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Jewish World Review March 15, 2001 / 20 Adar, 5761

MICHAEL WOODS

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Consumer Reports


Government quietly buying up a half-billion tablets used as bilogical attack antidote

http://www.jewishworldreview.com -- WHY is the federal government quietly buying up a half billion tablets of that familiar antibiotic, Cipro (ciprofloxacin), used in everyday medicine to common infections?

Say the right answer and get an A-plus in the 21st-century version of emergency medical preparedness: That's preparedness for a possible bioterrorist attack.

Government health agencies have designated Cipro as the first-line defense against the most likely kind of terrorist attack involving the release of deadly bacteria or viruses.

Cipro would protect civilians who inhale anthrax bacteria, perhaps the cheapest and most deadly bioterrorist weapon. Study after study warns about it: The anthrax sneak attack. Spray a few pounds of anthrax spores into the air over urban areas. Unlike a bomb, nobody will even know for a day or two, until victims start getting sick - perhaps by the million.

Left untreated, about 80 percent of infected people die because anthrax bacteria is incredibly lethal when inhaled into the lungs.

Japanese doomsday cultists planned to use anthrax in Tokyo in 1995 but then switched to a nerve gas subway attack that killed a dozen people and made thousands temporarily sick.

Public health and national security experts long have warned that the U.S. government is unprepared for a possible bioterrorist attack. Government agencies now are taking heed, with a multibillion-dollar effort to prepare medical and other resources needed to cope with the threat.

The Cipro buy-up is one part of the program.

Cipro last year became the first antibiotic specifically approved by the U.S. Food and Drug Administration for use as an anti-bioterrorism drug. The FDA invited the Bayer Corporation, Cipro's manufacturer, to seek the new approved use so an anti-anthrax drug would be available.

Since its debut in 1987, Cipro has been approved for 14 different uses, with treatment of intentional exposure to anthrax the latest. Two other antibiotics, penicillin and doxycycline, can be used for anthrax. But scientists worry that anthrax bacteria may be resistant to those antibiotics.

So urgent was the need, that the FDA approved Cipro for anthrax as it has perhaps no other drug: Without direct evidence that it actually will prevent anthrax in humans.

FDA had to rely on studies in animals, since the risks for humans were too great. Nine out of 10 untreated monkeys died after inhaling anthrax. Only one out of nine Cipro-treated monkeys died.

Cipro goes into the new National Pharmaceutical Stockpile, a part of the national anti-bioterrorism effort coordinated by the U.S. Centers for Disease Control and Prevention.

It supplements two existing emergency national drug stockpiles that include supplies to treat casualties of chemical and biological attacks. The are managed by the U.S. Marine Corps Chemical Biological Incident Response Force and the Federal Office of Emergency Preparedness.

The stockpiles are positioned throughout the country, for speedy deployment if the need ever arises. Will the drugs arrive fast enough? Who would get priority treatment if millions of people are exposed to anthrax and need treatment?

People who inhale anthrax must start Cipro almost immediately. Anthrax often is fatal unless treatment begins before the fever, chills, rash, lung problems and other symptoms. The anti-bioterrorist dosage is two 500-milligram (mg) tablets twice a day for 60 days.

A 500-mg tablet sells for about $4.25, so brace for sticker shock if you want to lay in a personal stockpile, and have an accommodating doctor who will write a prescription.

If the threat of bioterrorism is so real, people should be more aware of what they can do personally to prepare for this 21st-century emergency, just as they traditionally have prepared for conventional emergencies like fires and severe storms.

Michael Woods writes for the Toledo Blade. Comment by clicking here.

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