In the 10 years since 17 people survived the deadly anthrax attacks that terrorized the nation in the weeks following 9/11, little recent information is known about their health. But the National Institute of Health has quietly monitored the health of 7 of the those survivors, including [a Falls resident]. The group represents the largest pool of anthrax survivors US researchers have studied.

The ongoing study will provide the 1st comprehensive data on the long-term health effects of anthrax exposure, the project's head researcher said recently. "No one has ever documented follow up in anthrax survivors," said Dr Mary Wright, the principal investigator with the NIH's National Institute of Allergy and Infectious Disease [NIAID]. Before 2001, the last reported US anthrax case occurred in 1976, and it was reported 2 years later, according to the NIH. The only previous anthrax studies were 50 years old and contained little data about long-term effects or possible complications.

In fall 2001, 22 people in the US were exposed to anthrax through tainted letters sent through the US mail. 5 died. Many of those affected were US Postal Service [USPS] workers, who either inhaled anthrax spores or were exposed to it through skin contact. NIAD is the only research agency that is following the health of anthrax attack survivors, a project that started in February 2002. The study participants include 2 with inhaled exposure, and all but one are regularly tested and evaluated every one to 2 years, Wright said. The testing includes neuropsychological, blood, and hormone level tests. The study will continue as long as the participants are willing. And one survivor, a woman who has not recently participated, can return at any time, Wright said.

The most recently released information about the health of the survivors came in 2004. It was based on a one-year follow up study of 15 of the 17 survivors conducted by the Centers for Disease Control and Prevention. That study used medical interviews, standardized self-administered questionnaires, and a review of available medical records. The study found that 8 of the participants hadn't returned to work more than a year after the attacks, all were under psychiatric care, and most reported symptoms ranging from chronic cough, fatigue, and memory problems to depression, anxiety, and hostility. 8 survivors also reported moderate to severe joint problems and decreased physical functioning. But diagnostic tests performed on 6 of the 8 patients showed no signs of immune or inflammatory disorders or other common medical explanations for the symptoms.

Nearly 9 years later, Wright says her data shows the survivors who were the sickest in 2001 continue to experience the most persistent symptoms, including memory trouble and chronic fatigue. These survivors either inhaled anthrax or had it enter their bloodstream after they contracted the skin form.

The sickest patients also have had the most difficulty returning to work. Though some have returned, they can't perform at the same level as before, Wright said. Those with less severe symptoms appear to have returned to their regular lives. Wright added that researchers know some survivors will develop common age-related medical problems, but there likely will be no way to prove a cause-effect relationship with the anthrax exposure. "We are hoping what we learn, once we publish, is if there are new cases, including natural cases, that they can learn from this experience and monitor some of these variables, like hormone levels and memory testing and offer some support to folks," Wright said. [The Falls resident], now 45 and a US postal worker, was the 12th of the 22 anthrax attack victims. 4 coworkers also were exposed and survived. He returned to his job at the Hamilton, New Jersey, office in 2005, where he continued to work a "modified schedule" through Workers' Compensation, according to a recent post on the PostalWorker News Blog, which isn't affiliated with the US Postal Service.

He came in contact with one of the tainted envelopes, a letter addressed to then Senate Majority Leader Thomas Daschle, while working overtime on Columbus Day 2001. Normally, he didn't sort 1st-class mail. 5 days later, he noticed a welt-like sore on his neck where he had nicked himself shaving the day he worked the overtime. He was treated at an emergency room for a suspected spider bite and released.

The next morning, though, he woke to find his neck had swelled to 27 inches [69 cm] around. The welt was now a pus-filled boil and a softball-size lump protruded from his chest. He returned to the emergency room, where doctors confirmed he had an anthrax infection, triggering emergency infectious disease protocols. After 5 days in isolation with antibiotic treatments, [the man] was released.

He] last spoke to the newspaper in 2008. At the time, he complained of symptoms that he believed were the lingering effects of the anthrax -- stuffy head, achy joints, throbbing headaches, insomnia, and panic attacks. In a [6 Aug 2011] post on the PostalWorker blog, [the man] wrote that he still suffers severe post traumatic stress disorder, which a doctor has diagnosed. He said his condition has been worsened because he continues to work at a postal center 300 yards [275 m] from the building where he was exposed to anthrax and he's required to sort and throw away waste mail. He added that his repeated requests for a job transfer closer to home have gone nowhere. "Without having been through this experience, it has been impossible for others, including US Post officials, to comprehend the mental and physical toll I face each day driving back and forth to work and seeing the postal facility, a constant reminder of this terrible, near-fatal exposure I suffered," [his] post said. "This has proven to be no help whatsoever in me trying to obtain closure and getting on with my life. I just want to spend my last years of service at a facility with a less stressful, remindful environment."

The USPS cannot comment on employee claims without the employee's written permission, spokesman Ray Daiutolo said. But Daiutolo said that if an injured worker disagrees with the offered position, that employee can provide supporting documentation to the Office of Workers' Compensation Programs, which makes the final decision. If an employee is returned to duty in a "suitable position" and subsequently experiences a worsening of his/her condition or has a change in work tolerances, that employee has the right to submit a claim for recurrence, Daiutolo added.

[Byline: Jo Ciavaglia] Communicated by: ProMED-mail