In 2001, bioterrorist activities involving the U.S. Postal Service infected 22 individuals with Bacillus anthracis (anthrax), according to background information in the article. Six survivors had inhalational anthrax and 11 cutaneous anthrax disease. Little is known about potential long-term health effects of bioterrorism-related anthrax infection.

Dori B. Reissman, M.D., M.P.H., of the Centers for Disease Control and Prevention, Atlanta, and colleagues conducted a cross-sectional health assessment approximately 1 year after the 2001 onset of anthrax infection to better characterize the somatic (affecting the body) symptoms, health status, and functional capacity of the bioterrorism-related anthrax survivors.

The study included assessment of 15 of 16 adult survivors from September through December 2002 using a clinical interview, a medical review-of-system questionnaire, 2 standardized self-administered questionnaires, and a review of available medical records.

The researchers found that the anthrax survivors reported symptoms affecting multiple body systems, significantly greater psychological distress, and significantly reduced health-related quality-of-life indices compared with U.S. referent populations. "Eight survivors (53 percent) had not returned to work since their infection. Comparing disease manifestations, inhalational survivors reported significantly lower overall physical health than cutaneous survivors. Available medical records could not explain the persisting health complaints," the authors write.

The most common health complaints included respiratory tract problems (e.g., chronic cough), fatigue, joint complaints (e.g., swelling, pain), and cognitive impairment (e
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Contact: Gail Hayes
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JAMA and Archives Journals
27-Apr-2004