Many Anthrax Survivors are Still Sick 10 Years After Amerithrax

Posted on by Laurie Garrett

A local Philadelphia newspaper this week tells the saga of long term health problems suffered by some of the adults that were infected with anthrax amid the 2001 Amerithrax mailings. Among the seventeen survivors most of the adults have suffered apparently permanent damage to their physical and mental health. Most Americans have long forgotten about anthrax, but for these individuals and their families the impact and horror of the 2001 bioterrorism never escapes them.

The detailed account, written by journalist Jo Ciavaglia was posted by the infectious disease on-line bulletin ProMED , with this accompanying comment from the ProMED editor:

Obviously there are overlapping conditions of advancing age, mental stress, and trauma, and  possible chronic lesions directly associated with the anthrax infection. Off the cuff I would  expect that the ongoing problems to be associated with the 1st 2 aspects. Those of us working  every day with various diseases and pathogens can be unaware of the sharp stress of being ill  on her study when it comes out.

To which I responded on ProMED:

Date: Tue 13 Sep 2011
From: Laurie Garrett 

I interviewed the parents of one of the children exposed in 2001. I describe the case in great detail in my new book, "I Heard the Sirens Scream". Though the child nearly died 10 years ago -- was close to being pronounced -- he is absolutely fine and healthy today.

I think there is an age curve for anthrax (and many other bacterial ailments). I have no doubt, based on my scrutiny of the cases for my book, that time will show age at time of exposure, route of exposure, and time delay to proper antibiotic therapy will prove the decisive predictors of long term outcome.

As for depression, I think, on an anecdotal basis, that long term psychiatric outcomes of severe viral and bacterial infections are generally under-appreciated. When I returned to Kikwit 3 years after Ebola and Hong Kong 2 years after SARS I found all the adult survivors experiencing a range of psychiatric symptoms, and angry that nobody took them seriously or offered effective treatment.

The ProMED editor added:

[Infants and children are rarely afflicted with anthrax, mainly
because exposure is usually occupational and they have healthy immune
systems. The older you get from say 30 onwards, the more severe it
tends to be.

Our thanks to Laurie. Her well-rounded e-book is readily available at
a very reasonable download price. She worked very hard and interviewed
hundreds of people. It provides an excellent account of the FBI
investigation and the problems that ensued. According to Laurie some
10 individuals were in turn 'persons of interest' with lives trashed
and 2 suicides. - Mod.MHJ]

An infectious disease assault that strikes not only basic organs of the body but also the central nervous system and brain may have a range of permanent effects. Some common infections of the pre-vaccine era effectively destroyed the optic nerves, auditory processing and memories of victims, leaving them blind, deaf or amnesic. A severe episode of encephalitis may render the individual paralyzed. These are profound and clearly physiological impacts.

But just as the psychological impacts of war and trauma are typically underestimated and undervalued, so the depression and suicidal tendencies experienced by disease survivors may be overlooked or frankly ignored. Anybody that has suffered a high prolonged fever has experienced the depression and lethargy that accompanies it. The chemicals that flood the brain in immunological response to infection often cause the infected individual to sink into hallucinations and deep darkness.

In most cases these are transitory horrors. But when individuals fight for their lives against infections that are caused by new organisms or ones rarely found in human beings, such as inhaled anthrax or SARS, the bouts inside the brain can persist for many days or weeks before the microbes are fully defeated. And during that long battle collateral damage to the nervous system can result in permanent changes.

The next time you look at your U.S. postal carrier perhaps you will pause for one moment to recall the postal workers that suffered, and in two cases died, as a result of their work handling the mail. They tended to be middle-aged, and in some cases had other pulmonary problems, such as asthma. Among the survivors are men and women whose lives have spiraled downhill ever since the fateful day when they were unwillingly exposed to Bacillus anthracis.