- The Washington Times - Friday, July 19, 2002

Doctors in Baltimore who treated postal workers exposed to anthrax last fall believe they have discovered new, long-term symptoms of the deadly biological agent.

They have documented the symptoms in a postal inspector from the Brentwood facility in Northeast who handled anthrax spores mailed to members of Congress in October. However, blood tests on the man failed to detect anthrax.

Of the approximately 60 people seen at Sinai Hospital from the Brentwood facility and the Hart Senate Office Building, at least six showed some signs of illness, said Dr. Tyler Cymet, an osteopathic doctor and internist at Sinai Hospital. However, they sought follow-up treatment from their own doctors and were not studied further by the Sinai Hospital staff.

The Sinai Hospital doctors found previously unreported symptoms of fluid buildup around the heart, low hormone levels, chest pain and intermittent fevers in the 38-year-old postal investigator, who is seriously ill.

Known symptoms of anthrax exposure include fatigue, memory loss, joint pain, fluid in the lungs, low blood oxygen and swelling of lymph nodes.

The new symptoms might indicate the recovery period after anthrax exposure is longer than previously believed, Dr. Cymet said.

"Basically I've got one patient who is sick and we can't explain why he's sick," Dr. Cymet said. "I feel that the anthrax exposure is related."

Similar results are showing up in a survey by former personnel of the Brentwood facility, where 2,100 Postal Service employees worked.

Of the roughly 500 workers who responded to the survey from the postal worker support group Brentwood Exposed, "a large portion" say they believe they are suffering lingering symptoms of anthrax exposure, said Dena Briscoe, president of Brentwood Exposed.

"We still have people who are having problems with their kidneys, fatigue, respiratory problems," Miss Briscoe said.

About 300 workers have not responded to the 71-question survey. Brentwood Exposed is counting the results.

"Some people who were having symptoms felt they were from the antibiotics and some from the exposure," Miss Briscoe said. "It's hard for the doctors to say this is from anthrax. They can't pinpoint it."

Eleven persons nationwide suffered from anthrax exposure, five of whom died, according to the official tally from the Centers for Disease Control and Prevention (CDC) in Atlanta.

Two who died and two survivors were from the Brentwood facility.

The discovery of additional symptoms represents "either a new syndrome or a natural history of the disease we did not know about before because we know so little about anthrax," Dr. Cymet said.

The postal investigator was showered by anthrax spores as he removed an air filter from equipment at the Brentwood facility to deposit it in an evidence bag.

He was given a 10-day supply of the antibiotic Cipro. He took one pill but missed the next two doses, after which he developed a headache, cough and fatigue.

He suffered both the new and previously known symptoms of anthrax, Dr. Cymet said.

Blood tests have found no evidence of anthrax exposure in the man. The same tests missed anthrax evidence in two postal workers who died during the outbreak last fall.

Dr. Cymet and fellow internist Dr. Gary Kerkvliet reported the new symptoms in the July issue of the Journal of the American Osteopathic Association.

"He became very ill," Dr. Cymet said. "We have been looking for other causes but have not been able to find any other explanation." The man has spent four of the past nine months at Sinai Hospital.

The doctors are applying to Sinai Hospital's Institutional Review Board for permission to study other postal workers exposed to anthrax.

The Sinai Hospital doctors said other persons might have low levels of illness from anthrax, but tests do not exist to detect it and the symptoms might not be severe.

Only Brentwood workers showed possible symptoms of anthrax exposure, apparently because no more than half of them completed the drug regimen recommended by the CDC, Dr. Cymet said.

The drug Cipro was administered to workers at Brentwood and the Hart Senate Office Building. About 90 percent of the Hart building workers completed the drug regimen.

Research into anthrax-related illness is limited because until the most recent outbreak, most victims died soon after exposure. Exposures reported during the past half-century are most often linked to contact with animal hides.

As a result, little is known about the recovery period. A Massachusetts Institute of Technology study of outbreaks in 1959 at a New Hampshire meat processing plant and in 1979 at a Russian biological weapons facility indicate survivors made complete recoveries within a few years.

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