Medical authorities have said the survivors of last year's anthrax attacks in the United States are giving them invaluable information on how to detect and treat a disease not seen in America for 25 years.
Fifty-nine-year-old David Hose is walking on a treadmill, part of a physical therapy program he hopes will help him regain his strength.
"I can do a whole lot more than I could do a month ago," he says. "But I still get out of breath. It's not an inhaling thing, it's an exhaling thing, I don't know what it is, but there's like something there."
The fact that he is alive is remarkable because Mr. Hose inhaled anthrax spores, possibly from contaminated mail at a U.S. State Department mail facility in Virginia, where he worked. Dr. Mark Galbraith, an infectious disease specialist in Winchester, Virginia said Mr. Hose's case gives the medical community invaluable information.
"Because in the past there were not anthrax survivors that you could follow from week to week and take blood specimens and find out what is the level in his body of the antibody proteins that would fight the infection. Also we are trying to develop tests on the blood which would enable us to screen people to see if they had been exposed. Those tests usually try to measure a reaction to a protein in the blood and so his blood is actually being used to try to develop those tests," Dr. Galbraith explains.
Mr. Hose's symptoms first appeared on Monday evening, October 22, 2001. "Quite suddenly I started sweating very heavily, with no cold chills. And by the time I got home 15 minutes later I was soaking wet and I remained that way all night," Mr. Hose says.
Nevertheless, Mr. Hose went to work on Tuesday. On Wednesday, his symptoms worsening, he went to the emergency room at the Medical Center in his hometown of Winchester, Virginia. "This did not feel like the flu, bronchitis, or anything else. Sunlight was extremely bright which I didn't find out till months later was one of the symptoms. I could hardly see to walk in there in October, the sun was so bright to my eyes," he said.
The emergency room physician gave Mr. Hose a prescription for an antibiotic, took a blood sample to be tested for anthrax, and sent him home. At 7:00 AM the next day, Dr. Mark Galbraith was just beginning his day at the hospital.
"The head of the microbiology lab approached me and said, 'I think we may have a case of anthrax would you come look at this slide?' And I walked over and looked at it and said, 'That's what anthrax is supposed to look like.' And I said, 'Well, who is his doctor?' And they said, 'Well, you are.' Whereupon I said, 'O.K. Can we find out where this man lives?' And I called him from the lab and was delighted that he answered the phone. Meaning at least he was alive and still breathing," Dr. Galbraith says.
Mr. Hose was admitted to the hospital where the early diagnosis gave him a fighting chance. But Dr. Galbraith said the human body has a difficult time dealing with anthrax.
"Anthrax is a bacteria and it has a dormant state and it forms spores which are much like seeds. When the body inhales the spores, the body's defense cells engulf these spores, it swallows them up basically, and the cells then transport them to the lymph glands to be destroyed. Unfortunately, our body doesn't do a very good job of this and in the lymph glands, it is an ideal environment for these spores to sprout. So they germinate much like a seed would and they become filled with the anthrax bacteria. And once this occurs, the problems begin, because as the bacteria replicate, they release many toxins which are extremely harmful to the body," he explains.
A scan of Mr. Hose's chest showed enlarged lymph nodes - circular shapes Dr. Galbraith could easily point to. "Now these are normally present but they are usually impossible to see because they are so tiny. This is what the textbooks say should happen, but when you really see it, it is very amazing," he says.
"What I remember most was them trying to reduce my fever," says Mr. Hose. "My heart rate went up to 165 beats per minute and stayed there. They put some kind of a coolant sheet underneath me to bring my body temperature down. And they kept lowering that and lowering that until I got so cold I couldn't stop shaking. And they finally gave up on it, cause it wasn't affecting my fever at all."
Six days after Mr. Hose was admitted to the hospital, a second chest scan was taken. Looking at the X-ray, Dr. Galbraith said his patient had improved.
"He has received intravenous antibiotics, but he is having some difficulty breathing. And we see these large gray crescents here on both sides. And if you recall on the initial film, we had only a small thin crescent and now we have a large crescent on both sides, and this is fluid that has accumulated and is actually pressing against the lung," Dr. Galbraith says.
Mr. Hose does not remember everything that happened in the hospital, but he does remember the first time he saw what he looked like. "I discovered a mirror in the vanity on the tray that you get your food on, and I saw how bad I looked. I mean I was pure white, death," he says.
Mr. Hose said he is functioning at about 60 per cent these days, and spends a good portion of his time napping and watching television, because he is too tired to do much else. He has not returned to work and doesn't know when he will feel well enough to do so. But he was lucky. Five other people died after inhaling anthrax. Although those responsible for the attacks have not been caught, he hopes that will change.
"I would like to see the person caught, just because it would maybe put an end to it and no one else would have to go through it," Mr. Hose says.
David Hose went through it and survived. But the after effects still linger - symptoms for the doctors to treat and a living reminder of the threat of biological terrorism.