[EMED-L] [Hazmat-WMD] Anthrax - When do we worry? (fwd)

[measl at mfn.org]

This same thread just had a posting from a practitioner who was met with
"we don't care, go somewhere else" by several agencies (including the Fat
Dumb & Ignorant) when trying to report a possible case.

-- 
Yours, 
J.A. Terranson
sysadmin at mfn.org

---------- Forwarded message ----------
Date: Sat, 13 Oct 2001 19:47:22 -0400
From: Richard Paley <rpaley at ADELPHIA.NET>
Reply-To: EMED-L -- a list for emergency medicine practitioners.
    <EMED-L at ITSSRV1.UCSF.EDU>
To: EMED-L at ITSSRV1.UCSF.EDU
Subject: Re: [EMED-L] [Hazmat-WMD] Anthrax - When do we worry?

In Florida, the state department of health is telling us not to do any
cultures for Anthrax.  We are to refer asymptomatic patients who sent at
least one hour in the AMI building to the health department for interviewing
and testing
----- Original Message -----
From: "douglas yoshida" <dyoshida at BELLATLANTIC.NET>
To: <EMED-L at ITSSRV1.UCSF.EDU>
Sent: Saturday, October 13, 2001 5:16 PM
Subject: Re: [EMED-L] [Hazmat-WMD] Anthrax - When do we worry?


> Prior to the 12th I know of no one in our EDs( NYU and Bellevue) that
treated any
> one with antibiotics. Now that there is anthrax documented in New York,
things
> will changed.
>
> The Department of Health's official recommendation is to treat only the
NBC
> employees who were on the 3rd, 7th floor or in the mailroom on Sept. 18th
or 25th.
> Asymptomatic people were being treated on site with cipro and had nasal
cultures
> taken. Patients with any "symptoms" were being referred to the Bellevue
ED. I
> treated  and discharged one NBC employee who had a runny nose and sore
throat
> (nothing else) with a nasal swab and levofloxin who "probably" was on
those
> floors. I saw another person who works for a magazine publisher who got a
white
> powder on her hands hours before the NBC exposure was announced. She was
already
> on levofloxin for a a sinus infection so I swabbed her nose and notified
the
> on-site CDC person. For everyone else without the hint of credible
exposure I have
> been treating with reassurance that their rash or cold is not anthrax,
though what
> a credible exposure is will probably change if more cases/sites arise.
Other ED
> attendings have been taking nasal swabs of non-NBC employees who give a
vague
> history of exposure (e.g. there was white dust in the taxi cab driven by a
dark
> skinned man).
>
> I could find no data that states how sensitive or specific a nasal swab is
for
> anthrax exposure, does any one know?
>
> Douglas Yoshida MD
> Bellevue and NYU hospitals
>
> "Henry J. Siegelson, MD, FACEP" wrote:
>
> > I have had to deal with several individuals and families that were
worried
> > that they might have been anthrax victims.  THey either visited Florida
> > recently or had  an upper respiratory infection.
> >
> > What is everyone doing to workup these patients?
> >
> > How are you advising treatment?
> >
> > Henry J. Siegelson, MD, FACEP
> > Atlanta
> > ----- Original Message -----
> > From: <VanceB4660 at aol.com>
> > To: <Hazmat-WMD at yahoogroups.com>
> > Sent: Saturday, October 13, 2001 11:25 AM
> > Subject: [Hazmat-WMD] Anthrax - When do we worry?
> >
> > > I think it's time we started talking about how to evaluate whether or
not
> > > this anthrax business is a big deal or not. Here are some things that
> > would
> > > make me worry:
> > >
> > > 1. The various samples are genetically similar.
> > > 2. Similar handwriting on the letters.
> > > 3. Brown powder vice white starts showing up. (Anthrax is usually
brown.
> > You
> > > can find any white powder in any kitchen.)
> > > 4. More people actually get sick (NOT mass psychogenic illness).
> > >
> > > What do the rest of you think?
> > >
> > > Vance Bennett
> > > Hazmat Curmudgeon
> > >
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