By Rick Weiss
Washington Post Staff Writer
Friday, October 5, 2001

A 63-year-old Florida man is critically ill with inhalation anthrax, a rare and deadly disease that has long been considered one of the more plausible agents of biological warfare. But federal officials said yesterday they believe the case arose from natural causes and not from an act of terrorism.

State and federal health officials would not name the man, but his employer, the tabloid newspaper the Sun, said he was a photo editor, Robert Stevens, of Lantana. He was hospitalized on Monday soon after returning from North Carolina, said Florida Lt. Gov. Frank Brogan at a news conference yesterday.

It's not clear how the affected man acquired the infection. The case is being investigated by the federal Centers for Disease Control and Prevention and the FBI, Health and Human Services Secretary Tommy G. Thompson said in an unscheduled appearance at yesterday afternoon's regular White House news briefing.

Anthrax is a bacterial disease. It can manifest itself in three forms, depending on whether the infection results from skin contact, ingestion or inhalation of the bacterial spores, which live in soil and can be found on cattle hides and wool. Inhaled anthrax is the most lethal, killing up to 80 percent of those infected.

Only 18 cases of inhaled anthrax have occurred in the United States in this century, and the last known case was in 1978, according to a 1999 summary of anthrax as a biological weapon that was published in the Journal of the American Medical Association. So rare is inhaled anthrax, that article concluded, "that even a single case [is] a cause for alarm today."

Thompson encouraged just the opposite yesterday. He repeatedly calledthe case "isolated" and emphasized that anthrax cannot be spread from person to person.

Thompson praised the public health system for working as it was supposed to: Florida doctors contacted the state health department, which confirmed the diagnosis and contacted the CDC and the FBI.

Although it has been decades since the last case of inhaled anthrax was noted in this country, Thompson said, "it's entirely possible" that others had been occurring and had been going unnoticed until health departments beefed up their vigilance in the wake of the Sept. 11 terrorist attacks. The current case was initially tallied as probable meningitis.

Thompson discouraged citizens from seeking prescriptions for ciprofloxacin or other antibiotics that can halt progression of the disease. He said there is an ample supply of relevant drugs should emergency distribution be necessary.

At a news conference yesterday at JFK Medical Center in Atlantis, Fla., Larry Bush, an infectious disease specialist, said the affected man was "confused, had a high fever and he was vomiting," when he arrived at the hospital.

Symptoms of anthrax can arise anywhere from a few days to two months after exposure. Federal health investigators are looking into the man's activities during the past few weeks, seeking clues as to how he may have become infected. Officials characterized him as an "outdoorsman" but said they had no information suggesting he had been in recent contact with infected hides or hair.

Staff writer Sue Anne Pressley in Miami contributed to this report.