- The Washington Times - Saturday, October 27, 2001

NORTH MIAMI, Fla. Ernesto Blanco still endures bouts of coughing and has lost 16 pounds in two weeks. But he is doing what doctors a month ago thought was unlikely surviving the inhaled form of anthrax.

The 73-year-old grandfather was resting at his home Thursday after being released from a Miami hospital.

"I've been feeling better, day by day," Mr. Blanco, a Cuban-American, said in Spanish between intermittent bouts of coughing and calls from well-wishers.

He is still tired, he said, but wants to return to work.

"Who wouldn't be happy to be home after the odyssey that I went through?" Mr. Blanco asked, laughing, as his wife, Elda, served him a shot of Cuban coffee. "I had many difficult, difficult days in the hospital, but I'm here."

Mr. Blanco was directing mail distribution at the Boca Raton office of supermarket tabloid publisher American Media Inc. when he inhaled anthrax, likely from a letter.

He began feeling ill Sept. 28 and got a ride home from co-workers. After sleeping for two days, he went to the hospital.

When Mr. Blanco arrived, his labored breathing and fever seemed nothing more exotic than a bad case of pneumonia to the doctors. But then, they got a troubling call from Mr. Blanco's boss.

Robert Stevens, a photo editor who worked in the same building, had been diagnosed with inhaled anthrax.

Five days after Mr. Blanco entered the hospital, Mr. Stevens died of the disease.

Few U.S. doctors had ever seen a case of inhaled anthrax. Dr. Carlos Omenaca, an infectious-disease physician in Miami who had been called in to work on the case, turned to the lung specialist working with him.

"Look, my suspicion for anthrax is very low," he remembered saying, "but if we are wrong, not only is he going to die, but we won't make the diagnosis, and more people may die."

Mr. Blanco's health continued to deteriorate.

Fluid accumulated in his lungs, and tubes were inserted to alleviate his labored breathing.

Doctors had started him on one of the class of antibiotics that includes doxycycline. When he didn't seem to get better, Dr. Omenaca was brought in, and he quickly added another drug, cephalosporin. When the call came about Mr. Stevens, Mr. Blanco began taking Cipro.

The first hard evidence of anthrax came from a nasal swab showing spores in Mr. Blanco's nose, though the Centers for Disease Control and Prevention (CDC) would not be certain for two more weeks that he had the disease for two more weeks. Then, Mr. Blanco's blood pressure crashed, sending him into shock.

"I was near death. I felt physically, and in my soul, that I was leaving this world," Mr. Blanco said.

Doctors fought to keep him alive with fluids and drugs that boost blood pressure.

"It was grave," Dr. Omenaca said. "If he worsened, he definitely could have died."

That was the low point. Over the next week, Mr. Blanco began improving. On Tuesday, he was released from the hospital.

Mr. Blanco's doctors told him he eventually recover, but only after extended treatment. He must keep taking antibiotics and resting.

Dr. Omenaca doubts the bacteria will come back, and even if it does, Mr. Blanco's immune system should now be able to handle it.

Two other persons, both postal workers in the District, have died from the inhaled form of anthrax. Three others with confirmed cases of inhaled anthrax are stable or improving, said Dr. Julie Gerberding of the CDC.

Like Mr. Blanco, the three other survivors were treated with combinations of antibiotics. New CDC guidelines issued Thursday recommend similar treatments for future cases of inhaled anthrax.

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