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(More customer reviews)The Killer Strain: Anthrax and the Exposed Medicine
I am peruvian medical , and for some years , have been investigating anthrax in Peru, reason why caused to much interest for me the appearance of the book: The Killer Strain.
The book that narrates the events related to the first outbreak of bioterrorismo in the U.S.A., submerges to us in the interior of the scientific work during the epidemic , show some more than appears in the scientific journals . Although the author certainly has obtained much related information to this epidemic, probably, the lack of a biomedica formation, has taken it to an incomplete vision of the epidemic of anthrax. The book shows some mistakes that reflect the nonmedica formation of the author, as a sample : in the figures of the book, call as symptoms to the injuries of the skin,instead of use signs. Would had been ideal that some medical professional help in revising or writing the book.
Maybe , the great problem in analyzing this epidemic is that in the world exist few experts in anthrax As the same author recognizes in her book, many doctors what participated in the epidemic , never has been sight a case of anthrax. (1) For that reason many mistakes that exist during the epidemic maybe has been unnoticed. Some of these faults in the epidemic, can be justified by the low degree of scientific knowledge with respect to this pathology, maybe for example : not to diagnose inhalational anthrax.
Inhalation anthrax is the main clinical form in the bioterrorism scope given its high mortality, however early diagnosis (a time when treatment can be effective),(2) is rather difficult to achieve In their initial stage symptoms of inhalation anthrax are very similar to influenza .
Although the cutaneous form has low mortality rates and is thus, considered as less important in a bioterrorist attack, its diagnosis may serve as an epidemiological alerta and lead, indirectly, to the early search for possible inhalation anthrax cases. These difficulties in early recognition were observed in the recent bioterrorism event with anthrax in the United States. In the bioterrorism- related outbreak of anthrax , in october 2001, the first cases were not for inhalation, but cutaneos , the detection of these cases would likely iniate the epidemiological investigation more precociously and maybe diminished even more the mortality in this outbreak. Because of this, it is necessary for physicians to learn to recognize cutaneous anthrax at its early stage.
Contrary to what occurs with the inhalation form, cutaneous anthrax there are well defined clinical characteristics and is relatively easy to diagnose clinically, to however, the early stage of cutaneous anthrax often remains undiagnosed, probably due to many reasons: a) It is to rare pathology; b) The this physician associates pathology mainly with to annoys stage necrotic to ulcer and; c) Absence of pain in the cutaneous injury makes the patient recognize the cutaneous injury annoys and delay seeking medical attention clinical Emphasis on early recognition of cutaneous anthrax is highly used in anthrax endemic area in peruvians andens, as part of the traditional medicine knowledge developed by these communities due to the absence of physicians and it could be useful to the field of bioterrorism. In Peru, farmers emphasize the clinical recognition of cutaneous anthrax in an early stage and call it "waytacha" (A quechua term that means bad flower) (3).
In this outbreak , although is certain were errors of the government and of institutions, there were also medical mistakes, that are necessary to recognize them so that they do not repeat in the future. The most critical component for bioterrorism outbreak detection is the doctor ( 4 ), and the great medical mistake of this epidemic was not undiagnose anthrax by inhalation but not to diagnose the cases of cutaneous anthrax, the detection of these cases would also , of to be certain the relation between hijjackers and anthrax ( 5 ), also initiate the investigation related to hijjackers and maybe, help to prevent the tragedy of September 11.
This epidemic more than show a exposed government , show to an exposed medicine, exposed to anthrax , a disease that does not even manage to know nor to control.
David Salinas Flores
REFERENCES
1.Thompson. The Killer strain. Anthrax and a Government exposed. Harper Collins Publishers.2003. pg. 72-73
2.Mc Carthy M. Early and aggressive treatment saves US antrax victims. Lancet. 2001 ; 358 : 1703
3.Salinas D. Diagnóstico y Tratamiento del Antrax: Medicina Tradicional vs Medicina Científica. Revista Peruana de Enfermedades Infecciosas y Tropicales. 2001;1:157-164
4.Ashford D, Kaiser R, bales, M. et al Planning against biological terrorism.: Lessons from Outbreak investigations. Emerg Infect Dis . 2003 .9 :515
5.Report linking anthrax and hijackers is investigated. New York Times. 23 marzo 2002
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