What is anthrax?

By JEREMY LAURANCE

Two cases of Anthrax have been confirmed in Florida and hundreds of people who, like the victims, worked in the headquarters building of tabloid publisher American Media are lining up for tests and antibiotics.

LONDON - It takes a large dose of anthrax to kill. A human being must breathe at least 2,500 spores an hour to get a lethal dose, although some people are more susceptible than others, depending on their natural immunity.

This limits the value of the bacterium to terrorists. Although anthrax is always the first agent mentioned in any discussion of bio-terrorism it would not be easy to mount an attack using it.

The Japanese religious cult Aun Shinrikyo made four attempts with anthrax, throwing it off a building in Tokyo, before giving up and turning to the nerve agent, Sarin, which they released on the Tokyo subway in 1995. That attack killed 12 and injured 5,000.

Anthrax mainly affects livestock and the spores, which can survive for decades, are widely present in the soil. Isolated cases occur in Britain regularly. But it cannot be spread from one person to another so for an attack to claim many lives a very large number of spores would have to be released over a wide area to infect the population simultaneously.

Last year a factory worker in Bradford was struck by the cutaneous variety, which causes large sores on the skin, and there have been four previous cases in Britain in the last decade.

Pulmonary anthrax of the kind that claimed the life of Bob Stevens in Florida is rarer and more dangerous. Once infected, victims can be treated with large doses of antibiotics and the sooner treatment starts the greater the chances of success.

Some patients escape with nothing worse than a nasty attack of bronchitis. The difficulty is in knowing who has been infected.

In the early stages of pulmonary anthrax, the disease resembles flu with fever, aches and pains and tightness of the chest. As the disease progresses, the patient becomes increasingly breathless and weak until collapse occurs – followed rapidly by death. Treatment at this stage is hopeless.

The Iraqi government is reported to have experimented with an antibiotic-resistant strain of anthrax, that would have made it more lethal, and to have tried mixing it with detergent to make it float more readily on the wind.

Vaccination is effective against anthrax but must be given several days before exposure occurs. The real value of an anthrax attack to a terrorist organisation would be in triggering panic in the target population. It is silent, deadly and there is no way of telling where it is coming from.

In the UK, the 49 laboratories that make up the Government's Public Health Laboratory Service would maintain surveillance round the country and provide diagnostic experts to identify unusual substances. Blood samples and throat swabs taken from affected individuals would be sent to the laboratories for analysis.

The Government's worst fear is that during the time required to confirm the cause of an outbreak of disease, panic could grip the population with mobs descending on hospitals to demand treatment or vaccination. Even if it causes few deaths, an anthrax attack would claim among its victims our sense of security and safety and the freedom to go about our lives free of fear.

- INDEPENDENT

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