CDC plays a supportive role, both in our epidemiological investigations
and environmental sampling, and monitoring and in laboratory work to state
and local health departments so state and local health departments initiate
these investigations and control measures and if they need further
assistance we can provide that via phone consultation from a distance or
come and work with them in the field.
CDC has over 50 years experience working on public health problems. We
have a very talented staff with a wide range of skill sets including
epidemiology and laboratory work and environmental health and occupational
exposures. We brought them all to bear on this epidemic. We are considering
this our major priority at the moment and people have been moved from other
tasks and responsibilities to help work on this. We consider this is the
most important thing we’re doing right now, and we’re doing it in
partnership with state and local health authorities. We will do anything
and everything we can to control these outbreaks as quickly as we can with
a minimum of health un torrid effects and a minimum of disruption to
people.
2. What is the average risk of contracting
anthrax?
The risk of any individual in this country contracting anthrax is
infinitesimal. The risk is for people who have been in a place of known
exposure and we’ve seen that in a few instances in the last couple of weeks
in this country. It’s been in one business place in Florida and it’s been
in a couple of locations in New York City, a governmental office building
in Washington. Persons who have not been in these circumstances are not
at-risk.
3. What can the average person do to protect
himself/herself?
Citizens in the country the best approach to take in dealing with
anthrax, is to know a little bit more about anthrax. For one, it’s not
contagious, it doesn’t spread from person-to-person. Two, it’s a disease
that once exposed to is treatable and we have a number of different
antibiotics that can be used to treat it. And, those antibiotics are very
effective in preventing a person from ever getting the disease once
exposed. And, if someone does develop cutaneous anthrax, for example, it’s
readily treatable.
There’s no need to buy or store antibiotics, and indeed it can be
detrimental to both the individual and to the community. For one, only
people who are exposed to anthrax need to take antibiotics and that needs
to be in consultation with heath authorities to make that determination.
Two, the person may not stockpile or store the correct antibiotics; there
are number of different ones that can be used for this condition. Three, we
can get those antibiotics to you when you need them. We have the ability
and we have the dosage to deliver over 2 million full courses of therapy.
One of the antibiotics [is] Ciprofloxacin, or Cipro and we have other
medications available as well. So, individuals do not need to stockpile or
store antibiotics.
5. Should the public be vaccinated against
anthrax?
For persons exposed to anthrax or for people with the disease there is no
vaccine available for the general public. The antibiotics we use are very
effective in preventing anthrax from occurring.
6. Can a person get screened or tested for
anthrax?
There is no screening test for anthrax; there is no test that a doctor
can do for you that says you’ve been exposed to or carry it. The only way
that it can be determined is through a public health investigation. And in
those circumstances, for example, where people work in a given office or on
a given floor have been exposed, the public health officials make great and
aggressive efforts to inform people whether they have been exposed or not,
and thus their need for antibiotics. But, the tests that you read about or
hear about whether their blood tests or nasal swabs or other tests, are not
tests to determine whether an individual should be treated. These nasal
swabs and environmental tests are merely to determine the extent of
exposure in a given building or workplace.
There are three clinical presentations of anthrax. And they are largely
determined by the route of entry of the anthrax into the human body and
some of the clinical manifestations, the symptoms. But the three are:
cutaneuous anthrax, where your skin surface is exposed and you develop a
skin lesion. Inhalation anthrax in which you breathe in the particles. And,
gastrointestinal anthrax in which you ingest the particles, you eat the
particles. And those have three different clinical manifestations, symptoms
as well.
An important thing for people of the public in general, and certainly
healthcare providers in particular to realize in this, “what does cutaneous
anthrax look like?” Because that’s what we’ve seen in a couple of cases up
in New York and that’s something worth being able to spot and identify
quickly and report to your public health authorities.
Cutaneous anthrax looks like a brown recluse spider bite, those that have
seen those. And what it really looks like is a swelling on the skin, it
could be anywhere but often on the arms or hands and the swelling then
develops a central area of ulceration of a depression, and then a scab or
what we call a eschar, a very dark, blackish-brown scab forms over that
central area. It can be painless and it can be accompanied by a fever or
not. --- but this is something well worth noting. And, it doesn’t look like
a lot of other things.
Anthrax can not be spread from person-to-person. One person is not
contagious to another person. We can only get it from the mechanisms of
exposure to the skin, breathing it, or eating it.
9. What should an individual do about suspicious
mail?
We’ve all learned a lot in the last few days about having an increased
state of vigilance around life in general, and mail in particular. We’ve
been told by colleagues in law enforcement, that what constitutes a
suspicious envelope is one that you are not used to getting regularly such
as your bills or letters from friends and family with a known return
address. But letters that may have stains on them, may feel like they have
contents including powder that you can feel inside; a different postmark
address than the return address; any other kinds of items inside wires or
protruding elements. So, I think all of us are used to the kind of mail we
get regularly whether it’s the junk mail, our bills, or occasional cards
and letters from friends, other things need to be looked at quite
carefully.
If you find something suspicious in your mail be it a package or a
letter, be calm. If you’ve picked it up, put it down. If you have a plastic
bag or envelope handy, garbage bag, something for food small enough, just
slip it in it and close it. If you don’t have such a plastic item
available, cover it with a towel or some cloth or even a newspaper --- just
cover it so that it is protected over its borders. Wash your hands with
soap and water. Call local law enforcement and describe what you’ve got and
can they come and help you.
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