Rating: 
Summary: The Killer Strain : Anthrax and a Medicine Exposed
Review: The Killer Strain: Anthrax and the Exposed MedicineI am peruvian medical , and for some years , have been investigating anthrax in Peru, reason why caused to much interest for me the appearance of the book: The Killer Strain.
The book that narrates the events related to the first outbreak of bioterrorismo in the U.S.A., submerges to us in the interior of the scientific work during the epidemic , show some more than appears in the scientific journals . Although the author certainly has obtained much related information to this epidemic, probably, the lack of a biomedica formation, has taken it to an incomplete vision of the epidemic of anthrax. The book shows some mistakes that reflect the nonmedica formation of the author, as a sample : in the figures of the book, call as symptoms to the injuries of the skin,instead of use signs. Would had been ideal that some medical professional help in revising or writing the book.
Maybe , the great problem in analyzing this epidemic is that in the world exist few experts in anthrax As the same author recognizes in her book, many doctors what participated in the epidemic , never has been sight a case of anthrax. (1) For that reason many mistakes that exist during the epidemic maybe has been unnoticed. Some of these faults in the epidemic, can be justified by the low degree of scientific knowledge with respect to this pathology, maybe for example : not to diagnose inhalational anthrax.
Inhalation anthrax is the main clinical form in the bioterrorism scope given its high mortality, however early diagnosis (a time when treatment can be effective),(2) is rather difficult to achieve In their initial stage symptoms of inhalation anthrax are very similar to influenza .
Although the cutaneous form has low mortality rates and is thus, considered as less important in a bioterrorist attack, its diagnosis may serve as an epidemiological alerta and lead, indirectly, to the early search for possible inhalation anthrax cases. These difficulties in early recognition were observed in the recent bioterrorism event with anthrax in the United States. In the bioterrorism- related outbreak of anthrax , in october 2001, the first cases were not for inhalation, but cutaneos , the detection of these cases would likely iniate the epidemiological investigation more precociously and maybe diminished even more the mortality in this outbreak. Because of this, it is necessary for physicians to learn to recognize cutaneous anthrax at its early stage.
Contrary to what occurs with the inhalation form, cutaneous anthrax there are well defined clinical characteristics and is relatively easy to diagnose clinically, to however, the early stage of cutaneous anthrax often remains undiagnosed, probably due to many reasons: a) It is to rare pathology; b) The this physician associates pathology mainly with to annoys stage necrotic to ulcer and; c) Absence of pain in the cutaneous injury makes the patient recognize the cutaneous injury annoys and delay seeking medical attention clinical Emphasis on early recognition of cutaneous anthrax is highly used in anthrax endemic area in peruvians andens, as part of the traditional medicine knowledge developed by these communities due to the absence of physicians and it could be useful to the field of bioterrorism. In Peru, farmers emphasize the clinical recognition of cutaneous anthrax in an early stage and call it "waytacha" (A quechua term that means bad flower) (3).
In this outbreak , although is certain were errors of the government and of institutions, there were also medical mistakes, that are necessary to recognize them so that they do not repeat in the future. The most critical component for bioterrorism outbreak detection is the doctor ( 4 ), and the great medical mistake of this epidemic was not undiagnose anthrax by inhalation but not to diagnose the cases of cutaneous anthrax, the detection of these cases would also , of to be certain the relation between hijjackers and anthrax ( 5 ), also initiate the investigation related to hijjackers and maybe, help to prevent the tragedy of September 11.
This epidemic more than show a exposed government , show to an exposed medicine, exposed to anthrax , a disease that does not even manage to know nor to control. David Salinas Flores REFERENCES
1. Thompson. The Killer strain. Anthrax and a Government exposed. Harper Collins Publishers.2003. pg. 72-73 2. Mc Carthy M. Early and aggressive treatment saves US antrax victims. Lancet. 2001 ; 358 : 1703 3. Salinas D. Diagnóstico y Tratamiento del Antrax: Medicina Tradicional vs Medicina CientÃfica. Revista Peruana de Enfermedades Infecciosas y Tropicales. 2001;1:157-164 4. Ashford D, Kaiser R, bales, M. et al Planning against biological terrorism.: Lessons from Outbreak investigations. Emerg Infect Dis . 2003 .9 :515 5. Report linking anthrax and hijackers is investigated. New York Times. 23 marzo 2002
Rating:
Summary: Well reported, but a (mostly) slow read
Review: This book is a little dense and sometimes repetitive. For those looking for a medical mystery this book will probably not be very satisfying. The point of this book, which is made several times and then some, is that the response from federal agencies to the 2001 anthrax attacks was not perfect. And those mistakes cost lives. The history of US anthrax production was interesting and offered perspective, and the chapter on the US Justice Departments attack and smear of a scientist was good and should have been developed more.
Rating: 
Summary: Review for A Killer Strain
Review: This book is a rivoting account of one of the most unnerving periods in recent history--In A Killer Strain, Marilyn Thompson compassionately portrays the stories of those whose lives were uprooted by anthrax while pointing out alarming govermental negligence that resulted in the deaths of postal employees and panic worldwide.
Rating: 
Summary: Fine recapitulation of the anthrax mailings story
Review: This is a very carefully written account of the anthrax mailings with an emphasis on the victims and the governmental response. It sheds little new light on the investigation which to this day has still not turned up a suspect. Marilyn W. Thompson, who is an editor at the Washington Post, and her research assistants, Davene Grosfeld and Maryanne Warrick, interviewed scores of people from Leroy Richmond, a postal employee who almost died from inhalation anthrax, to Dr. Jeffrey P. Koplan, then director of the Centers for Disease Control, in putting together the story. But apparently they were not able to interview anybody in the FBI, nor did they talk to Steven J. Hatfill, who was dubbed by Attorney General John Ashcroft as "a person of interest" in the investigation and was prominently in the public eye as a possible suspect. Much of the material was culled from news sources and public records. Consequently, what we have here is a presentation of what is publically known about the case and a record of events. One of the aspects that Thompson concentrates on is the differential between the public health response to the anthrax found on Capitol Hill and the response to that found at the Brentwood Mail Processing and Distribution Center in Washington, D.C. with the suggestion that there was a dual standard at work, one for the white and powerful and another for the black and blue collar. This may be so, but the most damaging criticism she presents--against the CDC at least--is their failure to realize that anthrax could escape a sealed envelope. However it could, and did, especially in the Brentwood Center. Thompson does get into "who done it," hinting that Al-Qaeda may be responsible as she recalls the pre-9/11 activities of Mohammed Atta, alleged ringleader of the hijackings, who is reported to have met with Iraqi intelligence in Prague where he accepted "a glass container" that may have contained an anthrax sample. (pp. 53-54) She also recalls Atta's interest in crop dusters and his visits to a south Florida rural airstrip to check out an Air Tractor AT-502 crop duster. (p. 54) Even more sensational (to me at least) is the write up of "a textbook description of cutaneous anthrax" by Dr. Christos Tsonas of Fort Lauderdale, Florida after treating Ahmed Ibrahim al-Haznawi, one of the hijackers who went down with United Airlines Flight 93 in Somerset County Pennsylvania, for a "dry, blackish scab covered wound" on his leg. As Thompson remarks, "skin anthrax could be acquired in only one way: through direct contact with anthrax spores." (pp. 51-52) A lot of ink is also spent on Hatfill, although Thompson is careful not to propose that he is the culprit. What she does is give a report on his background including his partially falsified resume, including a false claim that he has a Ph.D in microbiology (p. 191) and a report on his soldier of fortune persona. She also quotes scientist Barbara Hatch Rosenberg's "likely portrait of the perpetrator," a portrait that fits Hatfill very well. (See pages 202-205.) However, Rosenberg also refused to name Hatfill. The way Thompson organizes this information in Chapter 15, "A Person of Interest," with the juxtaposition of the characterizations and the profiling and Hatfill's grand-standing insistence that he is innocence, suggests that he is, if nothing else, a prime suspect. Of course, this is nothing new. Since his name first surfaced he has been "a person of interest" in the media and in the minds of many people. But the FBI, despite investigating every aspect of his life, has failed to arrest him. The big question here is why the FBI has not solved this case. As reported here and elsewhere the number of people who could have the expertise, the opportunity, and some kind of motive for this crime (involving "weaponized" anthrax, remember) probably can be counted without taking off our shoes. I have speculated that either the FBI has somehow compromised the evidence and is stuck without enough for an indictment, or the identity of the culprit (or the details of the investigation) would somehow embarrass the administration--or (that old standby) compromise the investigation of other, perhaps larger crimes or even crimes being planned. Thompson allows Rosenberg to add a third possibility, namely that the perpetrator "participated in the past in secret activities that the government would not like to see disclosed." (p. 204) I have one small question. On page 174 and page 185 it is suggested that "over irradiation" of the mail (to kill possible anthrax spores) could cause those opening such letters to feel sick to their stomachs or feel some other illness. From what I know about the use of radiation to kill germs, whatever is radiated contains no residue of radiation (how could it?) and poses no health hazard whatsoever. Thompson's suggestion of the "post-traumatic stress of returning" to the once contaminated mail facility is the more likely reason for illness. Bottom line: this is a thoroughly professional tiptoe through the tulips that allows Thompson to maintain a journalistic objectivity while pointing an accusatory finger at governmental incompetence in the face of the first bioweapons attack ever in the United States.
Rating:
Summary: Fine recapitulation of the anthrax mailings story
Review: This is a very carefully written account of the anthrax mailings with an emphasis on the victims and the governmental response. It sheds little new light on the investigation which to this day has still not turned up a suspect. Marilyn W. Thompson, who is an editor at the Washington Post, and her research assistants, Davene Grosfeld and Maryanne Warrick, interviewed scores of people from Leroy Richmond, a postal employee who almost died from inhalation anthrax, to Dr. Jeffrey P. Koplan, then director of the Centers for Disease Control, in putting together the story. But apparently they were not able to interview anybody in the FBI, nor did they talk to Steven J. Hatfill, who was dubbed by Attorney General John Ashcroft as "a person of interest" in the investigation and was prominently in the public eye as a possible suspect. Much of the material was culled from news sources and public records. Consequently, what we have here is a presentation of what is publically known about the case and a record of events. One of the aspects that Thompson concentrates on is the differential between the public health response to the anthrax found on Capitol Hill and the response to that found at the Brentwood Mail Processing and Distribution Center in Washington, D.C. with the suggestion that there was a dual standard at work, one for the white and powerful and another for the black and blue collar. This may be so, but the most damaging criticism she presents--against the CDC at least--is their failure to realize that anthrax could escape a sealed envelope. However it could, and did, especially in the Brentwood Center. Thompson does get into "who done it," hinting that Al-Qaeda may be responsible as she recalls the pre-9/11 activities of Mohammed Atta, alleged ringleader of the hijackings, who is reported to have met with Iraqi intelligence in Prague where he accepted "a glass container" that may have contained an anthrax sample. (pp. 53-54) She also recalls Atta's interest in crop dusters and his visits to a south Florida rural airstrip to check out an Air Tractor AT-502 crop duster. (p. 54) Even more sensational (to me at least) is the write up of "a textbook description of cutaneous anthrax" by Dr. Christos Tsonas of Fort Lauderdale, Florida after treating Ahmed Ibrahim al-Haznawi, one of the hijackers who went down with United Airlines Flight 93 in Somerset County Pennsylvania, for a "dry, blackish scab covered wound" on his leg. As Thompson remarks, "skin anthrax could be acquired in only one way: through direct contact with anthrax spores." (pp. 51-52) A lot of ink is also spent on Hatfill, although Thompson is careful not to propose that he is the culprit. What she does is give a report on his background including his partially falsified resume, including a false claim that he has a Ph.D in microbiology (p. 191) and a report on his soldier of fortune persona. She also quotes scientist Barbara Hatch Rosenberg's "likely portrait of the perpetrator," a portrait that fits Hatfill very well. (See pages 202-205.) However, Rosenberg also refused to name Hatfill. The way Thompson organizes this information in Chapter 15, "A Person of Interest," with the juxtaposition of the characterizations and the profiling and Hatfill's grand-standing insistence that he is innocence, suggests that he is, if nothing else, a prime suspect. Of course, this is nothing new. Since his name first surfaced he has been "a person of interest" in the media and in the minds of many people. But the FBI, despite investigating every aspect of his life, has failed to arrest him. The big question here is why the FBI has not solved this case. As reported here and elsewhere the number of people who could have the expertise, the opportunity, and some kind of motive for this crime (involving "weaponized" anthrax, remember) probably can be counted without taking off our shoes. I have speculated that either the FBI has somehow compromised the evidence and is stuck without enough for an indictment, or the identity of the culprit (or the details of the investigation) would somehow embarrass the administration--or (that old standby) compromise the investigation of other, perhaps larger crimes or even crimes being planned. Thompson allows Rosenberg to add a third possibility, namely that the perpetrator "participated in the past in secret activities that the government would not like to see disclosed." (p. 204) I have one small question. On page 174 and page 185 it is suggested that "over irradiation" of the mail (to kill possible anthrax spores) could cause those opening such letters to feel sick to their stomachs or feel some other illness. From what I know about the use of radiation to kill germs, whatever is radiated contains no residue of radiation (how could it?) and poses no health hazard whatsoever. Thompson's suggestion of the "post-traumatic stress of returning" to the once contaminated mail facility is the more likely reason for illness. Bottom line: this is a thoroughly professional tiptoe through the tulips that allows Thompson to maintain a journalistic objectivity while pointing an accusatory finger at governmental incompetence in the face of the first bioweapons attack ever in the United States.
Rating:
Summary: Riveting!
Review: This is a well writen book. I could not put it down until I had read it through. Ms.Thompson took the truth and made it seem like fiction. It was hard to believe that someone could do this to innocent people. I hope all of your readers will buy this great book
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