Saturday, November 10, 2001

D.C. Department of Health officials say the city’s anthrax hot line is working, despite criticism that callers may or may not get the answers they need, depending on the time they call and who answers the phone.
In response to a report this week in The Washington Times, D.C. Health Director Dr. Ivan C.A. Walks said information on the anthrax hot line is “by and large accurate.”
But calls made by The Times to similar anthrax information hot lines, like the ones set up by the Centers for Disease Control and Prevention (CDC), Montgomery and Fairfax counties, elicited more up-to-date and concise answers to questions about both cutaneous and inhalation anthrax.
The information disseminated by the CDC appears accurate and reveals no apparent discrepancy, no matter who answers the phone, according to informal surveys.
The Fairfax and Montgomery County anthrax information hot lines also are consistent in terms of dispensing accurate and up-to-date information regarding symptoms and treatment. Both begin with a recorded message offering other avenues of learning about the disease.
The messages from the two hot lines also contain detailed accounts of what the county is doing regarding testing, treating and working in conjunction with larger, national health organizations.
The Fairfax hot line is staffed by a trained nurse at all times. The Montgomery hot line is not staffed by a nurse or doctor, but the information is no less precise. Officials from both regions did say their hot lines are not as taxed as the District’s, because they have fewer to no infected persons or contaminated facilities.
The District’s anthrax hot line, operated by the Department of Health’s call center, has taken in more than 5,000 calls since the anthrax exposures and infections began early last month, said Jack Pannell, health department spokesman.
“Staff members answering the calls follow a script, but said with the number of people working the hot line and the number of calls coming in, you are going to have a few glitches,” Dr. Walks said.
The call center is staffed by health department employees and temporary workers, said Sherry Adams, emergency health and medical services director. Three to four operators respond to calls round-the- clock, but unlike its counterparts, this hot line does not have an introductory recorded message with updates or other sources of information.
“The temp workers were brought in two or three months ago to cover other hot lines, but switched over to the anthrax hot line after the September 11 attacks and anthrax scares,” Mrs. Adams said.
Calls to the District’s anthrax hot line late last week elicited three different responses about the symptoms of cutaneous anthrax.
Two operators gave inaccurate information about the symptoms. “Symptoms for cutaneous anthrax are black spots, kind of. Do you have black spots?” asked one operator.
The other said, “A reddish rash is a symptom for cutaneous anthrax,” and added that a “blister will form in the center of the rash with a black spot in the center of the blister.”
Only one operator, Donna, gave intelligent and informed responses to questions on cutaneous and inhalation anthrax. Mrs. Adams said that the operator could have been a CDC nurse or doctor.
In terms of answering calls and providing informed, intelligent responses, there is “no discrepancy I am aware of in information distributed to callers between [health department] staff and our temps,” she said.
Calls to the CDC hot line provided more precise information on cutaneous anthrax. “What would occur in a cutaneous infection is swelling around the infected area and a painless blister will form,” an operator said, not providing a name, as is the CDC hot-line policy.
The operator added that within a week the blister would become ulcerous, but still painless, with a blackish-brown tint in the center. That is necrotic, or dead, tissue.
Cutaneous anthrax accounts for 95 percent of all anthrax cases.
The operator then explained how a person could detect inhalation anthrax, but stressed that it is difficult for a lay person to tell the difference between an internal anthrax infection and a common cold or flu.

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