Symptoms of Anthrax and Flu Overlap

B O S T O N, Oct. 26 -- Fever, body aches, cough, congestion, joint pain and stiffness — symptoms of the average flu, or warning signs of the more serious, even deadly, inhalation anthrax disease?

After the deadly inhalation anthrax case of a Washington, D.C., postal worker was misdiagnosed as flu, it seems Americans may be in for a nerve-wracking flu season. And experts are trying to underscore the message that extra vigilance will be needed this year.

Major Differences

While both the flu and inhalation anthrax can inflict calamitous damage to the body, they are vastly different germs.

The flu, or influenza, is a respiratory infection caused by a variety of contagious viruses. It is spread through coughing and sneezing and includes symptoms such as headache, chills and dry cough, fever and body aches as well as upper respiratory symptoms such as nasal congestion and sore throat.

Anthrax, by contrast, is caused by the bacterium Bacillus anthracis. It can lead to infection when spores of the bacterium are inhaled. Initial symptoms of inhalation anthrax may resemble a common cold. These symptoms may then decline for a short period, after which breathing problems and shock become a cause for concern.

Physicians battle hundreds of thousands of cases of flu each year in the United States alone. But before the recent cases in Florida, inhalation anthrax had not been seen in this country in 25 years, which only makes the already daunting job of distinguishing overlapping symptoms of anthrax and the flu a greater challenge.

"We're having to learn about the disease as we go along; there have been so few cases in the world," says Dr. Adrian Long, medical director of Kaiser Permanent Mid Atlantic, "We're in uncharted territory."

Kaiser's physicians are currently treating the two D.C.-based postal workers who came down with inhalation anthrax infection a few days ago.

In the cases of inhalation anthrax seen by Kaiser, Long says that general aches, profuse sweating and other flu-like symptoms existed with both patients. At the same time, one patient had respiratory symptoms, the other did not.