How Anthrax Can be Acquired
JUDY WOODRUFF, CNN ANCHOR: With the news of a fourth person in the United States having been exposed to anthrax, we are waiting now for a news conference at the department of Health and Human Services. Secretary Tommy Thompson and the attorney general, John Ashcroft will handle that, and we're going to go there in just a minute. Right now joining us on the telephone from the University of Michigan, Professor Philip Hanna, who is a microbiologist. Professor Hanna, there are so many questions I have, and I think our viewers have. But let me just start out -- we know that this woman contracted -- was exposed through the skin, that her infection came through the skin. She's been successfully treated so far with the antibiotic Cipro. How difficult is it to transfer, transport this type of anthrax?</s>PHILIP HANNA, ANTHRAX SPECIALIST: Hi, Judy. First of all, it's the same, exact organism that can causes the pulmonary infection. The difference between the cutaneous, or skin form and the lung form is the portal, or entry, into your body. So it's the same bug.</s>WOODRUFF: So -- and how easy is it -- I know Aaron was asking this of a doctor just a few minutes ago, but how easy is it for this organism, this bacteria to get out and around?</s>HANNA: Well, in nature it's stuck to soil, and only in animals -- sick animals. So the only people that pick up anthrax, of course, are those that mainly work with animals. And you can get it -- not just getting on your skin. To get the skin form, it has to be a scratch or cut in the skin and the spores have to get into that cut.</s>WOODRUFF: Now our medical correspondent Rhonda Rowland was just saying a few moments ago -- I don't know if you were able to hear her -- that in her -- what she's been able to learn is that within the last couple of years three people had been exposed to the cutaneous, through-the-skin sort of anthrax. They had all been successfully treated for it. Do you have -- does that square with your knowledge?</s>HANNA: That's absolutely true. This disease has been -- the skin form is most common. It's been around for many years, even before antibiotics. And the cutaneous form, in the large majority of cases, are self-healing, even without any medication. Of course, everyone in this country is going to be treated.</s>WOODRUFF: Now we know from the information we were getting from Florida, Professor Hanna -- I'm talking with Professor Philip Hanna at the University of Michigan, he's a microbiologist -- we gather that they've been able to determine that the anthrax in Florida at the American Media company was manmade; that it was manufactured.</s>HANNA: That's not an accurate report. It was certainly -- this is a case -- a veterinary case, a sick animal. I think it was first worked up by the University of Iowa in Ames. It's called the Ames strain. It's been kept in labs as a type strain for people doing vaccine research, to compare it to their vaccine strains and to see if their vaccine works, and has spread -- passed on from person to person, scientist to scientist, throughout the last 50 years, but not genetically modified. So it's not a manmade strain. This is a naturally occurring strain from a sick animal.</s>WOODRUFF: That is, I guess, different from what I had read; but I'm glad if you're able to clarify that, and if you're sure of your information. Why would it be passed on from scientist to scientist? This is for research purposes?</s>HANNA: For research purposes. Now, I'm not a part of this investigation team, so if -- the latest report I heard it was the Ames strain out of Ames, Iowa. And if that is the strain, that story pans out, then it has not been genetically modified.</s>WOODRUFF: All right.</s>HANNA: I just wanted to clear that up with you on this instance.</s>WOODRUFF: No, I appreciate that.</s>HANNA: I'm living from the news reports as well.</s>WOODRUFF: Well, we appreciate it. We've all got a lot of learning to do on this subject, and we're trying to do it very quickly.</s>HANNA: As to your question of why -- people been looking for better anthrax vaccine for a long, long time; ever since the advent of modern medicine. Now, there hasn't been hundreds and hundreds of labs, but there are several dozen in this country that have at one time or another, since the 1950s, tried to make a better anthrax vaccine or, in the case of a handful of labs, are trying to figure out how anthrax causes disease from a biomedical research standpoint...</s>WOODRUFF: And how good -- go ahead, I'm sorry.</s>HANNA: And so these reagents -- in this case, the anthrax spores -- were made available through a national resource and shipped, in our naive, earlier days, shipped without restriction to any bona fide lab.</s>WOODRUFF: And how easy is it to kill these spores? I mean, we know people can take Cipro, other forms of antibiotic. How successful are these antibiotics? Do they all work?</s>HANNA: For the naturally occurring strains, most all antibiotics work, including penicillin in human beings. Now, there's been reports, I think some valid, out of the biowarfare programs of other countries -- notably the ex-Soviet Union that they have genetically manipulated strains to become multi-drug resistant. Now the problem with anthrax, of course, is treating it before you're so sick -- in the case of Mr. Stevens, he didn't see his doctor until he -- until it was too late. The antibiotics weren't being able to be administered in time.</s>WOODRUFF: And we know that in the case of the woman in New York, the employee of NBC, she apparently went to the doctor as soon as she had symptoms, or almost as soon, and in that very first day she saw the doctor she was given the Cipro.</s>HANNA: I think her prognosis should be pretty good.</s>WOODRUFF: All right, well we're all certainly very relieved about that. Professor Philip Hanna, microbiologist at the University of Michigan helping us understand about this story, this phenomenon that has suddenly been thrust on all of us. And that is anthrax appearing not only now in south Florida, but in New York City with an NBC News employee. We want to tell those of you who are trying to understand, as we are, a little more about anthrax and how it spreads and what to do about it, how to prevent it, you can go on our Web site CNN.com. And you'll find there a special section on anthrax. This is a look at what's up right now on the Web site. So we would urge you, if you're looking for more information, not only to listen to people like Dr. Hanna, Professor Hanna, but to check the Web site. And I'm sure there are links there to other sources of information. And now we want to go to Aaron in Atlanta.</s>AARON BROWN, CNN ANCHOR: And I suspect they're working pretty hard to update that stuff, too. We add now, yet another disquieting note to this. White powder was found in the office that deals with correspondents at the State Department in Washington, D.C. according to Richard Boucher, the spokesman there. He said the FBI District of Columbia Hazardous Materials Squads have been called in. Nothing confirmed here; that is to say we don't know what this white powder was or is. But, at least for now, we can add Washington, D.C. to the list of cities that is (sic) dealing with this: New York, Washington, south Florida. One other thing on that: the letter, the substance, the package -- whatever precisely it was, was not anywhere near Secretary Powell's office. That much we do know. We don't know a whole lot -- well, no, we don't know any more than that. Not a whole lot more than that, we don't know any more than that, but we're working that pretty hard as well. Rhonda, you've been talking to the -- I don't mean to point, that's so rude -- you've been working the phones at the CDC. What have you got?</s>RHONDA ROWLAND, CNN MEDICAL CORRESPONDENT: That's right, we just heard from CDC spokesperson Barbara Reynolds. And she said the CDC is getting a lot of calls. There's a lot of confusion out there about this type of anthrax. And they want it known that anthrax is anthrax; it's just one disease. However, there are three different modes of transmission: the inhalation, which was the situation in Florida; and now the skin version in New York; and then there's the ingested type. But no matter how a person is exposed, it's the same kind of anthrax. That means the disease will manifest itself differently. Now, why...</s>BROWN: I'm sorry, does it manifest itself differently, or does it -- maybe this is synonymous here, I'm not sure -- that because of the way it enters the body, once it gets to the organs or in the bloodstream, it's weakened? Because it's, essentially, passed through the skin it gets there less quickly, and therefore is less strong?</s>ROWLAND: That's right, because it gets there less -- it's slower. It's slower to get in, that's why it's less deadly in you have the skin version. But once it does get into the bloodstream it acts the same, and the symptoms would be the same. The thing that's different, of course, is the rash with the skin version.</s>BROWN: And just -- you know, I'm not trying to be Pollyannish about this -- we talked a lot with doctor Philip Hanna over the last week or so -- I have. And one of the things he said with Judy, we ought to just underscore here, and that is even untreated, OK, no treatment at all, this skin form of anthrax, or anthrax that enters the body through the skin, is not nearly as dangerous; and left untreated, there's still an 80 percent chance of survival. No one is suggesting that you not get treatment; I don't mean to be silly about this, but...</s>ROWLAND: But it's reassuring.</s>BROWN: But in any case it tells you a bit about the difference in the power of the strain. That's the only point I'm trying to make.</s>ROWLAND: OK, and some other points...</s>BROWN: Perhaps not as intelligently as I might like.</s>ROWLAND: ... is that we've been hearing a lot about people actually having anthrax and being exposed to it, testing positive for an exposure. Remember, our first case in Florida was an actual case. The case in New York is also a case. So we have two cases of actual anthrax.</s>BROWN: Right. So it's not just a question of if they can detect it, it's actually in the system and doing damage?</s>ROWLAND: That's right. The second and third employee down in Florida, they've been just exposed to it. They're just positive for it.</s>BROWN: OK. I'm sorry, I didn't mean to interrupt you; go ahead.</s>ROWLAND: OK, some other points.</s>BROWN: Now your point.</s>ROWLAND: OK, my point, is whether or not the New York strain is the same as the Florida strain. CDC does not have that information yet. They do not know if the person in New York was exposed to the same strain of anthrax as the employees down in Florida. The next thing, because this is what the CDC does, they try to see if the anthrax is responsive to antibiotics. And here they're getting some mixed results. The employee in New York is getting Cipro. Now, the patients down in Florida may be getting other antibiotics, because penicillin work, doxycyline works, also Cipro. They don't know yet what antibiotic the New York case is responsive to.</s>BROWN: OK, here's a question on that, then. This actually came up a while ago when I was talking to a doctor who said he had a lot of patients who were calling him and asking for Cipro as, essentially, as a prophylactic, to protect them just in case. Is there a danger in taking Cipro before there is cause to?</s>ROWLAND: Yes, there is. The reason is, for anthrax you would need to take a 60-day course. And what the CDC says is a lot of people may not be willing to take it for 60 days. And that is very important, because if you don't take it that long it wouldn't work. Also if you stop taking it early it increases your chances of antibiotic resistance to a range of diseases. And also you may...</s>BROWN: Would one of the diseases be anthrax?</s>ROWLAND: It's possible.</s>BROWN: All right. Let's -- "it's possible" is a good one for me.</s>ROWLAND: We'll leave it at that.</s>BROWN: Let's find that out. And, again, the reason we ask this is we know from talking to a physician's friend that a lot of people have come in -- particularly this is true in New York, but it's probably true in other places, too -- have come in and asked for Cipro out of concern that something might happen. And, as with any antibiotic, these organisms -- Darwin being right on this point, are survival of the fittest -- they learn how to outwit the antibiotic if you're not careful. So we'll work on the degree to which that is an issue here. TO ORDER A VIDEO OF THIS TRANSCRIPT, PLEASE CALL 800-CNN-NEWS OR USE OUR SECURE ONLINE ORDER FORM LOCATED AT www.fdch.com