two-pronged assault consisting of a powerful antibiotic cocktail and high-tech intensive care pulled anthrax victim Ernesto Blanco back from the edge of death — and increased what doctors know about treating the deadly disease.Posted on 10/27/2001 4:00:49 AM PDT by kattracks
two-pronged assault consisting of a powerful antibiotic cocktail and high-tech intensive care pulled anthrax victim Ernesto Blanco back from the edge of death — and increased what doctors know about treating the deadly disease.
Blanco, 73, left Cedars Medical Center in Miami on Monday, still coughing and on antibiotics, but on the mend. Doctors expect him to do well and said his own immune system should fight off any recurring anthrax threat.
The anthrax crisis is an unwelcome but rich source of new knowledge about the rare disease, said the Centers for Disease Control and Prevention Director Dr. Jeffrey Koplan. For example, doctors now find that anthrax appears in varied ways, Koplan said.
Sparse, decades-old information about inhalation anthrax in humans, most based on reports of an accidental Russian exposure and a few wool workers who handled infected skins, suggest an 85% or higher mortality rate.
But among the current cases caught early enough to treat, including Blanco's, all are improving, said CDC official Dr. Julie Gerberding.
These cases have increased "our nationwide medical experience with this disease by almost 10% over the last century," Dr. Tom Davis, a resident physician at Weill Cornell Medical Center and ex-medical officer for the Marine Corps Chemical Biological Incident Response Force.
Blanco's illness did not respond to a tetracycline drug, so infectious-disease specialist Dr. Carlos Omenaca added a second powerful antibiotic, a cephalosporin, to the mix. He topped off the medical cocktail with Cipro. The bacteria died, but they already had triggered a deadly chain reaction.
Early on, Blanco needed oxygen to help him breathe and fluid had to be removed from his lungs. As his immune system cranked into overdrive, his blood pressure plummeted. He went into shock.
Doctors gave him fluids to maintain his electrolytes, the body's natural salts that maintain internal equilibrium, and drugs that help raise blood pressure. Later, they drained more fluid — a liter — from Blanco's lungs and put in a drain.
Dr. Mark Callahan of Weill Cornell Medical Center said there are other antibiotics that will work with Cipro.
Another cocktail ingredient could be the antibiotic rifampin, a good choice because it attacks the germ in a different way.
Also, certain steroids might help "because the body's immune system creates a big inflammatory situation inside the lungs and in the body in general," Callahan said.
If Blanco relapses, doctors can start him on antibiotics again, then "fall back on data that show that vaccination, in addition to [antibiotic] treatment can lead to higher rates of cure," Davis said.
With News Wire Services
Frightening Trail of Attacks
Traces of anthrax turned up at the Supreme Court and a CIA mailroom yesterday, and officials now fear that more than three anthrax letters have passed through the mail system, leaving a deadly trail of spores.
Contracted Anthrax:
Precautions:
The Postal Service is checking 200 post offices on the East Coast.
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