Anthrax is an acute infectious disease caused by the spore-forming bacterium Bacillus anthracis . It is most commonly found in wild and domestic animals, such as cattle, sheep, goats, camels, antelopes, and other herbivores. Generally, humans who become infected with anthrax do so by handling products from infected animals or by inhaling anthrax spores from these contaminated products. However, in the fall of 2001, letters sent through the U.S. Postal Service containing anthrax spores infected 22 American citizens.

For months after the attacks, local health officials and the popular press reported that after recovering from their initial infection, those who had survived the attacks complained of poorly defined but persistent health problems. This, however, was a surprise since most patients who had contracted anthrax through more conventional ways, did not report these kinds of lingering health problems immediately following their infections. Instead, the symptoms these survivors were reporting closely resembled those of posttraumatic stress disorder (PTSD) , a psychiatric disorder that can occur following life-threatening events such as military combat, natural disasters, terrorist incidents, serious accidents, or violent personal assaults like rape.

Because little is known as yet about the long-term health effects of anthrax infection, researchers began to wonder about the relationship between anthrax infection and persistent somatic (affecting the body) symptoms among the survivors of the 2001 anthrax bioterrorist attack. The results of their study were published in the April 28, 2004 issue of The Journal of the American Medical Association. They found that one year after their initial infection, survivors of the 2001 anthrax attack were still suffering from significant health problems and quality of life issues.

About the Study

The study included 15 adult survivors of the 2001 bioterrorist activities that resulted in the infection of U.S. Postal Service workers with either inhalational (lung-related) or cutaneous (skin-related) anthrax disease. Each of the participants completed one clinical interview and three self-administered questionnaires regarding any current, persistent, or residual health problems they may be experiencing. The researchers also reviewed each survivor’s medical records.

The Findings

When compared to the general population, the researchers found that anthrax infection survivors (regardless of the type of anthrax they contracted) reported a greater number of persistent health concerns (eg, respiratory tract problems, fatigue, joint swelling and pain, and memory problems) than the general population. They also reported more symptoms of psychological distress, including depression , anxiety , obsessive-compulsive disorder , and hostility. In fact, 53% (eight) of the survivors reported they had been unable to return to work since the attack and 100% (15) were still receiving some kind of psychiatric treatment.

How Does This Affect You?

The researchers found that almost all of the anthrax survivors continued to report significant health problems and poor life adjustment one year after their attack. They go on to suggest that posttraumatic stress disorder (PTSD) may be the cause of these issues, as many of those suffering from PTSD suffer with these same difficulties.

Few of us will ever forget the fall of 2001. The attacks on 9/11 and the subsequent anthrax attacks changed the very tenor of American life. Our sense of safety, our naïve belief that we, above all nations, were somehow untouchable vanished in two horrific clouds of smoke and a few poisoned envelopes.

In this sad new world, we must learn not only to defend ourselves from terrorist attacks, but to survive them. This means paying particular attention to the aftermath of these events, which, unfortunately, may include large numbers of people suffering the devastating psychological effects of disaster.