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Trenton Metro Area Local

American Postal Workers Union



November 27, 2002

Dr. Julie Gerberding,
Centers for Disease Control and Prevention
1600 Clifton Rd.
Atlanta, GA 30333

Dear Dr. Gerberding:

        I am writing to request that the Centers for Disease Control and Prevention (CDC) initiate a longitudinal medical study of all individuals - especially employees of the United States Postal Service - who were exposed to anthrax and treated with antibiotics during last year's anthrax terrorist attacks.

        Thousands of people, most of them postal employees and staffers on Capitol Hill, were treated for exposure to anthrax in the fall of 2001 after four anthrax-laced letters were mailed from the John K. Rafferty Post Office in Hamilton, New Jersey, in my Congressional District.  Nationwide, five people died of inhalation anthrax.  Thankfully, the two individuals who contracted inhalation anthrax in New Jersey recovered, as did the many others who contracted the cutaneous form of the disease.

        It is my understanding that despite the magnitude of the anthrax exposure and antibiotic treatment, the CDC has not yet initiated any comprehensive study to determine what the long-term health implications may be for people both exposed to anthrax and for those who received prolonged treatments of powerful anti-anthrax medications.  As you know, the original treatment regimen at the beginning of the anthrax crisis was 60 days of the medication Cipro.  Later on, other antibiotics (such as Doxycyclin and amoxicillin) were distributed as an antimicrobial prophylaxis when the CDC determined they were also effective against anthrax.  As antibiotic recipients began reaching the end of their 60-day treatment course, the Department of Health and Human Services (HHS) published a health advisory on December 18, 2001 advising people exposed to anthrax to consider two additional treatment options: (a) 40 additional days of antibiotic treatment, and (b) 40 days of additional antibiotic treatment, plus three doses of anthrax vaccine over a four-week period as an investigational treatment.  What were the results?

        Many of the postal employees in my district treated for anthrax have reported that they still suffer from medical complications they did not have prior to being exposed.  As you know, Cipro is a very powerful drug that, according to the Food and Drug Administration (FDA), can cause several serious side effects including intestinal problems, respiratory problems, dizziness, depression, hallucinations, aches and pains, and hives, among others.

         The anthrax crisis marks the first time Americans have been victimized by a bio-terror attack and the first time Cipro was prescribed en masse to guard against anthrax infection.  As such, many questions remain, chief among them (1) exactly how long anthrax spores can remain viable inside the human body, (2) exactly how long people exposed to anthrax would need to remain on an antibiotic treatment regimen, and (3) the long-term health effects (if any) on persons who were exposed to anthrax and treated with different antibiotics. 

        In Hamilton, postal employees exposed to anthrax were given a medical examination at  Robert Wood Johnson Hospital at Hamilton prior to being placed on the Cipro, and they were told to come back for follow-up evaluations.  It is my understanding that this comprehensive data from the hospital was turned over upon request to the CDC.  It is my further understanding that the CDC contracted with RTI International to conduct brief telephone interviews nearly one year ago of all people who were recommended to receive anti-anthrax medications. Obviously, more needs to be done to build upon and analyze this information, gather more data, and ensure that the people affected are provided with the results. 

        By conducting a thorough longitudinal medical study and publishing it, we will help ensure that the victims of this terror attack will be properly cared for should they need supplemental medical treatment or have adverse reactions in the years ahead.  And there will also be a better understanding of the short and long-term effects of anthrax and any side effects posed by the medications now used to treat people exposed to the bacteria.  Only by thoroughly understanding all aspects of anthrax - as well as other agents that could be used in biological or chemical attacks - will our government be better prepared should such terrorists strike again.

        Thank you for your careful consideration of my request, and I look forward to hearing from you shortly on this issue.  If you have additional questions on this issue, please do not hesitate to contact me or Nick Manetto of my staff at 202-225-3765.


                                        CHRISTOPHER H. SMITH
                                        Member of Congress