Twenty-two human frames developed ...

Twenty-two human frames developed anthrax infection after coming in contact with Bacillus anthracis spores from a bioterrorism act in October and November of 2001 Inhalational anthrax, the principally serious mode of infection, occurr in 11 of these cases. Patients became critically ill; five subsequently died. Kuehnert and colleagues at the Center for Disease ascendency and Prevention collected clinical data from these cases and near a description of features that may help distinguish this rapidly lethal disease from other routine respiratory infections.

Inhalational anthrax appears to be a biphasic illness. The initial infection is marked through nonspecific symptoms similar to influenza, which then is followed by the agency of rapid progression to severe pneumonia and septic concussion The investigators compared clinical data from the 11 inhalational anthrax cases with 2203 patients with influenza-like illness (ILI) who participated in a late trial of a drug for influenza treatment. They also compared anthrax cases with 784 parts with community-acquired pneumonia (CAP) from the North American Pneumonia Etiology inquiry Only patients 40 years of age and older were used in the comparison studies to match the age distribution of the 11 anthrax cases.

After various statistical modeling and data analysis arrangements the authors developed a scoring regularity to differentiate inhalational anthrax from ILI and CAP. A score of four or higher for the ILI body would have correctly identified all 11 anthrax cases and exclud 96 percent of those with routine ILI. For the pneumonia phase of the illness, a score of three or higher correctly included nine of the 11 anthrax cases and exclud 81 percent of routine CAP cases.

The authors bring to an end that there were similarities in clinical signs, symptoms, and laboratory markers among ones with inhalational anthrax that may help distinguish this illness from other routine respiratory infections.

Kuehnert MJ et al. Clinical features that discriminate inhalational anthrax from other acute respiratory illnesses. Clin Infect Dis February 1 2003;36:328-36

COPYRIGHT 2003 American Academy of Family Physicians

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