Getting the anthrax story straight

This partial transcript of Special Report with Brit Hume, October 14, 2001 was provided by the Federal Document Clearing House. Click here to order the complete transcript.

TONY SNOW, HOST:  How does one get anthrax, and how do we fight it?  Here from New York with answers, Fox News medical consultant Dr. Isadore Rosenfeld.  

Also here, our panel, Brit Hume and Mara Liasson and Juan Williams of National Public Radio.  And the first question goes to Mara.  

MARA LIASSON, FOX NEWS:  Dr. Rosenfeld, there's a lot of confusion about Cipro, the antibiotic that's used to treat anthrax.  Could you tell people whether they should run out and start taking it now if they're worried about anthrax or not? 

DR. ISADORE ROSENFELD, FOX NEWS MEDICAL ANALYST:  No, they shouldn't run out and start taking it prophylactically.  

I have given some Cipro prescriptions to my patients, and this is what I tell them:  If there is evidence that there's anthrax in the community and/or if you're suddenly surrounded by people with severe flu symptoms in the setting of an anthrax possibility, it's reasonable, I think, to take two Cipros and then see a doctor in an emergency room.  Do not continue to take the Cipro prophylactically. Because if you take it for long enough, there's a possibility of developing resistance for when you need it.  

But I think it's entirely reasonable, both from an antibacterial point of view and from a psychological point of view, that if you think you may have anthrax -- we can go into what the symptoms are -- and there are people around you with similar symptoms, and there's talk about anthrax, for example, in Boca Ratan and so on, then you take a couple of Cipro, 500 milligrams twice a day and get help.  If, in fact, it is anthrax, then the two Cipro that you've taken may make a difference.  

LIASSON:  But there is a danger if you took a full dose of it, that it wouldn't work next time?

Other guests and topics for October 14, 2001 included:
• Jim Angle: Five more people test positive for Anthrax exposure in Florida
• Steve Harrigan: Kabul hit hard overnight
• New Jersey Sen. Robert Torricelli talks about how Congress is helping to keep Americans safe
• HHS Secretary Tommy Thompson assures that U.S. is prepared for bio-terrorist attacks
Order the complete transcript

ROSENFELD:  I don't think so.  I don't think a full dose would do anything next time.  I think in order to develop resistance to Cipro, you've got to take it over a period of time.  If you take two as a false alarm or four as a false alarm, that is not going to cause resistance.  

JUAN WILLIAMS, FOX NEWS:  Now, Dr. Rosenfeld, let's talk about other antibiotics.  What about, let's say, being a concerned parent, should I horde penicillin or doxycycline or anything else in addition to Cipro? 

ROSENFELD:  The alternative to Cipro is doxycycline.  There are some doctors who think that it's even more effective.  You've got to be careful with doxycycline because it's in the tetracycline family, and it should not be used for any length of time by pregnant women or by children.  It can cause discoloration, permanent discoloration of the teeth.  So I prefer Cipro.  Penicillin is also effective in anthrax.  

WILLIAMS:  And would you suggest that families get gas masks? 

ROSENFELD:  No.  I tell you, there are all kinds of gas masks for different challenges.  And for a gas mask to work, you've got to be wearing it in advance.  When you get it -- in Israel, for example, if they get a warning of an attack, everybody puts on gas masks on and waits.  You can't walk around the United States wearing a gas mask.  

Most of these substances are odorless and colorless, and you can't tell that you've been exposed.  If you've breathed them in and then put on a gas mask, it's futile.  

Also, the gas mask has to really fit very tightly.  There are all kinds of gas masks.  

And I would wait, before getting a gas mask, I would wait for a government directive saying, listen, we have credible information that there will be mustard gas or phosgene or chlorine or sarin or any of the other things for which you may need it, and then get it.  I would not get a gas mask now.  

HUME:  Dr. Rosenfeld, perhaps you could give some advice for mail handlers.  Powderized anthrax looks like what?  Does it look like sugar granules? 

ROSENFELD:  Looks like talcum powder.  I've never seen it, but from what I have heard, it looks like talcum powder.  

And as far as handling mail is concerned, I think that you shouldn't -- if anything, you should look at the postmark first of all.  If the postmark says Trenton and the return address on the envelope is Malaysia, then there's something wrong.  


ROSENFELD:  And if the package is distorted, there are things sticking out it, discolored and so on, if it feels funny.  I mean, when I get a letter, it doesn't feel like powder you know.

HUME:  But how concentrated?

ROSENFELD:  You've got to use your common sense.

HUME:  Well, how concentrated would the powder have to be?  Would it be an amount so that if you held the thing up to the light, you might be able to see it?  Or would it just be a bit of it on the surface of the contents of whatever document or whatever's inside. How much does it take to be a danger? 

ROSENFELD:  I don't think holding it up to the light -- I think you have to open it.  If you see powder there, you know, run.  Don't pick it up to see how fine it is.  Don't sniff it to see what it smells like.  

HUME:  Yes, above all, don't sniff it, right?  

ROSENFELD:  If you see -- if you open up any envelope that's -- I mean, when people send me a letter, they don't send me powder.  They send me a letter.  And if you see powder in a letter, that's alarming. You should keep away from it.  Leave the room, shut the door, and call the FBI..  And if you're lucky, within two weeks, they'll come and get the letter.  

SNOW:  Dr. Rosenfeld, within two weeks -- what is the incubation period?  I mean, you pick it up.  You've got some on your hands. Suppose  you have a cut, because as I gather to get cutaneous anthrax, you also have to have some break in the skin.  If you wash your hands, you're OK.  

ROSENFELD:  I said -- my comment about two weeks was meant to be humorous.  Because when NBC notified the FBI that there was a letter with powder, it took them two weeks to get it.  Now, so that has nothing to do with the incubation period.  

The incubation -- you can get anthrax within two or three days after exposure or anywhere up to 40 days.  It depends.  

The cutaneous form is -- I've got to make clear again that the inhaled form and the cutaneous form are the same bug.  But the anthrax spore -- they tend to clump together.  When they clump together, they can affect the skin -- a breaking in the skin, and you get the skin form, which is very treatable.  It's very common in -- not very common.  But many people, animal handlers, have had anthrax over the years.  

The inhaled form is the same thing, but the spores are very fine and very small.  You need to inhale about 8,000 to 10,000 of them in order for them to get deep into your lung, from there into the bloodstream, where the bacteria form a toxin, a poison, that can poison you.  It's the same bug, different composition.  

SNOW:  All right.  Dr. Isadore Rosenfeld, thanks for joining us.  


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