Disease: Anthrax
Anthrax is an acute infectious disease caused by Bacillus anthracis, a GRAM-POSITIVE ROD. The cells of B. anthracis produce very resistant ENDOSPORES that can remain viable in the soil for years and even decades. The vegetative cells produce three toxins responsible for the clinical disease.
Anthrax most commonly occurs in wild and domestic vertebrates (cattle, sheep, goats, and other herbivores) and, in the United States, the incidence of naturally-acquired human anthrax is extremely rare. There are three clinical forms of human anthrax: CUTANEOUS (skin); GASTROINTESTINAL (digestive system); and, the most dangerous, as the scenario described, INHALATIONAL (respiratory system).
Federal Bureau of Investigation (FBI) offices in five U.S. cities have received warnings of an imminent bioterrorist attack unless certain demands are met immediately. One of these cities is Bigtown with a population of 2 million. The threats were credible, but no information was relayed to any city officials.
On the evening of November 1, a professional football game is being played in Bigtown’s outdoor stadium before 74,000 fans. The evening sky is overcast, the temperature mild, a breeze blows from west to east. During the game’s first quarter, an unmarked truck drives along an elevated highway a mile upwind of the stadium. As it passes, the truck releases an aerosol of powdered bacterial spores, creating an invisible, odorless cloud more than a third of a mile in breadth. The wind blows the cloud across the stadium parking lots, into and around the stadium, and onward for miles over the neighboring business and residential districts. After the release, the truck continues driving and is more than 100 miles away from the city by game’s end. The perpetrators will be out of the country by the next day.
Three days later, hundreds of people in and around Bigtown are becoming ill with fever, cough, shortness of breath, and chest pain. Some of the sick self-administer over-the-counter cold or flu remedies; some seek phone advice from physicians and nurses; others are seen in clinics, doctor’s offices, and hospital emergency departments.
On November 6, nurses and physicians note the increased volume of serious upper respiratory illness, and some contact the city health department for treatment recommendations. Blood cultures from the earliest patients grow gram positive bacilli in seven laboratories around the city. No further identification is requested, and none is pursued.
By evening, the earliest patients are experiencing severe complications, including difficulty with breathing, shock, and even meningitis. An alarmed state health department contacts the Centers for Disease Control and Prevention (CDC).
By November 8, patients who first experienced complications are dying. In fact, by midnight, 1,200 people around the city have fallen ill and 80 have died.
By mid-day on November 9, intensive-care units and isolation beds across the city are full. Even patients receiving the most advanced medical care are dying; still, there is no diagnosis.
The illness and unexplained deaths has created an atmosphere of desperation and confusion among hospital and clinic staff. The recommended isolation protocols quickly fall apart as staffs struggle to cope with the surge of patients. Many nurses and support staff do not report to work, fearing the disease can spread from infected individuals.
In the early evening, a university laboratory makes a preliminary diagnosis from the blood culture of a young patient who died. The laboratory immediately notifies the state health department, which in turn notifies the CDC and FBI. Antibiotics are prescribed.
By November 11, there are effectively no antibiotics left in the city and no records of who received them. By evening, 2,700 persons have become ill, 500 of whom have died.
On November 12, distribution centers receive Federal shipments of antibiotics and vaccine. Increasing numbers of the city’s critical work force are absent, including police and firefighters. Some are absent because of illness or death, while others, fearing contagious spread, leave the city. By evening, a total of 4,800 persons have become ill; 1,400 have died.
By November 20, the disease has begun to subside. Of the 20,000 persons infected in and around Bigtown, 5,000 died, most who did not receive antibiotics in the first 10 days after the attack. In all, approximately 250,000 persons received antibiotics.
-Dr. Pommerville-
Turkey season is here once again and everyone is excited to gather family together for the big feast. What is it about the big feast that makes it so enjoyable? Maybe the kinds of food consumed or maybe it’s the fact that it’s one time out of the year where the whole family sits together and just eat? After all that food, we tend to feel lethargic and fatigue, and the myth states that turkey causes this feeling. Is it true? Does turkey really make one tire and sleepy?
Barbara Bush, 83 years old, was the former first lady who married George H. W. Bush in 1945 and is also a distant cousin of Franklin Pierce.
ednesday. She have had two heart transplants and survived with artificial heart pumps.
