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    Anthrax Victims Suffering Long After Attacks

    2001 Anthrax Attacks Have Lasting Physical, Psychological Impact

    Bioterrorist Attacks Cause More Than Disease continued...

    Borio says she's not surprised that the anthrax survivors report feeling distressed. While working at the National Institutes of Health, she published a detailed account of the medical treatment of two Washington, D.C. postal workers who eventually died from inhalational anthrax.

    She says not only is exposure to a bioterrorist attack traumatic, but the aggressive measures required to treat anthrax may also be traumatic. Treatment of the cutaneous or skin form of anthrax usually involves taking powerful antibiotics to kill and prevent further spread of the infection.

    But once the bacteria has spread to the lungs, as in the inhaled form of anthrax, infected patients may require assistance to breathe and repeated drainage of fluid in the lungs, which Borio says is not a painless procedure.

    "The [inhaled form of the] disease is much scarier because it is a systemic disease," Borio tells WebMD. "People may feel that they have survived it, and they were not supposed to have survived because historically the death rates were so high, and they all required very aggressive medical care."

    In addition to the mental stress most Americans feel in the wake of the bioterrorist attacks of 2001, Borio says anthrax survivors must deal with a much more personal threat.

    "The stress of living under the threat of terrorism may play a part because it is not removed once you get better," says Borio. "What made you sick back then can come back again and make you sick again. That ought to be stressful."

    Reissman says the findings suggest that the psychological impact of the bioterrorist attacks may deserve more attention from health care providers rather than just the immediate physical effects.

    "In the follow-up of these kinds of events," says Reissman, "It's very, very important for us to be including the functional, psychological, and behavioral response to them as a standard practice."

    But Reissman says the study also suggests there is something that health care providers can do to lessen the impact of bioterrorist attacks. Potential interventions may include medications for specific PTSD-related symptoms as well as psychotherapy.

    "There is a lot of good hope in terms of intervening with these individuals and returning them to a good quality of life," says Reissman.

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