Anthrax investigators hope to learn where exposure occurred/ CIDRAP

Someone got inhalation anthrax along the old west cattle trail.  This is where cattle in decades past were herded, and sometimes died of anthrax.  When that happened, the spores entered the soil and even today emerge periodically, during extreme weather conditions, to reinfect cattle.

Only problem is, they do not reinfect humans.  The spores only affect those creatures who graze in the soil.  Humans only get inhalation anthrax indoors.  Or maybe from gardening, putting your nose into some contaminated blood or bone fertilizer.  “Naturally occurring” anthrax in the environment causes cutaneous anthrax.  Inhalation anthrax almost always requires many thousands of spores and was only a natural event for woolsorters and ragpickers. 

You can protect the person’s privacy but still give details about the illness.  This story is exceedingly skimpy and does not add up.–Meryl

Aug 10, 2011 (CIDRAP News) – An investigation into the origins of Minnesota’s first human anthrax case in many years is focusing on where the patient might have been exposed to the deadly pathogen, Minnesota State Epidemiologist Dr. Ruth Lynfield said today.
The Minnesota Department of Health (MDH) announced yesterday that a person who had recently traveled through North Dakota, South Dakota, Montana, and Wyoming was being treated for inhalational anthrax in a Minnesota hospital. Officials said the case was apparently caused by naturally occurring anthrax in the environment.
The MDH has not revealed the patient’s condition or listed any identifying details such as name, gender, home state, or hospital.
Lynfield said today that the patient had been on a “multi-week trip” and was sick on arrival in Minnesota after traveling through the four western states. “Anthrax is in the environment in the soil in all these places, so it’s hard to know for sure” where the exposure might have occurred, she said.
“We’re trying to go through the [travel] itinerary. We’ll be learning more, but at this point what we know is that the person was in a place where anthrax does cause disease in animals,” she said. She noted that the disease strikes cattle and wildlife such as bison and deer.
She also said officials are looking into whether the patient has any risk factors that could have made him or her more susceptible to inhalational anthrax.
Lynfield noted that floods can move Bacillus anthracis, the bacterium that causes anthrax, in the soil, leading to animal outbreaks. “One thing we’re doing now is checking in with various wildlife groups and veterinarians to try to determine if there’s anything going on this summer,” she said.
She said Minnesota has not had a confirmed human anthrax case in “decades,” and neighboring states have not had any recent cases, either.
Because of the potential for bioterrorist use of anthrax, the Federal Bureau of Investigation (FBI) initially collaborated with the MDH to investigate the case, the MDH said yesterday. The FBI ended its involvement after concluding there was no evidence of terrorist or criminal activity, officials said.
Lynfield declined to describe the patient’s condition today. “There was a rumor that the patient had died—that’s just a rumor,” she said. She noted that the patient’s family has had bad experiences with the news media in the past and has asked the MDH to protect its privacy.
Inhalational anthrax is the most deadly form of the disease. Anthrax spores that were sent by mail to several media offices and two US senators’ offices in 2001 sickened 22 people, killing five of them.

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Ed Lake
Ed Lake
11 years ago

Dr. Nass wrote: "Humans only get inhalation anthrax indoors.'

Humans typically get inhalation anthrax indoors, but there is no law that says you can't get inhalation anthrax outdoors. Plus, you can get spores on your clothing outdoors, and then inhale them when you brush off your clothing indoors.

""Naturally occurring" anthrax in the environment causes cutaneous anthrax."

The type of anthrax you get depends upon how the spores enter the body, not where you were at the time. Inhalation anthrax results from inhaling spores into the lungs. Cutaneous anthrax results from getting spores into a open sore or cut in the skin. Gastrointestinal anthrax results from eating contaminated meat.

"Inhalation anthrax almost always requires many thousands of spores and was only a natural event for woolsorters and ragpickers.

And drummers and drum makers.

In 1966, a 46-year-old machinist got inhalation anthrax when spores drifted into his machine shop from the woolsorting mill across an alley.

Infection appears to depend upon the person's age and the health of their immune system. It's quite possible that 94-year-old Ottilie Lundgren only inhaled a few spores, but it was enough to kill her.

I think the key part of this story is this:

"She noted that the patient's family has had bad experiences with the news media in the past"

That information, along with the location, suggests a name to me. If I'm right, the person is a pathologist and may have been doing some field work for some reason.

Ed

Anonymous
Anonymous
11 years ago

Very interesting.

Noted that she said that "officials are looking into whether the patient has any risk factors that could have made him or her more susceptible to inhalational anthrax".

Have to wonder if like some of the other inhalation anthrax victims who have died. Did the person with the new case of inhalation anthrax also immigrate to the USA during the end of the Vietnam War like Kathy Nguyen and Robert Stevens.

Meryl Nass, M.D.
Meryl Nass, M.D.
11 years ago

If you review the entire world literature on anthrax, you will not find inhalation cases in humans due to "natural" outdoor exposures, apart from those to contaminated fertilizers. The spores are just not concentrated enough "naturally." As someone who has read all the literature and dissected the largest anthrax outbreak in humans ever recorded, in Rhodesia (where both natural and unnatural cases occurred) I believe my analysis to be sound.

Sure there may have been some cases that went unnoticed and unrecorded. And a rare person may die from one spore. But in old tests the LD50 for a 10 pound rhesus monkey was 50,000 spores, and I believe it to be greater in humans for tested strains of anthrax.

Anonymous
Anonymous
11 years ago

Couldn't one get inhalational anthrax from buying a blanket made on an Indian reservation or by a hunter and then resting your head on it while sleeping?

Conditions were ripe for anthrax due to flooding of Missouri River in mid-July.

In South Dakota, the first case of anthrax in cattle for the year, has now been noted.

Anonymous
Anonymous
11 years ago

Note that when cattle get inhalational anthrax it is because their nose is close to the ground while eating the grass. Anyone with their nose to the ground would be in the same position. For example, an entomologist.

Ed Lake
Ed Lake
11 years ago

Dr. Nass wrote: "The spores are just not concentrated enough "naturally.""

Yes, and that means that if you stand on a hill top and breathe in the air, there probably aren't enough concentrated anthrax spores around to infect you. Agreed.

But, if you pet a horse with an anthrax infection on its hide, that's a different story.

If you walk around in a field where there's a dead cow and stand downwind of it as you poke at the carcass with a stick, that's a different story.

The point is, inhalation anthrax is so rare that nearly every case is unique.

We don't know what the victim was doing during that trip through North and South Dakota and Wyoming. Some articles seem to suggest that the victim may have handled animal carcasses. If the victim was a pathologist, that would fit.

There are a lot of possible explanations to consider before getting into conspiracies.

"But in old tests the LD50 for a 10 pound rhesus monkey was 50,000 spores, and I believe it to be greater in humans for tested strains of anthrax."

The age of the victim appears to be an important factor.

In the Sverdlovsk outbreak, there were over a hundred deaths, but not one was under the age of 20 even though the infected area included many children.

In the 2001 attacks, the youngest inhalation victim was 47 years old (Curseen), and the others were 55, 61, 63 and 94.

The Greenwich Village case in 2006 involved a 44 year old drum maker.

The man who died in the British drum maker case in 2008 was 35.

So, it's not just a matter of the LD-50 (which ranges from 2,500 to 55,000).

Ed

Meryl Nass, M.D.
Meryl Nass, M.D.
11 years ago

Theoretically, you could get inhalation anthrax a thousand ways. But when you read about every reported case, it just doesn't happen very often–like less than once a decade in the USA apart from the letters. This fits the hypothesis (generally accepted) that it takes a lot of spores to make you sick. Sure, the rare person may be especially susceptible. But although there is lots of anthrax in the soil of the US and most other countries, inhalation cases are so rare that hanky panky must be ruled out in every inhalation case.

Meryl

Anonymous
Anonymous
11 years ago

Ed Lake doesn't seem to understand the difference between a natural occurence and an unnatural one.

A drummer enthusiast who takes animal hides, dries them and then beats them can on rare occasions contract inhalational anthrax. Thst is a not a natural process – the animal hide has been artifically dried and mechanically agitated.

Likewise, woolsorters, and those in proximity to woolsorter facilities, artifically dry wool and mechanically agitate it. Not natural.

It is almost unprecendented for an individual to be walking down the street, or even across the countryside, and contract inhalational anthrax.

Meryl is aboslutely correct that the details behind the latest victim are pathetically inadequate. The authorities are hinting that the person was in direct contact with animal carcasses – but the reality appears to be that they in fact have no clue how this person contracted the disease.

It's even more bizarre that this victim has a family who states he or she already been in some controversial involvement with the media.

Ed Lake
Ed Lake
11 years ago

Dr. Nass wrote: "inhalation cases are so rare that hanky panky must be ruled out in every inhalation case."

I agree. And, I think they're doing that – or they've done that. They're just not releasing details in order to keep the media from harassing the victim and the family of the victim.

"This fits the hypothesis (generally accepted) that it takes a lot of spores to make you sick."

I think the anthrax attacks of 2001 changed that hypothesis. It's no longer generally accepted. I think the hypothesis is now: It takes a lot of spores to give the average person inhalation anthrax, but there are many many people who are more susceptible than average.

Ottilie Lundgren was on a mail route where a letter was delivered that had gone through the Trenton mail facility around the same time as the Daschle and Leahy letters. The person who received the letter didn't get sick, nor did anyone else on the mail route. But, Ottilie did.

Did she breathe in more spores than everyone else? There's no reason to believe that. The facts indicate that she was just more susceptible than everyone else.

Ed

Anonymous
Anonymous
11 years ago

Dr. Nass,

I agree with you it is regrettable more hasn't been disclosed (consistent with HIPPA).

And that it certainly is extremely rare — with woolsorters and the recent drum cases being inhalational and handling diseased animal in the past resulting in cutaneous.

But note also that it is very possible that past cases went misdiagnosed prior to the heightened sensitivity. And the death was attributed to pneumonia or what-have-you.

And, moreover, that the flooding in mid-July had prompted a specific warning in the press to be on the lookout for anthrax. See google.

Anonymous
Anonymous
11 years ago

Dr. Nass,

As another hypothetical, consider the workers who filled the sandbags in trying to stave off the flooding. They were in close contact with massive amounts of sand being moved, to include at the level of their face and nostrils.

Ed Lake
Ed Lake
11 years ago

River floods shouldn't be of any great concern.

However, heavy rains on a piece of pasture land will cause spores that have been safely underground for a long time to percolate to the surface and move with the water to some low spot where the spores will concentrate in the grass and under the surface as the water evaporates. So, a piece of pasture that was previously okay for grazing could suddenly have enough anthrax spores to kill cattle grazing there.

But, river floods are a very different story. The spores that get brought to the surface get thoroughly diluted by the moving water and carried long distances down the river, and the spores never really have a chance to concentrate.

In the entire history of sandbagging, no one has ever gotten inhalation anthrax from sand. It makes no sense. Sand would come from an area where there is no grass, therefore no grazing cattle, therefore no way to infect the sand.

Ed

Anonymous
Anonymous
11 years ago

Discernment between deliberate and natural infectious disease outbreaks
Z. F. DEMBEK,1* M. G. KORTEPETER,2 and J. A. PAVLIN3
1Department of Medicine, U.S. Army Medical Research Institute of Infectious Diseases, Fort Detrick, MD, USA
2Department of Medicine, Walter Reed Army Medical Center, Washington, D.C., USA
3Department of Emerging Infectious Diseases, Uniformed Services University of the Health Sciences, Bethesda, MD, USA

Clue no. 9 – Unusual disease manifestation. As over 95% of anthrax cases worldwide are cutaneous, even one case of inhalational anthrax should be considered an unnatural event until proven otherwise.

It has clearly NOT been proven that this case of anthrax was naturally occurring – the authorities have no idea how this person contracted anthrax.

Anonymous
Anonymous
11 years ago

To the contrary, Ed, an alert was issued in mid-July in connection with the flooding of the Missouri River.

You should cite authority in direct support for factual assertions and thus make fewer mistakes.

Your webpage is filled with misinformation that you never correct.

http://www.infozine.com/news/stories/op/storiesView/sid/48280/

Livestock Producers Should Watch for Signs of Anthrax After Flooding
Monday, July 18, 2011 :: Staff infoZine

Flooding along the Missouri and other rivers through the central United States is prompting a call for cattle and other livestock producers to watch for signs of the deadly anthrax bacteria once floodwaters recede.

Manhattan, KS – infoZine – “Cattle producers in areas along the Missouri River should watch for unexplained cattle deaths which might occur as a result of anthrax spores washing down and being consumed by cattle after the floodwaters recede,” said K-State Research and Extension veterinarian Larry Hollis. Veterinarians and animal health officials in North Dakota, Minnesota and Canada have issued similar warnings.

“Because the Missouri River is carrying water from the Dakotas where they historically have anthrax just about every summer, anthrax spores may be carried down and end up on flooded Kansas backwater pastures,” Hollis said. “Any unexplained cattle deaths should be reported immediately to a veterinarian. The veterinarian may choose to necropsy the carcass to make sure that anthrax is not the cause. Spores of other spore-forming organisms, such as the Clostridial specie that causes blackleg, also can be carried to new areas by floodwaters.”

In response to the query emailed this afternoon:
“Is there any public update that can be shared as to the 8/9 story “Health officials investigate case of inhalational anthrax from suspected natural environmental exposure,”

the Minnesota Department of Healthpublic affairs person Doug responded:

“Not at this time. We are continuing to investigate.”

Anonymous
Anonymous
11 years ago

Note there has only been one case reported of anthrax in cattle reported this year in South Dakota.

http://www.mitchellrepublic.com/event/article/id/55771/group/homepage/

Published August 12, 2011, 05:54 AM
Anthrax confirmed in SD for 1st time this year

Anthrax has been confirmed in South Dakota for the first time this year. The South Dakota Animal Industry Board has confirmed that one adult cow was lost in a herd of 175 unvaccinated animals in Aurora County.
***
Significant climate change, such as drought, floods and winds, can expose anthrax spores to grazing livestock. Alkaline soils, high humidity and high temperature present conditions for anthrax spores to vegetate and become infectious to grazing livestock.

Epidemiologic response to anthrax outbreaks: field investigations, 1950-2001. (Anthrax Perspectives).

Publication: Emerging Infectious Diseases
Publication Date: 01-OCT-02 Format: Online

We used unpublished reports, published manuscripts, and communication with investigators to identify and summarize 49 anthrax-related epidemiologic field investigations conducted by the Centers for Disease Control and Prevention from 1950 to August 2001. Of 41 investigations in which Bacillus anthracis caused human or animal disease, 24 were in agricultural settings, 11 in textile mills, and 6 in other settings. Among the other investigations, two focused on building decontamination, one was a response to bioterrorism threats, and five involved other causes. Knowledge gained in these investigations helped guide the public health response to the October 2001 intentional release of B. anthracis, especially by addressing the management of anthrax threats, prevention of occupational anthrax, use of antibiotic prophylaxis in exposed persons, use of vaccination, spread of B. anthracis spores in aerosols, clinical diagnostic and laboratory confirmation methods, techniques for environmental sampling of exposed surfaces, and methods for decontaminating buildings.

CDC anthrax-related field investigations from 1950 to 2001 were identified from several sources. First, the new database of historical Epi-Aid documents (1950-1999) was searched to retrieve all documents in which “anthrax” or “anthracis” appeared either as an assigned keyword or as a text string in a full-text search. Epi-Aid documents related to anthrax investigations in 2000 and 2001 were identified manually in an EIS administrative database. These searches identified a variety of types of documents, including initial requests for epidemiologic assistance, interim progress reports, final reports, and memoranda.

Routes of infection were largely a function of setting. Of the 27 cases in textile mills, 21 (78%) were cutaneous, and 6 (22%) were inhalational. Contaminated goat hair or wool was the primary vehicle of infection. Persons working with raw, unprocessed materials were at greatest risk for infection (4). Of the six inhalational cases in textile mills, five were fatal. Three cases of fatal inhalational anthrax were also reported in non-textile mill workers (12,31) (Epi-Aid 1967-43).

Of the 24 investigations in agricultural settings, 9 (38%) included at least one human case. All human cases were acquired cutaneously while a person was handling, performing necropsy on, or disposing of dead animals. The most extensive cross-infection between animals and humans occurred in the 1998 outbreak in Kazakhstan, in which at least 53 human cases occurred; most were cutaneous cases acquired from slaughtering animals (Epi-Aid 1998-83).

Although four investigation reports included concern over possible waterborne transmission ([15] and Epi-Aids 1966-12, 1975-6, 1979-95), this route was not identified in any of the repons of human cases, and water contamination was not regarded as a source of infection. However, disease incidence in animals usually coincided with extremes of wet and dry weather conditions.

Anonymous
Anonymous
11 years ago

This new article seeks to describe and investigate a case of rapidly progressive, fatal, anthrax-like pneumonia and the overwhelming infection caused by a Bacillus species of uncertain provenance in a patient residing in rural Texas. The researchers determined that the infection was caused by a previously unknown strain of B cereus that was closely related to, but genetically distinct from, B anthracis.

Arch Pathol Lab Med. 2011 Aug 9. [Epub ahead of print]

Rapidly Progressive, Fatal, Inhalation Anthraxlike Infection in a Human: Case Report, Pathogen Genome Sequencing, Pathology, and Coordinated Response.

Wright AM, Beres SB, Consamus EN, Long SW, Flores AR, Barrios R, Richter GS, Oh SY, Garufi G, Maier H, Drews AL, Stockbauer KE, Cernoch P, Schneewind O, Olsen RJ, Musser JM.
Abstract

Context.-Ten years ago a bioterrorism event involving Bacillus anthracis spores captured the nation’s interest, stimulated extensive new research on this pathogen, and heightened concern about illegitimate release of infectious agents. Sporadic reports have described rare, fulminant, and sometimes fatal cases of pneumonia in humans and nonhuman primates caused by strains of Bacillus cereus , a species closely related to Bacillus anthracis . Objectives.-To describe and investigate a case of rapidly progressive, fatal, anthrax-like pneumonia and the overwhelming infection caused by a Bacillus species of uncertain provenance in a patient residing in rural Texas. Design.-We characterized the genome of the causative strain within days of its recovery from antemortem cultures using next-generation sequencing and performed immunohistochemistry on tissues obtained at autopsy with antibodies directed against virulence proteins of B anthracis and B cereus . Results.-We discovered that the infection was caused by a previously unknown strain of B cereus that was closely related to, but genetically distinct from, B anthracis . The strain contains a plasmid similar to pXO1, a genetic element encoding anthrax toxin and other known virulence factors.

Immunohistochemistry demonstrated that several homologs of B anthracis virulence proteins were made in infected tissues, likely contributing to the patient’s death. Conclusions.-Rapid genome sequence analysis permitted us to genetically define this strain, rule out the likelihood of bioterrorism, and contribute effectively to the institutional response to this event. Our experience strongly reinforced the critical value of deploying a well-integrated, anatomic, clinical, and genomic strategy to respond rapidly to a potential emerging, infectious threat to public health.

Anonymous
Anonymous
11 years ago

http://www.livestockweekly.com/papers/97/06/05/5anthrax.html

Post-Flooding Anthrax Risk
Noted By N.D. Veterinarians

FARGO, N.D. —(AP)— North Dakota veterinarians are warning ranchers to be alert for the deadly anthrax bacteria in their herds this summer.

While no one is expecting a massive outbreak, veterinarians say history has shown the number of anthrax cases often rises following floods.

"There's an increase in our chances of having more cases," acting State Veterinarian Larry Schuler said last week. "I wouldn't say we're at a high risk, but it's a higher risk than we normally have."

Last year, the state reported just one confirmed case of anthrax in an animal found dead near Fordville in July.

Schuler said ranchers should not be overly concerned, but need to keep a close eye on their herds and be extremely cautious about handling any dead livestock. The disease usually appears in late summer, he said.

Anthrax is a bacterial infection that attacks the internal organs of animals. It produces a toxin that kills within a few days of being ingested. The disease can be transmitted to humans through the improper handling of infected carcasses.

"As long as the carcass remains intact and is burned or buried properly, the spores will remain in the carcass and there's little danger of spreading the disease," said Ivan Berg, a veterinarian and animal disease specialist with the North Dakota State University Veterinary Diagnostic Laboratory.

The bacterium comes from spores that often live buried in soils for years. Researchers believe floodwaters may expose the spores, which are then inadvertently eaten by livestock.

"Once the spores are in the system, the bacteria proliferate and it's only a matter of days until the animal is dead," Berg said.

While there is little ranchers can do to prevent anthrax, Berg said good herd management and communication with veterinarians will prevent its spread.

Veterinarians can prescribe a vaccine to protect other animals in an infected herd, but that means ranchers must immediately notify their veterinarians so blood tests on the dead animals can be performed.

Meanwhile, a continent away, an anthrax outbreak apparently claimed a third juman victim in Ukraine this week when a man died hours after being taken to the hospital with symptoms of the disease, an official said Wednesday.

The unidentified man in the Volnovakha area in eastern Ukraine's Donetsk region died Monday, Emergencies Ministry spokeswoman Natalia Tsushko said. Autopsy results were not yet available.

An outbreak at a state farm in the village of Privolnoye has put 31 people in the hospital and prompted a quarantine. Two people died a week ago, and the rest remain hospitalized but out of mortal danger, Tsushko said.

Anthrax can spread to humans through skin contact, ingestion and even inhaling the contaminated spores. It can be treated with penicillin.

Meryl Nass, M.D.
Meryl Nass, M.D.
11 years ago

ANTHRAX – USA (04): (MINNESOTA), ALERT
**************************************
A ProMED-mail post

ProMED-mail is a program of the
International Society for Infectious Diseases

Date: 11 Aug 2011
From: Martin Hugh-Jones

I have puzzled over this recent pneumonic case of anthrax hospitalised
in Minnesota. The region from Montana east to Minnesota does not have
imported hair or wool mills, and aerosol exposure from handling
carcasses is not a risk in this disease, so how was the patient
exposed? It occurs to me that exposure through the sniffing or
snorting of contaminated illegal drug such as cocaine or heroin, or
even maybe from smoking the latter drug, should be considered. If this
were the case this would involve a _batch_ of contaminated cocaine or
heroin: the potential would exist for other cases, and emergency
clinics in the northern tier of US states should be on the lookout for
similar pneumonic cases, or even nasal anthrax. As drug users tend to
be slow in seeking medical help, some might arrive on the point of
death.

If this hypothesis turned out to be correct, it would then be
necessary to identify what had been added to these illegal drugs and
why, which would make it doubly important for the legal authorities to
acquire samples for bacterial and chemical analysis.

The Scottish medical authorities' experience with injected
contaminated heroin in 2009-2010 may be applicable to the US. I am
assuming that they have truly diagnosed anthrax due to _Bacillus
anthracis_ and not an anthrax-like infection due to a toxic _B.
cereus_. See: .


Martin Hugh-Jones
ProMED-mail

Ed Lake
Ed Lake
11 years ago

One of the Anonymi wrote: “Because the Missouri River is carrying water from the Dakotas where they historically have anthrax just about every summer, anthrax spores may be carried down and end up on flooded Kansas backwater pastures,” Hollis said. “Any unexplained cattle deaths should be reported immediately to a veterinarian.

Back in 2003, I exchanged dozens of emails with top experts on how anthrax moves from place to place, and I'm still exchanging emails with them. I can't name the experts because, if I do, they'll be attacked by the "Anonymi" for talking with me.

However, in an email I received this morning, this was said, "Look at the source. Larry Hollis has not had an anthrax outbreak on his patch in decades.

But as an extension officer it is fair advice just in case of reports of unexpected deaths. It's always something one should be on the alert for whatever the cause. 9/10 are clostridial deaths; then there are plant poisonings, nitrate poisoning, heat exhaustion."

And I received this about the screwball notion that people can get anthrax from sandbags, "Sand has an acid pH which will not encourage long time survival of spores. Also any particle size will be too big to allow aerosol access to the alveoli. And as you say sand comes from beaches, cheniers, etc. The only way it could acquire spores would be if you buried a dead cow in it. But as you say, no grass on sand so no cattle grazing."

We talked for months back in 2003 about the mechanics of moving spores from place to place. It involves "floods," but NOT big river floods. Mostly, it involves "floods" where spores from a lethal spot in the hills get washed down to a valley and accumulate in a flooded pasture. When the flooded pasture dries out, the spores are left mixed with the grass and the roots of the grass. (Salt from the dead animal's blood may also get washed down with the spores, making the area very tasty to cattle. They love salt.)

Big river floods disperse spores. Pasture floods move and concentrate spores.

Some veterinarians think that big river floods can also spread concentrations of anthrax by some unknown mechanism, but they cannot prove whether a flooded pasture received spores from long distances away or from some nearby spot that was uncovered by the moving water.

You can read an article titled "The ecology of Bacillus Anthracis" by clicking HERE.

How far rain water can transport spores without diluting the spores to the point where they cannot infect anything is a matter of dispute, and that dispute isn't going to be resolved on this forum.

Ed

AnthraxSleuth
AnthraxSleuth
11 years ago

"I think the anthrax attacks of 2001 changed that hypothesis. It's no longer generally accepted. I think the hypothesis is now: It takes a lot of spores to give the average person inhalation anthrax, but there are many many people who are more susceptible than average."—ED

You got that all you scientist and Doctors reading this blog? Somewhere along the line Ed has become a PHD on Anthrax and is here to set you straight.

Thanks Ed. You just gave me my entertainment for today.

Anonymous
Anonymous
11 years ago

That's a fascinating possibility Martin Hugh-Jones suggests.

Personally, I don't think it is likely given that it is my guess that drug users likely don't get out much (through those 4 states).

But it is fascinating hypothesis to explore nonetheless and it hadn't occurred to me.

Now here's a really stupid question: Do people snort heroin? Relatedly, were there any inhalational cases in all of Scotland due to contaminated heroin? If people snort heroin, but there were no inhalational cases due to contaminated heroin in Scotland, why would there be one here but not there? (I don't think there is any precedent for cocaine contaminated with anthrax).

I have an Iranian friend who worked with Ken Alibek who had researched these issues years ago and he said that government agencies should focus on heroin processing sites on the border of Afghanistan / Iran as possible places of processing anthrax. He notes the same equipment is involved.

Personally, I favor the hypothesis that the patient was exposed to a dried skin and even slept on it. Once a family member brought a fur from Finland in the 1970s and if it had been given to me, I would have fallen asleep on it next to the campfire.

Anonymous
Anonymous
11 years ago

Anthrax Sleuth,

I just noticed in an earlier thread in a post I totally missed that you were talking about a link to authority. I was to search for the term "Raleigh" in a post under the wired article. Is there a URL you could give me here as going to the wired article just brought me to the wired article.

You mentioned a facility that was being discussed at APG in 2001. A B3 in fact was built there in 2001 as I recall and I recall from the press that by the end of the year there were 19 strains of anthrax kept there. I never could get a more precise date of completion of the B3 or the date the strains were acquired.

Anonymous
Anonymous
11 years ago

http://www.cidrap.umn.edu/cidrap/content/bt/anthrax/biofacts/anthrax_epi.html

An outbreak of anthrax was first observed among injection-drug users in Scotland in December 2009 (Ramsay 2010). Since then, 31 confirmed cases and 11 deaths among heroin users have been reported from three countries (Scotland, England, and Germany) (Christie 2010). The patients reported injecting, smoking, and/or snorting heroin. The symptoms at presentation varied greatly, were inconsistent, and were not typical of cutaneous, inhalational, or gastrointestinal anthrax (Booth 2010).

AnthraxSleuth
AnthraxSleuth
11 years ago

" Is there a URL you could give me here as going to the wired article just brought me to the wired article"—Anon

http://www.wired.com/magazine/2011/03/ff_anthrax_fbi/

Search for Raleigh and read my post there. I name the FBI agents I was in contact with.

"You mentioned a facility that was being discussed at APG in 2001. A B3 in fact was built there in 2001 as I recall and I recall from the press that by the end of the year there were 19 strains of anthrax kept there. I never could get a more precise date of completion of the B3 or the date the strains were "

What my boss, who was in the negotiations for the APG facility, told me is that it would be an Anthrax vaccine production facility to supply the military with the vaccine. This was being done b/c the FDA would not approve the Bioport vaccine. They would not approve Bioports b/c Bioport could not produce a consistent product not b/c of problems with the vaccine itself. So if the military produced it on their property it would be out of the FDA's jurisdiction b/c soldiers are not people. They are government issue.
Dr. Nass will not let me name names here. However I have supplied her with my former boss's name.

I doubt this facility was built b/c after the mailings the FDA quietly approved Bioport's vaccine. All I know for sure on that is the General stopped calling so we did not get the contract. He also said another big player was vying for the contract, I believe he said the other company was SAIC.

Ed Lake
Ed Lake
11 years ago

I just noticed that no one posted any new information about the Minnesota inhalation anthrax case.

The person in Minnesota who contracted inhalation anthrax close to a month ago has been identified, and he's doing well. According to the Minneapolis Star-Tribune, a pair of tourists from Florida, Dan Anders and his wife of 36 years, Anne, had been on a vacation visiting the national parks in Wyoming, Montana and the Dakotas. While they were visiting friends in Pelican Rapids, MN, Dan started feeling "punky." Two days later, he was in the hospital fighting for his life. Dan is 61 years old, which probably supports the observation that elderly people do not need to be exposed to many spores to become infected.

The couple, who live in St. Petersburg, flew to Fargo, rented a car, and drove to Yellowstone and to Wind Cave National Park and Custer State Park in South Dakota. "All the dirt roads and ponds, we saw it all," Anne said.

Dan, who is retired from the irrigation business, occasionally picked up garnets and other rocks to use in making jewelry. The couple drove through a herd of bison, but got no closer than any other tourists

The Dan Anders' case now seems to be more "mysterious" than "suspicious."

Unlike the case of Bob Stevens, who was initially thought to have contracted inhalation anthrax from "natural sources," but who later turned out to have been killed by an anthrax letter, this seems to be a true case of getting anthrax from "natural sources."

Unfortunately, health officials still haven't figured out where or how Dan encountered the spores.

Ed

Ed Lake
Ed Lake
11 years ago

Dr. Nass wrote; "This fits the hypothesis (generally accepted) that it takes a lot of spores to make you sick."

I've been reading Jeanne Guillemin's new book "American Anthrax," and Guillemin makes a big point on pages 59 to 63 that the "generally accepted hypothesis" you mention was largely responsible for the failure to shut down post offices after it was realized that Bob Stevens had been infected by a letter.

They found spores in Ernesto Blanco's van, and they found spores at the local post office. That was PROOF that spores had leaked from the envelope before it was opened, and it was proof that postal facilities had been contaminated. But, because of the faulty "generally accepted hypothesis" that it took at least 5,000 spores to INFECT ANYONE no one thought that the contamination might be dangerous to lots of people.

The same ERROR was repeated after the discovery of the Brokaw letter and then the Daschle letter.

Everyone believed the ERRONEOUS idea that it required AT LEAST 5,000 spores to infect a human with inhalation anthrax. That idea was WRONG WRONG WRONG.

No one should believe it anymore. It may take at least 5,000 spores to infect the AVERAGE person, but there are LOTS of people who are more susceptible than the average person.

Plus, in theory, it takes only a single spore to cause cutaneous anthrax, and, if improperly treated, cutaneous anthrax can also be fatal. The child who was infected at ABC almost died from cutaneous anthrax.

Ed

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