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Why running noses are a good thing

Doctors have a new clue to help sort out whether people with aches and coughs have the ominous first signs of inhaled anthrax or ordinary colds and flu: Anthrax victims don't have runny noses. In general, the first symptoms of inhaled anthrax are the same as the flu and other wintertime viruses -- fever, ache, cough, no energy. //

As a result, some worry that doctors will prescribe lots of anthrax-killing antibiotics -- which do nothing for colds and flu -- just to make sure they don't miss a case of anthrax in its early, treatable stage. But none of the five cases of inhaled anthrax so far have started with nasal congestion or runny nose. Those symptoms, of course, are common in flu and many other viruses that cause wintertime respiratory ills. So asking about it can help doctors rule out anthrax.

The possible overuse of antibiotics worries officials at the Centers for Disease Control and Prevention, which offered some guidance for doctors who wonder how to tell which is which. No test will reveal anthrax exposure or predict who might develop anthrax in the near future. Nasal swabs, if given soon enough, can help show whether anthrax was present in a particular location, but they do not tell doctors anything about an individual's risk.

So far, the single most important information is the patient's job. Doctors should be suspicious if patients are postal workers or handle mail, especially in areas where anthrax has been found.


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