| Home > Resources > Leadership > Executive Summary > Case Studies Case Study 2001, Treatment Protocols for Anthrax Revised in Wake of Letter Attacks Until the 2001 attacks, clinical knowledge about inhalation anthrax was based primarily on 16 historical cases of naturally occurring anthrax among goat mill and tannery workers. The 2001 anthrax letter attacks challenged prior assumptions and raised many new questions as to the physiological and environmental effects of a weaponized form of anthrax. For example, prior to the anthrax letter attacks, it was generally believed that anthrax victims with high toxicity levels would not respond well to antibiotic treatment and would die. However, the 2001 experience demonstrated otherwise, when a majority of patients recovered with antibiotics and aggressive treatment. Before the 2001 attacks, Ciproflaxacin had been recommended as the sole antibiotic treatment for inhalation anthrax; however, case evidence in 2001 led the CDC to revise recommendations and advocate the use of Doxycycline as well. Additionally, prior to the letter attacks, it had not been recognized that "weapons grade" anthrax spores could leak out of the edges of envelopes or through the pores of envelopes, thereby potentially exposing the envelope's handler; nor did scientists understand how factors such as machine processing or air flow in a building would affect the dispersal of spores. While it was once believed that it might require thousands of spores to make a person ill, evidence from the New York City and Connecticut victims suggests that this assumption could be false—it may only require 1 to 3 spores.
References Casani, Julie, Diane Matuszak and Georges Benjamin. 2003. "Under Siege: One State's Perspective of the Anthrax Events of October/November 2001" Biosecurity and Bioterrorism 1(1): 43-45. Inglesby, TV. et al. 2002. "Anthrax as a Biological Weapon, 2002: Updated Recommendations for Management" JAMA 287(17). |
