Public’s Anthrax Fear Called ‘Out of Proportion’

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, https://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.