Heading Off Anthrax
by By Julia Sommerfeld - www.msnbc.com

Report suspicious packages, early symptoms, experts urge

Oct. - While cases of anthrax have sparked alarm over the possibility of bioterrorist attacks on U.S. soil, many Americans are feeling vulnerable, wondering how they can protect themselves from a deadly enemy too small to see.
A microscopic view of anthrax bacteria.


AUTHORITIES are urging Americans to be familiar with the early symptoms of anthrax and report any suspicious letter or package to law enforcement, as each of the anthrax cases so far have been somehow linked to powdery substances arriving in the mail. While the anthrax germs are invisible to the eye, they must be mixed with some sort of additive - usually a powder of some sort - to keep them from clumping together, which makes the microbe less infectious, according to experts.

"Lets say you have an envelope and you think there is powder inside, or you happen to open it and you see powder, leave it where it is, get up, leave that room, go to another room, and call 911. Explain what it is and then the police and haz-mat people will take over. They'll test it and the vast majority of times it's going to turn out to be talcum powder or something like that. But given the fact you never know, that's probably the best way," advised New York Mayor Rudolph Giuliani.

But just how do you know if a package or letter is suspicious? The FBI says several things can tip you off: misspelled words or wrong titles on the label, having been sent from an unknown person in a foreign country, having excessive postage or no return address. Other tips could be restrictive markings such as "personal," or oily stains, discolorations or crystallization on the packaging.


KNOW THE SYMPTOMS
People also should be aware of early symptoms of anthrax - which vary depending on how the disease was contracted - because when caught early it can be effectively treated with antibiotics. The most common form of anthrax is cutaneous, which occurs when the germ enters a wound on the skin, as was the case with the NBC News employee in New York. The infection begins as a raised itchy bump similar to an insect bite that develops into a fluid-filled sac within a day or two. Then it becomes an ulcer with a dark area in the center - the hallmark of cutaneous anthrax. Initial signs of intestinal anthrax, which can follow eating contaminated food, are nausea, loss of appetite, vomiting and fever. Then, abdominal pain, vomiting of blood and severe diarrhea can develop. Unfortunately, the early symptoms of inhalation anthrax, the deadliest form of the disease, are similar to those of a cold. After several days, however, the symptoms may progress to severe breathing problems and shock.

Anthrax can be very deadly when it's not caught promptly, so health officials urge people to go to their doctor with any of the early symptoms. But with flu season starting, some doctors are worried that achy muscles and a cough will send hordes of people scrambling to the emergency room. So Dr. Mohammad Akhter, executive director of the American Public Health Association, urges Americans to get vaccinated. "The best thing this flu season really is to go get the flu vaccine so you can at least rule that possibility out," he advised.

ANTIBIOTIC WARNING
Three types of antibiotics are approved for preventing and treating anthrax: ciprofloxacin, tetracyclines and penicillins. People who have been exposed to the germ but do not have symptoms are given an antibiotic for 60 days to reduce the risk of developing the disease.

What people should not do, health officials said, is demand antibiotics from their doctors. "Physicians have a tremendous responsibility here," said U.S. Surgeon General David Satcher. "If these drugs are used inappropriately, the organism is going to develop resistance to them. The worst thing you can do is contribute to these organisms becoming resistant." Health and Human Services Secretary Tommy Thompson on Friday asked people not to hoard anthrax antibiotics, saying the government had enough to treat those who might require the drugs. The Associated Press and Reuters contributed to this report.

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