Last Updated

08 Jun 2003

Source: Newsday, October 17, 2001.

Baby's Case May Be First For U.S. Kid

By Delthia Ricks, STAFF WRITER

Of all the mysteries in the spate of anthrax infections, none is more baffling than how a 7-month-old boy contracted the skin form of the infection, apparently at ABC News headquarters in Manhattan.

Nary an employee has reported symptoms of Anthrax to health officials and the search for possible spores began in earnest yesterday.

The doctor who helped diagnose the baby said he recognized the blistering eruption as anthrax as soon as he saw it, and he is convinced the baby may, in fact, be the first recorded pediatric case of cutaneous anthrax in the United States.

"I was asked to see the baby on Saturday," said Dr. Martin Blaser, chairman of medicine at New York University Medical Center, and an infectious disease specialist. The eruption was on an elbow.

"When I saw it, I knew it was definitely anthrax ... based on a combination of factors - what the skin lesion looked like and the context of the exposure itself," Blaser said. "On Friday there was the anthrax reported at NBC, so I thought it was also very likely it [anthrax bacteria] was at ABC."

Laboratory tests confirmed the diagnosis.

Cutaneous anthrax, Blaser said, is not as dangerous as the inhaled form. The baby, who is being treated with antibiotics by pediatric specialists at NYU Medical Center, is expected to recover.

How the infant contracted anthrax is as mysterious to his doctors as it is to public health officials investigating the case. The baby visited ABC with his mother, an ABC news producer, last month. The names of mother and child have not been disclosed.

Adding to the mystery is the lack of evidence of contamination at ABC. No letters containing white powder have been reported by network officials.

Blaser believes the baby may garner a place in medical history.

"We're looking through the literature right now," Blaser said yesterday. "We haven't found it yet, but I am almost certain this is the first case," of cutaneous anthrax in a baby. "There can't be more cases in all of the world. This is an adult's disease."

The 19th century name for cutaneous anthrax was wool sorter's disease because it was so often found in people who sheared sheep or handled their wool.

Treating pediatric anthrax is tricky because it involves use of a potent antibiotic. Blaser acknowledged that intravenous Cipro is the best choice, but he would not the baby is receiving the drug.

Cipro can adversely affect bone cartilage in children, but with prudent use it often proves the most effective therapeutic weapon for dangerous infections in children.

Dr. Lorry Rubin, chief of pediatric infectious diseases at Schneider Children's Hospital of Long Island Jewish Medical Center, said Cipro is often given to children with cystic fibrosis.

"Cipro is not approved for children under 18 years of age, but there is experience using it," Rubin said. "I would be inclined to do that until it was clear that the baby was improving."

Rubin said the antibiotic for a pediatric case of anthrax might be penicillin or ampicillin. However, given the possibility the organism could be a biological weapon, the most logical choice of treatment, he said, would be the more powerful drug. Doctors don't recommend the preventative use of Cipro for adults, and certainly not for children.

Cases in which children with cystic fibrosis contracted severe lung infections and were given Cipro show they tolerate the drug well when it is administered prudently, Rubin said.

He added that diagnosis of anthrax is the same for children as adults. A sampling of fluid that has formed under the blister is taken to the hospital laboratory. Lab pathologists seek evidence of the rod-shaped cells that are characteristic of infection.

The cells are coaxed to grow in colonies in dishes to confirm the diagnosis.

Brokaw, closing his evening broadcast, alluded to the anxiety in his own newsroom. He said: "In Cipro we trust."

Staff writers Justin Blum and Peter Slevin in Delray Beach, Fla.; Susan Schmidt, Cheryl W. Thompson, Avram Goldstein and Rick Weiss in Washington; and Michael Powell, Christine Haughney and Dale Russakoff in New York contributed to this report.