title: One-year health assessment of adult survivors of Bacillus anthracis infection.
abstract: BACKGROUND
  Little is known about potential long-term health effects of bioterrorism-related Bacillus anthracis infection.
  
  
  OBJECTIVE
  To describe the relationship between anthrax infection and persistent somatic symptoms among adults surviving bioterrorism-related anthrax disease approximately 1 year after illness onset in 2001.
  
  
  METHODS
  Cross-sectional study of 15 of 16 adult survivors from September through December 2002 using a clinical interview, a medical review-of-system questionnaire, 2 standardized self-administered questionnaires, and a review of available medical records.
  
  
  METHODS
  Health complaints summarized by the body system affected and by symptom categories; psychological distress measured by the Revised 90-Item Symptom Checklist; and health-related quality-of-life indices by the Medical Outcomes Study 36-Item Short-Form Health Survey (version 2).
  
  
  RESULTS
  The anthrax survivors reported symptoms affecting multiple body systems, significantly greater overall psychological distress (P<.001), and significantly reduced health-related quality-of-life indices compared with US referent populations. Eight survivors (53%) had not returned to work since their infection. Comparing disease manifestations, inhalational survivors reported significantly lower overall physical health than cutaneous survivors (mean scores, 30 vs 41; P =.02). Available medical records could not explain the persisting health complaints.
  
  
  CONCLUSIONS
  The anthrax survivors continued to report significant health problems and poor life adjustment 1 year after onset of bioterrorism-related anthrax disease.
authors.affiliation: Office of the Director, Division of Violence Prevention, Centers for Disease Control and Prevention, Atlanta, Ga 30341, USA. DReissman@cdc.gov
authors.forename: Dori B
authors.initials: DB
authors.lastname: Reissman
authors.forename: Ellen A S
authors.initials: EA
authors.lastname: Whitney
authors.forename: Thomas H
authors.initials: TH
authors.lastname: Taylor
authors.forename: James A
authors.initials: JA
authors.lastname: Hayslett
authors.forename: Peter M
authors.initials: PM
authors.lastname: Dull
authors.forename: Ileana
authors.initials: I
authors.lastname: Arias
authors.forename: David A
authors.initials: DA
authors.lastname: Ashford
authors.forename: Eddy A
authors.initials: EA
authors.lastname: Bresnitz
authors.forename: Christina
authors.initials: C
authors.lastname: Tan
authors.forename: Nancy
authors.initials: N
authors.lastname: Rosenstein
authors.forename: Bradley A
authors.initials: BA
authors.lastname: Perkins
mesh_terms: D000041:Absenteeism; D000328:Adult; D000881:Anthrax / Q000503:physiopathology / Q000523:psychology; D023482:Bioterrorism / Q000523:psychology; D003430:Cross-Sectional Studies; D005500:Follow-Up Studies; D006304:Health Status; D006305:Health Status Indicators; D006801:Humans; D008875:Middle Aged; D011788:Quality of Life; D012141:Respiratory Tract Infections / Q000382:microbiology / Q000503:physiopathology / Q000523:psychology; D017192:Skin Diseases, Bacterial / Q000382:microbiology / Q000503:physiopathology / Q000523:psychology; D013315:Stress, Psychological; D017741:Survivors / Q000523:psychology; D014481:United States