Posted on 04/23/2002 7:58:39 AM PDT by Mitchell
Edited on 09/03/2002 4:50:21 AM PDT by Jim Robinson. [history]
Six months after inhaling anthrax spores, several of the mail workers who survived the deadly disease have yet to make a full recovery and are experiencing serious fatigue and memory loss....
The only survivor who appears to have made a full recovery is Ernesto Blanco....
(Excerpt) Read more at msnbc.com ...
Sorry, I should have elaborated on this, because I certainly haven't forgotten about Bob Stevens.
My point was that this report suggests a difference in the long-term effects of the different batches of anthrax: the NJ anthrax caused long-term effects (fatigue, memory loss, etc.) that were apparently not caused by the FL anthrax. Stevens' death doesn't bear on this issue: since he didn't survive his initial bout, we have no idea what long-term effects he would or wouldn't have suffered had he survived.
The big dividing line among the people who developed symptoms of infection is a simple one. All the deaths occurred with people over 50.
This group of people has substantial ethnic diversity. It could be that some populations have a degree of inherited immunity.
My understanding is that this is not true. All the anthrax is of the same strain (Ames), but there are small genetic differences. There also appear to be differences in physical preparation ("weaponization").
But Blanco was 74 -- not only did he survive, but he is the only survivor to have fully recovered.
In any case, I'm not suggesting a difference in mortality rate, but a possible difference in long-term effects among the survivors. (This is speculative, since there aren't enough cases for the difference to be statistically significant all by itself. But this adds to the other evidence that there were at least two, and maybe three, batches of anthrax involved.)
How's this for a hypothesis - there are maybe as many as 30 different batches. These were collected over the years. As the bacteria is grown and regrown over a long period of time you might get minor variations.
As far as the lab sourcing it would be concerned, it would all be the same thing.
The thieves would deal it as though it were identical. The final users wouldn't know the difference.
Some of it could have been sent in letters. Some of it handcarried to the site by saboteurs otherwise believed to be trustworthy employees.
And, the people buying the stuff may not have been aware that a number of the units they purchased had been sterilized.
Add in these quite reasonable conditions and the results would be dramatically variable.
Me: But Blanco was 74 -- not only did he survive, but he is the only survivor to have fully recovered.
You: I didn't say that everybody over 50 died, just that all who died were over 50.
I understand that -- I wasn't saying you were wrong.
The point was that it's interesting that Blanco not only survived, but he fully recovered, in spite of the fact that he was 74. Everything else being equal, his age would presumably make the illness more severe than it would be in a younger person.
It's natural to ask why Blanco (in FL) recovered fully, while the others who survived inhalation anthrax (in NJ) are still suffering from a variety of symptoms. One conceivable answer in such a situation would be that the patient is young and healthy, with a correspondingly strong immune system. But, in fact, Blanco is 74 years old -- and this makes it even more remarkable that he is the single survivor who has completely recovered.
This really suggests that the FL anthrax is different ("weaker" in some respect) than at least some of the anthrax that passed through the postal system in NJ.
The only hesitation here is the very small sample size. The differences can't be statistically signficant, because of the small sample size; the apparent difference in the FL and NJ anthrax symptoms could be due to chance.
I hesitate to put this thought out, but maybe this is due to the "subtle but possibly significant" differences between the FL and DC anthrax.
OTOH, maybe Ernesto Blanco's body simply has incredible healing power.
That's exactly what I was suggesting as a possibility.
OTOH, maybe Ernesto Blanco's body simply has incredible healing power.
That's possible, but his age (74) argues against it, as does the fact that he contracted the disease in the first place (only one other person contracted anthrax at AMI, despite widespread exposure there).
Let's analyze this statistically. Take as the null hypothesis the statement that there is no difference between the FL and NJ anthrax. Of the 6 inhalation anthrax survivors, 1 refuses to be interviewed. So, of the 5 we know about, 1 (Blanco) has fully recovered, and 4 are experiencing the syndrome of symptoms described in the article (memory loss, fatigue, joint pain). Assuming the null hypothesis now, all patients were exposed to the same anthrax; this anthrax would then appear to cause this syndrome among about 80% of the survivors (due to genetic differences among patients or other factors). The fully-recovered patient could equally likely have been any one of the five (by the null hypothesis). The probability that the fully-recovered patient (we would expect to have one) would be the patient from FL is 1 out of 5, or 20%.
So I conclude that the probability that this is due to chance (rather than to some difference between the FL and NJ anthrax) is 20%. In statistical terms, we can say that there is a difference between the FL and NJ anthrax at the p=0.8 confidence level. This is not statistically significant (because of the small sample size), but it's high enough to be suggestive. It does add to the weight of other evidence that there is a difference.
In terms of other measures, notice that there doesn't appear to be a difference in mortality rate between the FL anthrax and the NJ anthrax, among the people who contracted the inhalation form of the disease. Fatalities numbered 1 out of 2 cases in FL, and 4 out of 9 cases in the Northeast.
On the other hand, there does appear to be a difference in the site of infection. There were many cases of cutaneous anthrax in the Northeast, but none in FL. This suggests a difference in physical preparation or delivery method, but it's conceivable that a subtle genetic difference could make one type more virulent at a particular site than another.
I meant, of course, the 80% confidence level, or, equivalently, p=0.2. (Typically, people would like to see a 95% confidence level, or p <= 0.05, to call something statistically significant.)
This p value of 0.2 is based just on the differential rate of full recovery among survivors in the two populations (FL vs. the Northeast). I suspect that if you also include the difference in cutaneous anthrax incidence rate, the difference may prove to be statistically significant.
The lingering symptoms bear a resemblance to "Gulf War Syndrome." My niece's husband came back fromt the war with it, and still has it. Interestingly enough, one of the drugs he was given at a VA hospital to treat Gulf War Syndrome was Cipro.
This is fascinating. The University of Texas Southwestern Medical Center at Dallas did extensive research on Gulf War Syndrome. Here's a link to their press release: UT Southwestern team traces Gulf War illnesses to chemicals: Three primary syndromes identified.
According to this study (my emphases):
By conducting an exhaustive series of epidemiological and clinical studies on veterans from a U.S. Navy reserve unit, the UT Southwestern researchers identified a syndrome characterized by thought, memory and sleep difficulties; a second syndrome that involves more severe thought problems as well as confusion and imbalance; and a third syndrome of sore joints and muscles and tingling or numbness in the hands and feet.The symptoms described certainly sound similar to those experienced by the inhalation anthrax survivors in the Northeast. (I don't know if UT's identification of the cause has been widely accepted or not.)
The researchers determined that the syndromes can be traced to the use of flea collars, insect repellant and anti-nerve gas pills, as well as exposure to chemical nerve agents. The syndromes are variants of a rare disorder called organophosphate-induced delayed polyneuropathy, which is caused by exposure to certain chemicals that inhibit cholinesterase, an enzyme important to nervous system function.
The following are the natural questions I'd like to ask:
Blanco works for a private company in Florida.
The postal workers work for the Post Office in metropolitan Jersey and DC.
Big difference in work and living enviroments.
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