Anthrax Panic Leads Patients to Doctors, ER

Oct. 25 -- This is usually the time of year Americans go to their doctors for flu shots. But with the emergence of anthrax, some doctors and emergency rooms are hearing an additional request from patients — Cipro.

For the most part, doctors are not prescribing Cipro — the antibiotic in demand as an anthrax treatment — or vaccinations against anthrax. Instead, they are doing their best to calm fears, quiet panicked patients and inform them about anthrax, Cipro and other antibiotics.

"Fear is much more contagious than microbes," said Dr. Donald Shifrin, a Bellevue, Wash., pediatrician. "People are asking for prescriptions and saying things like, 'I know you don't want to prescribe Cipro, but can you just do it for me?'"

Doctors on Alert to Prevent Misdiagnoses

Part of the cause of patients' fears may be the initial misdiagnosis of a Washington postal worker who died from the inhalational form of anthrax. Just days before his death, the man was sent home by doctors after his symptoms were dismissed as the flu, which has similar symptoms in initial phases.

Many emergency doctors say such concern is unwarranted, and believe an ongoing flood of information to doctors on anthrax, a previously obscure disease, will help prevent such misdiagnoses. Numerous sources have been heading up the educational effort, say physicians — mainly the Centers for Disease Control and Prevention, but also professional organizations, hospitals, universities, and even the FBI. The American College of Emergency Physicians updated almost 4,000 emergency physicians on the topic at their scientific assembly last week.

"Without a high index of suspicion, this is an impossible diagnosis to make early in the course of symptoms," said Richard O'Brien, a spokesman for ACEP. "Fortunately, our suspicions are heightened right now so I think of the remote probability all of the time."

While most physicians agree that diagnosing inhalation anthrax is a challenge, they urge that context is key to making a diagnosis. Dr. Charles Emerman, chairman of emergency medicine at Metrohealth Medical Center in Cleveland, says physicians must consider if the patient belongs to societal groups that have been stricken by the disease.