This article brings up a good point which I'd heard before: the overlap in
symptoms between influenza and anthrax will cause a great many people who
develop the flu this winter to be convinced they have anthrax. Hopefully
this will be an additional incentive which will convince more people to get
the flu shot (providing it's available).
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<http://www.latimes.com/news/local/la-000082980oct18.story>
THE HOME FRONT
Public's Anthrax Fear Called 'Out of Proportion'
Health: Many visit emergency rooms with minor symptoms, doctors say.
Flu season poses more problems.
By CHARLES ORNSTEIN and RICHARD MAROSI
TIMES STAFF WRITERS
October 18 2001
The phones haven't stopped ringing at Dr. Giselle Namazie's medical office
in Sherman Oaks.
Callers wonder whether their run-of-the-mill sniffles and coughs could be
anthrax even though the bacteria hasn't been detected
anywhere in Southern California.
And flu season hasn't even started yet. Namazie and others are worried that
they will be flooded by panicked and confused
patients when the influenza virus arrives in about six weeks. "It's just a
matter of time, I'm sure," Namazie said. "When flu
season rips through, I suspect we will see more people calling." The
problem is that the initial symptoms of anthrax mirror those
of the flu: exhaustion, chills, sore throat, cough and aches. The flu is a
contagious viral infection. Anthrax, by contrast, cannot be
passed from person to person. It is acquired by inhaling spores, eating
contaminated food or absorbing the bacteria through
cuts in the skin.
Doctors at Namazie's center have swabbed the noses of only a handful of
patients for anthrax bacteria, most of them office
workers whose buildings received suspicious packages. All tested negative.
Even without anthrax anxiety, the teetering public health system in Los
Angeles County is especially vulnerable during flu
season. Last year, when the season was unusually mild, emergency rooms
still had more patients than they could handle and
turned ambulances away.
"We're stretched thin as it is," said Dr. Ilena J. Blicker, president of
the Los Angeles County Medical Society. "So if you have a
large number of people going to the emergency rooms when they really don't
need to do so, it takes time away from patients
that really need to be there."
Surge in Calls to Health Hotline
Some hospital officials say physicians are sending patients to emergency
rooms rather than addressing patients' fears.
"We're concerned about patients who wouldn't ordinarily come to the
emergency department, all of a sudden coming and
demanding the test," said Jim Lott, executive vice president of the
Healthcare Assn. of Southern California. "That's only going to
stress out the emergency system even more."
Dr. Jonathan Fielding, the county's public health officer, said the
public's fear is "out of proportion to the circumstances." The
county has experienced a surge in calls to its public health hotline and
unprecedented interest in its Web site,
http://www.labt.org.
"It's understandable that some people are concerned," Fielding said. "I
keep trying to put it in context."
Most respiratory infections resolve themselves in time and do not require
antibiotics, Fielding said. Viruses like the flu do not
respond to antibiotics. And unless a person has been exposed to confirmed
anthrax spores, they shouldn't worry about having
that infection.
Still, people are worried. Dr. Philip Schwarzman, medical director of the
emergency department at Burbank's Providence St.
Joseph Medical Center, said people sometimes come in with minor complaints
that in no way resemble anthrax just to be
certain they aren't related to bioterrorism.
One man came in with a bruised arm.
"I asked to find out why he was here, and he said, 'You know with
everything going on, I just wanted to make sure,' "
Schwarzman said.
Schwarzman said several NBC employees came to a hospital clinic last week
after a powdery substance was found at the
studio. The substance was not anthrax, but one man insisted that doctors
provide him with antibiotics anyway.
Some of the public's concerns could be allayed by flu shots. But because of
anticipated delays in the distribution of the flu
vaccine, the Centers for Disease Control and Prevention is urging most
people to postpone their shots so priority can go to
senior citizens and patients with weak immune systems.
Last year, doctors and hospitals reported problems obtaining adequate
supplies of flu shots in October and November because
the vaccine was in short supply and the shots were being given first to
drugstores and community centers. This year, drug
companies and the CDC say they are rationing supplies to make sure no one
goes without.
According to a CDC advisory last month, 79.1 million doses of flu vaccine
will be available this year, about 4 million more than
last year. About 45 million doses will be available by the end of this
month, with the rest coming by December, when the
season typically begins. The flu vaccine takes about two weeks to become
fully effective. More patients than usual have been
requesting flu shots, believing that they are less likely to be affected by
bioterrorism if their immune system remains strong, said
Dr. Jay Udani, a physician at Northridge Hospital.
"In the past, people waited well into November to begin even thinking about
their flu shots," Udani said. "This year, we're
seeing people call in and to schedule flu shots earlier."
Conserving Lab Resources
Flu shots don't always prevent flu in vaccinated patients, Udani said, but
they shorten its duration and minimize symptoms.
Although the flu season typically peaks between January and March, minor
health flare-ups are already creating major
headaches.
One asthmatic woman visited Northridge Hospital's emergency room in Van
Nuys because she was experiencing shortness of
breath. "That's common if you have asthma," said Dr. Ed Lowder, an
emergency room doctor at Northridge.
It turned out that the woman's building had had an anthrax scare.
Another 15 to 20 people call each day for background information on the
anthrax bacteria.
"We don't have time to sit down and do this for people all day," Lowder
said. "It takes away from patient care."
At the Medical Institute of Little Company of Mary in Torrance, doctors
have been instructed by county officials not to test
people unless absolutely necessary. County officials don't want to run
short of limited laboratory resources.
Dr. Michael Genova of the institute said one of his patients was worried
after a powdery substance spilled onto her when she
pulled the morning newspaper out of its plastic bag.
A colleague, Dr. Terence Hammer, said many of his patients are calling just
to be prepared in case of exposure. He said some
ask for Cipro but he only prescribes it in small quantities for those in
higher-risk occupations, such as federal or airport
workers.
"I won't deny them the peace of mind of having something," he said.
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