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9/11 See other 9/11 Articles Title: Six Years Later, Anthrax Victim Still Has Health Issues / WSJ Article Wall Street Journal Article Six Years Later, Anthrax Victim Still Has Health Issues By JACOB GOLDSTEIN August 4, 2008; Page A10 More than six years after he was infected with anthrax, Leroy Richmond says he still can't shoot baskets or go for bike rides with his son the way he did before he got sick. But Mr. Richmond, 64 years old, is lucky to have survived. Roughly half of those who contracted inhalation anthrax in the biological attack of 2001 died of the disease, according to the Centers for Disease Control and Prevention. (A less serious form of the disease, cutaneous anthrax, occurs when the bacteria come in contact with the skin.) Mr. Richmond thought he was coming down with a bug when he went to see his doctor in October 2001. He was short of breath and felt achy all over. "It was like someone had taken a stick and beat me on my back," he says. His doctor sent Mr. Richmond to the emergency room, where doctors diagnosed inhalation anthrax, put him on antibiotics and admitted him to the intensive-care unit. Mr. Richmond had inhaled anthrax spores released from a letter that passed through the Washington, D.C., mail-processing center where he worked. By the time he went to the hospital, white blood cells had transported the anthrax to lymph nodes in his chest. If he had waited much longer before seeking care, the bacteria would likely have spread throughout the bloodstream, causing a massive, deadly infection, says David Pegues, an infectious-disease specialist at UCLA's David Geffen School of Medicine. Dr. Pegues wasn't involved in Mr. Richmond's case. The disease is so deadly in part because it expresses a toxic protein called "lethal factor" that causes inflammation, inhibits part of the immune system, and "can chew up cells," Dr. Pegues says. As it was, the antibiotics kept Mr. Richmond alive but he remained in intensive care for about a month. In the first few days there, he says, it grew even more difficult for him to breathe. It turned out that fluid was building up inside his lungs. On a few occasions during his hospital stay, doctors used a needle to draw out several quarts of fluid. Dr. Pegues says inhalational anthrax sometimes leads to the death of some lung tissue, which is associated with fluid buildup of the sort Mr. Richmond describes. After roughly three weeks of slow recovery in the hospital, Mr. Richmond managed to get up out of bed for the first time, he says. About a week later, he was sent home. Initially, he was so weak that he could walk only about two blocks before becoming exhausted. But he tried to walk a little every day -- an effort that persists to this day. Now he can walk about a mile and a half, he says. "I've never gotten to the point where I have the same amount of stamina, the same amount of vigor" as before getting sick, he says. He has also noticed problems with his short-term memory. Dr. Pegues says the long-term effects of inhalational anthrax aren't well understood, because it is rare in the U.S. and because it often kills its victims quickly. The volume of lung tissue typically destroyed in the disease wouldn't be enough to cause long-term problems, he says. But simply being very ill can cause the kind of issues Mr. Richmond describes. "It's not unusual when you have been in the hospital with a critical illness to have long-term limitations and physical disabilities," Dr. Pegues says. "It's going to knock you for a loop." Write to Jacob Goldstein at healthblog@wsj.com Post Comment Private Reply Ignore Thread
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