Better Treatments Saved Anthrax Lives -CDC
dailynews.yahoo.com
By Maggie Fox, Health and Science Correspondent
Friday November 9 4:09 PM ET
WASHINGTON (Reuters) - The six survivors from the 10 people infected with inhaled anthrax last month probably owe their lives to modern lifesaving techniques such as draining the fluid out of their chests and giving them intravenous fluids, an expert said on Friday.
The Centers for Disease Control and Prevention (news - web sites) published a rushed report on Friday on the 10 people who suffered from inhaled anthrax, hoping that doctors and other health-care workers could learn what to look for and what to do in any future anthrax attacks.
``We think this is critical information to urgently get out to clinical physicians who may be seeing future cases of anthrax,'' Dr. Brad Perkins, one of the CDC's anthrax experts, told reporters in a telephone briefing.
Inhaled anthrax is rare, last previously seen in the United States in 1976. In the known cases, 89 percent of patients died.
Four patients made ill in October -- they are presumed to have been infected by letters containing powdered anthrax spores -- died. The CDC said a 40 percent fatality rate was much better than would have been expected.
Drug cocktails helped for sure, Perkins said.
``We think treatment with multiple drugs, including one fluroquinolone, is important,'' he said. There are several classes of antibiotics that work in varying ways to kill bacteria. Fluroquinolones include ciprofloxacin, the best-known drug used in the anthrax cases.
Penicillin and tetracyclines, notably doxyxycline, also work well against anthrax, the CDC says.
EMERGENCY TECHNIQUES KEEP PATIENTS ALIVE
Modern emergency room techniques probably kept patients alive long enough for the drugs to do their work, Perkins said. Anthrax causes widespread infection of the blood and tissues, which results in hemorrhaging, tissue death and deadly shock.
``There is a range of things that may have not been done ... in the past century that are now standard practice -- aggressive intravenous hydration, availability of pressor drugs that allow the maintenance of blood pressure,'' Perkins said.
The use of ventilators to help patients breathe and tubes to drain bloody fluid out of their chests was also important, Perkins said.
He said one patient had a procedure called plasmaphoresis, in which the blood plasma is filtered to try to get the anthrax toxins out. The theory may lead to future treatments, Perkins said.
He said the CDC was interested in the development of antibody-based products to try to pull out of the blood the toxins produced by anthrax bacteria. Such a targeted monoclonal antibody was used to treat botulism, a type of food poisoning caused by a bacterial toxin, he said.
Several groups are known to be working on such an approach.
Perkins said the CDC also learned that finding anthrax in an office did not mean anyone was infected, which suggests people can tolerate some level of spores.
``I think the most important thing we currently are learning is that there are many sites of environmental contamination in occupational settings that are not related to occurrence of human disease,'' Perkins said.
``That is good news and bad news. We do not want our occupational environment or any environment contaminated with Bacillus anthracis spores. I would rather not have them here, but clearly there is going to be a level of environmental contamination that does not represent a health risk for cutaneous (skin) or for inhalational disease.'' |
