Last Updated

13 Nov 2002

Source: Washington Post, December 22, 2001.

Postal Workers to Receive Anthrax Advice

Health Officials Use Video, Doctor Visits to Sort Out Confusion Over Vaccine Offer

By Avram Goldstein, Washington Post Staff Writer

Federal health officials took their first steps yesterday in offering guidance to those deemed at risk of inhalation anthrax, suggesting ways for them to decide whether to volunteer for experimental vaccinations in a program that has antagonized many in the public health community.

The Centers for Disease Control and Prevention, whose unprecedented offer has confused thousands of postal workers and upset local health officials, stopped far short of specific recommendations for vaccinating any particular risk groups and stressed that the vaccine plan did not mean that the workers were in an emergency. The material presented yesterday came in the form of carefully qualified "tips" and "key questions" for 3,000 individuals to consider before they decide on their own or in consultation with their physicians. That number includes postal workers and others who were exposed.

In the presentation broadcast to the Postal Service, Julie L. Gerberding, acting deputy director of CDC's National Center for Infectious Diseases, answered questions that seemed tailored to lead viewers through a decision-making process. Answers would have led viewers to identify their level of risk and suggest to them that vaccination was a good idea or perhaps unnecessary.

Viewing a tape of the discussion will be mandatory for affected postal workers, and counseling sessions are to begin today. Yesterday, some District postal workers said they had serious reservations. "I don't have a problem taking medicine that's going to help me," said mail handler Loretta Blackman. "But taking medicine to be experimental and putting my life on the line -- I have kids, I have a family."

She had not seen the broadcast, which will be replayed continually for postal workers over the next two weeks. In it, Gerberding acknowledged that the past week has been troublesome.

"This has been a very confusing and difficult time for all of us," she said.

"This is not an emergency," she said, while also urging workers to make their decisions as soon as possible. "We're trying to be extra careful so we don't see any late cases, but we actually don't have any information to suggest an imminent problem. But if people need extra protection, it makes sense to get it started fairly quickly."

Local and state health officials and Postal Service leaders have grown increasingly vocal in their criticism of CDC and the Health and Human Services Department.

They have criticized the federal offer of untested vaccinations without any firm recommendation as to who should take it. Postal officials said they were blindsided by the offer and could not prepare workers for the information, while District health officials and others urged workers to skip the vaccines. New Jersey state epidemiologist Eddy A. Bresnitz said, "The communication has been less than ideal."

Azeezaly Jaffer, the Postal Service's vice president of public affairs, said, "We would have hoped people could get through the busiest time for us, mail-wise."

CDC yesterday dispatched two physicians to Washington to begin group meetings with 2,100 workers from the Brentwood Road NE mail processing facility. That is far fewer than the 30 physicians Jaffer expected. Jaffer said he hoped others would follow soon. CDC does not plan to send any educators to New Jersey until Thursday, he said.

In the meantime, people who run out of antibiotics will be given "bridge" supplies to keep them protected until decisions are made, officials said.

The doctors were to go to work beginning at 3 a.m. today, meeting postal workers in groups of 15 at the V Street NE facility and next week at the Calvert facility in Hyattsville. The meetings will be mandatory for all workers who were placed on 60-day antibiotic regimens in October, postal officials said.

"I hope we get to a point here where our employees will be treated the same way Capitol Hill staffers were, with individual meetings for counseling," Jaffer said.

Gerberding said workers must decide whether to risk vaccination or the risk that anthrax spores inhaled in October might remain in their bodies and could germinate.

The broadcast was shown yesterday to postal managers and will be aired continuously on television monitors in all facilities where affected employees work, postal officials said.

Eleven people developed inhalation anthrax after exposure to letters containing anthrax spores this fall. Five died.

Gerberding said people should consider a number of questions and create a context from which they can make rational decisions. Anyone who was in the Hart Senate Office Building rooms where a contaminated letter was opened as well as anyone anywhere in the District's Brentwood facility would be at high risk and should consider the shots, she said.

"Our environmental tests there show widespread contamination in all corners of the facility," she said. "At some point in time, lots of anthrax spores were airborne and the people who were working there were at risk of inhaling spores."

If a person worked alongside one of the workers who contracted inhalation anthrax, "common sense" would signal that the risk for that person would be high as well, she said. Other risk factors: working in an area where an anthrax envelope passed through a mechanical sorter or having aggressively handled such an envelope.

She said people must factor in whether they took antibiotics for the full 60 days. "The people who were not able to do a pretty good job of completing antibiotic therapy could be at increased risk because they have had less antibiotic exposure to kill the spores they inhaled," she said.

People are at low risk if they had no known direct exposure, if they worked in an area with only "focal spots" of contamination, if they spent a short time there, if they were in groups with no cases of inhalational anthrax or if they were in groups where antibiotic therapy was delayed but no one was infected.

Confusion persisted among postal workers yesterday. Bernard Brown, 45, said he asked supervisors for information but did not receive any answers, and he had two antibiotic pills left in his 60-day regimen.

"I'm not taking that shot," Brown said. "They haven't been talking to us; I don't know what's going on."

Staff writers Helen Dewar, Allan Lengel, Dale Russakoff and Clarence Williams contributed to this report.