I called the participant twice on 4/5 and left messages and contacted her on 4/9 and 4/10. She has a past medical history of intermittent colitis for at least the last 5 years. On 10/19, the day after the anthrax release was announced and the facility where she works was closed, she was seen by her local MO and started on ciprofloxacin for anthrax PEP. Beginning with this therapy and while she was on all subsequent antibiotics, she continued to have intermittent severe nausea and vomiting. On 10/29, while at work, there was another anthrax scare precipitated by a possibly anthrax contaminated envelope reported in her work area and she "became hysterical and was vomiting and went home early". She continued vomiting at home and the morning of 10/30, she woke with symptoms of "a pulled back muscle". She was seen a doctor, who arranged for an MRI scan. She had continued intermittent vomiting. Three days later, she was sent to a hospital on advice of CDC and her PEP prophylaxis was changed to doxycycline. She remained off work 10/29 through 11/13. On 11/15, on follow-up with MD, she was dx'd, from the MRI scan, with 2 herniated disks (C5 and L7). She remained off work through 11/27. During this period, she had 2 visits to the ER and was dx'd with an ear infection and treated with topical ear drops and oral amoxicillin (in addition to her PEP doxycycline): second ER visit was for local "burning sensation" from ear drops. She returned to work on 11/28 and had follow-up with MD on 12/11 and began cortisone shots for her back and on 12/17 had migraine treated with fluorocet and Demerol injections. On 12/28, she enrolled in IND protocol, her 1st visit was delayed at her request until 12/30 when she received amoxicillin and 1st AVA injection. Approx. 1/6, she developed severe fatigue, lethargy and drowsiness and was off work 1/7 through 1/17 with these symptoms. She returned to work on 1/18 and received the 2nd AVA that day. On 2/8 through 2/10 and 2/25 was off work with symptoms of vomiting. On 3/1, she left work early because of vomiting. Seen by LMO on 3/8 for a migraine. On 3/9, she awoke with rectal and vaginal prolapse and was seen at the hospital and advised surgery was necessary and would need referral to another hospital. She was seen by her OB/GYN doctor who completed a MedWatch form and gave it to the participant but she has not filed it yet and will forward to CDC. MD referred her another MD who performed an operation to correct her rectal/vaginal prolapse on 3/26. She had been at home since the operation. On 4/4 and 4/5, she attended the ER for pain and dx'd with post/operative hematoma and was sent home. On 4/8, she had a follow-up visit and was told the hematoma had drained and was advised to rest at home. Her next appt is on 4/24. She stopped amoxicillin for IND, 2 weeks after the 3rd AVA injection (2/15). She has had no further antibiotic therapy. Impression: Recent elective hospitalization for operation to correct rectal/vaginal prolapse. Problems with severe nausea and vomiting associated with pre IND and IND antibiotic therapy. Also dx'd and treated for spinal disk herniations. Current condition stable and off all antibiotics since 2/15. Participant is mailing MedWatch and related medical summary to CDC.