An Industry-Related Outbreak of Human Anthrax: Massachusetts, 1868

bonucleic acid relatedness between Bacil-lus anthracis, Bacillus cereus and Bacillus thuringiensis. Deetz K. Oligonucleotides with fluorescent dyes at opposite ends provide a quenched probe system useful for detecting PCR product and nucleic acid hybridization. To the Editor: In Bioterrorism-Related Inhalational Anthrax: The First 10 Cases Reported in the United States, Jernigan et al. noted that in the mid-1800s inhalational anthrax related to the textile industry became known as woolsorters' disease (in England) and ragpickers' disease (in Germany and Austria) because of the frequency of infection in mill workers exposed to imported animal fibers contaminated with Bacillus anthracis spores (1). During the 1800s, as in Europe, industry related human cases of anthrax also occurred in the United States. In 1868, Silas Stone, a physician, reported that " an unusual number of cases of a rather rare affection have come under my observation within the past 14 months " (2). Stone described eight patients with " malignant pus-tules " who worked in or were associated with an animal hair factory in Massachusetts. The patients' cutane-ous lesions were described as dark red, dark purple, purplish-black, and black; six of the patients had " slough " lesions. Stone treated his patients with tincture of iodine, iron, and quinine. Since antibiotics were not available, six of the eight patients had severe clinical disease, and two died. Stone's patients demonstrated the full spectrum of anthrax, including gastrointes-tinal, mediastinal, and meningeal involvement. Four patients had gas-trointestinal symptoms, including epi-gastric distress and pain, nausea, and vomiting. Three patients had mediasti-nal involvement, manifested by chest distress and pain, dyspnea, and tac-hypnea. In the two fatal cases, meningitis appeared to have been the immediate cause of death; both of these patients were described as delirious. Among Stone's eight patients, most remarkable was case 5, which was strikingly similar to case 8 of Jernigan et al.; the signs and symptoms of both patients included chills, headache, fatigue, vomiting, chest pain, tachypnea, tachycardia, and cutaneous lesions. Stone's description of the 7-day clinical course of patient 5, a laborer at the hair factory, is as follows: " Called November 17. Had been sick since the Thursday previous (November 14). Was taken with chills, pain in head and back, and suffered loss of strength.