Anthrax is a species of Bacteria which has been used by terrorists to infect people and cause illness.  I do not believe that anyone in Bucks county or Montgomery county is at risk for Anthrax bioterrorism, or for any other kind of terrorism.  There are several reasons for this.  

First, terrorists like to attack major centers of activity, like New York and Washington, to get maximum attention. (If you work in Philadelphia, you should follow the advice of Philadelphia's Health Officials.)

Second, Anthrax is typically not contagious. It is found in the wool or meat of infected sheep, which are rare in the United States, or in their pastures.  It can be grown in a labratory, and spread by whatever method a terrorist may come up with. So far, the only method that terrorists have used is mailing envelopes with powder inside.  You would have to be exposed to a large amount of the powder to get the infection.  You cannot be infected by another person, only by the powder.  In the unlikely event that you receive an envelope with powder in it, simply put it into a plastic bag, and close the bag, then wash your hands with soap and water, and call health authorities.

Third, anthrax is susceptible to many common antibiotics, including penicillin and doxycycline.  Both the skin and the respiratory forms of Anthrax are curable if treated within a few days of onset. News reporters have talked about people being treated with an expensive antibiotic called cipro, which is no more effective than other common antibiotics, for the treatment of Anthrax.

There are two major types of Anthrax infection, Respiratory and Cutaneous. When large amounts of Anthrax powder are inhaled, Respiratory (lung) Anthrax can occur. When Anthrax powder is deposited onto an open wound, Cutaneous (skin) Anthrax can occur.

Respiratory Anthrax has two phases, the first consisting of 1-3 days of feeling lousy, with a mild fever, dry cough, and sometimes a feeling of chest pressure. If you have these symptoms, you should go to your doctor to be checked, and treated if appropriate. Without treatment, the second phase comes on suddenly, with shortness of breath, a wheezing sound on inhalation, dry cough, high fever, and profuse sweating, sometimes accompanied by bloody vomiting or bloody diarrhea. If you have these symptoms, you should go to a hospital immediately. Without treatment, death occurs after 1-2 days of the second phase.

Cutaneous or Skin Anthrax begins as an itchy bump that resembles an insect bite. It enlarges and within 1-2 days develops into an ulcer surrounded by small blisters. It is typically 1-3 cm in diameter and remains round and regular.  A central black charred area develops later, which is usually itchy but not painful, with associated swelling.  See your doctor if you think you have this type of sore.  After 1-2 weeks the sore dries, and the black area loosens and falls off, leaving a permanent scar.  There may be swelling of the infected arm or leg, with some enlarged lymph nodes, and some systemic symptoms such as fever, a lousy feeling, and headache. You should see your doctor if you have these symptoms. 

In summary, Anthrax is unlikely to be found in our area, it is hard to spread, and it is treatable with antibiotics.  Armed with this information, I believe it is safe for you to go about your business without worry.

                   Brad Paddock, MD