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Politics : Homeland Security -- Ignore unavailable to you. Want to Upgrade?

To: Jill who wrote (123)	10/26/2001 7:37:39 PM
From: Duffeck	Respond to of 827

<<The disease control agency is also seeking approval to study antitoxins>> Good grief get on with it! duff

To: Jill who wrote (123)	10/27/2001 6:34:03 PM
From: RocketMan	Read Replies (1) \| Respond to of 827

Another "shift" in policy--this bug ain't so easy to kill--this 'garden variety' stuff--they're talking 2 or 3 antibiotics at a time: We don't have a lot of experience with treating inhalation anthrax, and it appears the CDC is itself groping for the most effective combination of drugs. This is a very rare disease in nature, the vast majority of those who got it were wool workers, and even there the incidence was pretty low. The vaccine, created in the 50's and approved in the 70's, was only given to a few thousand people, and the DoD faced a lot of controversy with their plans to vaccinate Desert Storm troops. On the antibiotics, I found references to the original study done at Fort Dietrich, involving a number of monkeys who were made to inhale anthrax spores only 1 or a few microns wide (poor monkeys). The purpose of the study was to test the effectiveness of combinations of the vaccine and antibiotics. They divided the monkeys into six groups that got various combinations, either control (a saline placebo), the vaccine by itself, antibiotics alone (three types, penicillin, doxy, or cipro) and a combination of vaccine and antibiotic. After a month, they found that the antibiotics were effective while they were administered, but once they stopped the disease came back in some cases. The anthrax spores are pretty resilient, and can hide out until the medicines are gone (similar to some other diseases). Of the monkeys on penicillin, 30% died after treatment was stopped. For doxy or cipro, 10% died after treatment was stopped. Those on both vaccine and doxy all survived. Keep in mind that this was a controlled study, and treatment was started within 24 hours of exposure, who knows what the death rate would have been with delays. Also, we don't know how those animal studies translate to humans. This tells me that even with antibiotics, and/or if there is a delay between exposure and treatment, a single treatment may still have a substantial death rate after it is stopped. This may be why they are trying a combination of antibiotics, though I don't know if the monkey tests included that. P.S. I wonder if we have any medical people who can comment on this. Maybe it's difficult for them, due to liability issues.

To: Jill who wrote (123)	10/28/2001 5:06:57 PM
From: Snowshoe	Read Replies (2) \| Respond to of 827

Officials Switch Anthrax Drugs, Plan More Tests Germ Traces Found at N.J. Postal Site washingtonpost.com Jill, this sounds good to me because I've been concerned about those nasty side effects from Cipro. My mother is allergic to Levaquin, which is closely related to Cipro. -Snow Excerpts from the above article: Officials said they would switch medications in most cases from the brand-name antibiotic Cipro to the generic doxycycline after federal officials reported that the two medications are equally effective against the anthrax microbe. ... Doxycycline, described as a powerful antibiotic that causes fewer side effects and costs a fraction of its brand-name counterpart, is to be distributed to thousands of workers after the CDC published additional information Friday. The change comes less than a week after the federal government negotiated a $100 million contract with Bayer, the maker of Cipro, for the purchase of 95 million Cipro tablets. The results of a comparison of the drugs were published in the CDC's Morbidity and Mortality Weekly Report so that doctors and hospitals would immediately have the option of switching, agency officials said. Rhonda Smith, an agency spokeswoman, said the change was part of an evolving education on what combats anthrax successfully; before the tests whose results were published Friday, only Cipro had been tested against anthrax. "Our recommendations are being updated and revisited continually, and as we know more, we make hopefully better decisions," she said. Letters explaining the switch were handed out to mailroom workers and hundreds of others picking up 10-day dosages of medication. Most people who were taking the initial 10-day course of medication and who need to continue will be immediately switched over to doxycycline for the remaining 50 days. "The CDC and the D.C. Department of Health have determined this is the most effective treatment for you as it poses a substantially lower risk of side effects than Cipro when used long term," read the letter from the Postal Service, signed by Sylvester Black, manager of the Capitol Metro Operations division.