Health Officials Give Primer on Anthrax

To stem a flood of inquiries from doctors and patients worried about anthrax, Ventura County health officials are mailing educational videos and tip sheets to physicians and medical organizations.

“We are getting calls every day from people who are asymptomatic [but] who are requesting testing for exposure to anthrax, and from people who have colds, and from physicians who have patients with sore throats who want to be tested,” said Dr. Paul Russell, a county public health spokesman.

“This is an extremely challenging situation,” he said.

County health officials also said Monday they have teamed with several local government agencies to develop a Web site with information about biological and chemical agents, the county’s anti-terrorism efforts and ways to enhance safety.

While there have been no reported cases of anthrax in the state, Russell said the few positive diagnoses on the East Coast have dramatically heightened anxiety levels here.

The reports have also caused confusion among doctors on how to properly diagnose anthrax, which can mimic the early stages of the flu with symptoms such as fever, aches and sore throat.

“You have many different viruses that can cause a whole host of nonspecific symptoms, but the likelihood of anthrax here is extremely remote,” Russell said. “The anxiety is far in excess of the reality . . . and physicians need to attempt to allay some of that.”

Russell and other health officials have called area doctors and asked them to stop referring patients to the public health office for treatment of undiagnosed illnesses. The health department does not evaluate individuals.

“Just because a patient says he thinks he has anthrax is not an indication for a doctor’s office to say, ‘I can’t treat you, call public health,’ ” Russell said.

In a letter mailed recently to all doctors in the area, Dr. Robert M. Levin, the county’s top health officer, advises laboratory testing for anthrax in cases in which specific symptoms exist, such as a persistent lesion that won’t heal.

Levin asks doctors to rule out several other diseases using a county-drafted checklist.

If anthrax cannot be ruled out after obtaining the clinical history and doing a physical examination, doctors can obtain a culture to be sent to a private lab that could rule out other causes.

Only after that should a physician refer a case to public health officials.

Patients without symptoms but who fear that they have come in contact with a suspicious substance should be told to call police and fire authorities, not public health officials, because those agencies have hazardous-materials teams equipped to handle and contain anthrax.

Local doctors have also been advised not to perform nasal swabs because such tests should only be done by epidemiologists who are trying to determine the extent of a person’s exposure.

The letter from Levin also warned against the “unwarranted widespread use of antibiotics.” Nationwide, doctors have been inundated with patients wanting the prescription drug Cipro, which is used to treat anthrax.

Health officials, speaking to the news media on Monday at the County Government Center, also advised doctors to screen out patients with the flu. Flu season usually runs from November to April.

Due to a shortage of flu vaccine in the county caused by distribution problems, only the elderly and those with chronic lung and heart disease should be getting shots now, officials said.

During the next few days, medical groups countywide will receive a video titled “Anthrax, What Every Clinician Should Know,” which was edited by local health officials with help from the national Centers for Disease Control and Prevention.

Sheriff Bob Brooks also announced that Ventura County’s Terrorism Working Group--a panel representing several agencies--is building a Web site to offer tips, referrals and facts to the public. The site should be up in about two weeks.

“It will be a single clearinghouse that will cover virtually every area,” Brooks said of the site, which will include a links section called “Rumor Control Sites.”

Other officials at the news conference included representatives from the local FBI office and the Ventura County Fire Department.

Capt. Scott MacGregor, commander of the Ventura California Highway Patrol office, said officers are carefully monitoring the movements of hazardous materials in the county and are keeping the CHP’s Conejo inspection station open 24 hours a day, seven days a week.