for emotionally disturbed boys hopes to have more time to play with his smoky gray poodle Frenchy, more time to make sterling silver jewelry and get to an oil painting project that was put off because of the disease. He said he harbors no hatred for the person who made him ill.

"I feel sorry for the people who believe they have to do this," Hose said. "If they catch the people, I guess that would be all right. But if they stop it, that would be great. I don't want other people getting sick."