Don't Anguish Over Anthrax, Experts Advise

Drugs, gas masks seen as overreaction

THURSDAY, Oct. 11, 2001 (HealthDayNews) -- As medical officials in South Florida cope with a third case of anthrax exposure, more Americans are worrying about the simple act of breathing.

Gas masks are in short supply, a drug company is increasing production of a newly popular antibiotic, and scary books about germ attacks are flying off shelves.

Is there anything that average citizens can do to protect themselves from the airborne strain of this bacteria as they go to work, shop at malls and attend football games? The answer, according to experts, is no.

"There's absolutely nothing that people should do. Pulling off a large-scale terrorist activity would be extremely difficult and would take a lot sophistication, money and technical expertise," said Keith S. Kaye, an epidemiologist at Duke University. There are, he said, easier ways to kill large numbers of people.

Others aren't sure the risk is that low, but they agree that there's little that can be done other than simple disaster preparedness -- keeping food, water and a radio handy if you need to stay indoors.

Clearly, anthrax can attack without warning and not be noticed for days. Florida medical officials announced lat yesterday that a third person, a 35-year-old woman, had been exposed to anthrax at a Boca Raton building that houses supermarket tabloids. She is expected to survive, as is the second exposed person, a 73-year-old mail room supervisor.

Bob Stevens, a 63-year-old photo editor at The Sun newspaper, died last week of a rare form of inhaled anthrax. Investigators found anthrax spores on his computer keyboard, but no one knows where they came from.

Although U.S. tabloids have in print ravaged terrorist suspect Osama bin Laden, the FBI said there's no evidence that the outbreak was related to the Sept. 11 attacks.

The degree of difficulty in turning anthrax into a weapon is somewhere between easy and difficult, said Mike Sailor, a professor of chemistry and biochemistry at the University of California at San Diego.

He speculated that someone with a college education could do it and added that the process is similar to that of growing yeast to make beer.

The main ingredient, of course, is anthrax. Spores can be found in virtually any cow field, he said. "It's a naturally occurring disease of cattle and sheep. The reason everybody isn't dropping dead is that it isn't floating in the air, you aren't breathing in 8,000 spores."

Without advance warning, there are few effective ways to protect against an anthrax attack, experts said. People wouldn't know they were exposed until someone developed the disease a few days later. The most nightmarish scenarios -- such as one in a 2000 book about biological attacks called Living Terrors -- envision a cloud of anthrax spores landing invisibly on a stadium full of sports fans.

So what to do? One option would be to stock up on an antibiotic called ciprofloxacin, which is better known as Cipro. With some reservations, the federal government has approved it for use against inhalation anthrax, the extremely rare strain that killed the Florida photo editor.

Demand for Cipro has skyrocketed in recent weeks, and the company that makes it, Bayer Inc., is boosting production by 25 percent, said spokesman Rob Kloppenburg. Cipro, which has been on the market about 14 years, makes an estimated $1.5 billion in sales a year, and treats a variety of diseases, including urinary tract infections.

But the drug is expensive -- about $10 a day at wholesale rates -- and it only works if treatment begins a short time after anthrax exposure. It has side effects, and liberal use of the medication could boost drug-resistant germs.

"People are buying it because nobody they respect has told them, 'Don't worry, we will come to your aid, we will provide the drugs in a timely manner, we are ready,'" said Dr. Mohammad N. Akhter, executive director of the American Public Health Association. "People need to hear that message."

Some people are turning to gas masks. They will ward off anthrax if they have the proper filters, said Sailor. But he doesn't recommend them because terrorists could turn to other biological or chemical agents instead.

"There are many different kinds of scenarios," he said. "If everyone's wearing a gas mask, and they spray a nerve agent, it's going to get on your skin and kill you. People walking around in gas masks would be very cumbersome and give you a false sense of security."

Akhter suggests that people do one thing: watch the world around them. "The citizens just need to be vigilant," he said. "If they see an unusual incident or something out of the ordinary, they should report it to the authorities. Besides that, they don't need to do anything."

What To Do

Learn more about bioterrorism from the Centers for Disease Control and Prevention.

To read more about anthrax, check out the CDC.

To learn more about Cipro, visit this information sheet from Bayer Inc. Be aware, though, that it doesn't mention anthrax.

SOURCES: Interviews with Mohammad N. Akhter, M.D., Ph.D., executive director, American Public Health Association; Mike Sailor, Ph.D., professor of chemistry and biochemistry; University of California at San Diego; Keith S. Kaye, M.D., MPH, infectious diseases physician and epidemiologist, Duke University Medical Center, Durham, N.C.; Rob Kloppenburg, spokesman, Bayer Corp., West Haven, Conn.
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