(Ivy) Well, since you've already read the papers on anthrax, might as well put it to use...

Good thing I checked my e-mail before settling in for the evening, since all the papers are here (at home) Though to be honest I've read much more about bioterrorism scenarios in general than about anthrax in particular (i.e. this is how an anthrax bioweapon would work, this is a scenario of sucha bioweapon) but I think I've answered everything.

Also, see further resources at the bottom of the mail.

Well, last question first....

(Ivy) From what you know, is there ANY way this could have been just an awful coincidence?

No. There have been sixteen (eighteen?) cases of inhaled anthrax in the last century (Yes, 100 years). Both victims of the current attack worked in the same building, and buildings are NOT the primary mode of transmission, since anthrax is typically found in the soil (and in diseased animals). The inhaled (and more deadly) form of anthrax is quite rare. Typical anthrax transmission involves exposed farmers, usually from infected carcasses. (Either cutaneous, through the skin exposure or else gastrintestinal exposure, from eating infected meat.) The difficulty with anthrax is that it is it is quite hard to destroy, and can remain alive in the soil for quite awhile--Anthrax can survive in the soil for several years. This is apparently a problem in one of the former soviet republics that borders Afghanistan, where the USSR had their bioweapons programme--when they closed up shop, they did not do a very good job of cleaning up, and the buried much of the material. Resaerchers went and took samples and discovered live anthrax in the soil. The frightening thing about this is that these are spores that were "perfected" by the USSR for use as a bioweapon. This country borders Afghanistan, which means that it is possible that terrorists have access to anthrax spores that were developed by the USSR to be used as a bioweapon. (see link below)

(Ivy) Is inhalation the only method of transmission? Where does it breed? If I keep my hands washed and out of my oral and nasal orifices, will I be safe? If I am in the same room with a person who has been exposed, what are the chances of transmission? What is the incubation time? Cure? (I've heard that there is a run on a particular antibiotic, but that it may not necessarily be all it cracked up to be in fighting anthrax.)

Inhalation is NOT the only method of transmission, but it is the most deadly mode of transmission. Typical transmission is NOT inhaled, and the death rates are much lower (about 20%).

Anthrax is NOT contagious, in other words, for a terrorist attack to be most effective, a large number of people would have to be exposed at once, through the air. The one scenario I'm currently viewing talks about a truck (or, imagine a crop dusting plane) releasing powdered anthrax upwind of a professional football game. (Thomas V. Inglesby. "Anthrax A Possible Case History". Emerging Infections Diseases Vol 5 No 4. July-Aug 1999. p 556-560. (http//www.cdc.gov/ncidod/EID/index.htm)) The incubation period of *typical* anthrax is up to sixty days. The bioterrorism scenario looks at symptoms typically appearing 2 days later.

Aum Shinrikyo, the Japanese cult that released sarin gas into the subway in Japan, attempted several times to use anthrax as a biological weapon, and failed everytime. (They were apparently *stupid* and used the form of anthrax used for the vaccine, not the virulent form)

Anthrax can be "cured" only if it is treated before symptoms appear, which is why they are calling in and testing those who worked in the building with the man who died. Even if they were exposed, if they receive antibiotic treatment before they show symptoms, they will, most likely, be fine. Once symptoms have developed, however, you're looking at a 90% to 100% fatality rate.

BUT...

Let me repeat again, that anthrax is *not* contagious, which is why one would consider it a greater threat to ground troops that to a civilian population. It is extremely deadly, but kills only those it directly infects. In other words, perfect for decimating an attacking force.

To summarize, you are in danger of anthrax, only if you are present when the spores are released into the air. Although sporting events are the most commonly theorized scenario, I heard something about al Qaeda terrorists being trained to disperse anthrax through building ventilation systems.

(Don't read further if you are already paranoid)

Smallpox on the other hand, has a much lower death rate, but is highly infectious, so it would theoretically make a better bio-terrorism agent for a civilian population, since infection of a small number of people could hospitalize thousands (or more). Even though the death rates are much lower for smallpox, it is so infectious, that hospitals would be rapidly overwhelmed.

The scenario I'm looking at for this (Tara O'Toole. "Smallpox An Attack Scenario". Emerging Infections Diseases. Vol 5 No 4. July Aug 1999. p540-546.) starts with the infection of about 1000 people and ends with thousands infected and dead, and Marshall law being declared in the U.S. to stop infection and keep the peace. The problem is that our medical facilities could not handle such an onslaught. Y'all have been to the hospital recently, just to visit if not for a stay. How understaffed (especially with nurses) are typical hospitals currently? Now imagine that same (already overworked) staff having to deal with an epidemic or a pandemic.

To be honest, it scares the hell out of me.

CNN blurb on anthrax (Q and A) with a doctor
http//www.cnn.com/2001/COMMUNITY/10/05/gupta/index.html

CDC page of various links about anthrax
http//www.bt.cdc.gov/Agent/Anthrax/Anthrax.asp

Excellent FAQ from the CDC on anthrax
http//www.cdc.gov/ncidod/dbmd/diseaseinfo/anthrax_g.htm

All Things Considered Thursday, September 27, 2001
Anthrax in Central Asia NPR's Anne Garrels reports from Kazakhstan that one of the Soviet Union's most deadly legacies in Central Asia was the biological weapon testing sites they left behind 10 years ago. One of the worst is on a small and increasingly accessible island in the Aral Sea, between Uzbekistan and Kazakhstan.
http//search.npr.org/cf/cmn/cmnpd01fm.cfm?PrgDate=09%2F27%2F2001&PrgID=2