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Postal Employee Might Have Anthrax Man Likely Exposed, But CDC Tests Find No Anthrax in Blood

By Scott Shane
THE BALTIMORE SUN -- A 37-year-old Maryland postal inspector who handled anthrax-contaminated air filters at Washington’s Brentwood mail sorting center in October has been severely ill ever since with symptoms resembling those of inhalation anthrax, including fever and chest pain.

But because medical tests have never detected anthrax bacteria or antibodies in his blood, the federal Centers for Disease Control and Prevention have declined to classify his illness as anthrax.

Nevertheless, the doctors who have cared for him at Sinai Hospital for more than two months say in a medical journal article to be published Wednesday that they believe the anthrax spores he inhaled 12 weeks ago are to blame for his sickness.

The mysterious case of William R. Paliscak Jr. raises the troubling possibility that officials may not have fully recognized the extent of the wave of anthrax cases linked to poisoned letters sent last fall by a still unidentified bioterrorist.

Officially, the CDC has recorded 18 confirmed cases of anthrax, including seven skin infections and 11 people stricken with the far more serious inhalation form of the disease, five of whom died.

Two postal workers who died, as well as two others who recovered, contracted inhalation anthrax after working in the same area of the Brentwood facility where Paliscak removed filters. All five men worked around a sorting machine through which an infected letter passed on its way to the office of Senate Majority Leader Tom Daschle, D-S.D.

Paliscak’s illness may show that for reasons medical experts do not understand, some people infected with inhalation anthrax never test positive for the disease with existing test methods. That could mean other cases of flulike symptoms among postal workers and others exposed to anthrax spores were caused by anthrax but never identified as such blood tests for the bacteria were negative.

“We strongly believe that there is a relation between the patient’s exposure to anthrax and the symptoms displayed,” Paliscak’s doctors write in the article in the Journal of the American Osteopathic Association.

The lead author is Dr. Tyler C. Cymet, an osteopathic physician who heads family medicine at Sinai.

While calling Paliscak’s case “a suspected case of anthrax where a diagnosis is not definite,” Cymet and his co-authors, Drs. Gary J. Kerkvliet, Judy H. Tan, and Jeremy D. Gradon, write that his symptoms “do not have any other valid explanation -- despite extensive inpatient work-up.”

Now his doctors believe Paliscak may be finally getting better. He was discharged from Sinai Friday and is recuperating at his home in Edgewater, Md., near Annapolis, Md. Tuesday, he was still on intravenous antibiotics and was too weak to speak to a reporter, his family said.