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Dr. Sanjay Gupta: Dealing with the continuing anthrax attacks



Dr. Sanjay Gupta is a CNN medical correspondent. In addition to his work for CNN, Dr. Gupta is a staff and faculty member of the neurosurgery department at Emory University's school of medicine in Atlanta. He joined the CNN.com chat room from CNN Center in Atlanta, GA.

CNN: Hello, Dr. Sanjay Gupta. Good to have you back in CNN.com Newsroom.

SANJAY GUPTA: Hello, and thank you for coming. A lot has been happening with the anthrax story, and I'm anxious to hear your questions.

CNN: You met with Health and Human Services Secretary Tommy Thompson when he visited CNN yesterday. Give us some observations about the Bush administration's strategy toward the recent anthrax outbreaks.

GUPTA: Yes, I had a chance to meet with both the secretary of health, Tommy Thompson, as well as director of the Centers of Disease Control (CDC), Jeffrey Koplan. While there is no overarching strategy to combat anthrax, it was clear from speaking to the secretary that significant thought and resources are being devoted to this issue. Let me be more specific. With regards to testing and possible treatment options, Secretary Thompson is making significant attempts to ensure adequate antibiotics and trying to improve the consistency and reliability of testing around the country.

Anthrax attacks
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 EXTRA INFORMATION
  •  Anthrax symptoms
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  •  Advice on suspicious packages
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 If you receive a suspicious package:
  • Handle with care; don't shake or bump
  • Isolate and look for indicators
  • Don't open, smell or taste
  • Treat it as suspect; call 911

  • Source: FBI

    CHAT PARTICIPANT: Dr. Gupta -- has the anthrax scare been blown out of proportion?

    GUPTA: I think that may be a fair representation, however, there is generally a tremendous amount of fear of the unknown. While we likely haven't seen the full ramifications of the deliberate anthrax attacks, it is important to keep in mind other significant health risks out there. They should not be forgotten in light of all the attention being placed on anthrax.

    CHAT PARTICIPANT: Dr. Gupta, if you get cutaneous anthrax and recover, are you immune from pulmonary anthrax? It seems you should be.

    GUPTA: The whole concept of vaccinations involves exposing people to small amounts of either live or dead bacteria. It is unclear whether a cutaneous anthrax would provide certain immunity, although in theory, it might. In order to check, one would have to have antibodies drawn for anthrax.

    CHAT PARTICIPANT: After watching three weeks of anthrax attacks, how do you think the lack of public health infrastructure could impact the government's and our society's ability to respond to an even greater biological or chemical attack?

    GUPTA: I think that's an excellent question. Let me say that my impression has been, at a national level, our public health system has been operating reasonably well. The problem tends to occur at the local and state level, where resources and interest have been lacking. There have been public health triumphs amidst all this anthrax panic. To be specific, we may have been dealing with significantly more infections, and possibly death, were it not for some of the quick thinking and actions of our national public health system.

    CHAT PARTICIPANT: It was reported this morning that four mailrooms at the Food and Drug Administration have traces of anthrax. What impact will that have on us as far as further precautions?

    GUPTA: I think all buildings, including the FDA, the CDC, other governmental buildings, are certainly all tightening security. Until the investigation has provided more information, it's difficult for me to answer questions about this. It obviously will have a significant impact on the way people conduct their activities within these buildings, including how they open and read their mail.

    CNN: How do anthrax and the flu resemble or differ from one another symptomatically?

    GUPTA: The symptoms that people most commonly associate with flu are fever, muscle aches, general tiredness. These can be confused with anthrax, as well as numerous other infections. It is not uncommon for all sorts of infections to have the same sort of initial course. What is different about anthrax as we have seen four times now, is that it sometimes progresses to shock and death. Distinguishing the two can be very difficult, and because of this, we may see an increase in the number of people on antibiotics, as well as the number of people getting blood tests this flu season.

    CNN: What are the tests for anthrax?

    GUPTA: There is no test for an individual to determine whether or not they have been exposed to anthrax. Exposures are usually deemed as such through numerous tests, perhaps including a nasal swab, but also environmental sweeps, analysis of suspicious powder, if it exists. The diagnosis of infection is made by isolating the bacteria from a body fluid or tissue.

    CHAT PARTICIPANT: Dr. Gupta do you know whether the U.S. military will be reinstating mandatory anthrax vaccinations in light of recent events

    GUPTA: There is significant discussion going on right now to redefine who are considered high risk individuals. In the past, those groups have typically been farm workers and soldiers. Now is quite an amazing time, in that postal workers and others, including soldiers, may have vaccinations recommended.

    CHAT PARTICIPANT: With all these initial tests showing the bacteria family anthrax showing up, how common is that bacteria family and what is the possibility that they exist naturally in the environment, and could cause this?

    GUPTA: When preliminary tests are reported as positive, oftentimes it means from a microbiological perspective the bacillus family has been shown. Further tests are required to prove that it is in fact bacillus anthracis. There is naturally occurring bacillus and bacillus anthracis in the U.S. today. I couldn't give you numbers on the naturally occurring bacillus, but anthracis is obviously pretty rare.

    CNN: Dr. Gupta, do you have any closing comments for us today?

    GUPTA: As the flu season approaches, people will be understandably concerned about anthrax. While we have seen four deaths now out of ten inhalational cases, it becomes a very frightening prospect. I want to make a couple of points. Statistically speaking, this season, if you do have flu-like symptoms, you will most likely have the flu. If you have justifiable reason to be concerned about anthrax, because of a suspicious package, because of where you work, or because of known anthrax in your area, you should definitely alert public health officials. At that time, in addition to conducting testing on you as an individual, environmental sweeps will be able to prove whether anthrax exists, and hopefully prevent any outbreaks from occurring. What it may mean for you as an individual is extra doses of antibiotics, and perhaps blood tests if anthrax is a real concern. Be safe.

    CNN: Thank you for joining us today, Dr. Sanjay Gupta.

    GUPTA: Thank you. Enjoyed being here.

    Dr. Gupta joined the CNN.com chat room via telephone and CNN provided a typist. This is an edited transcript of the interview which took place on Thursday, November 1, 2001.