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Friday, Oct. 18, 2002

WASHINGTON -- The United States remains unprepared to deal with another anthrax attack and more needs to be done to increase preparedness - including vaccinating postal workers and emergency healthcare personnel against the deadly bacteria - a panel of experts concluded Thursday.

The panel was convened by Bioport, the maker of the only anthrax vaccine licensed in the United States.

However, bioterrorism experts not associated with the vaccine manufacturer called the panel's conclusions spurious and questioned the members' motives.

"Over a year has gone by since the anthrax attacks ... and we're still not prepared or even on the way to preparing for an anthrax attack," Gilbert Ross, a panel member and medical director of the American Council on Science and Health, said at a news briefing to announce the release of the panel's anthrax preparedness report.

Caused by the bacteria Bacillus anthracis, anthrax can be a fatal disease as evidenced by the contaminated letters last fall that killed five people and infected 22.

Ross accused the government of focusing more effort on preparing for a smallpox attack even though there is no evidence that any rogue nation possesses the deadly virus.

However, Steven Milloy, an adjunct scholar at the Cato Institute, a think tank in Washington, noted anthrax is a lesser threat than smallpox because it is not contagious and there are treatments - including the antibiotic Cipro - that can knock the bug out if people do become infected.

The six-member panel said the federal government should take steps to vaccinate at-risk civilians, including postal workers, first responders, employees of nuclear plants and airports and research scientists. The vaccine is not available to the general public and the Centers for Disease Control and Prevention in Atlanta does not recommend pre-exposure anthrax vaccination.

Llelwyn Grant, spokesman for the CDC, said the agency does not emphasize pre-exposure vaccination because there are antibiotics "available that could easily treat individuals exposed to anthrax."

Grant also noted the CDC's advisory committee on immunization practices has discussed the issue and recommended the vaccine only for scientists who work directily with anthrax in a lab, individuals who work with imported animal hides and furs (where anthrax can reside), veterinarians who travel to work in countries with a high incidence of anthrax and military personnel.

Unnecessary

Milloy dismissed the notion of vaccinating first responders as unnecessary. "No one was pre-vaccinated last year ... and there weren't any first responders that were affected," he said.

"It seems silly to vaccinate people since most people aren't going to encounter anthrax," Milloy said. The only real candidates for vaccination are military personnel, he said, and the Department of Defense already has a vaccination program in place. "In my opinion, this is just Bioport trying to make some money," Milloy said.

The Bioport panel cautioned anthrax could be bioengineered to be resistant to antibiotics and thus the only way to protect citizens from an attack with a resistant-strain would be to vaccinate. Resistant-strains have not been shown to be capable of evading the vaccine, Kenneth Chase, a member of the panel and president of Washington Occupational Health Associates, told United Press International.

"I don't know what [the CDC] can really do other than be prepared to respond if there's an anthrax attack," Milloy said. "You can treat everybody with antibiotics and everybody would be fine" provided treatment is initiated early, he said.

Joseph Barbera, co-director of George Washington University's Institute for Crisis Disaster and Risk Management, was involved in the response to the anthrax letters in the Washington area last year and he told UPI there was no push to vaccinate those who were exposed then "and there wouldn't be today." The response strategy would consist of identifying those who may have been exposed and treating them with appropriate antibiotics, he said.

However, post-exposure vaccination may be instituted in some cases. The CDC has found, in treating the workers cleaning up buildings contaminated by the anthrax letters, that using the vaccine in conjunction with the antibiotics, can be more effective than antibiotics alone.

Barbera said instead of pre-exposure vaccination the real focus should be on improving public health infrastructure and developing systems "that would allow us to determine when something new is occurring ... and enable a very rapid response to contain disease." This type of system would help us respond to "all kinds of terrorism," whether biological, chemical or nuclear, and also allow us to respond to emerging diseases such as West Nile virus, he said.

Copyright 2002 by United Press International.