| New
Study Distinguishes Anthrax from Flu in Event of Bioterrorist
Attack
edited
by Herman Rosen, M.D.
Doctors
in the Department of Public Health at Weill Cornell Medical
Center have identified key symptoms that may help distinguish
flu and other common respiratory conditions from more serious
inhaled anthrax in the event of a bioterrorist attack. Anthrax
is an infectious disease caused by spore-forming bacteria.
Inhalation of anthrax leads to disease that, without proper
treatment, can cause death from a combination of shock and
respiratory failure.
The
study, published in the Annals of Internal Medicine, found
that while both anthrax and common respiratory conditions presented
with symptoms such as fever and cough, other symptoms—such
as the neurologic symptoms of loss of consciousness, dizziness,
and confusion; serious gastrointestinal symptoms like nausea
and vomiting; and shortness of breath—were much more common
in patients with inhaled anthrax. Conversely, sore throat and
runny nose more often indicated viral infection rather than
bacterial anthrax.
“In
the case of bioterrorist attack, it is vitally important that
physicians’ offices and hospital emergency departments accurately
diagnose anthrax, especially considering that laboratory or
radiographic testing would not be feasible if there were a
high volume of potential cases,” said lead study author Dr.
Nathaniel Hupert. “Four of the 11 patients who developed anthrax
in 2001 were originally sent home with diagnoses of a viral
syndrome, bronchitis, or gastroenteritis.”
The
new evidence-based pre-hospital screening anthrax protocol
will help physicians more rapidly and accurately identify both
potential cases and likely non-cases, thus preserving scarce
hospital capacity while ensuring that patients receive appropriate
medical care. Dr. Hupert and co-authors Drs. Mushlin, Callahan
and Bearman compared the features of anthrax-related illness
with more than 4,000 cases of common viral respiratory infections
that could mimic or obscure the diagnosis of anthrax infection.
This
study was funded by the Agency for Healthcare Research and
Quality of the U.S. Dept. of Health and Human Services as part
of its bioterrorism preparedness portfolio.#
Dr.
Rosen is Clinical Professor of Medicine at Weill Medical
College of Cornell University.
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