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Anthrax Victims Suffering Long After Attacks

2001 Anthrax Attacks Have Lasting Physical, Psychological Impact

WebMD Health News

April 27, 2004 -- The legacy of the 2001 anthrax attacks lives on in the minds of millions. But for a small group of Americans who survived exposure to the deadly bacteria, the effects of the bioterrorist attacks also continue to plague their bodies.

A new study shows 15 people infected with anthrax during the attacks continue to report significant health problems, psychological distress, and trouble readjusting to life at least a year after the terrorist attacks involving the U.S. Postal Service in the fall of 2001.

Researchers found that more than half of the victims had not returned to work more than a year after the attacks, all were under psychiatric care, and most reported symptoms ranging from chronic cough, fatigue, and memory problems to depression, anxiety, and hostility.

The findings appear in the April 28 issue of The Journal of the American Medical Association.

First Look at Long-Term Effects of Bioterrorism

Researcher Dori Reissman, MD, MPH, senior advisor for emergency preparedness and mental health at the CDC, says the study is the first to look at the long-term effects of bioterrorism-related anthrax infection and suggests that the psychological impact of the exposure may be as significant as the physical effects of the disease.

The study involved 15 of the 16 adult anthrax survivors from September to December 2002, approximately one year after they were infected as a result of the bioterrorist attacks. Six survivors had the more serious inhalational anthrax caused by inhaling the anthrax spores, and 11 had cutaneous anthrax, caused by skin contact with the anthrax bacteria.

The survivors were interviewed about their health complaints and completed two standardized questionnaires about their psychological symptoms and health-related quality of life. Researchers also reviewed available medical records to check for evidence of some of the most commonly reported health problems.

The results showed that the anthrax survivors reported moderate to severe symptoms affecting many body systems. Eight of the survivors had not returned to work since their infection.

The most commonly reported health complaints included:

  • Chronic cough
  • Fatigue

  • Joint swelling and pain

  • Memory problems

The most frequently cited symptoms of psychological distress were:


  • Anxiety

  • Obsessive-compulsive behavior

  • Hostility

The researchers noted that medical tests often could not pinpoint the cause of their complaints.

For example, eight survivors reported moderate to severe joint problems, decreased physical functioning, and prolonged work absence. But 11 diagnostic tests, including X-rays and lab tests, performed on six of these patients showed no signs of immune or inflammatory disorders or other common medical explanations for these symptoms.

Reissman says those findings suggest that posttraumatic stress disorder (PTSD) may be responsible for some of the physical as well as psychological symptoms.

"Since we were not able to link from a causal point of view the ongoing health problems with the anthrax infection or the toxins released by the bacteria, we're left with the traumatic situation," says Reissman.

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