Is it flu or anthrax? Don't panic, experts say

By Maggie Fox, Reuters, 10/11/01

WASHINGTON -- You have a little fever, some achy muscles, a cough. Flu season is starting, but is this simple influenza or is it something worse?

Americans are nervous after the Sept. 11 attacks on the World Trade Center, Pentagon and four airliners, and even more jumpy with word that three people who worked in a Florida tabloid newspaper office were exposed to anthrax.

Anthrax is one of the top three agents that experts say bioterrorists would use in an attack. It is spread by invisible spores, it is highly deadly when breathed in, and by the time symptoms develop, a victim is very likely to die.

Even worse, the symptoms start out looking like a plain old cold. By the time serious pneumonia or meningitis develops, it is probably too late to treat the infection.

That is what happened to 63-year-old Robert Stevens, a photo editor at a south Florida tabloid newspaper whose case touched off the nationwide anthrax scare.

The State Department has told all U.S. embassies abroad to stock up on the antibiotic ciprofloxacin in case of anthrax attacks and health departments across the country are stocking up on the drug.

So, if someone gets a cold, should he or she rush to the hospital to get antibiotics too, just in case?

"This is not an emergency situation where you need to run to the emergency room," Dr. Mohammad Akhter, Executive Director of the American Public Health Association, said in a telephone interview. "I think you should go to your physician."

Dr. David Satcher, the U.S. Surgeon General, agrees.

"I know people are scared. I think it's almost natural to expect that, following that tremendous disaster, people would be scared," he said in a telephone interview.

"There are some people, for example, that have not had flu for many, many years. If one all of a sudden comes down with it, it may not be inappropriate in a situation like that to call your doctor and say 'should I be worried about this'."

What people should not do, Satcher and many other experts have said, is demand antibiotics from their doctors.

"Physicians have a tremendous responsibility here," Satcher said. "If these drugs are used inappropriately, the organism is going to develop resistance to them. The worst thing you can do is contribute to these organisms becoming resistant."

The U.S. Centers for Disease Control and Prevention (CDC) will distribute antibiotics if it becomes clear that many people have been exposed to anthrax.

"It is not appropriate to start stockpiling home antibiotics," he said. "We can deliver the antibiotic, as we delivered it in Florida."

Akhter and Satcher both urged Americans to get vaccinated against flu so they do not develop frightening symptoms in the first place. "The best thing this flu season really is to go get the flu vaccine so you can at least rule that possibility out," Akhter advised.

Antibiotics are useless against the flu, which puts 100,000 Americans into the hospital every year and kills 20,000.

Health officials have long been complaining that too many Americans are prescribed useless antibiotics -- cutting into the supply for people who really need them and helping various bacteria evolve into drug-resistant "superbugs".

But experts also say the United States is highly vulnerable to a biological or chemical weapons attack, lacking the drugs, vaccine and infrastructure to respond.

That is true, Akhter said, but he praised Florida officials for their quick response to Stevens's case. He said someone who fears he or she has anthrax will be checked out quickly.

"I think this is the highest level of alert I have ever seen," he said. "Everything that comes in is looked at as suspicious."