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Which Measures to Treat, Prevent Anthrax? - 2001-10-12


As state and federal officials intensify their investigation of anthrax cases in New York and Florida, there are calls for stepped up measures to protect Americans from a bio-terrorist attack. These include providing enough anthrax vaccine for every U.S. citizen, and adopting better methods to detect a biological terrorist assault.

The last time Americans feared a bio-terrorist attack was about a decade ago in a different context. During the Persian Gulf War, Iraqi leader Saddam Hussein threatened to use the highly toxic bacterium, anthrax, against population centers in Israel. The Pentagon worried about protecting U.S. troops fighting in the Gulf.

In 1997, the U.S. government launched a massive campaign to vaccinate 2.4 million active and reserve members of the military. There was an anthrax vaccine, but it was not approved for the most deadly form of anthrax disease, inhaled anthrax. And the vaccination campaign came to a standstill.

Today, supplies of what remains the only anthrax vaccine in the U.S. have dwindled. And the drug's manufacturer, BioPort of Lansing, Michigan is still having trouble obtaining federal approval of the drug to combat an inhaled anthrax attack.

This disturbs lawmakers like Arkansas Republican Senator Tim Hutchinson. "Now, a decade later, here we are," he said. "Our troops are unprotected and our civilian population is unprotected from a vaccine standpoint."

Senator Hutchinson and other lawmakers believe future supplies of anthrax vaccine should not be left in the hands of a single, private company. They are considering ways to address the problem of drug shortages now and in the future.

Having enough anthrax vaccine to go around is one problem. Another issue is bio-detection. State and federal officials need to be alerted when there's a bio-terrorist attack so there's enough time to mount an adequate response.

Leonard Cole is a professor of history and science at Rutgers University in Newark, New Jersey, who has written about bio-terrorism. "Now how would you identify an anthrax or smallpox or plague attack?" he asks.

"The most likely way," says Mr. Cole, "would be with a surprising leap in the numbers of people who come to emergency rooms or physicians or some hospital arrangement whereby they'd be immediately raising suspicions that this was an unusual event taking place. And we would hope that tests would be done immediately on these people to identify the organisms or reasons for their illness. And they would be the lead, in effect, to tell us whether there has been a likely release of a biological agent."

In the case of anthrax poisoning, experts say the disease can be cured with antibiotics before symptoms appear. But inhaled anthrax disease is almost 100 percent fatal once people start to feel sick.

Alvin Fox is a bacteriologist at the University of South Carolina. For professor Fox, waiting for people to show up in emergency rooms is not the best approach. "What you'd be doing is trying to work out who's actually already infected so that basically on the death certificate you can write down the cause," he says.

Mister Fox is editor-in-chief of the Journal of Microbiological Methods. An expert in bio-detection methods, professor Fox advocates what he calls "real-time" detection of anthrax. "We need simple machines -monkey press button, monkey get results - that you can put them into a building and you can basically get a result very quickly," he explains.

Mister Fox says there are devices called "real-time" PCR machines that can determine within hours whether anthrax is in a building's ventilation system. But the samples have to be prepared by individuals who know what they're doing. And that, he says, can result in the loss of valuable time when lives are at stake.

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