To the Editor.—
The extensive and informative article about bioterrorism published in the April 2002 issue of Pediatrics1 has some gaps in information that I feel are important to mention.
We deeply appreciate the comments made by Dr Madariaga but would like to clarify 1 or 2 of the points that he addressed:
Dr Madariaga indicates that the yield of a diagnostic Gram stain or positive culture from the sputum sample is very low and that none of the cases of bioterrorism-related inhalational anthrax reported after September 11, 2001, had a positive sputum culture. In our report, we emphasized that “laboratory diagnosis of inhalational anthrax relies on blood cultures, as productive cough is not common with the disease ….” We did indicate that sputum should be sent if available.
Dr Madariaga indicates that none of the cases of bioterrorism-related inhalational anthrax reported after September 11,...