Dr. Anthony Fauci Discusses Anthrax

The New York anthrax case sent another chill through this already-shaken city. But how worried should New Yorkers and the rest of the country be? Dr. Anthony Fauci, director of the National Institute of Allergy & Infectious Diseases, gives some perspective.

For 25 years Americans pretty much forgot about anthrax. Exactly what is anthrax?

Well, anthrax is a bacteria that is not an uncommon infection in certain types of animals. What is the issue with regard to affecting mankind is that when animals die and their carcasses decay in the ground, the anthrax can form a spore, which allows it to infect individuals. One person cannot infect another. There are three types of anthrax. You can inhale it and get a very serous form of anthrax. You could have a minor, less serious form, when it gets in through a rent or lesion in the skin; it doesn’t get through intact skin. And then there’s a very, very rare form of ingestion when you ingest contaminated meat. The one that’s the scariest is obviously the aerosolized, or inhaled, anthrax, which is a thing that can happen when those spores get into the lung.

How do we know that these cases of anthrax that we’re talking about, three in Florida and one in New York, all came through the mail?

Well, I think that’s still under investigation. We’ve heard reports that the powder has been negative; we’ve heard other reports that it’s positive. I think we should wait until the final tests are done. And there’s several levels of tests that are done at the CDC [the Centers for Disease Control and Prevention] and by people who really know how to do it. One thing is clear--that the individuals themselves clearly have anthrax. The gentleman, unfortunately, who expired with pulmonary anthrax or inhalation anthrax, and the other cases that had cutaneous anthrax, or anthrax just isolated from the nose and other parts of the body.

But is it safe to say we’re not clear as to how they got the anthrax exactly?

Well again, this suspicious, circumstantial evidence is pointing to that, but the definitive matching of what’s in a powder with what the individual got, I think, is still under investigation. And we really can’t say anything definitive about that right now. But it’s highly suspicious given the circumstances juxtaposed against each other.

We are being told by the White House, ‘Don’t be scared,’ but should people be concerned at this point, Doctor?

Well, I think obviously we’re in a very unusual situation and they should be concerned, certainly not panic. Be vigilant. When we’re talking about concern, we’re talking about being on a higher state of alert, being vigilant and being very careful. If something is suspicious, report it. If you see a lesion or if you get something on your skin that s similar to what’s being described now regarding cutaneous anthrax, don’t just brush it off. Call your physician, and if it looks suspicious, report it to the public health authorities. That’s what we mean by being concerned. But certainly there’s a big difference between that and panicking. There really is no need to panic, but we should be on a state of alert and be careful.

I understand that making anthrax is quite simple but that what is called the weaponizing of this is difficult. What does that mean, exactly?

Well that means putting it in a form where you could widely disperse it and have it affect a large number of individuals. Anthrax is seen in the soil; it’s seen in sick animals. So it’s not an uncommon microbe. But to get it in the form that has an impact, particularly in a bioterrorism-type scenario, is not an easy thing to do. It can be done, but it’s not easy.

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