Amerithrax Read Online Free PDF

hours.
    Dr. Flannagan made the familiar Y-shaped incision, folded the skin back, then snipped away each of the ribs with a pair of gardening shears. The chest cavity was a lake of blood. They had never seen so much. With a ladle they bailed it out so they could see what they were doing. Be- cause of potential contamination of the morgue, they stop- pered the huge quantity of tainted blood inside containers. All of the victim’s internal organs were glistening—shot through with signature gram-positive rods of Bacillus an- thracis from three to eight micrometers in length.
    Dr. Zaki and his team examined them to absolutely con- firm the type of anthrax that had caused Stevens’s death. The surgeon cleared his mind and, like any good detective, began his postmortem examination with no preconceived ideas. They had found no hint of cutaneous anthrax on the
    exterior of the body. The interior was another story. Dr. Zaki studied the swollen, black lymph nodes—so engorged that they exploded at the slightest touch of his scalpel.
    The mechanics of the victim’s death were laid out on the tilted table to be read as clearly as a road map or book. Airborne anthrax spores had settled into tiny sacs in Ste- vens’s lungs. Spores are always more deadly when inhaled because they are disseminated more widely within the body. Bacteria from spores germinating in his lungs had produced several toxins that attacked his cells. Beset by a killer like anthrax, the lymph had accelerated its already speedy flow, moving bacteria to lymph nodes to be destroyed. But when the lymph nodes failed to overcome the infection, the mul- tiplying bacteria inflamed the lymph nodes. They became enlarged, bloody, black, and necrotic. The surgeon could see that. It was a horrible way to die. Stuck to the inside of his lungs was more of the thick, gobby paste. Foamy, golden- yellow glue, anthrax sputum exudate, was everywhere.
    Rapidly, the rods and threads must have swept through Stevens’s body, causing toxic shock, internal ulceration, and bleeding. Once blood poisoning had developed, death had followed the onset of the fulminant phase in one to two days. A secondary pneumonia infection had developed, fol- lowed by shock, coma, and instant respiratory collapse. By counting backward the doctor might be able to determine when Stevens had been infected, but not how, nor where the source of that infection was now. His autopsy findings indicated:

    Gangrenous lesions in different parts of the lungs, massive thoracic and gastrointestinal bleeding and inflammatory infiltrates. Hemorrhagic mediastinal lymphadenitis, and immunohistochemical staining showed disseminated B. anthracis in multiple organs.

    The surgeons examined the patient’s cerebrospinal fluid and noted the documented meningitis findings. Meningitis often accompanies inhalational anthrax. Anthrax meningitis, a complication of that form, is characteristically hemor- rhagic. Decades earlier, in the world’s worst accidental in-
    halational anthrax release (described in “Anthrax City,” chapter 14), 55 percent of the victims had shown evidence of meningeal involvement at autopsy.
    In complete medicolegal autopsies the brain is removed and inspected for evidence of disease. A rubber block under the victim’s shoulder blades pushes the chest upward and causes the head to fall back so the skull can be sawed open. The surgeon, after carefully avoiding penetration of the brain beneath, gives a twist to a T-shaped bone chisel forced into the cut line. This lifts the skullcap, which is pried off, cranial material still clinging, and allows the victim’s brain to be removed for inspection. In this instance, though, after much debate, it was agreed that it was far too dangerous to open the skull with an electric saw. A saw’s blade, moving back and forth at high speed, might spread anthrax spores in a cloud of bone dust. Thus, this important step was never accomplished. However, if it had, even the most